PIMA COMMUNITY ACCESS PROGRAM: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization: PIMA COMMUNITY ACCESS PROGRAM (EIN 86-1014012)
Tax period: 2012-01-01 to 2012-12-31
Filed: 2013-10-03
IRS object ID: 201342769349300234
Schema version: 2012v2.3
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule D
Schedule I
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2013-10-03T15:54:57-05:00	Timestamp
Tax Period End Date	2012-12-31	TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	FESTER & CHAPMAN PC	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	8283 N HAYDEN RD STE 200	AddressLine1
City	SCOTTSDALE	City
State	AZ	State
ZIP Code	852582456	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2012-01-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	861014012	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	PIMA COMMUNITY ACCESS PROGRAM INC	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	PIMA	NameControl
Phone	5203092922	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	3480 E BRITANNIA DRIVE	AddressLine1
Address Line2	ROOM/SUITE 120	AddressLine2
City	TUCSON	City
State	AZ	State
ZIP Code	85706	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	MICHAL GOFORTH	Name
Title	CEO	Title
Phone	5203092922	Phone
Date Signed	2013-09-16	DateSigned
Authorize Third Party	true	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Name	RACHEL R LOCKE CPA	Name
Phone	6022643077	Phone
Date Prepared	2013-10-03	DatePrepared

