2013-05-02T11:13:42-05:00 2012-06-30 BKD LLP 910 E ST LOUIS 200/PO BOX 1190 SPRINGFIELD MO 658062523 990 2011-07-01 942237120 MARIN COMMUNITY CLINIC % SCOTT GOODIN MARI 4154481500 6090 REDWOOD BLVD NOVATO CA 94945 LINDA TAVASZI 2013-02-12 true Brian D Todd 4178658701 2011 2016-03-07 17:11:31Z LINDA TAVASZI 1177 E FRANCISCO BLVD SAN RAFAEL CA 94901 28742312 false X WWW.MARINCLINIC.ORG X 1973 CA TO IMPROVE THE HEALTH AND WELL-BEING OF VULNERABLE LOW-INCOME CHILDREN AND ADULTS IN MARIN COUNTY, CALIFORNIA, BY PROVIDING PRIMARY CARE, ORAL HEALTH, MENTAL HEALTH, AND OTHER HEALTH CARE SERVICES. 14 14 236 33 0 0 4418439 6700469 15611618 22023420 1030 321 -2849 -11760 20028238 28712450 0 272093 0 0 10841097 12793872 49855 12390 22097 7990911 9598675 18881863 22677030 1146375 6035420 17776613 20428141 6361230 2977338 11415383 17450803 X TO IMPROVE THE HEALTH OF OUR PATIENTS AND COMMUNITY BY PROVIDING HIGH QUALITY, COST-EFFECTIVE, CULTURALLY SENSITIVE, PATIENT-CENTERED HEALTH CARE. false false 12133415 272093 15416394 PRIMARY CARE - PEDIATRIC CARE (INCLUDING AFTER HOURS), ADULT CARE (INCLUDING AFTER HOURS), TEEN HEALTH CARE, IMMUNIZATIONS, ANNUAL CHECKUPS, CHRONIC CARE MANAGEMENT, FAMILY PLANNING FOR MEN AND WOMEN, OBSTETRICS AND GYNECOLOGY, INCLUDING BREAST AND CERVICAL SCREENING & EDUCATION, POST-NATAL CARE, AND REFERRALS FOR SPECIALTY CARE. 4160028 5285621 ORAL HEALTH - PREVENTIVE & RESTORATIVE DENTISTRY. SERVICES INCLUDE: EXAMS AND X-RAYS, ORAL HYGIENE INSTRUCTIONS, CLEANINGS, TOOTH DECAY REMOVAL AND FILLINGS, EXTRACTIONS, ROOT CANALS AND CROWNS DENTURES. 866672 1101171 BEHAVIORAL HEALTH SERVICES - OFFERED TO CHILDREN, TEENS, AND ADULTS, AND INCLUDES PSYCHIATRY AND COUNSELING BY LICENSED CLINICAL SOCIAL WORKERS. 173334 220234 17333449 true true false true false false false false false true true false false true false false true false false false false false false false true false false true false true false false false false false false false false false false false false false false false false false false true 237 0 true 236 true false false false false false false false false false false X 14 14 true false false false false false false true true false false false true true true true true true true false CA X SCOTT GOODIN 4155268532 6090 REDWOOD BLVD SUITE G NOVATO CA 94945 JENNIFER LOUCKS 1.0 X 0 0 0 WALTER KOPP 1.0 X X 0 0 0 DAVID KLINETOBE 1.0 X X 0 0 0 CARLOS GARCIA-BEDOYA 1.0 X 0 0 0 MICHAEL HOLLOWAY 1.0 X 0 0 0 FRESHTE KASHANI 1.0 X X 0 0 0 WILLIAM KERR 1.0 X 0 0 0 SUE MACE 1.0 X 0 0 0 TEO MARTINEZ 1.0 X 0 0 0 CHARLES J OKEN 1.0 X X 0 0 0 SHARON REPP 1.0 X 0 0 0 FRANK TAVEL 1.0 X 0 0 0 JEFFREY KRAFT 1.0 X 0 0 0 MICHAEL S HARRIS 1.0 X 0 0 0 CRAIG LINDQUIST MD 1.0 X 0 0 0 MARTIN SLEATH 1.0 X