FURP.ORG / PUBLIC DATA EXPLORER

SAN BENITO HEALTH FOUNDATION: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
SAN BENITO HEALTH FOUNDATION (EIN 94-2299959)
Tax period
2010-07-01 to 2011-06-30
Filed
2012-03-01
IRS object ID
201230619349301988
Schema version
2010v3.4
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 ReturnHeader

FieldValueIRS element (for citing)
Timestamp2012-03-01T14:51:49-06:00Timestamp
Tax Period End Date2011-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1BKD LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1910 E ST LOUIS 200/PO BOX 1190AddressLine1
CitySPRINGFIELDCity
StateMOState
ZIP Code658062523ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN942299959EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1SAN BENITO HEALTH FOUNDATIONBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlSANBNameControl
Phone8316375306Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1351 FELICE DRAddressLine1
CityHOLLISTERCity
StateCAState
ZIP Code95023ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameROSA VIVIAN FERNANDEZName
TitlePRESIDENT & CEOTitle
Date Signed2012-01-28DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameBrian D ToddName
Phone4178658701Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonROSA VIVIAN FERNANDEZNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1351 FELICE DRIVEAddressLine1
CityHOLLISTERCity
StateCAState
ZIP Code950233361ZIPCode
FieldValueIRS element (for citing)
Gross Receipts4964628GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteN/AWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1975YearFormation
State Legal DomicileCAStateLegalDomicile
Activity Or Mission DescriptionPROVISION OF PRIMARY MEDICAL, DENTAL, ANCILLARY, AND WOMEN, INFANT AND CHILDREN (WIC) SERVICES. SEE SCHEDULE O FOR MORE INFORMATION.ActivityOrMissionDescription
Nbr Voting Members Governing Body8NbrVotingMembersGoverningBody
Nbr Independent Voting Members8NbrIndependentVotingMembers
Total Nbr Employees58TotalNbrEmployees
Total Nbr Volunteers8TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year2573178ContributionsGrantsPriorYear
Contributions Grants Current Year2272256ContributionsGrantsCurrentYear
Program Service Revenue Prior Year2949125ProgramServiceRevenuePriorYear
Program Service Revenue CY2683634ProgramServiceRevenueCY
Investment Income Prior Year10779InvestmentIncomePriorYear
Investment Income Current Year8738InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year5533082TotalRevenuePriorYear
Total Revenue Current Year4964628TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year2484474SalariesEtcPriorYear
Salaries Etc Current Year2219398SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year2083269OtherExpensePriorYear
Other Expenses Current Year2792457OtherExpensesCurrentYear
Total Expenses Prior Year4567743TotalExpensesPriorYear
Total Expenses Current Year5011855TotalExpensesCurrentYear
Revenues Less Expenses Prior Year965339RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-47227RevenuesLessExpensesCY
Total Assets BOY4543726TotalAssetsBOY
Total Assets EOY4337619TotalAssetsEOY
Total Liabilities BOY1379968TotalLiabilitiesBOY
Total Liabilities EOY1221088TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY3163758NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY3116531NetAssetsOrFundBalancesEOY
Mission DescriptionTHE MISSION OF SAN BENITO HEALTH FOUNDATION IS TO PROVIDE QUALITY, AFFORDABLE PRIMARY HEALTH CARE, DENTAL CARE, AND OTHER PUBLIC HEALTH SERVICES.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense2484825Expense
Revenue1913020Revenue
DescriptionTO PROVIDE QUALITY AND AFFORDABLE HEALTHCARE TO QUALIFYING FAMILIES OF HOLLISTER, CALIFORNIA, AND THE SURROUNDING AREA. FOR THE YEAR ENDED JUNE 30, 2011, 20,029 MEDICAL VISITS WERE PROVIDED, WITH MEDICAL SERVICES FUNCTIONING AS THE LARGEST PROGRAM SERVICE AREA. MEDICAL SERVICES INCLUDE PREVENTATIVE MEDICINE, INTERNAL MEDICINE, OBSTETRICS & GYNECOLOGY, FAMILY PLANNING, PEDIATRICS, IMMUNIZATION & HEALTH SCREENING SERVICES, NUTRITION COUNSELING, AND HIV/AIDS TESTING & COUNSELING.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense660844Expense
Revenue0Revenue
DescriptionWOMEN, INFANT AND CHILDREN (WIC) SERVICES IS A SIGNIFICANT PROGRAM AREA FOR THE ORGANIZATION. FOR THE YEAR ENDED JUNE 30, 2011, A MONTHLY CASE LOAD OF 2,456 AND ANNUAL SERVICE POPULATION OF 29,601 CASE LOADS WERE MAINTAINED.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense1100141Expense
Revenue770614Revenue
DescriptionDENTAL SERVICES FOR CHILDREN AND ADULTS ARE OFFERED AT SAN BENITO HEALTH FOUNDATION, AND FOR THE YEAR ENDED JUNE 30, 2011, 13,630 VISITS WERE PROVIDED.Description
FieldValueIRS element (for citing)
Total Program Service Expense4245810TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiesfalseReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmttrueIndependentAuditFinancialStmt
Consolidated Audit Financial StmtfalseConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionstrueDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntityfalseRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With109615NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees58NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members8NbrVotingGoverningBodyMembers
Number Independent Voting Members8NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocstrueChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledCAStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonROSA VIVIAN FERNANDEZNamePerson
Telephone Number8316375783TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1351 FELICE DRIVEAddressLine1
CityHOLLISTERCity
StateCAState
ZIP Code95023ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (14 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
VICTORIA VASQUEZ
BOARD CHAIR1.0XX000
EUSEBIO RIVERA
BOARD MEMBER 10/2010 - 06/20111.0X000
ISABEL FLETES
BOARD MEMBER1.0X000
MONICA MARSHALL
BOARD SECRETARY1.0XX000
VICKY MONTOYA
VICE CHAIR1.0XX000
JIM GIBSON
BOARD TREASURER1.0XX000
NATALIE VELAZQUEZ
BOARD MEMBER1.0X000
BONITA VILLALOBOS-RIVERA
BOARD MEMBER BEG 05/20111.0X000
ROSA VIVIAN FERNANDEZ
PRESIDENT & CEO40.0X164728014223
JUMNAH THANAPATHY
CHIEF MEDICAL OFFICER24.0234846030161X
EDWIN ACOSTA
CHIEF DENTAL OFFICER30.010355806725X
SONALI SHAH
PHYSICIAN40.016865705424X
PATRICIA CLARKE
PHYSICIAN32.011797700X
MANU CHAUDHRY
DENTIST40.010932106479X
FieldValueIRS element (for citing)
Total Reportable Comp From Org899087TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation63012TotalOtherCompensation
Number Individuals GT100 K6NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (2 entries)

