2015-11-12T13:23:09-06:00 2014-12-31 721396621 CARR RIGGS & INGRAM LLC 4210 SPICEWOOD SPRINGS RD STE 108 AUSTIN TX 787598653 990 2014-01-01 311624871 INTEGRATED CARE COLLABORATION INTE 5128042090 8627 N MOPAC NO 300 AUSTIN TX 78759 EDIE L MORRIS EXECUTIVE DIRECTOR & CFO 5128042090 2015-11-11 1 K DALE COOPER P00142251 5123461880 2014 2016-03-07 17:11:31Z EDIE L MORRIS 8627 N MOPAC NO 300 AUSTIN TX 78759 2121558 0 X WWW.ICC-CENTEX.ORG X 1998 TX THE ICC IS AN ALLIANCE OF HEALTH CARE SAFETY NET PROVIDERS THAT WORK TOGETHER TO IMPROVE THE EFFICIENCY AND QUALITY OF HEALTH CARE SERVICES AVAILABLE FOR UNINSURED INDIVIDUALS IN CENTRAL TEXAS (WILLIAMSON, TRAVIS, AND HAYS COUNTIES). ICC ACTS AS A CONVENER AND INCUBATOR AND IS NOT A HEALTH PROVIDER. 4 4 0 0 0 0 0 0 2538628 2121438 461 120 0 0 2539089 2121558 0 0 0 0 1212326 784487 0 0 31633 2188536 1572834 3400862 2357321 -861773 -235763 2105716 1629969 799824 559840 1305892 1070129 X THE ICC IS AN ALLIANCE OF HEALTH CARE SAFETY NET PROVIDERS THAT WORK TOGETHER TO IMPROVE THE EFFICIENCY AND QUALITY OF HEALTH CARE SERVICES AVAILABLE FOR UNINSURED INDIVIDUALS IN CENTRAL TEXAS (WILLIAMSON, TRAVIS, AND HAYS COUNTIES). ICC ACTS AS A CONVENER AND INCUBATOR AND IS NOT A HEALTH PROVIDER. 0 0 1385215 1506221 ICARE SYSTEM/HEALTH INFORMATION TECHNOLOGY: ICC OWNS, MAINTAINS, AND OPERATES A REGIONAL HIE CALLED THE ICARE 2.0 SYSTEM. THE NEW SYSTEM ALLOWS THE ICC AND ITS MEMBERS TO:-ACHIEVE MEANINGFUL USE STANDARDS BY MAXIMIZING MEMBER OPPORTUNITIES TO DEMONSTRATE MEANINGFUL USE OF INFORMATION EXCHANGE, CARE COORDINATION AND PUBLIC HEALTH PARTICIPATION THROUGH HIE.-EXPAND AND ENHANCE CARE COORDINATION PROGRAMS.-IMPROVE HEALTH OUTCOMES AND COMMUNITY HEALTH.-EXPAND AND ENHANCE RESEARCH AND EVALUATION CAPABILITIES.-MEET THE GOALS OF THE STATE OF TEXAS STRATEGIC HIE PLAN TO CONNECT 80% OF PHYSICIANS AND HOSPITAL IN A 47 COUNTY REGION. 296181 339430 ACCESS AND COMMUNITY COLLABORATION: ICC FACILITATES COMMUNITY BASED ENROLLMENT FOR INCREASED ACCESS AND COMMUNITY INTEGRATION. ICC MEMBERS HAVE ACCESS TO A COMMON ELIGIBILITY PROGRAM, MEDICAIDER, THROUGH WHICH PATIENTS ARE SCREENED FOR ELIGIBILITY FOR THIRD PARTY FUNDING AND FEDERAL, STATE AND LOCAL HEALTH COVERAGE PROGRAMS. THE PATIENT PRESCRIPTION ASSISTANCE PROGRAM (PPAP) IS ALSO AVAILABLE TO MEMBERS. 217006 275787 MEMBER ANALYTICS TO SUPPORT COMMUNITY COLLABORATION: ICARE 2.0 INCLUDES A ROBUST DATA WAREHOUSE AND ANALYTICS SOLUTION THAT FACILITATES PERFORMANCE-BASED OUTCOMES AND VALIDATED PATIENT INFORMATION WHICH DRIVES EVIDENCE-BASED PROGRAMS. THE SOLUTION ALSO SUPPORTS COMMUNITY HEALTH RESEARCH BY TRACKING POPULATION CARE PATTERNS, MEASURING EFFECTS OF PUBLIC POLICY CHANGES AND IDENTIFYING HEALTHCARE UTILIZATION PATTERNS. ICC ANALYTICS PROVIDE VALUABLE DATA THAT HELPS TO INCREASE ACCESS TO CARE, IMPROVE CARE COORDINATION AND PROVIDE MORE EFFICIENT AND APPROPRIATE CARE. 1898402 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 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 1 2 0 1 0 0 0 0 0 0 0 0 0 0 0 X 4 4 0 0 0 0 1 0 0 1 1 0 0 0 1 1 1 1 1 1 1 0 X EDIE MORRIS 5128042090 8627 N MOPAC SUITE 300 AUSTIN TX 78759 X TRISH YOUNG BROWN BOARD CHAIR & DIRECTOR 0.00 X 0 0 0 DAVID EVANS BOARD VICE CHAIR & DIRECTOR 0.00 X 0 0 0 EARL MAXWELL DIRECTOR 0.00 X 0 0 0 GREG HARTMAN DIRECTOR 0.00 X 0 0 0 EDIE MORRIS EXECUTIVE DIRECTOR & CFO 40.00 X 0 106860 0 CARL D ANGEL FORMER EXECUTIVE DIRECTOR 32.00 X 0 114349 0 CAROLE TAMAYO DIRECTOR OF TECHNOLOGY 40.00 X 0 145054 0 0 366263 0 3 0 0 0 LONE STAR CIRCLE OF CARE 205 E UNIVERSITY AVE STE 200 GEORGETOWN TX 78626 REIMBURSEMENT FOR PAYROLL AND BENEFITS 649454 AUSTIN TRAVIS COUNTY INTEGRAL CARE PO BOX 3548 AUSTIN TX 78764 REIMBURSEMENT FOR PAYROLL AND BENEFITS 396465 NETWORK