Field	Value	IRS element (for citing)
Tax Year	2012	TaxYear
Build TS	2016-02-24 21:20:13Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	MICHAL GOFORTH	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	3480 E BRITANNIA DRIVE SUITE 120	AddressLine1
City	TUCSON	City
State	AZ	State
ZIP Code	85706	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	1237988	GrossReceipts
Group Return For Affiliates	false	GroupReturnForAffiliates
Organization501c3	X	Organization501c3
Web Site	WWW.MYPCAP.ORG	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	2000	YearFormation
State Legal Domicile	AZ	StateLegalDomicile
Activity Or Mission Description	PCAP PROVIDES AN EFFECTIVE, COORDINATED SYSTEM FOR ACCESSING COMPREHENSIVE HEALTH CARE AT HIGHLY DISCOUNTED RATES FOR ALL LOW INCOME, UNINSURED RESIDENTS OF PIMA AND SANTA CRUZ COUNTIES. THE GOAL IS TO IMPROVE HEALTH CARE OUTCOMES, TO REDUCE UNCOMPENSATED CARE AND TO FACILITATE EQUITABLE DISTRIBUTION OF CARE FOR OUR TARGETED POPULATION AMONG PROVIDERS IN OUR COMMUNITY. PCAP'S MISSION IS TO PROMOTE THE HEALTH OF MEDICALLY UNDERSERVED INDIVIDUALS AND FAMILIES BY ENROLLING ALL WHO ARE ELIGIBLE IN EITHER PCAP OR PUBLIC HEALTH PROGRAMS, TO FACILITATE PRIMARY CARE AND SPECIALTY SERVICES AND TO HELP REDUCE THE NUMBER OF AVOIDABLE HOSPITAL ADMISSIONS AND INAPPROPRIATE USE OF COMMUNITY EMERGENCY DEPARTMENTS.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	19	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	19	NbrIndependentVotingMembers
Total Nbr Employees	11	TotalNbrEmployees
Total Gross UBI	0	TotalGrossUBI
Contributions Grants Prior Year	775379	ContributionsGrantsPriorYear
Contributions Grants Current Year	836528	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	349020	ProgramServiceRevenuePriorYear
Program Service Revenue CY	372780	ProgramServiceRevenueCY
Investment Income Prior Year	1567	InvestmentIncomePriorYear
Investment Income Current Year	1574	InvestmentIncomeCurrentYear
Other Revenue Prior Year	51988	OtherRevenuePriorYear
Other Revenue Current Year	27106	OtherRevenueCurrentYear
Total Revenue Prior Year	1177954	TotalRevenuePriorYear
Total Revenue Current Year	1237988	TotalRevenueCurrentYear
Grants And Similar Amnts CY	369892	GrantsAndSimilarAmntsCY
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	481281	SalariesEtcPriorYear
Salaries Etc Current Year	451775	SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	0	TotalFundrsngExpCurrentYear
Other Expense Prior Year	587894	OtherExpensePriorYear
Other Expenses Current Year	349143	OtherExpensesCurrentYear
Total Expenses Prior Year	1069175	TotalExpensesPriorYear
Total Expenses Current Year	1170810	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	108779	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	67178	RevenuesLessExpensesCY
Total Assets BOY	726015	TotalAssetsBOY
Total Assets EOY	837800	TotalAssetsEOY
Total Liabilities BOY	61232	TotalLiabilitiesBOY
Total Liabilities EOY	105839	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	664783	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	731961	NetAssetsOrFundBalancesEOY
Info In Schedule O Part III	X	InfoInScheduleOPartIII
Mission Description	PCAP PROVIDES AN EFFECTIVE, COORDINATED SYSTEM FOR ACCESSING COMPREHENSIVE HEALTH CARE AT HIGHLY DISCOUNTED RATES FOR ALL LOW INCOME, UNINSURED RESIDENTS OF PIMA AND SANTA CRUZ COUNTIES. THE GOAL IS TO IMPROVE HEALTH CARE OUTCOMES, TO REDUCE UNCOMPENSATED CARE AND TO FACILITATE EQUITABLE DISTRIBUTION OF CARE FOR OUR TARGETED POPULATION AMONG PROVIDERS IN OUR COMMUNITY. PCAP'S MISSION IS TO PROMOTE THE HEALTH OF MEDICALLY UNDERSERVED INDIVIDUALS AND FAMILIES BY ENROLLING ALL WHO ARE ELIGIBLE IN EITHER PCAP OR PUBLIC HEALTH PROGRAMS, TO FACILITATE PRIMARY CARE AND SPECIALTY SERVICES AND TO HELP REDUCE THE NUMBER OF AVOIDABLE HOSPITAL ADMISSIONS AND INAPPROPRIATE USE OF COMMUNITY EMERGENCY DEPARTMENTS.	MissionDescription
Significant New Program Services	false	SignificantNewProgramServices
Significant Change	false	SignificantChange
Expense	1007190	Expense
Grants	369892	Grants
Description	TO LINK LOW INCOME, UNINSURED RESIDENTS OF PIMA COUNTY WITH AN AFFORDABLE, COMPREHENSIVE AND COORDINATED NETWORK OF HEALTHCARE PROVIDERS.	Description
Total Program Service Expense	1007190	TotalProgramServiceExpense
Described In501 C3	true	DescribedIn501C3
Schedule B Required	true	ScheduleBRequired
Political Activities	false	PoliticalActivities
Lobbying Activities	false	LobbyingActivities
Subject To Proxy Tax	false	SubjectToProxyTax
Donor Advised Funds	false	DonorAdvisedFunds
Conservation Easements	false	ConservationEasements
Collections Of Art	false	CollectionsOfArt
Credit Counseling	false	CreditCounseling
Term Or Permanent Endowments	false	TermOrPermanentEndowments
Report Land Bldg Equip	false	ReportLandBldgEquip
Report Invest Oth Securities	false	ReportInvestOthSecurities
Report Prog Rel Invest	false	ReportProgRelInvest
Report Other Assets	false	ReportOtherAssets
Report Other Liabilities	false	ReportOtherLiabilities
Report Fin48 Footnote	false	ReportFin48Footnote