Description Of ServicesDescriptionOfServicesCompensationCompensation
BKD LLP
CONSULTING, TAX200587
GODOFREDO TORRES
PHYSICIAN127822
FieldValueIRS element (for citing)
Number Of Contractors GT100 K2NumberOfContractorsGT100K
Government Grants1750503GovernmentGrants
All Other Contributions521753AllOtherContributions
Noncash Contributions369681NoncashContributions
Total Contributions2272256TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
NET PATIENT SERVICE REVENUE62410026054572605457
OTHER INCOME6241007817778177
FieldValueIRS element (for citing)
Total Program Service Revenue2683634TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column8738TotalRevenueColumn
Exclusion$8,738ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Total Other Revenue0TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column4964628TotalRevenueColumn
Related Or Exempt Function Income2683634RelatedOrExemptFunctionIncome
Exclusion$8,738ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total443958Total
Program Services265007ProgramServices
Management And General178951ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total1422076Total
Program Services1268298ProgramServices
Management And General153778ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total23269Total
Program Services23089ProgramServices
Management And General180ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total189286Total
Program Services154365ProgramServices
Management And General34921ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total140809Total
Program Services116947ProgramServices
Management And General23862ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total21066Total
Management And General21066ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total248477Total
Program Services160683ProgramServices
Management And General87794ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total515040Total
Program Services468295ProgramServices
Management And General46745ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total42982Total
Program Services39988ProgramServices
Management And General2994ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total294644Total
Program Services215893ProgramServices
Management And General78751ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total98430Total
Program Services72787ProgramServices
Management And General25643ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total81990Total
Program Services62824ProgramServices
Management And General19166ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total30325Total
Program Services30325ProgramServices

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total39593Total
Program Services25301ProgramServices
Management And General14292ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total66716Total
Program Services44777ProgramServices
Management And General21939ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total213920Total
Program Services180148ProgramServices
Management And General33772ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total61303Total
Program Services57012ProgramServices
Management And General4291ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
BAD DEBT288460288460
LICENSES, DUES & SUBSCRIPTIONS21889170224867
RECRUITING24722012460
MEDICAL SUPPLIES & DRUGS647914647914
REPAIRS & MAINTENANCE71032625188514

