ARIZONA ASSOCIATION OF COMMUNITY HEALTH CENTERS INC: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization
ARIZONA ASSOCIATION OF COMMUNITY HEALTH CENTERS INC (EIN 86-0494702)
Tax period
2009-04-01 to 2010-03-31
Filed
2011-02-07
IRS object ID
201110389349300106
Schema version
2009v1.7
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)
Timestamp2011-02-07T10:25:41-06:00Timestamp
Tax Period End Date2010-03-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1FESTER & CHAPMAN PCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line18283 N HAYDEN RD STE 200AddressLine1
CitySCOTTSDALECity
StateAZState
ZIP Code852582456ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2009-04-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN860494702EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1ARIZONA ASSOCIATION OF COMMUNITYBusinessNameLine1
Business Name Line2HEALTH CENTERS INCBusinessNameLine2
FieldValueIRS element (for citing)
Name ControlARIZNameControl
Phone6022530090Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1700 E JEFFERSON STREETAddressLine1
Address Line2ROOM/SUITE 100AddressLine2
CityPHOENIXCity
StateAZState
ZIP Code85034ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameJOHN MCDONALDName
TitleCEOTitle
Phone6022530090Phone
Date Signed2011-01-20DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
NameWILLIAM F CHAPMANName
Phone6022643077Phone
Date Prepared2011-02-07DatePrepared
FieldValueIRS element (for citing)
Tax Year2009TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonLINDA ROSS CFONameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1700 E JEFFERSON STREET SUITE 100AddressLine1
CityPHOENIXCity
StateAZState
ZIP Code85034ZIPCode
FieldValueIRS element (for citing)
Gross Receipts2150665GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501cXOrganization501c
Web SiteWWW.AACHC.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1997YearFormation
State Legal DomicileAZStateLegalDomicile
Activity Or Mission DescriptionPROMOTION AND IMPROVEMENT OF PRIMARY MEDICAL CARE TO MEDICALLY UNDERSERVED POPULATIONS OF AZ. ENHANCEMENT OF PRODUCTIVITY, FINANCIAL PERFORMANCE, CLINICAL CAPABILITY, COMMUNITY DEVELOPMENT, AND CLINIC SERVICES TO MEMBER CLINICS. FORMULATION AND ADVOCATION OF LEGISLATION AND APPROPRIATIONS FOR PRIMARY CARE PROGRAMS FOR LOW-INCOME UNINSURED AZ RESIDENTS UTILIZING PRIMARY CARE FACILITY GRANTS, PRIMARY CARE PROVIDER LOAN REPAYMENT PROGRAM, AND UNIVERSITY OF AZ MEDICAL STUDENT LOAN PROGRAM. MAINTENANCE OF AUDITING, PATIENT SATISFACTION SURVEYS, PRACTICE MANAGEMENT INFORMATION SYSTEMS, & QUALITY ASSURANCE SYSTEMS. REPRESENTATION OF MEMBERS ON DEVEKOPMENT OF COST-BASED REIMBURSEMENT METHODOLOGY FOR AHCCCS PATIENTS. REPRESENTATION OF MEMBERS ON VARIOUS STATE-WIDE HEALTH CARE TASK FORCES, STUDY COMMITTIES, AND HEALTH CARE COALITIONS.ActivityOrMissionDescription
Nbr Voting Members Governing Body21NbrVotingMembersGoverningBody
Nbr Independent Voting Members0NbrIndependentVotingMembers
Total Nbr Employees30TotalNbrEmployees
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income-16667NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year1521513ContributionsGrantsPriorYear
Contributions Grants Current Year1579134ContributionsGrantsCurrentYear
Program Service Revenue Prior Year355543ProgramServiceRevenuePriorYear
Program Service Revenue CY178013ProgramServiceRevenueCY
Investment Income Current Year0InvestmentIncomeCurrentYear
Other Revenue Prior Year712644OtherRevenuePriorYear
Other Revenue Current Year393518OtherRevenueCurrentYear
Total Revenue Prior Year2589700TotalRevenuePriorYear
Total Revenue Current Year2150665TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year1383680SalariesEtcPriorYear
Salaries Etc Current Year1427394SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year1199646OtherExpensePriorYear
Other Expenses Current Year1075165OtherExpensesCurrentYear
Total Expenses Prior Year2583326TotalExpensesPriorYear