Independent Audit Financial Stmt	true	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	false	ConsolidatedAuditFinancialStmt
School	false	School
Foreign Office	false	ForeignOffice
Foreign Activities	false	ForeignActivities
More Than5000 K To Organizations	false	MoreThan5000KToOrganizations
More Than5000 K To Individuals	false	MoreThan5000KToIndividuals
Professional Fundraising	false	ProfessionalFundraising
Fundraising Activities	false	FundraisingActivities
Gaming	false	Gaming
Hospital	false	Hospital
Grants To Organizations	true	GrantsToOrganizations
Grants To Individuals	false	GrantsToIndividuals
Schedule J Required	false	ScheduleJRequired
Tax Exempt Bonds	false	TaxExemptBonds
Excess Benefit Transaction	false	ExcessBenefitTransaction
Prior Excess Benefit Transaction	false	PriorExcessBenefitTransaction
Loan To Officer Or DQP	false	LoanToOfficerOrDQP
Grant To Related Person	false	GrantToRelatedPerson
Bsnss Rltnshp With Organization	false	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	false	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	false	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	false	DeductibleNonCashContributions
Deductible Contributions Of Art	false	DeductibleContributionsOfArt
Terminated	false	Terminated
Partial Liquidation	false	PartialLiquidation
Disregarded Entity	false	DisregardedEntity
Related Entity	true	RelatedEntity
Related Org Controlled Entity	false	RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org	false	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	false	ActivitiesConductedPartnership
Schedule O Required	true	ScheduleORequired
Number Forms Transmitted With1096	15	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Number Of Employees	11	NumberOfEmployees
Employment Tax Returns Filed	true	EmploymentTaxReturnsFiled
Unrelated Business Income	false	UnrelatedBusinessIncome
Foreign Financial Account	false	ForeignFinancialAccount
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTrans
Taxable Party Notification	false	TaxablePartyNotification
Non Deductible Contributions	false	NonDeductibleContributions
Indoor Tanning Services	false	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	19	NbrVotingGoverningBodyMembers
Number Independent Voting Members	19	NumberIndependentVotingMembers
Family Or Business Relationship	false	FamilyOrBusinessRelationship
Delegation Of Management Duties	false	DelegationOfManagementDuties
Changes To Organizing Docs	false	ChangesToOrganizingDocs
Material Diversion Or Misuse	false	MaterialDiversionOrMisuse
Members Or Stockholders	false	MembersOrStockholders
Election Of Board Members	false	ElectionOfBoardMembers
Decisions Subject To Approval	false	DecisionsSubjectToApproval
Minutes Of Governing Body	true	MinutesOfGoverningBody
Minutes Of Committees	true	MinutesOfCommittees
Officer Mailing Address	false	OfficerMailingAddress
Local Chapters	false	LocalChapters
Form990 Provided To Governing Body	true	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	true	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	true	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	true	RegularMonitoringEnforcement
Whistleblower Policy	true	WhistleblowerPolicy
Document Retention Policy	true	DocumentRetentionPolicy
Compensation Process CEO	true	CompensationProcessCEO
Compensation Process Other	true	CompensationProcessOther
Investment In Joint Venture	false	InvestmentInJointVenture
States Where Copy Of Return Is Filed	AZ	StatesWhereCopyOfReturnIsFiled
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Field	Value	IRS element (for citing)
Name Person	THE ORGANIZATION	NamePerson
Telephone Number	5203092922	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	3480 E BRITANNIA DR SUITE 120	AddressLine1
City	TUCSON	City
State	AZ	State
ZIP Code	85706	ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (20 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Individual Trustee Or DirectorIndividualTrusteeOrDirector	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	OfficerOfficer
KIM BURTON
DIRECTOR	1.00	X	0	0	0
KATHY BYRNE
DIRECTOR	1.00	X	0	0	0
ANDREA CHIASSON
DIRECTOR	1.00	X	0	0	0
MIKE CODY
DIRECTOR	1.00	X	0	0	0
DAWN DANIEL
DIRECTOR	1.00	X	0	0	0
FRAN DRIVER
DIRECTOR	1.00	X	0	0	0
GAIL WINTERKORN
DIRECTOR	1.00	X	0	0	0
MARY KAEHLER
DIRECTOR	1.00	X	0	0	0
LIBBY LONERGAN
SECRETARY/TR	1.00	X	0	0	0
AMY BEITER
DIRECTOR	1.00	X	0	0	0
STEVE NASH
DIRECTOR	1.00	X	0	0	0
SUSIE NASH
VICE PRESIDE	1.00	X	0	0	0
KATHY SALOIS
DIRECTOR	1.00	X	0	0	0
ED SICURELLO
PRESIDENT	1.00	X	0	0	0
JAMES STOVER
DIRECTOR	1.00	X	0	0	0
CHRIS WILSEY
DIRECTOR	1.00	X	0	0	0
CLARENCE VATNE
DIRECTOR	1.00	X	0	0	0
HONEY PIVIROTTO
DIRECTOR	1.00	X	0	0	0
GINNY ROUNTREE
DIRECTOR	1.00	X	0	0	0
MICHAL GOFORTH
CEO	40.00		85000	0	22139	X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	85000	TotalReportableCompFromOrg
Total Other Compensation	22139	TotalOtherCompensation
Formers Listed	false	FormersListed
Total Comp GT150 K	false	TotalCompGT150K
Compensation From Other Sources	false	CompensationFromOtherSources
Government Grants	836528	GovernmentGrants
Total Contributions	836528	TotalContributions

