Department of the Treasury Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
Attach to Form 990 or Form 990-EZ. See separate instructions.
OMB No. 1545-0047
2011
Open to Public Inspection
Name of the organization
REDWOOD COMMUNITY HEALTH COALITION
Employer identification number
94-3220029
Part I
Reason for Public Charity Status
(All organizations must complete this part.) See instructions
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).
f
If the organization received a written determination from the IRS that it is a Type I, Type II or Type III supporting organization, check this box
..................................................
g
Since August 17, 2006, has the organization accepted any gift or contribution from any of the following persons?
(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the the supported organization?
................
11g(i)
(ii)
a family member of a person described in (i) above?
......................
11g(ii)
(iii)
a 35% controlled entity of a person described in (i) or (ii) above?
................
11g(iii)
h
Provide the following information about the supported organization(s).
(i) Name of supported organization
(ii) EIN
(iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions))
(iv) Is the organization in col. (i) listed in your governing document?
(v) Did you notify the organization in col. (i) of your support?
(vi) Is the organization in col. (i) organized in the U.S.?
(vii) Amount of support?
Yes
No
Yes
No
Yes
No
Total
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2011
Schedule A (Form 990 or 990-EZ) 2011
Page 2
Part II
Support Schedule for Organizations Described in IRC 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi) (Complete only if you checked the box on line 5, 7, or 8 of Part I or if the
organization failed to qualify under Part III. If the organization fails to
qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year(or fiscal year beginning in)
(a) 2007
(b) 2008
(c) 2009
(d) 2010
(e) 2011
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
1,843,669
1,504,585
1,015,862
1,341,985
1,531,945
7,238,046
2
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
3
The value of services or facilities furnished by a governmental unit to the organization without charge..
4
Total. Add lines 1 through 3..
1,843,669
1,504,585
1,015,862
1,341,985
1,531,945
7,238,046
5
The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included
on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6
Public Support. Subtract line 5 from line 4.
7,238,046
Section B. Total Support
Calendar year(or fiscal year beginning in)
(a) 2007
(b) 2008
(c) 2009
(d) 2010
(e) 2011
(f) Total
7
Amounts from line 4..
1,843,669
1,504,585
1,015,862
1,341,985
1,531,945
7,238,046
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
12,084
11,401
5,778
10,510
320
40,093
9
Net income from unrelated business activities, whether or not the business is regularly carried on..
10
Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..
455,792
20,387
35,729
20,561
1,070
533,539
11
Total support (Add lines 7 through 10).
7,811,678
12
Gross receipts from related activities, etc. (See instructions.)
..................
12
184,587
13
First Five Years
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here..........................................
Section C. Computation of Public Support Percentage
14
Public Support Percentage for 2010 (line 6 column (f) divided by line 11 column (f))
.........
14
92.657 %
15
Public Support Percentage for 2009 Schedule A, Part II, line 14
...............
15
92.400 %
16a
33 1/3% support test—2011.
If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization
......................
b
33 1/3% support test—2010.
If the organization did not check the box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization
.....................
17a
10%-facts-and-circumstances test—2011.
If the organization did not check a box on line 13, 16a, or 16b and line 14
is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported
organization
..................................................
b
10%-facts-and-circumstances test—2010.
If the organization did not check a box on line 13, 16a, 16b, or 17a and line
15 is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported organization
..............................................
18
Private Foundation
If the organization did not check a box on line 13, 16a, 16b, 17a or 17b, check this box and see
instructions
...................................................
Schedule A (Form 990 or 990-EZ) 2011
Schedule A (Form 990 or 990-EZ) 2011
Page 3
Part III
Support Schedule for Organizations Described in IRC 509(a)(2) (Complete only if you checked the box on line 9 of Part I or if the organization
failed to qualify under Part II. If the organization fails to qualify under
the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year(or fiscal year beginning in)
(a) 2007
(b) 2008
(c) 2009
(d) 2010
(e) 2011
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2
Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......
3
Gross receipts from activities that are not an unrelated trade or business under section 513..
4
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5
The value of services or facilities furnished by a governmental unit to the organization without charge..
6
Total. Add lines 1 through 5.
7a
Amounts included on lines 1, 2, and 3 received from disqualified persons...
b
Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c
Add lines 7a and 7b..
8
Public Support (Subtract line 7c from line 6.)
