Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| ORGANIZATION'S MISSION | FORM 990 - ORGANIZATION'S MISSION | PROMOTE PROACTIVE OPERATIONAL AND CLINICAL PEER NETWORKS; ADVOCATE FOR EXPANDED RESOURCES, PARTNERSHIPS, AND SUPPORTIVE PUBLIC POLICIES; FOSTER SEAMLESS COMMUNITY-CENTERED ACCOUNTABLE CARE THROUGH EXPANDED HORIZONTAL RELATIONSHIPS; PROVIDE DATA THAT SPEAKS TO VALUE AND EFFECTIVENESS OF COMMUNITY HEALTH CENTERS; SERVE COMMUNITIES IN NEED TO IDENTIFY SOLUTIONS TO HEALTH CARE ISSUES |
| FIRST ACHIEVEMENT DESCRIPTION | FORM 990, PAGE 2, PART III, LINE 4A | MEDICAL HOME AND OTHER NEW INITIATIVES, DATA AND EVALUATION, NEEDS ASSESSMENTS, RECRUITMENT AND RETENTION, GOVERNANCE AND BOARD TRAINING. |
| RELATED PARTY INFORMATION AMONG OFFICERS | FORM 990, PAGE 6, PART VI, LINE 2 | LIL ANDERSON ALAN STRANGE BOARD MEMBER OFFICER MARRIED |
| CLASSES OF MEMBERS OR STOCKHOLDERS | FORM 990, PAGE 6, PART VI, LINE 6 | MEMBERSHIP CONSISTS OF VARIOUS HEALTH CARE CENTERS THROUGHOUT MONTANA. |
| ELECTION OF MEMBERS AND THEIR RIGHTS | FORM 990, PAGE 6, PART VI, LINE 7A | EACH MEMBER APPOINTS ONE DIRECTOR OF THE GOVERNING BODY |
| ORGANIZATION'S PROCESS USED TO REVIEW FORM 990 | FORM 990, PAGE 6, PART VI, LINE 11B | FORM 990 IS REVIEWED BY STAFF, THEN PROVIDED TO ALL BOARD MEMBERS FOR REVIEW AND QUESTIONS. THE PREPARER IS AVAILABLE TO ANSWER QUESTIONS REGARDING THE FORM 990. THE BOARD OF DIRECTORS WILL AUTHORIZE AND APPROVE FORM 990 AT THEIR NOVEMBER 2011 BOARD MEETING. |
| ENFORCEMENT OF CONFLICTS POLICY | FORM 990, PAGE 6, PART VI, LINE 12C | THE ORGANIZATION'S CEO ROUTINELY AND THOROUGHLY REVIEWS COMPLIANCE AND MONITORS POLICIES. THE CEO FACILITATES THE REVIEW AND APPROVAL OF THE BOARD ANNUALLY BY VERBAL REVIEW OF THE POLICIES AND DISCUSSIONS OF ANY ISSUES OR NECESSARY CHANGES TO POLICIES DURING THEIR ANNUAL MEETING. THE BOARD MEMBERS ARE REQUIRED TO DISCLOSE CONFLICTS. |
| COMPENSATION PROCESS FOR TOP OFFICIAL | FORM 990, PAGE 6, PART VI, LINE 15A | SALARY OF THE CEO IS DETERMINED, REVIEWED AND APPROVED BY THE BOARD OF DIRECTORS AND DOCUMENTED IN THE EMPLOYMENT CONTRACT. |
| COMPENSATION PROCESS FOR OFFICERS | FORM 990, PAGE 6, PART VI, LINE 15B | CEO SETS SALARIES FOR OTHER EMPLOYEES BASED ON PERFORMANCE AND SALARIES PAID BY OTHER PCA ORGANIZATIONS. |
| GOVERNING DOCUMENTS DISCLOSURE EXPLANATION | FORM 990, PAGE 6, PART VI, LINE 19 | FINANCIAL STATEMENTS AND OTHER DOCUMENTS ARE AVAILABLE UPON REQUEST. |
| Software ID: | |
| Software Version: |