2014-11-12T16:03:51-06:00 2013-12-31 721396621 CARR RIGGS & INGRAM LLC 4210 SPICEWOOD SPRINGS RD STE 108 AUSTIN TX 787598653 990 2013-01-01 311624871 INTEGRATED CARE COLLABORATION INTE 5128042090 8627 N MOPAC NO 300 AUSTIN TX 78759 EDIE L MORRIS INTERIM COO 5128042090 2014-11-11 1 K DALE COOPER P00142251 5123461880 2013 2015-11-30 17:44:51Z EDIE L MORRIS 8627 N MOPAC NO 300 AUSTIN TX 78759 2539089 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. 5 5 0 0 0 0 0 0 2914126 2538628 609 461 0 0 2914735 2539089 0 0 0 0 1362904 1212326 0 0 43022 1997121 2188536 3360025 3400862 -445290 -861773 2935999 2105716 768334 799824 2167665 1305892 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 1795810 1588620 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. 667129 590160 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. 406781 359848 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. 2869720 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 X 5 5 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 JESUS GARZA BOARD CHAIR 0.00 X 0 0 0 PETE PERIALAS BOARD TREASURER 0.00 X 0 0 0 TRISH YOUNG BROWN DIRECTOR 0.00 X 0 0 0 DAVID EVANS DIRECTOR 0.00 X 0 0 0 EARL MAXWELL DIRECTOR 0.00 X 0 0 0 CARL D ANGEL EXECUTIVE DIRECTOR 32.00 X 0 157552 0 CAROLE TAMAYO DIRECTOR OF TECHNOLOGY 40.00 X 0 142190 0 DANA CRAVEN IT PROJECT MANAGER 40.00 X 0 140113 0 0 439855 0 1 0 1 0 LONE STAR CIRCLE OF CARE 205 E UNIVERSITY AVE STE 200 GEORGETOWN TX 78626 REIMBURSEMENT FOR PAYROLL AND BENEFITS A 966916 CENTEX SYSTEMS SUPPORT SERVICES 8627 N MOPAC STE 350 AUSTIN TX 78759 PURCHASE OF UPGRADED HIE AND RELATED EQU 608700 NETWORK SCIENCES 14205 BURNET RD STE 110 AUSTIN TX 78728 MEDICAIDER PRODUCT & SERVICES 360925 ATCICMHMR PO BOX 3548 AUSTIN TX 78764 REIMBURSEMENT FOR PAYROLL AND BENEFITS 331552 4 MEMBERSHIP FEES 519100 1635095 1635095 HIE U.S DHHS FUNDING 519100 661914 661914 MISCELLANEOUS REVENUE 519100 241619 241619 2538628 461 461 2539089 2538628 0 461 X 708348 501390 185509 21449 330483 233926 86550 10007 129272 91503 33855 3914 44223 31302 11582 1339 21554 20462 1092 439267 392891 46376 21572 20092 1326 154 813376 771993 41380 3 147510 137388 9073 1049 12925 12038 795 92 17575 16369 1081 125 301 280 19 2 679087 632486 41771 4830 27209 27209 STAFF DEVELOPMENT - HIE 3286 3061 202 23 DUES AND LICENSES 1788 1665 110 13 MISCELLANEOUS 1695 1579 104 12 STAFF DEVELOPMENT 1391 1295 86 10 3400862 2869720 488120 43022 41308 27463 294837 98126 25563 52280 72442 105084 3382654 1559891 2501849 1822763 2935999 2105716 227266 499824 541068 300000 768334 799824 X 2167665 1305892 2167665 1305892 2935999 2105716 -861773 0 X X 0 1 X 1 1 1 X 126000 34947 637688 1082097 661914 2542646 126000 34947 637688 1082097 661914 2542646 42207 2500439 1532 20 837 609 461 3459 26934 241619 268553 2814658 10892083 0.88840 0.92480 X 3382654 1559891 1822763 1822763 X 2602089 63000 63000 2539089 0 2539089 3463862 63000 63000 3400862 0 3400862 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, 2013 AND 2012. 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 2013, 2012 AND 2011 ARE OPEN TAX YEARS SUBJECT TO EXAMINATION BY THE IRS FOR WHICH ICC COULD BE LIABLE. 0 0 0 0 0 0 0 0 0 CARL D ANGEL EXECUTIVE DIRECTOR 0 157552 0 0 0 0 0 0 0 0 0 157552 0 0 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 IT SUPPORT SERVICE: PROGRAM SERVICE EXPENSES 39,586. MANAGEMENT AND GENERAL EXPENSES 2,113. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 41,699. ICARE 2.0 SUPPORT SERVICES: PROGRAM SERVICE EXPENSES 284,795. MANAGEMENT AND GENERAL EXPENSES 15,205. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 300,000. OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 18,512. MANAGEMENT AND GENERAL EXPENSES 988. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 19,500. OUTREACH/IAK: PROGRAM SERVICE EXPENSES 49,839. MANAGEMENT AND GENERAL EXPENSES 2,661. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 52,500. CONTRACT LABOR: PROGRAM SERVICE EXPENSES 159. MANAGEMENT AND GENERAL EXPENSES 25,409. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 25,568. FORM 990, PART XII, LINE 2C ICC HAS NOT CHANGED THE AUDIT SELECTION PROCESS FROM PRIOR YEAR.