X 0 0 0 STACY SCOTT 1.0 X 0 0 0 GEORGIANNA FARREN 40.0 X 176958 0 6309 LINDA TAVASZI PHD 40.0 X 145248 0 0 STEVE AMOS 40.0 X 99227 0 13841 KATHY WINSTON MD 40.0 X 147603 1693 CONSTANCE KADERA DDS 40.0 X 126985 0 25167 COURTNEY BENEDICT 40.0 X 111897 329 DARRELL BOYCHUK 40.0 X 114697 1758 JOLAINE BEAL 40.0 X 112684 3450 JOHN SHEN 0.0 X 191020 0 3352 1226319 0 55899 19 true true false PRIMA MEDICAL GROUP MEDICAL 200452 MONICA TONG DDS DENTAL 130000 BKD LLP CONSULTING/AUDIT/TAX 102754 3 53735 3943765 2702969 6700469 NET PATIENT SERVICE REVENUE 624100 20861958 20861958 EHR INCENTIVE 624100 1062500 1062500 OTHER INCOME 624100 98962 98962 22023420 321 321 0 0 7020 7020 7020 7020 0 11082 53735 29862 -18780 -18780 0 0 0 28712450 22023420 -11439 272093 272093 0 0 0 441583 183267 258316 194372 194372 9145671 7674598 1471073 85377 68763 16614 2076075 1702400 373675 850794 668248 182546 0 183856 183856 114808 114808 0 12390 12390 0 3529920 2995888 534032 0 727491 410782 307002 9707 465365 8989 456376 0 1552187 1396535 155652 37091 8384 28707 0 61418 21234 40184 104465 21936 82529 0 1473086 865764 607322 94977 1500 93477 BAD DEBT 138439 138439 MEDICAL SUPPLIES & DRUGS 850860 850860 LICENSES, DUES, SUBSCRIPTIONS 89408 32133 57275 RECRUITING & RETENTION 101324 10117 91207 73980 1519 72461 22677030 17333449 5321484 22097 1003745 3409980 783063 12039 238984 269327 1299395 2878609 0 0 0 0 0 0 0 116625 168873 258726 16693485 5421315 12082553 11272170 0 0 0 0 0 0 0 0 2200000 2210665 17776613 20428141 1962178 2787701 0 0 31716 119157 0 0 0 0 0 0 4327336 50480 40000 20000 0 0 6361230 2977338 X 10648667 16489510 766716 961293 0 0 11415383 17450803 17776613 20428141 6035420 X false true true X true true X 3366000 4371512 4455745 4418439 6700469 23312165 3366000 4371512 4455745 4418439 6700469 23312165 988194 22323971 70901 23968 1642 611 7341 104463 9099 9099 23425727 65194441 0.95297 0.91552 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true false OTHER LOBBYING ACTIVITIES SCHEDULE C, PART II-B, QUESTION 1I THE ORGANIZATION PAYS ANNUAL DUES TO CALIFORNIA PRIMARY CARE ASSOCIATION (CPCA) - A PORTION OF WHICH MAY BE ATTRIBUTABLE TO LOBBYING. 272888 928 273816 244707 40183 12002 272888 234349 23188 12830 244707 279990 -32267 13374 234349 1.00000 true false 1300000 1300000 7186971 1735647 5451324 4131124 1389002 2742122 4075390 2296666 1778724 0 11272170 EST AMT DUE FROM 3RD PTY PYR 1675000 OTHER RECEIVABLES 535665 2210665 28712450 22677030 6035420 6035420 28858577 116265 116265 28742312 -29862 -29862 28712450 22823157 116265 29862 146127 22677030 22677030 ENDOWMENT FUNDS SCHEDULE D, PART V, LINE 4 THE MARIN COMMUNITY FOUNDATION (THE "FOUNDATION") RECEIVES DONATIONS AND MANAGES AN ENDOWMENT FUND, THE MARIN