2014-05-15T12:18:45-05:00 2013-06-30 952302617 SINGERLEWAK LLP 10960 WILSHIRE BLVD STE 700 LOS ANGELES CA 900243783 990 2012-07-01 952769432 VENICE FAMILY CLINIC VENI 3103928630 604 ROSE AVENUE VENICE CA 90291 ELIZABETH B FORER 3103928630 2014-05-07 1 LIOR TEMKIN P00748170 3104773924 2014-05-07 2012 2015-11-30 17:44:51Z ELIZABETH B FORER 604 ROSE AVENUE VENICE CA 90291 34893915 0 X HTTP://VENICEFAMILYCLINIC.ORG/ X 1970 CA THE VENICE FAMILY CLINIC IS PRIVATE, NONPROFIT COMMUNITY HEALTH CENTER. FOUNDED IN 1970 TO MEET THE HEALTH CARE NEEDS OF THE LOW-INCOME RESIDENTS OF VENICE THE CLINIC HAS GROWN TO NINE LOCATIONS ACROSS THE WESTSIDE OF LOS ANGELES COUNTY. ITS MISSION IS TO PROVIDE QUALITY PRIMARY HEALTH CARE TO PEOPLE IN NEED. 17 17 240 1630 0 0 26310106 23660784 9303267 8149722 702351 1905478 64740 98585 36380464 33814569 7463 0 0 0 18562730 18754602 121750 0 1195548 19422592 15030384 38114535 33784986 -1734071 29583 22564245 21512049 3946259 2571627 18617986 18940422 X SEE SCHEDULE O 0 0 28884705 8149722 VENICE FAMILY CLINIC SERVES AS A PRIMARY CARE MEDICAL HOME, PROVIDING COORDINATED AND COMPREHENSIVE MEDICAL, DENTAL AND MENTAL HEALTH SERVICES THAT INCLUDE PEDIATRICS, GENERAL ADULT MEDICINE, WOMEN'S, SENIOR, HOMELESS AND CHRONIC CARE SERVICES, PRENATAL CARE, SPECIALTY CLINICS IN CARDIOLOGY, DERMATOLOGY, EAR/NOSE/THROAT, GASTROENTEROLOGY, GYNECOLOGY, NEUROLOGY, OPHTHALMOLOGY, OPTOMETRY, ORTHOPEDICS AND PODIATRY, PSYCHOLOGICAL SERVICES, DIAGNOSTIC TESTS AND MEDICATIONS. HEALTH CARE IS PROVIDED FIVE DAYS AND FOUR EVENINGS PER WEEK, WITH 72,906 PRIMARY HEALTH CARE VISITS, 4,317 SPECIALTY CARE VISITS, 5,153 DENTAL VISITS, 5,937 MENTAL HEALTH CARE VISITS AND 7,925 HEALTH EDUCATION VISITS PROVIDED DURING THE YEAR ENDED JUNE 30, 2013.VENICE FAMILY CLINIC'S 21,068 PATIENTS IN YEAR ENDED JUNE 30, 2013 ARE PRIMARILY THE UNINSURED WORKING POOR, UNEMPLOYED AND HOMELESS, THE VAST MAJORITY OF WHOM HAVE INCOMES BELOW THE POVERTY LEVEL AND NO HEALTH INSURANCE. A HIGH PROPORTION OF THE CLINIC'S CHILDREN AND ADULT PATIENTS ARE MINORITY GROUP MEMBERS. THE CLINIC'S PRIMARY SERVICE AREA INCLUDES VENICE, SANTA MONICA, PALMS, MAR VISTA, INGLEWOOD, CULVER CITY AND MIDTOWN, ALL IN LOS ANGELES COUNTY. 28884705 1 1 0 1 0 0 0 0 0 1 1 1 0 0 0 1 0 1 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 1 99 0 1 240 1 0 0 0 0 0 1 1 0 0 0 0 X 17 17 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X X LORETO S MELO 3106647902 604 ROSE AVENUE VENICE CA 90291 MAYER B DAVIDSON MD 1.00 X 0 0 0 PAULA DAVIS 1.00 X 0 0 0 AIME ESPINOSA 1.00 X 0 0 0 WILLIAM FLUMENBAUM 2.00 X 0 0 0 LUIS GALVEZ 1.00 X 0 0 0 REVEREND LYNDA D GRAY 1.00 X 0 0 0 NEIL H PARKER MD 1.00 X 0 0 0 BILL RESNICK MD 1.00 X 0 0 0 PAUL M SABEN MBA 1.00 X 0 0 0 FLORA SANTACRUZ 1.00 X 0 0 0 LOURDES SERVIN 1.00 X 0 0 0 STEWART SERADSKY 1.00 X 0 0 0 CARMEN THOMAS-PARIS 1.00 X 0 0 0 LEISA WU 1.00 X 0 0 0 BRIAN D KAN MD 2.00 X X 0 0 0 YVONNE ASHLEY JOHNSON 2.00 X X 0 0 0 JEFFREY E SINAIKO 2.00 X X 0 0 0 ELIZABETH B FORER 40.00 