Total Expenses Current Year2502559TotalExpensesCurrentYear
Revenues Less Expenses Prior Year6374RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-351894RevenuesLessExpensesCY
Total Assets BOY1333887TotalAssetsBOY
Total Assets EOY1274035TotalAssetsEOY
Total Liabilities BOY432515TotalLiabilitiesBOY
Total Liabilities EOY380736TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY901372NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY893299NetAssetsOrFundBalancesEOY
Mission DescriptionPROMOTION AND IMPROVEMENT OF PRIMARY MEDICAL CARE TO MEDICALLY UNDERSERVED POPULATIONS OF AZ. ENHANCEMENT OF PRODUCTIVITY, FINANCIAL PERFORMANCE, CLINICAL CAPABILITY, COMMUNITY DEVELOPMENT, AND CLINIC SERVICES TO MEMBER CLINICS. FORMULATION AND ADVOCATION OF LEGISLATION AND APPROPRIATIONS FOR PRIMARY CARE PROGRAMS FOR LOW-INCOME UNINSURED AZ RESIDENTS UTILIZING PRIMARY CARE FACILITY GRANTS, PRIMARY CARE PROVIDER LOAN REPAYMENT PROGRAM, AND UNIVERSITY OF AZ MEDICAL STUDENT LOAN PROGRAM. MAINTENANCE OF AUDITING, PATIENT SATISFACTION SURVEYS, PRACTICE MANAGEMENT INFORMATION SYSTEMS, & QUALITY ASSURANCE SYSTEMS. REPRESENTATION OF MEMBERS ON DEVEKOPMENT OF COST-BASED REIMBURSEMENT METHODOLOGY FOR AHCCCS PATIENTS. REPRESENTATION OF MEMBERS ON VARIOUS STATE-WIDE HEALTH CARE TASK FORCES, STUDY COMMITTIES, AND HEALTH CARE COALITIONS.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense1880432Expense
DescriptionPROMOTION AND IMPROVEMENT OF PRIMARY MEDICAL CARE TO MEDICALLY UNDERSERVED POPULATIONS OF ARIZONADescription
Total Program Service Expense1880432TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Balance Sheet Amounts ReportedtrueBalanceSheetAmountsReported
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 RequiredfalseScheduleJRequired
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 ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredfalseScheduleORequired
Number Forms Transmitted With10965NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees30NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Nbr Voting Governing Body Members21NbrVotingGoverningBodyMembers
Number Independent Voting Members0NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
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 FiledAZStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonARIZONA ASSOCIATION OF COMMUNITYNamePerson
Telephone Number6022530090TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1700 E JEFFERSON STREET SUITE 100AddressLine1
CityPHOENIXCity
StateAZState
ZIP Code85034ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (24 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficer
ELADIO PEREIRA MD
DIRECTOR1.00X000
ARTHUR MARTINEZ MD
DIRECTOR1.00X000
KATHY BYRNE
SECRETARY1.00X000
JOHN SWAGERT MD
DIRECTOR1.00X000
CLARENCE VATNE
DIRECTOR1.00X000
PEGGY NIES
DIRECTOR1.00X000
JENNIFER GINGER RYAN
DIRECTOR1.00X000
JAMES WELDEN
DIRECTOR1.00X000
DAVID ROGERS
DIRECTOR1.00X000
AVEIN SAATY-TAFOYA
DIRECTOR1.00X000
DIANNA GONZALES
DIRECTOR1.00X000
LIZ LATHAM
DIRECTOR1.00X000
RUTH KISH
DIRECTOR1.00X000
TRAVIS J ROBINETTE
DIRECTOR1.00X000
ANN ROGGENBUCK MPH MBA PHD
DIRECTOR1.00X000
BEN KUHN
DIRECTOR1.00X000
MATTHEW KING MD
DIRECTOR1.00X000
FATIMA MCCASLAND
DIRECTOR1.00X000
CINDY HALLMAN
DIRECTOR1.00X000
DANA PEPPER
DIRECTOR1.00X000
LINDA ROSS
CFO40.0013650000X
JOE COATSWORTH
CEO40.009211100X
ADDA ALEXANDER
CEO40.006709400X
RICHARD POLHEBER
CEO40.00000X
FieldValueIRS element (for citing)
Total Reportable Comp From Org295705TotalReportableCompFromOrg
Number Individuals GT100 K1NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KfalseTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources
Government Grants1579134GovernmentGrants
Total Contributions1579134TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
MEMBERSHIP DUES & ASSESSMENTS101853101853
MEETINGS & CONFERENCES7496074960
TECHNICAL ASSISTANCE PROJECTS12001200
FieldValueIRS element (for citing)
Total Program Service Revenue178013TotalProgramServiceRevenue