COMMUNITY CLINIC ENDOWMENT OF THE MARIN COMMUNITY FOUNDATION. THE ASSETS FROM THIS AND OTHER ENDOWMENTS ARE MAINTAINED IN THE FOUNDATION'S ENDOWMENT FUND AND ARE POOLED ON A MARKET VALUE BASIS. INVESTMENT RETURN FROM SECURITIES IN THE ENDOWMENT FUND IS ALLOCATED TO THE INDIVIDUAL ENDOWMENTS BASED ON THE RELATIONSHIP OF THE FAIR VALUE OF THE INTEREST OF EACH ENDOWMENT TO THE TOTAL FAIR VALUE OF THE ENDOWMENT FUND, AS ADJUSTED FOR ADDITIONS TO OR DEDUCTIONS FROM THESE ACCOUNTS. THE FOUNDATION MAKES QUARTERLY DISTRIBUTIONS TO THE ORGANIZATION FOR INVESTMENT RETURNS RECEIVED ON THESE ENDOWMENTS BASED ON THE FOUNDATION'S SPENDING POLICY. AS THE SPENDING POLICY IS AT THE DISCRETION OF THE FOUNDATION AND CAN BE CHANGED, THE ENDOWMENT CONTRIBUTIONS ARE CONSIDERED CONDITIONAL AND ARE NOT RECORDED AS ASSETS OF THE ORGANIZATION. DURING THE YEARS ENDED JUNE 30, 2012 AND 2011, THE FOUNDATION'S SPENDING POLICY WAS TO DISTRIBUTE 5.5% OF THE ROLLING 12 QUARTER AVERAGE OF THE MARKET VALUE OF THE POOLED FUND. THE ORGANIZATION RECEIVED DISTRIBUTIONS OF $0 AND $12,002 FOR THE YEARS ENDED JUNE 30, 2012 AND 2011, RESPECTIVELY, WHICH ARE INCLUDED IN THE STATEMENT OF OPERATIONS. AT JUNE 30, 2012 AND 2011, THE BALANCE OF THE ENDOWMENT FUND WAS $273,816 AND $272,888, RESPECTIVELY. UNCERTAIN TAX POSITIONS SCHEDULE D, PART X, LINE 2 MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. AMOUNTS INCLUDED ON FORM 990, PART VIII, LINE 12, BUT NOT ON LINE 1 SCHEDULE D, PART XII, LINE 4B (29,862) SPECIAL EVENTS EXPENSES AMOUNTS INCLUDED ON LINE 1 BUT NOT ON FORM 990, PART IX, LINE 25 SCHEDULE D, PART XIII, LINE 2D 29,862 SPECIAL EVENTS EXPENSES ELLIOT LEVIN PY CAMPAIGN ADVISOR CONSULTING false KATHLEEN CLARK FUNDRAISING false SUMMER SOLSTICE 64817 53735 11082 386 1800 11082 350 16244 0 64817 53735 11082 386 1800 11082 350 16244 29862 -18780 true BAY AREA COMMUNITY RESOURCES 171 CARLOS DRIVE SAN RAFAEL CA 94903 942346815 501(C)(3) 13160 SUPPORT HUCKLEBERRY YOUTH PROGRAMS 361 THIRD STREET SUITE G SAN RAFAEL CA 94901 941687559 501(C)(3) 158013 SUPPORT NOVATO YOUTH CENTER 1767 GRANT AVE NOVATO CA 94945 941735064 501(C)(3) 84920 SUPPORT PLANNED PARENTHOOD SHASTA PACIFIC 2185 PACHECO STREET CONCORD CA 94520 941575233 501(C)(3) 16000 SUPPORT 4 GRANT MONITORING SCHEDULE I, PART I, LINE 2 THE DIRECTOR OF GIVING AT MCC MONITORS PROGRESS TOWARD PROJECT GOALS BY PARTICIPATING IN THE MARIN ADOLESCENT HEALTH NETWORK MEETINGS AND REVIEWING WRITTEN REPORTS INCLUDING PROGRAM NARRATIVE AND BUDGET REPORTS. AFTER RECEIVING THE REPORTS FROM EACH AGENCY, THE REPORTS ARE COMPILED INTO A COMPOSITE REPORT AND IT IS SUBMITTED TO MARIN COMMUNITY FOUNDATION ALONG WITH COPIES TO EACH AGENCY. X X X false false false false false false false false false JOHN