X 172679 0 61568 JASON VU HUA 40.00 X 104139 0 45340 LORETO S MELO 40.00 X 138807 0 61423 ANITA M ZAMORA FROM 12013 40.00 X 0 0 0 KAREN C LAMP 40.00 X 182810 0 72140 LANEY KAPGAN 40.00 X 124526 0 33453 BLANCA ANDRES 36.00 X 140291 0 45933 CATHERINE A CHAROUHAS 40.00 X 140272 0 49373 SAKURA LING KUO 40.00 X 147922 0 50632 MARGARITA LOEZA 40.00 X 147712 0 56327 SHARON NG 40.00 X 157192 0 60569 1456350 0 536758 10 0 1 0 RANSTAD US LP 10940 WILSHIRE BLVD LOS ANGELES CA 90024 EMPLOYMENT 116375 1 1168346 310000 5981358 16201080 11397645 23660784 MEDICARE/MEDICAID PYMT 621400 8149722 8149722 8149722 264442 264442 614720 1855103 582076 246711 32644 1608392 1641036 1641036 250559 1168346 250559 0 MISCELLANEOUS INCOME 900099 98585 98585 98585 33814569 8149722 0 2004063 1016713 438411 578302 12490562 10334359 1375696 780507 1167624 986360 122881 58383 3164598 2653611 356144 154843 915105 748465 123896 42744 2877 2877 80758 80758 791176 717327 42918 30931 145040 86622 52192 6226 438547 362144 72460 3943 103652 95093 6973 1586 101009 101009 823927 664781 138086 21060 208206 4563 203643 DONATED DRUGS AND PHARM 10523028 10523028 REPAIRS & MAINTENANCE 479978 364136 102488 13354 MEDICAL SUP & REMOVAL 211317 211312 5 PHARMACEUTICAL AND LAB 183982 183982 936887 510511 344405 81971 33784986 28884705 3704733 1195548 802 702 1413981 1851790 5664436 5143434 2530237 977393 800707 975104 114959 115551 14263707 8797563 6481308 5466144 3539 2534 5080792 6492589 473484 486808 22564245 21512049 188433 223641 3757826 2347986 3946259 2571627 X 7239379 7277763 6104550 6188602 5274057 5474057 18617986 18940422 22564245 21512049 29583 292852 0 X 0 1 X 1 1 1 X 20031532 26260250 29119560 26310106 23659163 125380611 9491046 9052847 9689336 9303267 8149722 45686218 29522578 35313097 38808896 35613373 31808885 171066829 189764 369725 388782 375046 317165 1640482 0 189764 369725 388782 375046 317165 1640482 169426347 158565 123217 213493 213009 264442 972726 158565 123217 213493 213009 264442 972726 51789 84160 54190 64740 98585 353464 29732932 35520474 39076579 35891122 32171912 172393019 0.98280 0.98020 0.00560 0.00580 X SCHEDULE A, PART II, LINE 12, EXPLANATION OF OTHER INCOME: 2008 OTHER REVENUE 51789 2009 OTHER REVENUE 84160 2010 OTHER REVENUE 54190 2011 OTHER REVENUE 64740 2012 OTHER REVENUE 98585 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 1 0 0 0 0 1 888 1 888 0 1776 0 EXPLANATION OF LOBBYING ACTIVITIES: PART II-B, LINE 1: DURING THE 2012-2013 FISCAL YEAR, VENICE FAMILY CLINIC'S IN-HOUSE ADVOCACY TEAM MET ON A QUARTERLY BASIS WITH THE BOARD COMMITTEE OVERSEEING ADVOCACY WORK, AND ADDRESSED HEALTH CARE ISSUES AT THE LOCAL, STATE AND NATIONAL POLICY LEVELS. THE MAJORITY OF OUR ADVOCACY EFFORTS WERE FOCUSED ON PREPARING FOR THE ROLL OUT OF THE AFFORDABLE CARE ACT. LOCALLY, WE WORKED WITH THE COUNTY DEPARTMENT OF HEALTH TO ENROLL SEVERAL THOUSAND OF OUR PATIENTS INTO THE PROGRAM WHICH WILL TRANSITION TO THE PLANNED FEDERAL MEDICAID EXPANSION FOR THE LOWEST INCOME MEMBERS OF