2013-05-14T21:26:52-05:00 2012-06-30 261659234 CW ASSOCIATES CPAS 700 BISHOP STREET SUITE 1040 HONOLULU HI 96813 990 2011-07-01 990149797 KOKUA KALIHI VALLEY COMPREHENSIVE FAMILY SERVICES KOKU 8087919411 2239 NORTH SCHOOL STREET HONOLULU HI 96819 DAVID DERAUF 8087919411 2013-05-14 1 MARK A HAYES P00085205 8085311040 2011 2016-02-24 21:20:13Z DAVID DERAUF 2239 NORTH SCHOOL STREET HONOLULU HI 96819 13863594 0 X WWW.KKV.NET X 1972 HI KOKUA KALIHI VALLEY AND AFFILIATE (THE "CENTER") WERE INCORPORATED IN THE STATE OF HAWAII IN MAY 1972 TO PROMOTE HEALTH AND TO PROVIDE COMPREHENSIVE FAMILY SERVICES IN THE KALIHI VALLEY COMMUNITY IN THE CITY & COUNTY OF HONOLULU, HAWAII. THE CENTER IS A FEDERALLY-QUALIFIED HEALTH CENTER THAT PROVIDES A BROAD RANGE OF HEALTH AND SOCIAL SERVICES TO A LARGELY MEDICALLY-UNDERSERVED IMMIGRANT POPULATION. 11 11 189 27 0 0 4968434 9824923 3888859 4006498 10489 6859 51959 25314 8919741 13863594 0 0 0 0 7030483 7632834 0 0 91171 2360767 2295272 9391250 9928106 -471509 3935488 11268361 16721919 638302 2156372 10630059 14565547 TOGETHER WE WORK TOWARD HEALING, RECONCILIATION AND THE ALLEVIATION OF SUFFERING IN KALIHI VALLEY, BY SERVING COMMUNITIES, FAMILIES AND INDIVIDUALS THROUGH STRONG RELATIONSHIPS THAT HONOR CULTURE AND FOSTER HEALTH AND HARMONY. 0 0 7797902 4031812 SERVICES PERFORMED TO PROVIDE ACCESS TO MEDICAL, DENTAL AND SOCIAL SERVICES IN THE KALIHI VALLEY COMMUNITY. 7797902 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 1 27 0 189 1 0 0 0 0 0 0 0 0 0 0 X 11 11 0 0 1 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 HI X DALLYS SALAS CHIEF FINANCIAL OFFIC 8087919411 2239 NORTH SCHOOL STREET HONOLULU HI 96819 RICKEY MURASHIGE 1.00 X X 0 0 0 KAREN FOX 1.00 X X 0 0 0 DAVID NAKAMOTO 1.00 X X 0 0 0 SHARON ROUPPET 1.00 X X 0 0 0 EDWARD KEMPER 1.00 X X 0 0 0 GRACE COBB 1.00 X 0 0 0 GEOFFREY PANG 1.00 X 0 0 0 MARYROSE MCCLELLAND 1.00 X 0 0 0 MARISSA FAY WENGLER 1.00 X X 0 0 0 JOVY WOOLSEY 1.00 X X 0 0 0 JOHN R VAUGHN 1.00 X 0 0 0 DAVID DERAUF 40.00 X 149592 0 27239 CYNTHIA STURDEVANT 40.00 X 62129 0 16693 DALLYS SALAS 40.00 X 76951 0 14148 LAURA DEVILBISS 40.00 X 162231 0 18141 DAVID R BREESE 40.00 X 108780 0 14697 BRADLEY CHUN 40.00 X 119257 0 22429 JASON Y HIRAMOTO 40.00 X 109276 0 13994 JONAS NAVICKAS 40.00 X 122770 0 21443 MYA M HLA 40.00 X 102167 0 16786 1013153 0 165570 7 0 1 0 0 7541559 2283364 50041 9824923 MEDICAID 624110 2934800 2934800 PRIVATE INSURANCE 624110 629142 629142 MEDICARE 624110 347971 347971 SELF-PAY 624110 92706 92706 CAPITATION FEES 624110 1879 1879 4006498 6859 6859 MEDICAL RECORD CHARGES 624110 24404 24404 CARETAKER HOUSING 900099 910 910 25314 13863594 4031812 0 6859 507886 417276 84681 5929 4762081 3935442 761626 65013 651835 524334 127501 1207536 943484 264052 503496 416172 87324 1270 1270 50312 50312 595933 398313 197620 765172 624550 135914 4708 275083 211043 60271 3769 62362 58170 4192 250929 64939 175584 10406 69217 53103 15166 948 TRAINING 70071 62114 7957 REPAIRS AND MAINTENANCE 62005 32337 29668 MISCELLANEOUS 32392 24033 8359 DUES AND SUBSCRIPTIONS 31462 10294 21168 29064 22298 6368 398 9928106 7797902 2039033 91171 942579 962953 2536042 1820652 865922 1130847 592171 959063 16186 18928 15221632 3392156 6315461 11829476 11268361 16721919 638302 1906372 0 250000 638302 2156372 X 8795925 13977830 1834134 587717 10630059 14565547 11268361 16721919 3935488 0 X 0 1 1 X 1 1 X 3630049 3450251 