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total46204Total
Program Services42145ProgramServices
Management And General4059ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total5011855Total
Program Services4245810ProgramServices
Management And General766045ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY800BOY
EOY800EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY1084906BOY
EOY740023EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY525951BOY
EOY469235EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY236418BOY
EOY161756EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY59672BOY
EOY111856EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY38259BOY
EOY56976EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis4455036LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec1658063LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY2597720BOY
EOY2796973EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY4543726BOY
EOY4337619EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY239787BOY
EOY285461EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY1074493BOY
EOY935627EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY65688BOY
EOY0EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY1379968BOY
EOY1221088EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY3163758BOY
EOY3116531EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY3163758BOY
EOY3116531EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY4543726BOY
EOY4337619EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses-47227ReconcilationRevenueExpenses
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit RequiredtrueFederalGrantAuditRequired
Federal Grant Audit PerformedtrueFederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org170b1 AviXPubliclySupportedOrg170b1Avi

Gifts Grants Contrib Received170 GiftsGrantsContribReceived170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years956075CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years1848006CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years1868579CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year2573178CurrentTaxYearMinus1Year
Current Tax Year2272256CurrentTaxYear
Total9518094Total

Total170 Total170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years956075CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years1848006CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years1868579CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year2573178CurrentTaxYearMinus1Year
Current Tax Year2272256CurrentTaxYear
Total9518094Total
FieldValueIRS element (for citing)
Public Support Total1709518094PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years13851CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years19848CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years18014CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year10779CurrentTaxYearMinus1Year
Current Tax Year8738CurrentTaxYear
Total71230Total

Other Income170 OtherIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years4418CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years20CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years40482CurrentTaxYearMinus2Years
Total44920Total
FieldValueIRS element (for citing)
Total Support9634244TotalSupport
Gross Receipts From Admissions Etc11753054GrossReceiptsFromAdmissionsEtc
Public Support Pertcentage1700.98794PublicSupportPertcentage170
Public Support Pertcent Prior Year0.98315PublicSupportPertcentPriorYear
Thirty Three Percnt Tests CY170XThirtyThreePercntTestsCY170

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbying
Total Direct LobbyingTotalDirectLobbying
Total Lobbying ExpendituresTotalLobbyingExpenditures
Other Exempt Purpose ExpendituresOtherExemptPurposeExpenditures
Total Exempt Purpose ExpendituresTotalExemptPurposeExpenditures
Lobbying NontaxableLobbyingNontaxableAmount
Grassroots NontaxableGrassrootsNontaxableAmount
Tot Lobbying Grassroot Minus Non TxTotLobbyingGrassrootMinusNonTx
Tot Lobby Expend Mns Lobbying NontxTotLobbyExpendMnsLobbyingNontx
VolunteersfalseVolunteers
Paid Staff Or ManagementfalsePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MembersfalseMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationsfalseGrantsOtherOrganizations
Direct Contact LegislatorsfalseDirectContactLegislators
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiestrueOtherActivities
Not Described In501c3falseNotDescribedIn501c3
Form4720 Filed4912 TaxfalseForm4720Filed4912Tax

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierOTHER ACTIVITIESIdentifier
Return ReferenceSCHEDULE C, PART II-B, LINE 1IReturnReference
ExplanationTHE ORGANIZATION PAYS ANNUAL DUES TO THE CALIFORNIA PRIMARY CARE ASSOCIATION; A PORTION OF DUES MAY BE ATTRIBUTABLE TO LOBBYING.Explanation