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
MCAP235701235701
TAPI144590144590
OTHER1322713227
FieldValueIRS element (for citing)
Total Other Revenue393518TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column2150665TotalRevenueColumn
Related Or Exempt Function Income571531RelatedOrExemptFunctionIncome

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total295705Total
Program Services220334ProgramServices
Management And General75371ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total1131689Total
Program Services843240ProgramServices
Management And General288449ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total11564Total
Program Services7788ProgramServices
Management And General3776ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total22450Total
Program Services15120ProgramServices
Management And General7330ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total3293Total
Program Services2218ProgramServices
Management And General1075ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total1067Total
Program Services1167ProgramServices
Management And General-100ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total20686Total
Program Services8615ProgramServices
Management And General12071ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total130031Total
Program Services100735ProgramServices
Management And General29296ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total64192Total
Program Services43095ProgramServices
Management And General21097ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total49173Total
Program Services23409ProgramServices
Management And General25764ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total18376Total
Program Services13188ProgramServices
Management And General5188ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total5160Total
Program Services-648ProgramServices
Management And General5808ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
SUBCONTRACT226130226130
CONSULTING21958613393085656
SPECIAL PROJECTS117721117551170
MISCELLANEOUS483472783420513
EQUIPMENT RENTAL35797266409157

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total101592Total
Program Services70086ProgramServices
Management And General31506ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total2502559Total
Program Services1880432ProgramServices
Management And General622127ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY700760BOY
EOY329165EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY278809BOY
EOY284058EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY52356BOY
EOY30631EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
EOY225978EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY1279BOY
EOY5479EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis298337LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec141707LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY118386BOY
EOY156630EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY182297BOY
EOY242094EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY1333887BOY
EOY1274035EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY301086BOY
EOY127233EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY71872BOY
EOY4500EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY59557BOY
EOY249003EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY432515BOY
EOY380736EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY901372BOY
EOY893299EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY901372BOY
EOY893299EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY1333887BOY
EOY1274035EOY
FieldValueIRS element (for citing)
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
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 Years1563383CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years1261430CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years1472842CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year1616897CurrentTaxYearMinus1Year
Current Tax Year1579134CurrentTaxYear
Total7493686Total

Total170 Total170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years1563383CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years1261430CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years1472842CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year1616897CurrentTaxYearMinus1Year
Current Tax Year1579134CurrentTaxYear
Total7493686Total
FieldValueIRS element (for citing)
Public Support Total1707493686PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years26471CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years24980CurrentTaxYearMinus3Years
Total51451Total

Other Income170 OtherIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years1601570CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years1500298CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years1148195CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year972803CurrentTaxYearMinus1Year
Total5222866Total
FieldValueIRS element (for citing)
Total Support12768003TotalSupport
Gross Receipts From Admissions Etc571531GrossReceiptsFromAdmissionsEtc
Public Support Pertcentage1700.58690PublicSupportPertcentage170
Public Support Pertcent Prior Year0.51400PublicSupportPertcentPriorYear
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 D IRS990ScheduleD

FieldValueIRS element (for citing)
Disclosed Orgs Legal ControlfalseDisclosedOrgsLegalControl
Disclosed For Charitable PurposesfalseDisclosedForCharitablePurposes
Written Policy MonitoringfalseWrittenPolicyMonitoring
Sect170h Requirements SatisfiedfalseSect170hRequirementsSatisfied
Solicited Assets For SalefalseSolicitedAssetsForSale
Agent Trustee EtcfalseAgentTrusteeEtc
Included On FSfalseIncludedOnFS
Endowments Held By Unrelated OrgsfalseEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgsfalseEndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule RfalseAreRelatedOrgsListedScheduleR

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis86562OtherCostOrOtherBasis
Depreciation14745Depreciation
Book Value71817BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis199119OtherCostOrOtherBasis
Depreciation124747Depreciation
Book Value74372BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis12656OtherCostOrOtherBasis
Depreciation2215Depreciation
Book Value10441BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings156630TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
REFUNDABLE ADVANCE$249,003
DUE TO TAPI
FieldValueIRS element (for citing)
Total Of Amounts249003TotalOfAmounts
Total Revenue2150665TotalRevenue
Total Expenses2502559TotalExpenses
Excess Or Deficit For Year-351894ExcessOrDeficitForYear
Net Unrealized GL On Investments58286NetUnrealizedGLOnInvestments
Other$285,535OtherAmount
Total Adjustments343821TotalAdjustments
Excess Or Deficit Per FS-8073ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt2494486TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments58286NetUnrealizedGainsInvestments
Other Revenues285535OtherRevenues
Revenue Not Rptd F990343821RevenueNotRptdF990
Revenue Subtotal2150665RevenueSubtotal
Total Revenue Per Form9902150665TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt2502559TotExpensesEtcAuditedFinclStmt
Expenses Subtotal2502559ExpensesSubtotal
Total Expenses Per Form9902502559TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
RECONCILIATION OF CHANGES - OTHERSCHEDULE D, PAGE 4, PART XI, LINE 8TAPI OPERATIONS 285,535
REVENUE AMOUNTS INCLUDED IN FINANCIALS - OTHERSCHEDULE D, PAGE 4, PART XII, LINE 2DTAPI OPERATIONS 285,535