6146036 4968434 9824923 28019693 3630049 3450251 6146036 4968434 9824923 28019693 983412 27036281 87876 10489 6859 105224 107463 101151 97657 51959 25314 383544 28508461 20051887 0.94840 0.92740 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: OTHER INCOME RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 2288000 2288000 4950295 2388647 2561648 1522632 1003509 519123 6460705 6460705 11829476 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE UNCERTAIN TAX POSITIONS TO BE RECOGNIZED IN THE FINANCIAL STATEMENTS IF THEY ARE MORE LIKELY THAN NOT TO FAIL UPON REGULATORY EXAMINATION. MANAGEMENT HAS EVALUATED THE TAX POSITIONS OF KKV AND AFFILIATE AS OF JUNE 30, 2012 AND 2011 AND FOR THE YEARS THEN ENDED BY REVIEWING THEIR INCOME TAX RETURNS AND CONFERRING WITH THEIR TAX ADVISORS, AND DETERMINED THAT THERE WERE NO UNCERTAIN TAX POSITIONS REQUIRED TO BE REPORTED IN ACCORDANCE WITH SUCH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES. SUCH RETURNS ARE OPEN FOR EXAMINATION UNTIL THE STATUTE OF LIMITATIONS EXPIRES. X X X 0 0 0 0 0 0 0 0 0 DAVID DERAUF 149592 0 0 0 0 0 12933 0 14306 0 176831 0 0 0 LAURA DEVILBISS 162231 0 0 0 0 0 13784 0 4357 0 180372 0 0 0 X WATER BOTTLES 1 1016 X MICROSOFT SOFTWARE LICENSE 1 48350 X STUFFED ANIMALS 1 675 0 0 0 METHOD FOR DETERMINING NUMBER OF CONTRIBUTORS: PART I, COLUMN (B): THE ORGANIZATION IS REPORTING THE NUMBER OF CONTRIBUTORS. FORM 990, PART VI, SECTION A, LINE 4 CHANGES TO THE ORGANIZATION'S BYLAWS AS FOLLOWS: ARTICLES 1, 2, AND 5: THE NAME OF THE ORGANIZATION SHALL BE "KOKUA KALIHI VALLEY COMPREHENSIVE FAMILY SERVICES". ARTICLE 4, SECTION 4: "ACTION BY WRITTEN CONSENT OR EMAIL." FORM 990, PART VI, SECTION B, LINE 11 THE EXECUTIVE DIRECTOR REVIEWS THE REPORT IN CONJUNCTION WITH THE CFO BEFORE PRESENTING TO THE FINANCE COMMITTEE FOR REVIEW. AFTER THE FINANCE COMMITTEE REVIEWS THE 990 REPORT, AN ELECTRONIC COPY IS SENT TO ALL BOARD MEMBERS FOR REVIEW AND APPROVAL; A HARD COPY IS ALSO PROVIDED AT THE FOLLOWING BOARD OF DIRECTORS MEETING. FORM 990, PART VI, SECTION B, LINE 12C A COPY OF THIS POLICY IS GIVEN TO ALL BOARD MEMBERS UPON COMMENCEMENT OF SUCH PERSON'S RELATIONSHIP WITH THE ORGANIZATION. EACH BOARD MEMBER SIGNS AND DATES THE POLICY AT THE BEGINNING OF HER/HIS TERM OF SERVICE OR EMPLOYMENT AND EACH YEAR THEREAFTER. FAILURE TO SIGN DOES NOT NULLIFY THE POLICY. THE POLICY AND DISCLOSURE FORM MUST BE FILED ANNUALLY BY ALL SPECIFIED PARTIES. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION COMMITTEE USES SALARY GRADE AND RANGE TO MAKE SURE OUR SALARIES ARE COMPARABLE WITH COMMUNITY STANDARDS. THE HAWAII PRIMARY CARE ASSOCIATION DOES REGULAR ASSESSMENTS OF THE COMMUNITY HEALTH CENTERS SO WE CAN MAKE SURE OUR SALARIES ARE COMPARABLE WITH OTHER HEALTH CENTERS. THE SALARY RANGE FOR EACH INDIVIDUAL IS DEPENDENT ON EXPERIENCE AND EDUCATION. THE EXECUTIVE DIRECTOR'S SALARY IS DETERMINED BY THE COMPENSATION COMMITTEE AND APPROVED BY THE BOARD OF DIRECTORS. THE COMPENSATION COMMITTEE RECOMMENDS THE SALARY RANGES TO THE EXECUTIVE DIRECTOR, WHO APPROVES THE SALARIES FOR OFFICERS AND KEY MANAGEMENT EMPLOYEES. 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. KALIHI VALLEY COMMUNITY FOUNDATION 2239 NORTH SCHOOL STREET HONOLULU HI 96819 990329894 PROVIDE FINANCIAL SUPPORT TO CENTER HI 501(C)(3) LINE 7 KOKUA KALIHI VALLEY COMP FAMILY SVCS 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0