SHEN 171227 0 0 19793 0 3352 0 0 0 194372 0 0 0 GEORGIANNA FARREN 176958 0 0 0 5758 0 551 0 183267 0 0 0 CONSTANCE KADERA DDS 126985 0 0 0 0 0 25167 0 152152 0 0 0 ORGANIZATION'S MISSION FORM 990, PART I, LINE 1 TO IMPROVE THE HEALTH AND WELL-BEING OF VULNERABLE LOW-INCOME CHILDREN AND ADULTS IN MARIN COUNTY CALIFORNIA - MOBILIZING A CARING AND COLLABORATIVE COMMUNITY RESPONSE TO PROVIDE HIGH QUALITY, ACCESSIBLE AND CULTURALLY RESPONSIVE HEALTH CARE SERVICES. VALUES THE INTERACTIONS OF OUR PHYSICIANS, NURSES, MEDICAL ASSISTANTS AND STAFF WITH OUR PATIENTS BEST ILLUSTRATE THE ORGANIZATIONAL VALUES THAT GUIDE OUR WORK: INTEGRITY - PROFESSIONAL EXCELLENCE REQUIRES PERSONAL AND ORGANIZATIONAL INTEGRITY AND A COLLECTIVE COMMITMENT TO ETHICAL BEHAVIOR. RESPECT - OUR RELATIONSHIPS AND REPUTATION ARE BASED ON PERSONAL TRUSTWORTHINESS AND MUTUAL RESPECT - FOR OUR PATIENTS, COLLEAGUES AND CONTRIBUTORS. DIVERSITY - WE DEDICATE OURSELVES TO CARING FOR, PROMOTING AND RESPECTING THE DIVERSITY AMONG OUR STAFF, OUR PATIENTS AND OUR COMMUNITY. COMPETENCY - WE COMMIT TO THE HIGHEST LEVEL OF ACCOUNTABILITY IN DEMONSTRATING OUR ABILITIES AND COMMITMENT TO QUALITY CARE FOR OUR PATIENTS AND COMMUNITY. TEAMWORK - WE VALUE TEAMWORK AND COLLABORATION IN ALL OUR ENDEAVORS. TOTAL NUMBER OF VOLUNTEERS FORM 990, PART 1, LINE 6 THE TOTAL NUMBER OF VOLUNTEERS INCLUDES MEMBERS OF THE BOARD OF DIRECTORS AND VOLUNTEER LICENSED MEDICAL PROVIDERS. OTHER PROGRAM SERVICES FORM 990, PART III, LINE 4D HEALTH EDUCATION - ASTHMA, CARDIOVASCULAR, CHRONIC PAIN, DIABETES BUSINESS RELATIONSHIP FORM 990, PART VI, SECTION A, LINE 2 MARTIN SLEATH, BOARD SECRETARY, & DAVID KLINETOBE, BOARD TREASURER, HAVE A BUSINESS RELATIONSHIP. BOARD COMMITTEES FORM 990, PART VI, SECTION A, LINE 8B Executive Committee shall have the full powers and authorities of the Board in the intervals between meetings of the Board, except that it may not: a) Elect officers b) Create or fill vacancies on any committee c) Amend, repeal or adopt new Bylaws d) Remove any member of the Board e) Sign any contract with a value in excess of $25,000 or with a duration exceeding one year, or incur any obligation in excess of $25,000 f) Amend or repeal any resolution of the Board 990 REVIEW POLICY FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION. THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS REVIEWS THE FORM 990 PRIOR TO FILING, AND RECORDS ITS APPROVAL OF THE FILINGS IN ITS REGULAR MEETING MINUTES. CONFLICT OF INTEREST POLICY FORM 990, PART VI, SECTION B, LINE 12C MARIN COMMUNITY CLINICS (MCC) REPRESENTATIVES SHALL NOT BE INVOLVED IN ACTIVITIES WHICH ADVERSELY AFFECT MCC'S REPUTATION OR RELATIONS WITH OTHERS, OR WHICH INTERFERE WITH THE FULFILLMENT OF ITS