2012-11-06T09:24:45-06:00 2011-12-31 561965804 THOMAS JUDY & TUCKER P A 4700 FALLS OF NEUSE ROAD SUITE 400 RALEIGH NC 27609 990 2011-01-01 273541505 NORTH CAROLINA HEALTH INFORMATION EXCHANGE NORT 9199261042 2300 REXWOODS DRIVE NO 390 RALEIGH NC 27607 JEFFREY D MILLER 9199261042 2012-11-06 1 KRISTEN HOYLE CPA P00118964 9195717055 2011 2016-02-24 21:20:13Z X JEFFREY D MILLER 2300 REXWOODS DRIVE NO 390 RALEIGH NC 27607 3650862 0 X WWW.NCHIE.ORG X 2010 NC NORTH CAROLINA HEALTH INFORMATION EXCHANGE ("NC HIE") MAKES CRITICAL HEALTH CARE DATA AVAILABLE WHEN AND WHERE IT'S NEEDED TO IMPROVE HEALTH OUTCOMES AND CONTROL HEALTH CARE COSTS IN NORTH CAROLINA. 24 24 6 0 0 0 3650862 0 0 0 3650862 380000 0 521210 0 0 2724627 3625837 25025 6808477 6783452 25025 X NC HIE WILL PROVIDE A SET OF SECURE AND SCALABLE SERVICES THAT PROMOTE THE ACCESS TO, THE EXCHANGE OF, AND THE ANALYSIS OF HEALTH CARE INFORMATION. NC HIE SERVICES WILL ALSO ENABLE PARTICIPATING ORGANIZATIONS TO IMPROVE MEDICAL DECISION-MAKING AND COORDINATION OF CARE, IMPROVE HEALTH OUTCOMES, AND CONTROL HEALTH CARE COSTS. 0 0 2867193 NC DIRECT:NC DIRECT IS A HEALTH INFORMATION EXCHANGE SERVICE THAT FACILITATES SECURE CLINICAL MESSAGING, REDUCING MANUAL HANDLING OF PAPER RECORDS. NC DIRECT ALLOWS PROVIDERS TO SHARE A PATIENT'S MEDICAL HISTORY INCLUDING LAB RESULTS, DISCHARGE SUMMARIES, AND OTHER IMPORTANT INFORMATION WITH OTHER PROVIDERS WHO HAVE SEEN OR WILL SEE THE PATIENT - EVEN IF THOSE PROVIDERS ARE NOT PART OF THE SAME PRACTICE OR HEALTH SYSTEM. NC DIRECT DOES NOT REQUIRE PROVIDERS TO USE AN EHR OR TO PURCHASE SPECIAL SOFTWARE.THE NC DIRECT PROGRAM IS PART OF THE DIRECT PROJECT LAUNCHED BY THE OFFICE OF THE NATIONAL COORDINATOR FOR HEALTH INFORMATION TECHNOLOGY IN MARCH 2010 AS A PART OF THE NATIONWIDE HEALTH INFORMATION NETWORK. THE DIRECT PROJECT WAS CREATED TO SPECIFY A SIMPLE, SECURE, SCALABLE, STANDARDS-BASED WAY FOR PARTICIPANTS TO SEND AUTHENTICATED, ENCRYPTED HEALTH INFORMATION DIRECTLY TO KNOWN, TRUSTED RECIPIENTS OVER THE INTERNET.HIE CONNECTIVITY FABRIC:THE HIE CONNECTIVITY FABRIC PROVIDES THE FOUNDATIONAL ELEMENTS THAT ALLOW THE DIVERSE AND MULTIPLE SOURCES OF HEALTH INFORMATION TO BE CONNECTED IN A COMMON PATIENT AND PROVIDER CONTEXT. THE FOUNDATIONAL ELEMENTS OF THIS SERVICE PROVIDES THE CAPABILITY TO CONNECT PATIENT RECORDS AND INFORMATION ACROSS MULTIPLE ENTERPRISES, THE NORMALIZATION OF DATA FROM DIFFERENT