Program Service Revenue ProgramServiceRevenue

Field	Value	IRS element (for citing)
Description	PATIENT SERVICES	Description
Business Code	624100	BusinessCode
Total Revenue Column	372780	TotalRevenueColumn
Related Or Exempt Function Income	372780	RelatedOrExemptFunctionIncome

Field	Value	IRS element (for citing)
Total Program Service Revenue	372780	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	1574	TotalRevenueColumn
Exclusion	$1,574	ExclusionAmount

Other Revenue Misc OtherRevenueMisc

Field	Value	IRS element (for citing)
Description	OTHER	Description
Business Code	624100	BusinessCode
Total Revenue Column	27106	TotalRevenueColumn
Related Or Exempt Function Income	27106	RelatedOrExemptFunctionIncome

Field	Value	IRS element (for citing)
Total Other Revenue	27106	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	1237988	TotalRevenueColumn
Related Or Exempt Function Income	399886	RelatedOrExemptFunctionIncome
Exclusion	$1,574	ExclusionAmount

Field	Value	IRS element (for citing)
Info In Schedule O Part IX	X	InfoInScheduleOPartIX

Grants To Domestic Orgs GrantsToDomesticOrgs

Field	Value	IRS element (for citing)
Total	369892	Total
Program Services	369892	ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	85150	Total
Program Services	62927	ProgramServices
Management And General	22223	ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	278631	Total
Program Services	171079	ProgramServices
Management And General	107552	ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	14832	Total
Program Services	9433	ProgramServices
Management And General	5399	ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	45553	Total
Program Services	31607	ProgramServices
Management And General	13946	ManagementAndGeneral

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	27609	Total
Program Services	18173	ProgramServices
Management And General	9436	ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	2180	Total
Program Services	1980	ProgramServices
Management And General	200	ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	12500	Total
Program Services	10100	ProgramServices
Management And General	2400	ManagementAndGeneral

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	171456	Total
Program Services	171456	ProgramServices

Advertising Advertising

Field	Value	IRS element (for citing)
Total	12000	Total
Program Services	12000	ProgramServices

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	9826	Total
Program Services	9426	ProgramServices
Management And General	400	ManagementAndGeneral

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	29421	Total
Program Services	29421	ProgramServices

Travel Travel

Field	Value	IRS element (for citing)
Total	343	Total
Program Services	265	ProgramServices
Management And General	78	ManagementAndGeneral

