2012-10-30T16:09:12-05:00 2011-12-31 721396621 CARR RIGGS & INGRAM LLC 4210 SPICEWOOD SPRINGS RD STE 108 AUSTIN TX 787598653 990 2011-01-01 311624871 INTEGRATED CARE COLLABORATION INTE 5128042090 8627 N MOPAC NO 140 AUSTIN TX 78759 CARL D ANGEL 5128042090 2012-10-22 1 K DALE COOPER P00142251 5123461880 2011 2016-02-24 21:20:13Z CARL D ANGEL 8627 N MOPAC NO 140 AUSTIN TX 78759 4923620 0 X WWW.ICC-CENTEX.ORG X 1998 TX THE ICC IS AN ALLIANCE OF HEALTH CARE SAFETY NET PROVIDERS THAT WORK TOGETHER TO IMPROVE THE EFFICIENCY AND QUALITY OF HEALTH CARE SERVICES AVAILABLE FOR UNINSURED INDIVIDUALS IN CENTRAL TEXAS (WILLIAMSON, TRAVIS, AND HAYS COUNTIES). ICC ACTS AS A CONVENER AND INCUBATOR AND IS NOT A HEALTH PROVIDER. 5 5 0 0 0 0 34947 0 1555697 4922783 20 837 0 0 1590664 4923620 0 0 0 0 693022 942949 0 0 38215 913494 1180655 1606516 2123604 -15852 2800016 242377 3895815 429438 1282860 -187061 2612955 X THE ICC IS AN ALLIANCE OF HEALTH CARE SAFETY NET PROVIDERS THAT WORK TOGETHER TO IMPROVE THE EFFICIENCY AND QUALITY OF HEALTH CARE SERVICES AVAILABLE FOR UNINSURED INDIVIDUALS IN CENTRAL TEXAS (WILLIAMSON, TRAVIS, AND HAYS COUNTIES). ICC ACTS AS A CONVENER AND INCUBATOR AND IS NOT A HEALTH PROVIDER. 0 0 882572 2461392 ICARE SYSTEM/HEALTH INFORMATION TECHNOLOGY: ICC OWNS, MAINTAINS, AND OPERATES A REGIONAL HIE CALLED THE ICARE 2.0 SYSTEM. THE NEW SYSTEM ALLOWS THE ICC AND ITS MEMBERS TO:-ACHIEVE MEANINGFUL USE STANDARDS BY MAXIMIZING MEMBER OPPORTUNITIES TO DEMONSTRATE MEANINGFUL USE OF INFORMATION EXCHANGE, CARE COORDINATION AND PUBLIC HEALTH PARTICIPATION THROUGH HIE.-EXPAND AND ENHANCE CARE COORDINATION PROGRAMS.-IMPROVE HEALTH OUTCOMES AND COMMUNITY HEALTH.-EXPAND AND ENHANCE RESEARCH AND EVALUATION CAPABILITIES.-MEET THE GOALS OF THE STATE OF TEXAS STRATEGIC HIE PLAN TO CONNECT 80% OF PHYSICIANS AND HOSPITAL IN A 47 COUNTY REGION. 176515 492278 ACCESS AND COMMUNITY COLLABORATION: ICC FACILITATES COMMUNITY BASED ENROLLMENT FOR INCREASED ACCESS AND COMMUNITY INTEGRATION. ICC MEMBERS HAVE ACCESS TO A COMMON ELIGIBILITY PROGRAM, MEDICAIDER, THROUGH WHICH PATIENTS ARE SCREENED FOR ELIGIBILITY FOR THIRD PARTY FUNDING AND FEDERAL, STATE AND LOCAL HEALTH COVERAGE PROGRAMS. THE PATIENT PRESCRIPTION ASSISTANCE PROGRAM (PPAP) IS ALSO AVAILABLE TO MEMBERS. 706058 1969113 MEMBER ANALYTICS TO SUPPORT COMMUNITY COLLABORATION: ICARE 2.0 INCLUDES A ROBUST DATA WAREHOUSE AND ANALYTICS SOLUTION THAT FACILITATES PERFORMANCE-BASED OUTCOMES AND VALIDATED PATIENT INFORMATION WHICH DRIVES EVIDENCE-BASED PROGRAMS. THE SOLUTION ALSO SUPPORTS COMMUNITY HEALTH RESEARCH BY TRACKING POPULATION CARE PATTERNS, MEASURING EFFECTS OF PUBLIC POLICY CHANGES AND IDENTIFYING HEALTHCARE UTILIZATION PATTERNS. ICC ANALYTICS PROVIDE VALUABLE DATA THAT HELPS TO INCREASE ACCESS TO CARE, IMPROVE CARE COORDINATION AND PROVIDE MORE EFFICIENT AND APPROPRIATE CARE. 1765145 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 15 0 1 0 0 0 0 0 0 0 0 0 0 0 X 5 5 0 0 0 0 1 0 0 1 1 0 0 0 1 1 1 1 1 1 1 0 X EDIE MORRIS 5128042090 8627 N MOPAC SUITE 140 AUSTIN TX 78759 X CHARLES BARNETT 0.00 X 0 0 0 PETE PERIALAS 0.00 X 0 0 0 TRISH YOUNG BROWN 0.00 X 0 0 0 DAVID EVANS 0.00 X 0 0 0 EARL MAXWELL 0.00 X 0 0 0 CARL D ANGEL 32.00 X 0 0 0 CAROLE TAMAYO 40.00 X 132268 0 0 132268 0 0 1 0 0 0 CENTEX SYSTEMS SUPPORT SERVICES 8627 N MOPAC STE 350 AUSTIN TX 78759 PURCHASE OF UPGRADED HIE AND RELATED EQU 2973386 LONE STAR CIRCLE OF CARE 205 E UNIVERSITY AVE STE 200 GEORGETOWN TX 78626 REIMBURSEMENT FOR PAYROLL AND BENEFITS A 710736 ATCICMHMR PO BOX 3548 AUSTIN TX 78764 REIMBURSEMENT FOR PAYROLL AND BENEFITS 469622 NETWORK SCIENCES 14205 BURNET RD STE 110 