Attach to Form 990 or 990-EZ.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at| Return Reference | Explanation |
|---|---|
| FORM 990, PART III, LINE 1 | ORGANIZATION'S MISSION: TO IMPROVE THE DELIVERY OF ACCESSIBLE, EFFICIENT, COORDINATED, QUALITY AND APPROPRIATE HEALTH CARE SERVICES THAT MEETS THE NEEDS AND IMPROVES THE HEALTH STATUS OF THE MEDICALLY NEEDY THROUGH THE CREATION OF A COMPREHENSIVE, COMMUNITY BASED INTEGRATED HEALTH CARE DELIVERY NETWORK. |
| FORM 990, PART V, LINE 2A AND PART IX, LINES 5, 7, 8, 9 & 10 | COMMON PAYMASTER: IOWA PRIMARY CARE ASSOCIATION, A RELATED ORGANIZATION, CONTRACTS WITH FOCUS ONESOURCE, A PROFESSIONAL EMPLOYER ORGANIZATION, TO FILE ALL EMPLOYEE PAYROLL TAXES AND W-3 FILINGS. THE SALARY EXPENSES, PAYROLL TAXES, PENSION EXPENSE, AND EMPLOYEE BENEFITS LISTED ON PART IX ARE PAID BY IOWA PRIMARY CARE ASSOCIATION AND ALLOCATED TO IN CONCERTCARE FOR THE EMPLOYEES THAT ARE WORKING ON IN CONCERTCARE PROGRAMS. THESE EXPENSES ARE REIMBURSED BY IN CONCERTCARE TO IOWA PRIMARY CARE ASSOCIATION. |
| FORM 990, PART VI, SECTION A, LINE 3 | MANAGEMENT DUTIES: THE ORGANIZATION RECEIVES MANAGEMENT AND ADMINISTRATIVE SERVICES FROM IOWA PRIMARY CARE ASSOCIATION, A RELATED ORGANIZATION. |
| FORM 990, PART VI, SECTION B, LINE 6 & 7A | MEMBERS: THE ORGANIZATION MEMBERS ARE COMPRISED OF CORPORATE MEMBERS. FROM TIME TO TIME, BY VOTE OF APPROVAL OF THE BOARD OF DIRECTORS, THE CORPORATE MEMBERS MAY BE REQUIRED TO PROVIDE FUNDING TO THE CORPORATION. EACH CORPORATE MEMBER HAS THE RIGHT TO ANNUALLY APPOINT A SINGLE DIRECTOR TO SERVE ON THE BOARD OF DIRECTORS, WHICH OCCURS AT THE ANNUAL MEETING OF THE BOARD OF DIRECTORS. ANY DIRECTOR MAY BE REMOVED, WITH OR WITHOUT CAUSE, BY THE CORPORATE MEMBER THAT ELECTED THE DIRECTOR. |
| FORM 990, PART VI, SECTION B, LINE 11B | FORM 990 REVIEW PROCESS: THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION. PRIOR TO BEING FILED, A TENTATIVE DRAFT OF THE FORM 990 IS REVIEWED BY TOP MANAGEMENT AND THE BOARD FINANCE COMMITTEE. A FINAL DRAFT IS THEN PROVIDED TO THE FULL BOARD FOR REVIEW. |
| FORM 990, PART VI, SECTION B, LINE 12C | MONITORING COMPLIANCE WITH CONFLICTS OF INTEREST POLICY: THE ORGANIZATION'S CONFLICT OF INTEREST POLICY COVERS ALL EMPLOYEES AND BOARD MEMBERS. ALL BOARD MEMBERS, OFFICERS, AND KEY EMPLOYEES ARE REQUIRED TO SUBMIT AN ANNUAL CONFLICT OF INTEREST QUESTIONNAIRE. THE QUESTIONNAIRES ARE REVIEWED BY MANAGEMENT AND POTENTIAL CONFLICTS ARE PRESENTED TO THE CHIEF EXECUTIVE OFFICER AND/OR THE BOARD AS NEEDED. IF A CONFLICT OF INTEREST IS IDENTIFIED, RESTRICTIONS ARE DETERMINED ON CASE BY CASE BASIS. |
| FORM 990, PART VI, SECTION B, LINE 15A | COMPENSATION REVIEW POLICY: THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS OF IOWA PRIMARY CARE ASSOCIATION REVIEWED THE COMPENSATION OF THE CEO IN MARCH 2014 USING SALARY INFORMATION COMPILED BY THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS (NACHC). THE CEO'S SALARY IS PAID BY IOWA PRIMARY CARE ASSOCIATION AND IS ALLOCATED TO IN CONCERTCARE BASED ON ACTUAL WORK PERFORMED. THE BOARD CHAIR RETAINS A FILE DOCUMENTING THE COMPENSATION REVIEW PROCESS. |
| FORM 990, PART VI, SECTION B, LINE 15B | OTHER OFFICER COMPENSATION REVIEW POLICY: THE CEO OF IOWA PRIMARY CARE ASSOCIATION AND IN CONCERTCARE REVIEWED THE COMPENSATION OF THE CFO IN MARCH 2014 USING SALARY INFORMATION COMPILED BY THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS (NACHC). THE CFO'S SALARY IS PAID BY IOWA PRIMARY CARE ASSOCIATION AND IS ALLOCATED TO IN CONCERTCARE BASED ON ACTUAL WORK PERFORMED. THE CEO RETAINS A FILE DOCUMENTING THE COMPENSATION REVIEW PROCESS. |
| FORM 990, PART VI, SECTION C, LINE 19 | DOCUMENTS DISCLOSURE: THE ORGANIZATION GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE AT THE ORGANIZATION OFFICES OR UPON REQUEST. |
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