SOURCES, AND THE ENFORCEMENT OF PRIVACY POLICIES AND CONSUMER CONSENT DECLARATIONS. THEN USING THESE FOUNDATIONAL ELEMENTS, THE HIE CONNECTIVITY FABRIC ALLOWS HEALTHCARE ORGANIZATIONS TO EXCHANGE INFORMATION THROUGH A COMMON MESSAGING ARCHITECTURE WITH PARTICIPATING SYSTEMS. KEY INTERFACE TECHNOLOGIES AND SPECIFICATIONS SUPPORTED INCLUDE CCD, HL7, AND WEB SERVICES. NC HIE FULLY UNDERSTANDS THAT FROM A TECHNOLOGY PERSPECTIVE THERE ARE MULTIPLES WAYS TO ACHIEVE HEALTH INFORMATION EXCHANGES THAT ARE IN ACCORDANCE WITH NC HIE PRIVACY AND SECURITY POLICIES. THEREFORE, AND TO MEET THE TECHNOLOGICAL CAPABILITIES OF ITS PARTICIPANTS, NC HIE SUPPORTS MULTIPLE INTEGRATION PROFILES ON THE CONTINUUM FROM A FEDERATED PROFILE TO A TIGHTLY INTEGRATED PROFILE.PATIENT RECORD NETWORK ("PRN"):THIS SERVICE PROVIDES NC HIE PARTICIPANTS WITH WEB-BASED ACCESS TO THE LONGITUDINAL PATIENT RECORD THAT IS ESTABLISHED BY THE HIE CONNECTIVITY FABRIC. FROM THIS PRN PORTAL, PARTICIPANTS CAN VIEW DEMOGRAPHIC AND DISCRETE CLINICAL INFORMATION SOURCED FROM MULTIPLE HEALTHCARE ORGANIZATIONS AND SYSTEMS. THIS TOOL ALSO PROVIDES THE ABILITY TO VIEW CLINICAL DOCUMENTS STORED IN REMOTE SYSTEMS, SEND OR RECEIVE MESSAGES TO OTHER HEALTHCARE PROVIDERS INCLUDING THE ABILITY TO ATTACH SPECIFIC PATIENT DATA, AND THE ABILITY TO SELECT ALERTS AND NOTIFICATIONS BASED ON CHANGES IN THEIR PATIENTS' HEALTH STATUS (E.G. ABNORMAL LAB RESULT).AS WITH ALL NC HIE SERVICES, ACCESS TO HEALTH INFORMATION FOR SPECIFIC PATIENT DATA IS RESTRICTED TO THOSE HEALTHCARE PROVIDERS WHO HAVE AN ESTABLISHED RELATIONSHIP WITH THE PATIENT OR AN EMERGENT MEDICAL NEED AND CAN ONLY BE USED FOR HIPAA APPROVED PURPOSES. ADDITIONALLY, ALL INFORMATION ACCESS RIGHTS ARE DICTATED BASED ON CONSUMER CONSENT DECLARATIONS AS MANDATED BY NC STATUTE. 424333 380000 CHALLENGE GRANT - MEDICATION MANAGEMENT APPLICATION:NC HIE WILL WORK WITH THE INFORMATICS CENTER FOR COMMUNITY CARE OF NORTH CAROLINA ("N3CN") TO BUILD ON N3CN'S EXISTING "PHARMACY HOME" APPLICATION, A MODEL WEB-BASED MEDICATION MANAGEMENT APPLICATION THAT PROVIDES A BASIC MANAGEMENT TOOL TO PROVIDERS FOR USE WITH ITS 1.2 MILLION N3CN MEDICAL HOME MEDICAID ENROLLEES. UNDER THIS GRANT, NC HIE AND N3CN WILL ENHANCE THE "PHARMACY HOME" APPLICATION TO CONNECT IT TO THE NC HIE AS A VALUE ADDED SERVICE TO ENCOMPASS ALL PAYERS AND PROVIDERS. BY PROJECT COMPLETION, THE NC HIE WILL BE THE PRIMARY INBOUND SOURCE OF THE DISPARATE MEDICATION LISTS TO THE APPLICATION, AS WELL AS THE CONDUIT FOR OUTBOUND COMMUNICATION WITH NC HIE PARTICIPANTS, INCLUDING A PROVIDER'S OWN ELECTRONIC SYSTEM OF RECORD. 