OUR COMMUNITY. AT THE STATE LEVEL, WE JOINED WITH THE CALIFORNIA PRIMARY CARE ASSOCIATION AND OTHER AGENCIES TO SUPPORT THE RETURN OF ADULT DENTAL MEDI-CAL COVERAGE. AT THE NATIONAL LEVEL, WE ENLISTED STAFF, BOARD MEMBERS AND PATIENTS IN PHONE AND E-MAIL CAMPAIGNS TO ENCOURAGE MEMBERS OF CONGRESS TO OPPOSE FEDERAL SEQUESTRATION CUTS TO SOCIAL SERVICE PROGRAMS (WHICH IMPACTED THE BUDGET FOR OUR CHILDREN FIRST EARLY HEAD START PROGRAM), AS WELL AS TO CONTINUE SUPPORT FOR FUNDING OF COMMUNITY HEALTH CENTERS AND MEDICAID/MEDICARE. IN ADDITION, SEVERAL ELECTED OFFICIALS ON THE STATE AND FEDERAL LEVELS WERE INVITED TO TOUR THE CLINIC AND LEARN MORE ABOUT THE NEEDS OF THE MEDICALLY UNDERSERVED AND THE PROVIDERS TREATING THEM. 5178737 200000 544036 215595 5707178 4406652 1050000 -74201 203714 5178737 4030445 575967 199760 4406652 3033757 750000 372368 125680 4030445 3824957 10700 -657819 144081 3033757 1.00000 0 0 1116512 1116512 6002656 4770042 1232614 4858838 2649041 2209797 2285701 1378480 907221 5466144 UCLA EIP FUND 4345627 F UCLA STIP FUND 2146962 F 6492589 X 39138933 292852 4229749 801763 5324364 33814569 0 33814569 38729649 4229749 714915 4944664 33784985 0 33784985 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: INTEREST/DIVIDEND INCOME FROM THE CLINIC'S ENDOWMENT FUNDS ARE USED TO PAY FOR THE SALARIES AND BENEFITS OF PHYSICIANS, MENTAL HEALTH STAFF AND DOMESTIC VIOLENCE STAFF. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: EFFECTIVE JULY 1, 2009, THE CLINIC ADOPTED FASB ASC TOPIC NO. 740, "UNCERTAINTY IN INCOME TAXES" ("ASC 740"). IN ACCORDANCE WITH ASC 740, THE CLINIC RECOGNIZES THE IMPACT OF TAX POSITIONS IN THE FINANCIAL STATEMENTS IF THAT POSITION IS MORE LIKELY THAN NOT TO BE SUSTAINED ON AUDIT, BASED ON THE TECHNICAL MERITS OF THE POSITION. TO DATE, THE CLINIC HAS NOT RECORDED ANY UNCERTAIN TAX POSITIONS. THE CLINIC RECOGNIZES POTENTIAL ACCRUED INTEREST AND PENALTIES RELATED TO UNCERTAIN TAX POSITIONS IN INCOME TAX EXPENSE. DURING THE YEAR ENDED JUNE 30, 2013, THE CLINIC DID NOT RECOGNIZE ANY AMOUNT IN POTENTIAL INTEREST AND PENALTIES ASSOCIATED WITH UNCERTAIN TAX POSITIONS. THE CLINIC'S INCOME TAX RETURNS REMAIN SUBJECT TO EXAMINATION FOR ALL TAX YEARS ENDED ON OR AFTER JUNE 30, 2010 WITH REGARD TO ALL TAX POSITIONS AND THE RESULTS REPORTED. PART XI, LINE 2D - OTHER ADJUSTMENTS: AMOUNT REPORTED ON OTHER RETURN 551,204. SPECIAL EVENTS 250,559. PART XII, LINE 2D - OTHER ADJUSTMENTS: AMOUNT REPORTED ON OTHER RETURN 464,356. SPECIAL EVENTS 250,559. SILVER CIRCLE 1201385 1002183 199202 138499 20107 40596 HOLIDAY MOVIE 116546 105326 11220 11220 2 100974 60837 40137 40137 1418905 1168346 250559 138499 20107 91953 250559 0 X X 0 0 0 0 0 0 0 0 0 ELIZABETH B FORER 172679 0 0 0 0 0 15750 0 45818 0 234247 0 0 0 LORETO S MELO 138807 0 0 0 0 0 12713 0 48710 0 200230 0 0 0 KAREN C LAMP 182810 0 0 0 0 0 16831 0 55309 0 254950 0 0 0 LANEY KAPGAN 124526 0 0 0 0 0 12500 0 20953 0 157979 0 0 0 BLANCA ANDRES 140291 0 0 0 0 0 12971 0 32962 0 186224 0 