AUSTIN TX 78728 MEDICAIDER PRODUCT & SERVICES 329750 ASCENSION HEALTH PO BOX 45998 ST LOUIS MO 63145 HOSTING OF AND SUPPORT FOR ICARE DATA RE 190391 5 HIE MEMBER FUNDING 519100 2650000 2650000 MEMBERSHIP FEES 519100 1635095 1635095 HIE U.S DHHS FUNDING 519100 637688 637688 4922783 837 837 4923620 4922783 0 837 156446 118899 32854 4693 599007 455246 125791 17970 156025 118579 32765 4681 31471 23918 6609 944 20008 19208 800 344736 322031 22705 1595 1212 335 48 20545 15614 4315 616 480780 456456 24297 27 96868 73620 20342 2906 6626 5036 1391 199 1049 797 221 31 423 321 89 13 199395 151540 41873 5982 5120 5120 DUES AND LICENSES 2881 2190 605 86 MISCELLANEOUS 504 383 106 15 STAFF DEVELOPMENT 125 95 26 4 2123604 1765145 320244 38215 92350 73368 133270 859421 1250 3194884 233108 12091 2961776 4666 0 242377 3895815 124708 568895 300000 697627 4730 16338 429438 1282860 X -187061 2612955 -187061 2612955 242377 3895815 2800016 0 X X 0 1 1 X 1 1 X 232593 311851 126000 34947 637688 1343079 232593 311851 126000 34947 637688 1343079 352662 990417 29304 12145 1532 20 837 43838 3264 1655 4919 1391836 9614542 0.71160 0.65100 X 3194884 233108 2961776 2961776 DEFERRED RENT EXPENSE 16338 16338 4923620 2123604 2800016 2800016 5151597 227977 227977 4923620 0 4923620 2351581 227977 227977 2123604 0 2123604 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: FOOTNOTE TO FINANCIAL STATEMENTS REGARDING INCOME TAX STATUS: ICC QUALIFIES AS TAX-EXEMPT UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. CONSEQUENTLY, THE ACCOMPANYING FINANCIAL STATEMENTS DO NOT REFLECT ANY PROVISIONS FOR INCOME TAXES. ICC HAS TAKEN NO UNCERTAIN TAX POSITIONS DURING OR FOR THE YEAR ENDED DECEMBER 31, 2011. ICC CONTINUALLY EVALUATES THE TAX EFFECTS OF EXPIRING STATUTES OF LIMITATIONS, AUDITS, PROPOSED SETTLEMENTS, CHANGES IN TAX LAW, AND NEW AUTHORITATIVE RULINGS. IN ADDITION, TAX YEARS 2011, 2010, AND 2009 ARE OPEN TAX YEARS SUBJECT TO EXAMINATION BY THE IRS FOR WHICH ICC COULD BE LIABLE. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION HAS MEMBERS, WHO ARE THE SAFETY NET PROVIDERS BELONGING TO THE ALLIANCE. FORM 990, PART VI, SECTION B, LINE 11 FORM 990 IS REVIEWED BY THE BOARD TREASURER AND IS LATER PRESENTED AT THE NEXT BOARD MEETING FOR APPROVAL. FORM 990, PART VI, SECTION B, LINE 12C THE OFFICERS, DIRECTOR AND KEY EMPLOYEES ARE REQUIRED ANNUALLY TO SUBMIT A SIGNED STATEMENT AFFIRMING THAT THE POLICY HAS BEEN REVIEWED AND COMPLIED WITH. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD EVALUATES AND APPROVES ALL NEW EMPLOYEES' SALARIES. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AVAILABLE ON REQUEST. FORM 990, PART VII, PAGE 7 ICC PERSONNEL ARE PAID THROUGH LONESTAR CIRCLE OF CARE AND AUSTIN TRAVIS COUNTY INTEGRAL CARE VIA A CONTRACTUAL ARRANGEMENT BETWEEN THE TWO ENTITIES. ALL SALARIES AND BENEFITS ARE PAID BY LONESTAR CIRCLE OF CARE AND AUSTIN TRAVIS COUNTY INTEGRAL CARE AND ARE THEN INVOICED TO THE ICC. WHEN THE ICC PAYS THESE INVOICES, THE EXPENSES ARE CODED TO THE APPROPRIATE ACCOUNTS SUCH AS SALARY EXPENSE AND BENEFIT EXPENSE. ICC DOES NOT ISSUE W-2'S OR A W-3; ALL ARE ISSUED THROUGH LONESTAR CIRCLE OF CARE AND AUSTIN TRAVIS COUNTY INTEGRAL CARE. HOWEVER, COMPENSATION FOR THE EXECUTIVE DIRECTOR AND EMPLOYEES PAID OVER $100,000 ARE BEING REFLECTED IN COLUMNS (D) AND (F). COMMITTEE FOR AUDIT, REVIEW, AND OVERSIGHT COMPILATION FORM 990, PAGE 12, PART XII, LINE 2C THIS SELECTION INDICATES THE PRESENCE OF A COMMITTEE FOR OVERSIGHT OF AUDIT, REVIEW, AND COMPILATION PROJECTS. THIS DOES NOT REPRESENT A CHANGE FROM PRIOR YEARS ALTHOUGH THE SAME SELECTION WAS INADVERTENTLY NOT MADE ON THE 2010 RETURN.