75709 NORTH CAROLINA PROGRAM TO ADVANCE TECHNOLOGY FOR HEALTH ("NC PATH"):BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA, IN COLLABORATION WITH THE NC HIE AND ALLSCRIPTS, LAUNCHED NC PATH - A PROGRAM CREATED TO PLACE NORTH CAROLINA AT THE FOREFRONT OF HEALTH CARE REFORM. NC PATH EQUIPS PHYSICIANS WITH ALLSCRIPTS EHR SOFTWARE AND SUPPORT, CONNECTS HEALTH CARE PROVIDERS ACROSS THE STATE THROUGH NC HIE AND PROVIDES ASSISTANCE TO PRACTICES WITH ACHIEVING MEANINGFUL USE AND PATIENT CENTER MEDICAL HOME RECOGNITION. DESIGNED TO MEET THE NEEDS OF BOTH PHYSICIANS AND PATIENTS, NC PATH WILL MOVE NORTH CAROLINA INTO A NEW ERA OF QUALITY HEALTH CARE. NC PATH STREAMLINES COORDINATED CARE, ELEVATES THE QUALITY OF PATIENT CARE, IMPROVES HEALTH OUTCOMES, REDUCES HEALTH CARE SPENDING, AND AIDS PRACTICES IN BECOMING HIT COMPLIANT. 3367235 1 1 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 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 14 0 1 6 1 0 0 0 0 0 0 0 0 0 0 X 24 24 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 X DAVID B WELKER 9199261042 2300 REXWOODS DRIVE STE 390 RALEIGH NC 27607 WILLIAM ATKINSON 2.00 X X 0 0 0 LANIER CANSLER 4.00 X X 0 0 0 ALLEN DOBSON MD 4.00 X X 0 0 0 BRADLEY WILSON 2.00 X X 0 0 0 JOHN RICHTER 2.00 X 0 0 0 STEVE CLINE DDS 4.00 X 0 0 0 JERRY FRALICK 1.00 X 0 0 0 CRAIGAN GRAY MD 1.00 X 0 0 0 THOMAS BRIDGES 1.00 X 0 0 0 HADLEY CALLAWAY MD 1.00 X X 0 0 0 ANTHONY CIVELLO 1.00 X 0 0 0 SAMUEL CYKERT MD 1.00 X 0 0 0 GLORIA FRELIX MD 1.00 X 0 0 0 DAVID KING 1.00 X 0 0 0 REBECCA KITZMILLER 1.00 X 0 0 0 BENJAMIN MONEY 1.00 X 0 0 0 WARREN NEWTON MD 1.00 X 0 0 0 WILLIAM ROPER MD 1.00 X 0 0 0 CHARLES SANDERS MD 1.00 X X 0 0 0 GEORGE SAUNDERS MD 2.00 X X 0 0 0 SAM SPICER MD 1.00 X 0 0 0 SENATOR JOSH STEIN 1.00 X 0 0 0 DAVE TAYLOE MD 1.00 X 0 0 0 SPEAKER TOM TILLIS 1.00 X 0 0 0 JEFFREY D MILLER 40.00 X 217526 0 0 RODERICK SCOTT 40.00 X 103744 0 4500 321270 0 4500 2 0 1 0 MANATT PHELPS & PHILLIPS 11355 WEST OLYMPIC BLVD LOS ANGELES CA 90064 CONSULTANT TO REACH STATEWIDE HIE CAPABI 884275 CAPGEMINI 2250 CORPORATE PARK DRIVE HERNDON VA 20171 IT FRAMEWORK FOR HIE DEPLOYMENT 369320 MASSACHUSETTS EHEALTH COLLABORATIVE 860 WINTER ST WALTHAM MA 02451 ASSIST ACQUISITION OF