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis491887OtherCostOrOtherBasis
Book Value491887BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis2035757OtherCostOrOtherBasis
Depreciation955566Depreciation
Book Value1080191BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis749217OtherCostOrOtherBasis
Depreciation94337Depreciation
Book Value654880BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis1052693OtherCostOrOtherBasis
Depreciation608160Depreciation
Book Value444533BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis125482OtherCostOrOtherBasis
Book Value125482BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings2796973TotalOfBookValueLandBuildings
Total Revenue4964628TotalRevenue
Total Expenses5011855TotalExpenses
Excess Or Deficit For Year-47227ExcessOrDeficitForYear
Excess Or Deficit Per FS-47227ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt4964628TotRevenueEtcAuditedFinclStmt
Revenue Subtotal4964628RevenueSubtotal
Total Revenue Per Form9904964628TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt5011855TotExpensesEtcAuditedFinclStmt
Expenses Subtotal5011855ExpensesSubtotal
Total Expenses Per Form9905011855TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierUNCERTAIN TAX POSITIONSIdentifier
Return ReferenceSCHEDULE D, PART X, LINE 2ReturnReference
ExplanationTHE CENTER ADOPTED ACCOUNTING GUIDANCE RELATED TO THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES ON JULY 1, 2009. THE CENTER FILES A FORM 990 (RETURN OF ORGANIZATION EXEMPT FROM INCOME TAXES). WHEN THE RETURN IS FILED, IT IS HIGHLY CERTAIN THAT SOME POSITIONS TAKEN WOULD BE SUSTAINED UPON EXAMINATION BY THE TAXING AUTHORITIES, WHILE OTHERS ARE SUBJECT TO UNCERTAINTY ABOUT THE MERITS OF THE POSITION TAKEN OR THE AMOUNT OF THE POSITION THAT WOULD ULTIMATELY BE SUSTAINED. EXAMPLES OF TAX POSITIONS COMMON TO HEALTH CENTERS INCLUDE SUCH MATTERS AS THE FOLLOWING: TAX-EXEMPT STATUS OF THE ENTITY, THE CONTINUED TAX-EXEMPT STATUS OF BONDS ISSUED BY THE ORGANIZATION, THE NATURE, CHARACTERIZATION AND TAXABILITY OF JOINT VENTURE INCOME AND VARIOUS POSITIONS RELATIVE TO POTENTIAL SOURCES OF UNRELATED BUSINESS TAXABLE INCOME (UBIT). UBIT IS REPORTED ON INTERNAL REVENUE SERVICE FORM 990-T, AS APPROPRIATE. THE BENEFIT OF A TAX POSITION IS RECOGNIZED IN THE FINANCIAL STATEMENTS IN THE PERIOD DURING WHICH, BASED ON AVAILABLE EVIDENCE, MANAGEMENT BELIEVES IT IS MORE LIKELY THAN NOT THE TAX POSITION WILL BE SUSTAINED UPON EXAMINATION, INCLUDING THE RESOLUTION OF APPEALS OR LITIGATION PROCESSES, IF ANY. TAX POSITIONS ARE NOT OFFSET OR AGGREGATED WITH OTHER POSITIONS. TAX POSITIONS THAT MEET THE "MORE LIKELY THAN NOT" RECOGNITION THRESHOLD ARE MEASURED AS THE LARGEST AMOUNT OF TAX BENEFIT THAT IS MORE THAN 50% LIKELY TO BE REALIZED ON SETTLEMENT WITH THE APPLICABLE TAXING AUTHORITY. THE PORTION OF THE BENEFITS ASSOCIATED WITH THE TAX POSITIONS TAKEN THAT EXCEEDS THE AMOUNT MEASURED AS DESCRIBED ABOVE IS REFLECTED AS A LIABILITY FOR UNRECOGNIZED TAX BENEFITS IN THE BALANCE SHEET ALONG WITH ANY ASSOCIATED INTEREST AND PENALTIES THAT WOULD BE PAYABLE TO THE TAXING AUTHORITIES UPON EXAMINATION. AT JUNE 30, 2011, THERE WERE NO UNRECOGNIZED TAX BENEFITS IDENTIFIED OR RECORDED AS LIABILITIES.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentstrueAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (3 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
ROSA VIVIAN FERNANDEZ
15198805101268904712095110178951000
JUMNAH THANAPATHY
23479505100000301610265007000
SONALI SHAH
164963000369400054240174081000

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
NON-FIXED PAYMENTSSCHEDULE J, PART I, LINE 7THE ORGANIZATION'S PRESIDENT & CEO IS ELIGIBLE TO RECEIVE INCENTIVE COMPENSATION BASED ON NEW GRANT DOLLARS SECURED ON BEHALF OF SBHF.
OTHER REPORTABLE COMPENSATIONSCHEDULE J, PART II, COLUMN (B)(III)OTHER REPORTABLE COMPENSATION REPORTED FOR ROSA VIVIAN FERNANDEZ AND SONALI SHAH REPRESENTS PTO CASH OUT PAYMENTS MADE IN 2010.