Insurance Insurance

Field	Value	IRS element (for citing)
Total	241	Total
Program Services	241	ProgramServices

Other Expenses OtherExpenses (4 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices	Management And GeneralManagementAndGeneral
OTHER	46960	46666	294
OTHER FEDERAL GRANT SUBAW	40116	40116
SUPPLIES	19795	18663	1132
ACCESS SERVICES	4305	3745	560

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	1170810	Total
Program Services	1007190	ProgramServices
Management And General	163620	ManagementAndGeneral
Fundraising	0	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	476748	BOY
EOY	579417	EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

Field	Value	IRS element (for citing)
BOY	246180	BOY
EOY	245876	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	3087	BOY
EOY	12507	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	726015	BOY
EOY	837800	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	61232	BOY
EOY	105839	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	61232	BOY
EOY	105839	EOY

Field	Value	IRS element (for citing)
Follow SFAS117	X	FollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	664783	BOY
EOY	731961	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	664783	BOY
EOY	731961	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	726015	BOY
EOY	837800	EOY

Field	Value	IRS element (for citing)
Reconcilation Revenue Expenses	67178	ReconcilationRevenueExpenses
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	false	AccountantCompileOrReview
FS Audited	true	FSAudited

FS Audited Basis FSAuditedBasis

Field	Value	IRS element (for citing)
Financial Statement Separate	X	FinancialStatementSeparate

Field	Value	IRS element (for citing)
Audit Committee	true	AuditCommittee
Federal Grant Audit Required	true	FederalGrantAuditRequired
Federal Grant Audit Performed	true	FederalGrantAuditPerformed

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Publicly Supported Org509a2	X	PubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	552589	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	388015	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	746554	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	775379	CurrentTaxYearMinus1Year
Current Tax Year	836528	CurrentTaxYear
Total	3299065	Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	239748	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	326688	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	346890	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	401008	CurrentTaxYearMinus1Year
Current Tax Year	399886	CurrentTaxYear
Total	1714220	Total

Total509 Total509

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	792337	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	714703	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	1093444	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	1176387	CurrentTaxYearMinus1Year
Current Tax Year	1236414	CurrentTaxYear
Total	5013285	Total

Amts From Subst Contributors AmtsFromSubstContributors

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	231666	CurrentTaxYearMinus4Years
Total	231666	Total

Support From DQ Ps Etc SupportFromDQPsEtc

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	231666	CurrentTaxYearMinus4Years
Total	231666	Total

Field	Value	IRS element (for citing)
Public Support Total509	4781619	PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	15836	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	3463	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	1542	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	1567	CurrentTaxYearMinus1Year
Current Tax Year	1574	CurrentTaxYear
Total	23982	Total

Investment Income And UBTI InvestmentIncomeAndUBTI

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	15836	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	3463	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	1542	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	1567	CurrentTaxYearMinus1Year
Current Tax Year	1574	CurrentTaxYear
Total	23982	Total

Total Support Total TotalSupportTotal

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	808173	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	718166	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	1094986	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	1177954	CurrentTaxYearMinus1Year
Current Tax Year	1237988	CurrentTaxYear
Total	5037267	Total

Field	Value	IRS element (for citing)
Public Support Percentage509	0.94920	PublicSupportPercentage509
Prior Year Support Percentage	0.88510	PriorYearSupportPercentage
Investment Income Percentage	0.00000	InvestmentIncomePercentage
Prior Yr Invest Income Percentage	0.01000	PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509	X	ThirtyThreePercntTestsCY509

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

Field	Value	IRS element (for citing)
Contributor Number	RESTRICTED	ContributorNumber

Contributor Name Business ContributorNameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor Address US ContributorAddressUS

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Aggregate Contributions	RESTRICTED	AggregateContributions