TECH SERVICES VEND 221390 STATE OF NC - ITS PO BOX 17209 RALEIGH NC 27619 IT PROJECT MANAGER SERVICES 132306 ALAN HIRSCH 2300 REXWOODS DRIVE STE 390 RALEIGH NC 27607 INTERIM CEO/STRATEGIC ADVISOR 123518 5 3563190 87672 3650862 3650862 0 0 0 380000 380000 325770 325770 156247 86326 69921 6937 3188 3749 32256 26179 6077 76235 76235 20402 20402 1674849 1580495 94354 39723 39723 14900 4757 10143 799327 784116 15211 36499 36499 20233 20129 104 2294 2294 1515 1515 4191 4191 5033 1524 3509 RELOCATION EXPENSES 16119 16119 VACATION ACCRUAL 7280 7280 STAFF TRAINING & DEVELO 2621 2621 DUES & SUBSCRIPTIONS 439 439 2967 2967 3625837 3367235 258602 0 551212 958302 670 5207400 3363 80450 4191 0 76259 11271 0 6808477 1015615 5707400 0 60437 0 6783452 X 25025 0 25025 0 6808477 25025 0 X X 0 1 1 X 1 1 X 3650862 3650862 3650862 3650862 3650862 3650862 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 5000 1667 3333 75450 2524 72926 76259 CAPITAL LEASES PAYABLE 60437 60437 3650862 3625837 25025 25025 3895431 244569 244569 3650862 0 3650862 3870406 244569 244569 3625837 0 3625837 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE ORGANIZATION DOES NOT BELIEVE THERE ARE ANY MATERIAL UNCERTAIN TAX POSITIONS AND, ACCORDINGLY, IT WILL NOT RECOGNIZE ANY LIABILITY FOR UNRECOGNIZED TAX BENEFITS. THE ORGANIZATION IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER THERE ARE CURRENTLY NO AUDITS FOR ANY TAX YEARS IN PROGRESS. AT DECEMBER 31, 2011, THE ORGANIZATION HAS NO UNCERTAIN TAX POSITIONS THAT QUALIFY FOR EITHER RECOGNITION OR DISCLOSURE IN THE FINANCIAL STATEMENTS. 1 NC COMMUNITY CARE NETWORKS 2300 REXWOODS DR STE 200 RALEIGH NC 27607 205408367 501(C)(3) 380000 0 TO PROVIDE MEDICATION MANAGEMENT APPLICATION 1 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: NC HIE UNDERTAKES APPROPRIATE MONITORING ACTIONS TO ENSURE COMPLIANCE WITH SUB-AGREEMENT PERFORMANCE REQUIREMENTS, FINANCIAL TERMS AND CONDITIONS, AND ALL APPLICABLE FEDERAL RULES AND REGULATIONS. NC HIE'S MONITORING PROCEDURES INCLUDE, BUT ARE NOT LIMITED TO: (1) ROUTINE RECEIPT AND REVIEW OF TECHNICAL PERFORMANCE REPORTS; (2) ROUTINE REVIEW OF EXPENSES-TO-BUDGET; (3) PERIODIC PERFORMANCE OF ON-SITE VISITS, IF NECESSARY; (4) THE OPTION TO PERFORM "AUDITS," IF NECESSARY; (5) REVIEW OF A-133 AUDIT REPORTS FILED BY SUBRECIPIENTS AS WELL AS REVIEW OF ANY AUDIT FINDINGS. X X X X 0 0 0 0 0 0 0 0 0 JEFFREY D MILLER 200026 0 17500 