SCIENCES 14205 BURNET RD STE 110 AUSTIN TX 78728 MEDICAIDER PRODUCT & SERVICES 340388 CENTEX SYSTEMS SUPPORT SERVICES 8627 N MOPAC STE 350 AUSTIN TX 78759 HIE SUPPORT 258842 QUALITY SYSTEMS INC 12301-B RIATA TRACE PARKWAY SUITE AUSTIN TX 78727 ANNUAL LICENSES 251757 6 MEMBERSHIP FEES 519100 2005595 2005595 MISCELLANEOUS REVENUE 519100 115843 115843 2121438 120 120 2121558 2121438 0 120 X 784487 487693 270375 26419 2695 2695 21500 21500 1087692 1029121 53357 5214 44738 44738 MIRTH FEES 213687 213687 ICARE 2.0 SUPPORT SERVI 171650 171650 IT SUPPORT SERVICES 34621 34621 OUTREACH/IAK 26251 26251 -30000 -30000 2357321 1898402 427286 31633 27463 217078 98126 90244 52280 65104 105084 83275 3375231 2227177 1822763 1148054 0 26214 2105716 1629969 499824 259840 300000 300000 799824 559840 X 1305892 1070129 1305892 1070129 2105716 1629969 -235763 0 X 0 1 X 1 0 X 34947 637688 1082097 661914 2416646 34947 637688 1082097 661914 2416646 2416646 20 837 609 461 120 2047 26934 241619 115843 384396 2803089 11670973 0.86210 0.88840 X 3375231 2227177 1148054 1148054 X 2354224 232666 232666 2121558 0 2121558 2589987 232666 232666 2357321 0 2357321 PART X, LINE 2: FOOTNOTE TO FINANCIAL STATEMENTS REGARDING INCOME TAX STATUS: ICC QUALIFIES AS TAX-EXEMPT UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. CONSEQUENTLY, THE ACCOMPANYING FINANCIAL STATEMENTS DO NOT REFLECT ANY PROVISIONS FOR INCOME TAXES. ICC HAS TAKEN NO UNCERTAIN TAX POSITIONS DURING OR FOR THE YEARS ENDED DECEMBER 31, 2014 AND 2013. ICC CONTINUALLY EVALUATES THE TAX EFFECTS OF EXPIRING STATUTES OF LIMITATIONS, AUDITS, PROPOSED SETTLEMENTS, CHANGES IN TAX LAW, AND NEW AUTHORITATIVE RULINGS. IN ADDITION, TAX YEARS 2014, 2013 AND 2012 ARE OPEN TAX YEARS SUBJECT TO EXAMINATION BY THE IRS FOR WHICH ICC COULD BE LIABLE. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION HAS MEMBERS, WHO ARE THE SAFETY NET PROVIDERS BELONGING TO THE ALLIANCE. FORM 990, PART VI, SECTION B, LINE 11 FORM 990 IS REVIEWED BY THE BOARD TREASURER AND IS LATER PRESENTED AT THE NEXT BOARD MEETING FOR APPROVAL. FORM 990, PART VI, SECTION B, LINE 12C THE OFFICERS, DIRECTOR AND KEY EMPLOYEES ARE REQUIRED ANNUALLY TO SUBMIT A SIGNED STATEMENT AFFIRMING THAT THE POLICY HAS BEEN REVIEWED AND COMPLIED WITH. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD EVALUATES AND APPROVES ALL NEW EMPLOYEES' SALARIES. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AVAILABLE ON REQUEST. FORM 990, PART VII, PAGE 7 ICC PERSONNEL ARE PAID THROUGH LONESTAR CIRCLE OF CARE AND AUSTIN TRAVIS COUNTY INTEGRAL CARE VIA A CONTRACTUAL ARRANGEMENT BETWEEN THE TWO ENTITIES. ALL SALARIES AND BENEFITS ARE PAID BY LONESTAR CIRCLE OF CARE AND AUSTIN TRAVIS COUNTY INTEGRAL CARE AND ARE THEN INVOICED TO THE ICC. WHEN THE ICC PAYS THESE INVOICES, THE EXPENSES ARE CODED TO THE APPROPRIATE ACCOUNTS SUCH AS SALARY EXPENSE AND BENEFIT EXPENSE. ICC DOES NOT ISSUE W-2'S OR A W-3; ALL ARE ISSUED THROUGH LONESTAR CIRCLE OF CARE AND AUSTIN TRAVIS COUNTY INTEGRAL CARE. HOWEVER, COMPENSATION FOR THE EXECUTIVE DIRECTOR AND EMPLOYEES PAID OVER $100,000 ARE BEING REFLECTED IN COLUMN (E). FORM 990, PART IX, LINE 11G OFFICE OPERATIONS: PROGRAM SERVICE EXPENSES 770,952. MANAGEMENT AND GENERAL EXPENSES 53,357. FUNDRAISING EXPENSES 5,214. TOTAL EXPENSES 829,523. MEDICAIDER: PROGRAM SERVICE EXPENSES 180,750. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 180,750. OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 49,773. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 49,773. OTHER PROFESSIONAL SERVICES: PROGRAM SERVICE EXPENSES 10,583. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 10,583. CONTRACT LABOR: PROGRAM SERVICE EXPENSES 17,063. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 17,063.