2013-04-30T10:10:54-05:00 2012-09-30 020400296 BRAD BORBIDGE PA 197 LOUDON ROAD STE 350 CONCORD NH 03301 990 2011-10-01 043349104 Community Health Access Network COMM 6036592494 207 South Main Street Newmarket NH 03857 Kirsten Platte 6036592494 2013-04-30 1 DIMITRIOS PANACOPOULOS CPA P01603705 6032240849 2011 2016-02-25 16:41:14Z Kirsten Platte 207 South Main Street Newmarket NH 03857 1750186 0 X www.chan-nh.org X 1995 NH To enable our member agencies to develop the program and resources necessary to assure access to efficient, effective quality health care for all clients in our communities particularly the uninsured, Medicaid, and medically underserved populations. 7 0 6 0 0 0 877869 981316 702774 768870 0 0 0 0 1580643 1750186 0 0 0 0 240126 275350 0 0 0 1347478 1316238 1587604 1591588 -6961 158598 1904187 1846406 1118140 901761 786047 944645 To enable our member agencies to develop the program and resources necessary to assure access to efficient, effective quality health care for all clients in our communities particularly the uninsured, Medicaid, and medically underserved populations. 0 0 1404045 768870 To provide services and conduct activities that improve the health status of communities served. 1404045 1 1 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 1 0 0 0 0 0 0 0 0 0 0 1 9 0 1 6 1 0 0 0 0 0 0 0 0 0 0 X 7 0 0 0 1 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 NH X Kirsten Platte 6032927205 207 South Main Street Newmarket NH 03857 Helen Taft 0.00 X 0 0 0 Edward George 0.00 X 0 0 0 Richard Silverberg 0.00 X 0 0 0 Janet Atkins 0.00 X 0 0 0 Ann Peters 0.00 X 0 0 0 Dustin Hawk 0.00 X 0 0 0 Peter Kelleher 0.00 X 0 0 0 Kirsten Platte 40.00 X 72264 0 7539 72264 0 7539 0 0 0 0 Lamprey Health Care 207 South Main Street Newmarket NH 03857 Contracted Staff 302657 Southern New Hampshire AHEC 207 South Main Street Newmarket NH 03857 Chronic Disease Management 137201 2 121815 859501 981316 Service Revenue 518210 768870 768870 768870 1750186 768870 0 0 79803 79803 158382 127460 30922 18713 10341 8372 18452 10197 8255 5620 5620 13000 13000 588840 588840 857 474 383 291834 291834 42816 23661 19155 10895 6021 4874 8766 4844 3922 322611 322611 12163 6722 5441 Telephone 13164 7275 5889 Dues 3250 1796 1454 Program Supplies 1409 1409 Other Expenses 716 396 320 297 164 133 1591588 1404045 187543 0 54839 76211 1060345 803522 58505 9243 119438 154442 2482886 1679898 611060 802988 1904187 1846406 61251 335178 1056889 566583 1118140 901761 X 786047 944645 786047 944645 1904187 1846406 158598 0 X 0 1 1 X 1 1 X 251818 455304 926625 877869 981315 3492931 251818 455304 926625 877869 981315 3492931 3492931 510 34 544 3493475 3332499 0.99980 0.99930 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 2482886 1679898 802988 802988 1750186 1591588 158598 158598 1750186 0 1750186 0 1750186 1591588 0 1591588 0 1591588 Part IV, line 11f - The Organization is a public charity under Section 501(c)(3) of the Internal Revenue Code. As a public charity, the Organization is exempt from state and federal income taxes on income earned in accordance with its tax exempt purpose. Unrelated business income is subject to state and federal income tax. Management has evaluated the Organization's tax position and concluded that the Organization has no unrelated business income or uncertain tax positions that require adjustment to the financial statements. Janet Atkins Board Member 153342 Janet Atkins is the CEO of Goodwin Community Health, a member of Community Health Access Network. Transactions reported here include the following: Dues $18,150, Shared IT Systems $135,025, and other income $168. 0 Helen Taft Board President 72150 Helen Taft is the Executive Director of Families First of Greater Seacoast, a member of Community Health Access Network. Transactions reported here include the following: Dues $18,150, Shared IT Systems $50,466, Licenses purchased $1,890 and Other income $1,644. 0 Richard Silverberg Board Treasurer 43132 Richard Silverberg is the Executive Director of Health First Family Care Center, Inc. (HFFCC), a member of Community Health Access Network. Transactions reported here include the following: Dues $18,150, Shared IT Systems $10,616, Consulting $1,541, Licenses purchased $12,240 and Other income $585. 0 Ann Peters Board Member 286938 Ann Peters is the CEO of Lamprey Health Care, Inc. (LHC), a member of Community Health Access Network. Transactions here include the following revenue transactions: Dues received: $18,150, Shared IT Sytems: $244,767, Other Income: $23,556 and Consulting $466. 0 Ann Peters Board Member 356018 Ann Peters is the CEO of Lamprey Health Care, Inc. (LHC), a member of Community Health Access Network. Transactions here include the following expense transactions: Employees leased from LHC: $302,657, and facilities leased from LHC (including utilities): $53,361. 0 Edward George Board Secretary 127142 Edward George is the President/CEO of Manchester Community Health Center, a member of Community Health Access Netowrk. Transactions reported here include the following: Dues $18,150, Shared IT Systems $104,137, Other income $2,140 and Licenses purchased $2,715. 0 Dustin Hawk Board Member 141841 W. Greg Henson is the Executive Director at Shackleford County Community Resource Center. transactions reported here include the following: Dues $18,150, Shared IT Systems $79,697, Other income $6,678 and Licenses purchased $37,316. 0 Form 990, Part VI, Section A, line 4 Articles of Agreement: Article 2, paragraph 7 - changes distribution of any remaining assets in event of termination, dissolution or winding-up of the Corporation from founding members of the Corporation which are members at time of such distribution to members of the Corporation which are members at time of such distribution. Bylaws Article IV, Section 1 deletes any reference to the founding members of the Corporation. Verbiage inserted to note that not only do full members provide comprehensive primary health care to the community regardless of payment source, but that this be the principle purpose of full members of the Corporation. Article V Section 2 notes appointed representative from full members to have decision making authority on behalf of appointing organization. Article V Section 3 gives consumer representative the right to vote and the right to appoint a member of the Board of Directors by deleting verbiage noting consumer representative shall not have voting rights nor the right to appoint a member to the Board of Directors. Article V Section 8 changes regular meetings of the Board of Directors from at least four to at least eight times each year. Also adds verbiage noting with 3 unexcused absences each year director may be removed by 75% of Board of Directors vote, with replacement to be appointed within 30 days. Form 990, Part VI, Section B, line 11 The 990 is reviewed by the Executive Director and the Board treasurer. Form 990, Part VI, Section B, line 12c Board members sign the policy upon becoming a member and periodically review the policy. Form 990, Part VI, Section B, line 15 The Board of Directors review and approve the compensation of the Executive Director. Form 990, Part VI, Section C, line 19 They are made available upon request.