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Tot Revenue Etc Audited Fincl Stmt	1237988	TotRevenueEtcAuditedFinclStmt
Revenue Subtotal	1237988	RevenueSubtotal
Total Revenue Per Form990	1237988	TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt	1170810	TotExpensesEtcAuditedFinclStmt
Expenses Subtotal	1170810	ExpensesSubtotal
Total Expenses Per Form990	1170810	TotalExpensesPerForm990

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Records Maintained	true	RecordsMaintained

Recipient Table RecipientTable (11 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EIN Of RecipientEINOfRecipient	IRC SectionIRCSection	Amount Of Cash GrantAmountOfCashGrant	Method Of ValuationMethodOfValuation	Description Of Non Cash AssistanceDescriptionOfNonCashAssistance	Purpose Of GrantPurposeOfGrant
DESERT SENITA COMMUNITY HEALTH CENT
410 N MALACATE ST	AJO	AZ	85321	860871311	3	17802	FMV	N/A	CHILD HEALTH ASSIST
MARIPOSA COMMUNITY HEALTH CENTER
1852 N MASTICK WAY	NOGALES	AZ	85621	860524321	3	32698	FMV	N/A	CHILD HEALTH ASSIST
CATHOLIC COMMUNITY SERVICES OF SOUT
140 W SPEEDWAY BLVD SUITE 230	TUCSON	AZ	85705	860100880	3	16935	FMC	N/A	CHILD HEALTH ASSIST
UNITED WAY OF TUCSON AND SOUTHERN
330 N COMMERCE PARK LOOP STE 200	TUCSON	AZ	85745	860098932	3	50533	FMV	N/A	CHILD HEALTH ASSIST
CHILDREN'S ACTION ALLIANCE
4001 N 3RD STREET SUITE 160	PHOENIX	AZ	85012	860594785	3	127967	FMV	N/A	CHILD HEALTH ASSIST
EL RIO SANTA CRUZ NEIGHBORHOOD
839 W CONGRESS STREET	TUCSON	AZ	85745	860285857	3	8965	FMV	N/A	CHILD HEALTH ASSIST
MARANA HEALTH CENTER INC
13395 N MARANA MAIN ST	MARANA	AZ	85653	866053462	3	26752	FMV	N/A	CHILD HEALTH ASSIST
CARONDELET HEALTH NETWORK
2202 N FORBES BLVD	TUCSON	AZ	85745	860455920	3	24275	FMV	N/A	CHILD HEALTH ASSIST
UNITED COMMUNITY HEALTH CENTER
1260 S CAMPBELL AVE 2	GREEN VALLEY	AZ	85614	942905416	3	18418	FMV	N/A	CHILD HEALTH ASSIST
EMPOWERMENT SYSTEMS INC
2066 W APACHE TRAIL SUITE 116	APACHE JUNCTION	AZ	85120	860664708	3	27400	FMV	N/A	CHILD HEALTH ASSIST
PIMA COUNTY
130 W CONGRESS 6TH FLOOR	TUCSON	AZ	85701		GOV	13460	FMV	N/A	CHILD HEALTH ASSIST

Field	Value	IRS element (for citing)
Total Nbr Of501 C3 And Govt Grants	11	TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations	1	TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