Schedule M IRS990ScheduleM

FieldValueIRS element (for citing)
Works Of ArtWorksOfArt
Art Historical TreasuresArtHistoricalTreasures
Art Fractional InterestArtFractionalInterest
Books And PublicationsBooksAndPublications
Clothing And Household GoodsClothingAndHouseholdGoods
Cars And Other VehiclesCarsAndOtherVehicles
Boats And PlanesBoatsAndPlanes
Intellectual PropertyIntellectualProperty
Securities Publicly TradedSecuritiesPubliclyTraded
Securities Closely Held StockSecuritiesCloselyHeldStock
Securities Prtnrshp Trust IntrstsSecuritiesPrtnrshpTrustIntrsts
Securities MiscellaneousSecuritiesMiscellaneous
Qualified Contrib Hist StructQualifiedContribHistStruct
Qualified Contrib OtherQualifiedContribOther
Real Estate ResidentialRealEstateResidential
Real Estate CommercialRealEstateCommercial
Real Estate OtherRealEstateOther
CollectiblesCollectibles
Food InventoryFoodInventory

Drugs And Medical Supplies DrugsAndMedicalSupplies

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
Number Of Contributions1NumberOfContributions
Noncash Contribs Rptd F990369681NoncashContribsRptdF990
Method Of Determining RevenuesFMVMethodOfDeterminingRevenues
FieldValueIRS element (for citing)
TaxidermyTaxidermy
Historical ArtifactsHistoricalArtifacts
Scientific SpecimensScientificSpecimens
Archaeological ArtifactsArchaeologicalArtifacts
Number Of8283 Received0NumberOf8283Received
Any Property That Must Be HeldfalseAnyPropertyThatMustBeHeld
Review Process Unusual NC GiftsfalseReviewProcessUnusualNCGifts
Third Parties UsedfalseThirdPartiesUsed