MISSION. NEITHER EMPLOYEES NOR VOLUNTEERS NOR BOARD MEMBERS SHALL USE THEIR POSITION OR INFLUENCE OR INFORMATION TO WHICH THEY HAVE ACCESS TO AS A RESULT OF THEIR ASSOCIATION OR ANY ASSETS OR RESOURCES MCC FOR THEIR OWN PERSONAL GAIN, FOR TRADING, OR FOR THE IMPROPER BENEFIT OF OTHERS. (A) NO MEMBER OF THE BOARD OF DIRECTORS SHALL BE AN EMPLOYEE OF MARIN COMMUNITY CLINIC, INC., OR SPOUSE OR CHILD, PARENT, BROTHER OR SISTER BY BLOOD OR MARRIAGE OF SUCH AN EMPLOYEE; (B) THE BOARD OF DIRECTORS SHALL STRICTLY COMPLY WITH PROVISIONS OF CALIFORNIA CORPORATE CODE 5233 IN APPROVING ANY TRANSACTION IN WHICH A BOARD MEMBER HAS FINANCIAL INTEREST; (C) ALL MEMBERS OF THE BOARD OF DIRECTORS SHALL COMPLY WITH THE DISCLOSURE REQUIREMENTS OF CALIFORNIA CORPORATE CODE 5234 CONCERNING TRANSACTIONS BETWEEN MARIN COMMUNITY CLINIC, INC. AND ANY OTHER ENTITY IN WHICH A DIRECTOR IS AN OFFICER OR DIRECTOR; AND (D) MARIN COMMUNITY CLINIC WILL MAKE NO LOAN OF MONEY OR OTHER PROPERTY, OR GUARANTEE THE OBLIGATION, OF ANY DIRECTOR OR OFFICER OF MARIN COMMUNITY CLINIC, INC., EXCEPT AS AUTHORIZED BY CALIFORNIA CORPORATION CODE 5236. (E) MARIN COMMUNITY CLINIC PROHIBITS ANY CONFLICT OF INTEREST OR THE APPEARANCE OF CONFLICT OF INTEREST BY BOARD MEMBERS, EMPLOYEES, CONSULTANTS OR THOSE WHO PROVIDE SERVICES OR FURNISH GOODS TO THE CORPORATION. THE POLICIES OF MARIN COMMUNITY CLINIC BOARD OF DIRECTORS REQUIRE REGULAR DISCLOSURE OF MEMBER (1) AFFILIATIONS (AS TRUSTEE, BOARD MEMBER, OFFICER, EMPLOYEE, ADVISORY COMMITTEE MEMBER, DEVELOPMENT COMMITTEE MEMBER, VOLUNTEER, ETC.) WITH ANY OTHER ORGANIZATION WITH WHICH MCC MAY HAVE A FINANCIAL RELATIONSHIP, AND (2) AFFILIATIONS OF PERSONS WITH WHOM YOU HAVE A CLOSE PERSONAL RELATIONSHIP (SUCH AS A MEMBER OF THE YOUR IMMEDIATE FAMILY OR A MEMBER OF YOUR HOUSEHOLD) WITH ANY OTHER ORGANIZATION WITH WHICH THE MCC MAY HAVE A FINANCIAL RELATIONSHIP. EMPLOYEES, VOLUNTEERS AND BOARD MEMBERS HAVE A CONTINUING RESPONSIBILITY TO ADVISE THE BOARD SECRETARY OF ADDITIONAL AFFILIATIONS AS THEY MAY ARISE. COMPENSATION SETTING PROCEDURE FORM 990, PART VI, SECTION B, LINE 15A & 15B THE ORGANIZATION'S HUMAN RESOURCE DIRECTOR OBTAINS INDUSTRY COMPENSATION DATA FROM LOCAL AND STATE RESOURCES TO BE USED FOR COMPARISON PURPOSES. DATA FROM ASSOCIATION SURVEYS (NACHC, CPCA) AND ANY RECOMMENDATIONS ARE REVIEWED AND REPORTED TO THE EXECUTIVE COMMITTEE FOR APPROVAL & DISCUSSION. THE OFFICERS' PAY RATES ARE REVIEWED ANNUALLY OR AS NECESSARY IF THERE IS A CHANGE IN STAFF. THE OTHER OFFICERS' COMPENSATION IS REVIEWED EACH YEAR WHEN THE BUDGET IS APPROVED. DOCUMENT DISCLOSURE FORM 990, PART VI, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON WRITTEN REQUEST. REQUESTED DOCUMENTS WILL BE MAILED TO THE REQUESTOR.