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
ORGANIZATION'S MISSIONFORM 990 - ORGANIZATION'S MISSIONPROMOTION AND IMPROVEMENT OF PRIMARY MEDICAL CARE TO MEDICALLY UNDERSERVED POPULATIONS OF AZ. ENHANCEMENT OF PRODUCTIVITY, FINANCIAL PERFORMANCE, CLINICAL CAPABILITY, COMMUNITY DEVELOPMENT, AND CLINIC SERVICES TO MEMBER CLINICS. FORMULATION AND ADVOCATION OF LEGISLATION AND APPROPRIATIONS FOR PRIMARY CARE PROGRAMS FOR LOW-INCOME UNINSURED AZ RESIDENTS UTILIZING PRIMARY CARE FACILITY GRANTS, PRIMARY CARE PROVIDER LOAN REPAYMENT PROGRAM, AND UNIVERSITY OF AZ MEDICAL STUDENT LOAN PROGRAM. MAINTENANCE OF AUDITING, PATIENT SATISFACTION SURVEYS, PRACTICE MANAGEMENT INFORMATION SYSTEMS, & QUALITY ASSURANCE SYSTEMS. REPRESENTATION OF MEMBERS ON DEVEKOPMENT OF COST-BASED REIMBURSEMENT METHODOLOGY FOR AHCCCS PATIENTS. REPRESENTATION OF MEMBERS ON VARIOUS STATE-WIDE HEALTH CARE TASK FORCES, STUDY COMMITTIES, AND HEALTH CARE COALITIONS.
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990FORM 990, PAGE 6, PART VI, LINE 11THE ORGANIZATION PROVIDED A COPY OF THE 990, VIA EMAIL, TO THE GOVERNING BODY BEFORE IT WAS FILED. ANY QUESTIONS AND COMMENTS ARE RESOLVED PRIOR TO SUBMISSION.
ENFORCEMENT OF CONFLICTS POLICYFORM 990, PAGE 6, PART VI, LINE 12CEACH DIRECTOR, PRINCIPAL OFFICER, AND MEMBER OF A COMMITTEE WITH BOARD-DELEGATED POWERS, AND KEY EMPLOYEES SIGN A STATEMENT EACH YEAR AFFIRMING THEY HAVE RECEIVED A COPY OF THE POLICY AND THAT THEY HAVE READ AND UNDERSTAND THE POLICY. AN INTERESTED PERSON MAY DISCLOSE THE EXISTENCE OF A POSSIBLE CONFLICT TO THE COMMITTEE WITH BOARD-DELEGATED POWERS, IN WHICH THEREAFTER THE BOARD WILL DETERMINE APPROPRIATE ACTION BY MAJORITY VOTE.
COMPENSATION PROCESS FOR TOP OFFICIALFORM 990, PAGE 6, PART VI, LINE 15AA CONSULTANT WAS HIRED TO DO A SURVEY OF COMPARABLE POSITIONS.
COMPENSATION PROCESS FOR OFFICERSFORM 990, PAGE 6, PART VI, LINE 15BA CONSULTANT WAS HIRED TO DO A SALARY SURVEY OF COMPARABLE POSITIONS.
GOVERNING DOCUMENTS DISCLOSURE EXPLANATIONFORM 990, PAGE 6, PART VI, LINE 19NO DOCUMENTS AVAILABLE TO THE PUBLIC

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1CHC COLLABORATIVE VENTURESBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1700 E JEFFERSON STREET SUITE 100AddressLine1
CityPHOENIXCity
StateAZState
ZIP Code85034ZIPCode
FieldValueIRS element (for citing)
EIN860873658EIN
Primary ActivitiesADMIN SERVPrimaryActivities
Legal Domicile StateAZLegalDomicileState
Exempt Code Section3ExemptCodeSection
Public Charity Status7PublicCharityStatus

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1AACHCBusinessNameLine1
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgstruePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

FieldValueIRS element (for citing)
Business Name Line1CHC COLLABORATIVE VENTURESBusinessNameLine1
FieldValueIRS element (for citing)
Transaction TypeRTransactionType
Amount Involved47840AmountInvolved

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