0 0 CATHERINE A CHAROUHAS 140272 0 0 0 0 0 12813 0 36560 0 189645 0 0 0 SAKURA LING KUO 147922 0 0 0 0 0 13500 0 37132 0 198554 0 0 0 MARGARITA LOEZA 147712 0 0 0 0 0 13648 0 42679 0 204039 0 0 0 SHARON NG 157192 0 0 0 0 0 14398 0 46171 0 217761 0 0 0 X 7 703408 FAIR MARKET VALUE X 15 10694237 FAIR MARKET VALUE 0 0 1 0 ORGANIZATION MISSION STATEMENT FORM 990, PART III, LINE 1 THE VENICE FAMILY CLINIC'S MISSION IS TO PROVIDE QUALITY PRIMARY HEALTH CARE TO PEOPLE IN NEED. IT WAS FOUNDED IN 1970 BY DR. PHILLIP ROSSMAN AND CO-FOUNDER DR. MAYER B. DAVIDSON. THEY WERE ALARMED THAT EVEN THE MOST BASIC MEDICAL SERVICES SUCH AS IMMUNIZATIONS, ANTIBIOTICS AND PRENATAL CARE WERE UNAVAILABLE FOR THE LOW-INCOME FAMILIES OF VENICE. BEGINNING IN THE EARLY 1990'S THROUGH 2011, VENICE FAMILY CLINIC WAS THE LARGEST FREE CLINIC IN THE UNITED STATES AND VIEWED AS A MODEL OF CARE. IN 2012, AS PART OF ITS RESPONSE TO THE AFFORDABLE CARE ACT, VENICE FAMILY CLINIC BECAME A SECTION 330(E) COMMUNITY HEALTH CENTER AND RECEIVED ADDITIONAL FUNDING THROUGH THE FEDERAL GOVERNMENT'S DEPARTMENT OF HEALTH AND HUMAN SERVICES, HRSA- DIVISION OF PRIMARY HEALTH CARE SERVICES. THE VENICE FAMILY CLINIC IS A BEACON OF HOPE AND HEALING FOR PEOPLE WITH LOW INCOMES AND PEOPLE AT HIGH RISK SUCH AS HOMELESS PEOPLE AND PEOPLE WHO ARE HIV+. THE VENICE FAMILY CLINIC HAS PROVEN ITSELF TO BE AN INNOVATIVE, EFFICIENT AND VIABLE RESPONSE TO THE NEED FOR PRIMARY HEALTH CARE SERVICES FOR THE WORKING POOR OF LOS ANGELES COUNTY. FORM 990, PART VI, SECTION B, LINE 11 THE INFORMATIONAL RETURN IS PREPARED BY OUTSIDE ACCOUNTANTS AND IS REVIEWED BY THE AUDIT COMMITTEE. ONCE APPROVED BY THE AUDIT COMMITTEE, THE RETURN IS THEN REVIEWED AND APPROVED BY THE BOARD OF DIRECTORS PRIOR TO ELECTRONIC FILING. FORM 990, PART VI, SECTION B, LINE 12C IF ANY EMPLOYEE REASONABLY BELIEVES THAT SOME POLICY, PRACTICE, OR ACTIVITY OF VENICE FAMILY CLINIC IS IN VIOLATION OF LAW, A WRITTEN COMPLAINT MAY BE FILED BY THAT EMPLOYEE WITH THE CHIEF EXECUTIVE OFFICER AND/OR CHAIR OF THE AUDIT AND COMPLIANCE COMMITTEE. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD HIRES, OVERSEES, AND ANNUALLY EVALUATES THE PERFORMANCE OF THE CHIEF EXECUTIVE OFFICER OF THE ORGANIZATION, AND CONDUCTS SUCH AN EVALUATION PRIOR TO ANY CHANGE IN THAT OFFICER'S COMPENSATION, UNLESS THERE IS A MULTI-YEAR CONTRACT IN FORCE OR THE CHANGE CONSISTS SOLELY OF ROUTINE ADJUSTMENTS FOR INFLATION OR COST OF LIVING. FORM 990, PART VI, SECTION C, LINE 18 THE ORGANIZATION MAKES ITS FORM 990 AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. UNIVERSITY OF CALIFORNIA LOS ANGELES 405 HILGARD AVE LOS ANGELES CA 90024 956006143 PUBLIC RESEARCH UNIVERSITY CA 501(C)(3) 170(B)(1) (A)(II) N/A 0 VENICE FAMILY CLINIC FOUNDATION 604 ROSE AVENUE VENICE CA 90291 273484548 FUNDRAISING ACTIVITIES CA 501(C)(3) 170(B)(1) (A)(VI) N/A 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 UNIVERSITY OF CALIFORNIA LOS ANGELES C 60000 CASH VENICE FAMILY CLINIC FOUNDATION C 250000 CASH