Section B. Total Support
Calendar year (or fiscal year beginning in)
(a) 2007
(b) 2008
(c) 2009
(d) 2010
(e) 2011
(f) Total
9
Amounts from line 6...
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c
Add lines 10a and 10b.
11
Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12
Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)
13
Total support (Add lines 9, 10c, 11 and 12.).
14
First Five Years
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here.............................................
Section C. Computation of Public Support Percentage
15
Public Support Percentage for 2011 (line 8 column (f) divided by line 13 column (f))
.........
15
16
Public support percentage from 2010 Schedule A, Part III, line 15
...............
16
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2011 (line 10c column (f) divided by line 13 column (f))
......
17
18
Investment income percentage from 2010 Schedule A, Part III, line 17
.............
18
19a
33 1/3% support tests—2011.
If the organization did not check the box on line 14, and line 15 is more than 33 1/3% and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
..........
b
33 1/3% support tests—2010.
If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
....
20
Private Foundation
If the organization did not check a box on line 14, 19a or 19b, check this box and see instructions
.....
Schedule A (Form 990 or 990-EZ) 2011
Schedule A (Form 990 or 990-EZ) 2011
Page 4
Part IV
Supplemental Information.
Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
Explanation
Schedule A (Form 990 or 990-EZ) 2011
Additional Data
Software ID:
Software Version:
-
TIN:
SCHEDULE O (Form 990 or 990-EZ)
Department of the Treasury Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ
Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2011
Open to Public Inspection
Name of the organization
REDWOOD COMMUNITY HEALTH COALITION
Employer identification number
94-3220029
Identifier
Return Reference
Explanation
FORM 990, PART I , LINE 1 & PART III, LINE 1: THE MISSION STATEMENT OF THE
COALITION AS A CONSORTIUM OF SAFE-NET HEALTH CARE SERVICE PROVIDERS IS
DEDICATED TO STRENGTHENING A COMMUNITY-WIDE SYSTEM OF COMPREHENSIVE, HIGH QUALITY, ACCESSIBLE, AFFORDABLE HEALTH SERVICES. THE COALITION IS COMMITTED TO MEETING THE NEEDS OF ITS MEMBERS' DIVERSE, MULTI-CULTURED POPULATION THROUGH SERVICE, EDUCATION AND ADVOCACY.
FORM 990, PART VI, SECTION A, LINE 6: THE ORGANIZATION HAS TWO CLASSES OF
MEMBERS: ASSOCIATED MEMBERS AND COLLABORATIVE MEMBERS.
ASSOCIATED MEMBERS ARE MEMBERS OF THE CORPORATION. EACH MEMBER SHALL HAVE ONE VOTE. ASSOCIATED MEMBERS CONSTITUTE LICENSED COMMUNITY, FREE AND TRIBAL CLINICS. EACH ASSOCIATED MEMBER HAS A COMMUNITY-BASED BOARD OF DIRECTORS AND IS EXEMPT FROM TAXATION UNDER SECTION 501(C)(3) OR THE INTERNAL REVENUE CODE. EACH ASSOCIATED MEMBER IS ALSO A PRIMARY CARE CLINIC WITH A MISSION TO SERVE LOW-INCOME INDIVIDUALS IN AN AREA LOCATED WITHIN THE CORPORATION'S SERVICE AREA AND TO OFFER SERVICES WITH A SLIDING FEE SCALE AND WITHOUT REGARD FOR A PATIENT'S ABILITY TO PAY. COLLABORATIVE MEMBERS ARE MEMBERS OF THE CORPORATION. EACH COLLABORATIVE MEMBER SHALL HAVE ONE VOTE. COLLABORATIVE MEMBERS SHALL CONSTITUTE PUBLIC OR PRIVATE PRIMARY HEALTH CARE PROVIDERS THAT DO NOT MEET THE REQUIREMENTS OF AN ASSOCIATED MEMBER. EACH COLLABORATIVE MEMBER SHALL HAVE A MISSION TO SERVE LOW-INCOME INDIVIDUALS IN AN AREA LOCATED WITHIN THE CORPORATION'S SERVICE AREA AND TO OFFER SERVICES WITH A SLIDING FEE SCALE AND WITHOUT REGARD FOR A PARTIENT'S ABILITY TO PAY.