Field	Value	IRS element (for citing)
Identifier	PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS INSIDE THE UNITED STATES	Identifier
Return Reference	SCHEDULE I, PAGE 1, PART I, LINE 2	ReturnReference
Explanation	THE ORGANIZATION RECEIVES INVOICES AND SUPPORTING DOCUMENTATS OF REQUESTS FOR REIMBURSEMENTS FROM GRANT RECIPIENTS. THE ORGANIZATION ALSO CONDUCTS SITE VISITS OF GRANT RECIPIENTS.	Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (7 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
ORGANIZATION'S MISSION	FORM 990 - ORGANIZATION'S MISSION	PCAP PROVIDES AN EFFECTIVE, COORDINATED SYSTEM FOR ACCESSING COMPREHENSIVE HEALTH CARE AT HIGHLY DISCOUNTED RATES FOR ALL LOW INCOME, UNINSURED RESIDENTS OF PIMA AND SANTA CRUZ COUNTIES. THE GOAL IS TO IMPROVE HEALTH CARE OUTCOMES, TO REDUCE UNCOMPENSATED CARE AND TO FACILITATE EQUITABLE DISTRIBUTION OF CARE FOR OUR TARGETED POPULATION AMONG PROVIDERS IN OUR COMMUNITY. PCAP'S MISSION IS TO PROMOTE THE HEALTH OF MEDICALLY UNDERSERVED INDIVIDUALS AND FAMILIES BY ENROLLING ALL WHO ARE ELIGIBLE IN EITHER PCAP OR PUBLIC HEALTH PROGRAMS, TO FACILITATE PRIMARY CARE AND SPECIALTY SERVICES AND TO HELP REDUCE THE NUMBER OF AVOIDABLE HOSPITAL ADMISSIONS AND INAPPROPRIATE USE OF COMMUNITY EMERGENCY DEPARTMENTS.
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990	FORM 990, PAGE 6, PART VI, LINE 11B	THE CEO WILL REVIEW THE TAX RETURN. THEN THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS WILL REVIEW THE TAX RETURN AND MAKE A MOTION TO THE FULL BOARD. THE FULL BOARD WILL APPROVE AT THE BOARD MEETING. IF MEETING IS NOT AVAILABLE, THE TAX RETURN WILL BE SUBMITTED VIA EMAIL TO THE EXECUTIVE COMMITTEE MEMBERS AND THEN REVIEWED AND APPROVED VIA EMAIL.
ENFORCEMENT OF CONFLICTS POLICY	FORM 990, PAGE 6, PART VI, LINE 12C	AT THE ANNUAL BOD MEETING THERE IS A CALL FOR DIRECTORS OR OFFICERS TO DECLARE ANY CONFLICT OF INTEREST AND IT IS SO NOTED IN THE MINUTES OF THE ANNUAL MEETING AND DURING THE YEAR IF A CONFLICT ARISES IT IS DISCLOSED AT THE TIME.
COMPENSATION PROCESS FOR TOP OFFICIAL	FORM 990, PAGE 6, PART VI, LINE 15A	THE PROCESS FOR DETERMINING COMPENSATION OF THE KEY EMPLOYEES INCLUDE A REVIEW AND APPROVAL BASED ON COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT AND COMPENSATION SURVEY OR STUDY.
COMPENSATION PROCESS FOR OFFICERS	FORM 990, PAGE 6, PART VI, LINE 15B	THE PROCESS FOR DETERMINING COMPENSATION OF THE KEY EMPLOYEES INCLUDE A REVIEW AND APPROVAL BASED ON COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT AND COMPENSATION SURVEY OR STUDY.
GOVERNING DOCUMENTS DISCLOSURE EXPLANATION	FORM 990, PAGE 6, PART VI, LINE 19	CURRENTLY IT IS AVAILABLE UPON REQUEST- WE DO SHARE WITH ALL OUR CONTRACTORS
OTHER FEES FOR SERVICES	FORM 990, PART IX, LINE 11G	OUTSIDE SERVICES 171,456 0 0

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

Field	Value	IRS element (for citing)
Business Name Line1	EL RIO SANTA CRUZ NEIGHBORHOOD	BusinessNameLine1
Business Name Line2	HEALTH CENTER INC	BusinessNameLine2

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	839 W CONGRESS STREET	AddressLine1
City	TUCSON	City
State	AZ	State
ZIP Code	85745	ZIPCode

Field	Value	IRS element (for citing)
EIN	860285857	EIN
Primary Activities	HEALTHCARE	PrimaryActivities
Legal Domicile State	AZ	LegalDomicileState
Exempt Code Section	3	ExemptCodeSection
Public Charity Status	7	PublicCharityStatus
Direct Controlling Entity NA	N/A	DirectControllingEntityNA
Controlled Org	false	ControlledOrg