Form990 Schedule M Part II Form990ScheduleMPartII

FieldValueIRS element (for citing)
IdentifierNON-CASH CONTRIBUTIONSIdentifier
Return ReferenceSCHEDULE M, PART I, LINE 20ReturnReference
ExplanationALL VACCINE CONTRIBUTIONS WERE PROVIDED THROUGH THE CALIFORNIA DEPARTMENT OF PUBLIC HEALTH.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
ORGANIZATION'S MISSIONFORM 990, PART I, LINE 1THE MISSION OF SAN BENITO HEALTH FOUNDATION IS TO PROVIDE QUALITY, AFFORDABLE PRIMARY HEALTH CARE, DENTAL CARE, AND OTHER PUBLIC HEALTH SERVICES TO THE UNDER-SERVED POPULATIONS OF SAN BENITO COUNTY IN AN EMPATHETIC, CULTURALLY-SENSITIVE MANNER, AT RATES THAT ARE CONSISTENT WITH A CLIENT'S ABILITY TO PAY. THE FOUNDATION WILL COLLABORATE WITH OTHER AGENCIES, INDIVIDUALS, AND ORGANIZATIONS TO INSURE ACCESSIBILITY OF SPECIALTY CARE TO MEMBERS OF THE COMMUNITY WHO ARE TRADITIONALLY UNDER-SERVED, DUE TO LIMITED INCOME, RESOURCES, CULTURAL AND LANGUAGE BARRIERS. SIGNIFICANT CHANGES TO GOVERNING DOCUMENTS FORM 990, PART VI, SECTION A, LINE 4 THE ORGANIZATION AMENDED ITS BYLAWS IN A PRIOR YEAR TO CHANGE THE NUMBER OF MEMBERS OF THE BOARD OF DIRECTORS FROM 11 TO A RANGE OF 9 TO 11. THE CHANGE ALSO LIMITED OFFICERS TO A 1 YEAR TERM IN OFFICE, AS WELL AS A LIMITATION OF 4 CONSECUTIVE TERMS IN THE SAME OFFICE.
990 REVIEW PROCESSFORM 990, PART VI, SECTION B, LINE 11BTHE FORM 990 IS PREPARED BY AN ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION. PRIOR TO FILING, A TENTATIVE DRAFT IS REVIEWED BY THE PRESIDENT AND CEO AND THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS. ONCE ANY UPDATES ARE MADE, A FINAL DRAFT WILL BE PROVIDED TO THE BOARD OF DIRECTORS.
CONFLICT OF INTEREST POLICYFORM 990, PART VI, SECTION B, LINE 12CALL STAFF AND BOARD OF DIRECTORS ARE REQUIRED TO COMPLETE AN ANNUAL CONFLICT OF INTEREST STATEMENT OF DISCLOSURE WHICH IS KEPT IN PERSONNEL AND BOARD VOLUNTEER FILE. POLICY ALSO INCLUDES THE DISCLOSURE OF CONFLICTS OF INTEREST AS THEY ARISE.
COMPENSATION REVIEWFORM 990, PART VI, SECTION B, LINES 15A & BAN INDEPENDENT CONSULTING AGENCY, MANAGEMENT RESOURCE CENTER, INC, CONDUCTS BI-ANNUAL SALARY SURVEY AND PREPARES THE COMPENSATION SCALE AS APPROPRIATE. MRC UTILIZED A SYSTEMATIC APPROACH TO EMPLOYEE COMPENSATION THAT INVOLVES THE USE OF POINT FACTOR JOB EVALUATION TO ASSIGN JOBS TO PAY GRADES, AND SURVEYS OF THE LABOR MARKET TO ENSURE THAT PAY IS COMPETITIVE, AND A METHODOLOGY FOR ASSESSING INDIVIDUAL PAY LEVELS. ON A BI-ANNUAL BASIS, SAN BENITO HEALTH FOUNDATION (SBHF) RETAINS MRC TO REVIEW THE COMPETITIVE LABOR MARKET AND DEVELOP PAY RANGES FOR THE UPCOMING YEAR. MRC RECOMMENDS THE ADOPTION OF THE NEW RANGES TO THE BOARD OF DIRECTORS WHO REVIEW THE INFORMATION PROVIDED, AND CONSIDERATION OF ADJUSTMENTS TO CURRENT COMPENSATION, WHERE APPROPRIATE, TO ENSURE THAT ALL EMPLOYEES ARE PAID ACCORDING TO THEIR CONTRIBUTION TO THE ORGANIZATION. THE BOARD ADOPTS CHANGES TO THE COMPENSATION SCALE BASED ON MRC INPUT. THIS PROCEDURE WAS LAST PERFORMED IN MARCH 2010. THE BOARD ALSO REVIEWS THE PERFORMANCE OF THE CHIEF EXECUTIVE OFFICER AND MAKES SALARY DETERMINATIONS BASED ON THE ABOVE MENTIONED METHODOLOGY. OTHER BENEFITS ARE IN LINE WITH WHAT IS OFFERED TO ALL EMPLOYEES OF THE ORGANIZATION. THE CEO'S COMPENSATION WAS REVIEWED, USING THIS PROCEDURE, IN AUGUST 2011. THE CEO EVALUATES KEY MANAGEMENT STAFF ON AN ANNUAL BASIS AND MAKES COMPENSATION DETERMINATIONS BASED ON THE ABOVE MENTIONED METHODOLOGY AS APPROVED BY THE BOARD OF DIRECTORS.
DOCUMENT DISCLOSUREFORM 990, PART VI, SECTION C, LINE 19DOCUMENTS ARE MADE AVAILABLE AND UPON REQUESTS WHILE KEEPING WITHIN LIMITS OF HIPPA GUIDELINES FOR PROTECTED INFORMATION. ALL DOCUMENTS ARE AVAILABLE ON AN ANNUAL BASIS WITHOUT RESTRICTION TO THE INDEPENDENT AUDITOR. BOARD OF DIRECTORS FORM 990, PART VII, SECTION A AS OF JUNE 30, 2011, THERE WERE TWO VACANCIES ON THE BOARD OF DIRECTORS. THESE VACANT POSITIONS WERE FILLED IN SEPTEMBER 2011.
ACCOUNTING AND CONSULTING SERVICESFORM 990, PART IX, LINE 11CCERTAIN DUTIES TRADITIONALLY PERFORMED BY THE FINANCE DEPARTMENT WERE PERFORMED BY AN ACCOUNTING FIRM WITH EXPERTISE IN THE FIELD. DUTIES PERFORMED INCLUDED ASSISTING WITH FINANCIAL ESTIMATES, ASSISTING THE CEO WITH THE BUDGET PROCESS, AND AIDING THE CEO ON FINANCIAL STATEMENT PRESENTATION. FINAL DECISION MAKING RESIDED SOLELY WITH THE CEO IN ALL CIRCUMSTANCES.