FORM 990, PART VI, SECTION A, LINE 7A: ASSOCIATED MEMBERS AND
COLLABORATIVE MEMBERS HAVE THE POWER TO ELECT OR APPOINT ONE OR MORE MEMBERS OF THE GOVERNING BODY.
FORM 990, PART VI, SECTION A, LINE 7B: THE FOLLOWING DECISIONS OF THE
GOVERNING BODY ARE SUBJECT TO APPROVAL BY THE ORGANIZATION'S MEMBERS:
1. APPOINTMENT AND REMOVAL OF DIRECTORS 2. APPOINTMENT AND REMOVAL OF MEMBERS 3. ADOPTION OF A PLAN OF MERGER, CONSOLIDATION, OR ASSETS ACQUISITION INVOLVING THE ORGANIZATION 4. AUTHORIZATION OR REVOCATION OF PROCEEDINGS FOR A VOLUNTARY DISSOLUTION OF THE ORGANIZATION
FORM 990, PART VI, SECTION B, LINE 11B: THE FORM 990 IS REVIEWED BY THE
CHIEF FINANCIAL OFFICER BEFORE IT IS FILED WITH THE IRS.
FORM 990, PART VI, SECTION B, LINE 12C: OFFICERS, DIRECTORS, TRUSTEES, AND
KEY EMPLOYEES ARE REQUIRED TO READ AND UNDERSTAND THIS POLICY AND SELF
REPORT. IF AN OFFICER, DIRECTOR, TRUSTEE, OR KEY EMPLOYEE IS INVOLVED IN A CONFLICT OF INTEREST SITUATION, THEY ARE REQUIRED TO BRING IT TO THE ATTENTION OF THE APPROPRIATE PERSON OR GROUP (BOARD CHAIR, THE ENTIRE BOARD OR THE MEMBERS OF THE COMMITTEE CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT THAT RELATES TO THE ACTUAL OR POSSIBLE CONFLICT OF INTEREST) SO THAT THE POTENTIAL CONFLICT CAN BE EVALUATED AND ADDRESSED.
FORM 990, PART VI, SECTION B, LINE 15A: THE PROCESS USED TO DETERMINE THE
COMPENSATION FOR THE CEO IS AN ANNUAL REVIEW PERFORMED BY MEMBERS. THE BOARD OF DIRECTORS DETERMINES NEW SALARY.
FORM 990, PART VI, SECTION B, LINE 15B: THE PROCESS USED TO DETERMINE THE
COMPENSATION OF OTHER OFFICERS IS AN ANNUAL REVIEW AND COMPARATIVE SALARY ANALYSES REPORTED BY SIMILAR COALITIONS TO DETERMINE THE SALARY BASE.
FORM 990, PART VI, SECTION C, LINE 19: REDWOOD COMMUNITY HEALTH COALITION
MAKES ITS FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART XI, LINE 5: UNRESTRICTED NET ASSETS AT JUNE 30, 2011 HAVE
BEEN ADJUSTED FOR COMPUTER SOFTWARE LICENSES BOUGHT BY THE ORGANIZATION
ON BEHALF OF AN AFFILIATE. WHEN THESE LICENSES WERE TRANSFERRED TO THE AFFILIATE, THEY WERE NOT PROPERLY REMOVED FROM THE ORGANIZATION'S PROPERTY AND EQUIPMENT. THE CORRECTION RESULTED IN A $251,697 DECREASE IN NET ASSETS.
HOURS DEVOTED FOR RELATED ORGANIZATION
FORM 990 PART VII
NAME:MARY SZECSEY TITLE:CHAIR HOURS:1
HOURS DEVOTED FOR RELATED ORGANIZATION
FORM 990 PART VII
NAME:KATHIE POWELL TITLE:TREASURER HOURS:1
HOURS DEVOTED FOR RELATED ORGANIZATION
FORM 990 PART VII
NAME:JACK NEUREUTER TITLE:SECRETARY HOURS:1
HOURS DEVOTED FOR RELATED ORGANIZATION
FORM 990 PART VII
NAME:ERIC HOLZBERG TITLE:CFO - PART YEAR HOURS:10
HOURS DEVOTED FOR RELATED ORGANIZATION
FORM 990 PART VII
NAME:ROBERT SCOTT YTURRIA TITLE:CFO - PART YEAR HOURS:20
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.