Field	Value	IRS element (for citing)
Receipt Of Int Ann Rents Royalties	false	ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org	false	GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org	false	GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org	false	LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org	false	LoansOrGuaranteesFromOtherOrg
Dividends Related Organization	false	DividendsRelatedOrganization
Sale Of Assets To Other Org	false	SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org	false	PurchaseOfAssetsFromOtherOrg
Exchange Of Assets	false	ExchangeOfAssets
Rental Of Facilities To Other Orgs	false	RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs	false	RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs	false	PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs	false	PerformOfServicesByOtherOrgs
Sharing Of Facilities	false	SharingOfFacilities
Sharing Of Paid Employees	false	SharingOfPaidEmployees
Reimbursement Paid To Other Org	true	ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org	false	ReimbursementPaidByOtherOrg
Other Transfer To Other Org	false	OtherTransferToOtherOrg
Other Transfer From Other Org	false	OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

Field	Value	IRS element (for citing)
Business Name Line1	EL RIO SANTA CRUZ	BusinessNameLine1

Field	Value	IRS element (for citing)
Transaction Type	P	TransactionType
Amount Involved	695695	AmountInvolved
Method Of Amt Determination	AMOUNT ACTUALLY PAID	MethodOfAmtDetermination

PIMA COMMUNITY ACCESS PROGRAM: Form 990, tax year 2012

Return header ReturnHeader

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

Preparer Firm US Address PreparerFirmUSAddress

Filer Filer

Name Name

US Address USAddress

Officer Officer

Preparer Preparer

Form 990 IRS990

Address Principal Officer US AddressPrincipalOfficerUS

The Books Are In Care Of TheBooksAreInCareOf

Address US AddressUS

Form990 Part VII Section A Form990PartVIISectionA (20 entries)

Program Service Revenue ProgramServiceRevenue

Investment Income InvestmentIncome

Other Revenue Misc OtherRevenueMisc

Total Revenue TotalRevenue

Grants To Domestic Orgs GrantsToDomesticOrgs

Comp Current Officers Directors CompCurrentOfficersDirectors

Other Salaries And Wages OtherSalariesAndWages

Pension Plan Contributions PensionPlanContributions

Other Employee Benefits OtherEmployeeBenefits

Payroll Taxes PayrollTaxes

Fees For Services Legal FeesForServicesLegal

Fees For Services Accounting FeesForServicesAccounting

Fees For Services Other FeesForServicesOther

Advertising Advertising

Office Expenses OfficeExpenses

Occupancy Occupancy

Travel Travel

Insurance Insurance

Other Expenses OtherExpenses (4 entries)

Total Functional Expenses TotalFunctionalExpenses

Cash Non Interest Bearing CashNonInterestBearing

Pledges And Grants Receivable PledgesAndGrantsReceivable

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Total Assets TotalAssets

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Total Liabilities TotalLiabilities

Unrestricted Net Assets UnrestrictedNetAssets

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FS Audited Basis FSAuditedBasis

Schedule A IRS990ScheduleA

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

Gross Receipts From Admissions GrossReceiptsFromAdmissions

Total509 Total509

Amts From Subst Contributors AmtsFromSubstContributors

Support From DQ Ps Etc SupportFromDQPsEtc

Gross Investment Income509 GrossInvestmentIncome509

Investment Income And UBTI InvestmentIncomeAndUBTI

Total Support Total TotalSupportTotal

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

Contributor Name Business ContributorNameBusiness

Contributor Address US ContributorAddressUS

Schedule D IRS990ScheduleD

Schedule I IRS990ScheduleI

Recipient Table RecipientTable (11 entries)

Form990 Schedule I Part IV Form990ScheduleIPartIV

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (7 entries)

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

Address US AddressUS

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

Comments