0 0 0 0 0 0 0 217526 0 0 0 FORM 990, PART VI, SECTION A, LINE 1 THE GOVERNING BODY OF NC HIE MAY DELEGATE TO THE EXECUTIVE COMMITTEE ALL OR ANY PORTION OF THE AUTHORITY OF THE BOARD, EXCEPT THE AUTHORITY TO AMEND THE BYLAWS OR THE CORPORATION'S ARTICLES OF INCORPORATION, AND EXCEPT TO THE EXTENT PROHIBITED BY THE NORTH CAROLINA NONPROFIT CORPORATION ACT. THE EXECUTIVE COMMITTEE IS COMPRISED OF THE SIX PRINCIPAL OFFICERS OF NC HIE, THE IMMEDIATE PAST CO-CHAIRPERSON ELECTED BY THE BOARD, AND ONE DIRECTOR AT LARGE ELECTED BY THE BOARD, WITH THE CEO SERVING AS AN EX OFFICIO MEMBER WITHOUT VOTE. FORM 990, PART VI, SECTION A, LINE 2 JEFF MILLER AND ALLEN DOBSON; BUSINESS RELATIONSHIP JEFF MILLER AND BRAD WILSON; BUSINESS RELATIONSHIP FORM 990, PART VI, SECTION B, LINE 11 FORM 990 IS REVIEWED IN DETAIL BY MANAGEMENT AND PROVIDED TO EACH VOTING MEMBER OF THE BOARD IN FULL BEFORE FILING WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C PRIOR TO TAKING HIS OR HER POSITION ON THE BOARD OF DIRECTORS, AND ANNUALLY THEREAFTER, EACH DIRECTOR SHALL COMPLETE AND SUBMIT TO THE SECRETARY OF THE BOARD OF DIRECTORS A CONFLICT OF INTEREST STATEMENT AS REQUIRED BY NC HIE'S CONFLICT OF INTEREST POLICY. THE CO-CHAIRPERSONS AND THE BOARD OF DIRECTORS SHALL BECOME FAMILIAR WITH THE STATEMENTS OF ALL DIRECTORS IN ORDER TO GUIDE THE CONDUCT OF THE BOARD OF DIRECTORS SHOULD SUCH A CONFLICT ARISE. AT SUCH TIME AS ANY MATTER COMES BEFORE THE BOARD OF DIRECTORS WHICH INVOLVES OR MAY INVOLVE A CONFLICT OF INTEREST, THE AFFECTED DIRECTOR SHALL MAKE KNOWN THE POTENTIAL CONFLICT, WHETHER DISCLOSED BY HIS OR HER WRITTEN STATEMENT OR NOT. SUCH DIRECTOR SHALL ANSWER ANY QUESTIONS THAT MIGHT BE ASKED OF HIM OR HER AND SHALL DISCLOSE ALL MATERIAL FACTS. AT THE REQUEST OF ONE OF THE CHAIRPERSONS, SUCH DIRECTOR SHALL WITHDRAW FROM THE MEETING FOR SO LONG AS THE MATTER SHALL CONTINUE UNDER DISCUSSION. FORM 990, PART VI, SECTION B, LINE 15A THE COMPENSATION, IF ANY, OF ALL OFFICERS AND AGENTS OF THE CORPORATION SHALL BE FIXED BY THE BOARD OF DIRECTORS. AN INDEPENDENT COMPENSATION CONSULTANT ALONG WITH A COMPENSATION STUDY WAS USED TO ESTABLISH THE COMPENSATION OF THE CEO. CEO COMPENSATION IS DOCUMENTED BY A WRITTEN EMPLOYMENT CONTRACT AND WAS APPROVED BY THE BOARD OF DIRECTORS IN 2011. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. THE BOARD OF DIRECTORS IS RESPONSIBLE FOR SELECTING THE INDEPENDENT AUDITORS.