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. Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
CARE ALLIANCE
Employer identification number
34-1748776
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 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 monetary support
Yes
No
Yes
No
Yes
No
Total
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 2
Part II
Support Schedule for Organizations Described in Sections 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) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
3,769,804
4,216,916
3,971,238
5,330,511
10,996,533
28,285,002
2
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
0
3
The value of services or facilities furnished by a governmental unit to the organization without charge..
0
4
Total. Add lines 1 through 3
3,769,804
4,216,916
3,971,238
5,330,511
10,996,533
28,285,002
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)..
413,938
6
Public support. Subtract line 5 from line 4.
27,871,064
Section B. Total Support
Calendar year
(or fiscal year beginning in)
(a) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(f) Total
7
Amounts from line 4..
3,769,804
4,216,916
3,971,238
5,330,511
10,996,533
28,285,002
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
20,301
16,963
37,552
23,760
413
98,989
9
Net income from unrelated business activities, whether or not the business is regularly carried on..
0
10
Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)..
183,789
157,842
168,965
199,655
208,868
919,119
11
Total support (Add lines 7 through 10).
29,303,110
12
Gross receipts from related activities, etc. (see instructions)
..................
12
4,516,605
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 2013 (line 6, column (f) divided by line 11, column (f))
.........
14
95.113 %
15
Public support percentage for 2012 Schedule A, Part II, line 14
...............
15
95.577 %
16a
33 1/3% support test—2013.
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—2012.
If the organization did not check a 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—2013.
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—2012.
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) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 3
Part III
Support Schedule for Organizations Described in Section 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) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(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) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(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 2013 (line 8, column (f) divided by line 13, column (f))
.........
15
16
Public support percentage from 2012 Schedule A, Part III, line 15
...............
16
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2013 (line 10c, column (f) divided by line 13, column (f))
......
17
18
Investment income percentage from 2012 Schedule A, Part III, line 17
.............
18
19a
33 1/3% support tests—2013.
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—2012.
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) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 4
Part IV
Supplemental Information.
Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; and 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) 2013
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.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
CARE ALLIANCE
Employer identification number
34-1748776
Return Reference
Explanation
REVIEW OF FORM 990 - FORM 990, PART VI, LINE 11B:
A DRAFT COPY OF FORM 990 IS REVIEWED BY MANAGEMENT AND MEMBERS OF THE FINANCE COMMITTEE WITH THE ASSISTANCE OF AN OUTSIDE PUBLIC ACCOUNTING FIRM. AFTER ANY CHANGES ARE MADE, AN UPDATED VERSION OF FORM 990 IS E-MAILED TO ALL BOARD MEMBERS FOR COMMENT BEFORE IT IS FILED.
MONITORING AND ENFORCEMENT OF CONFLICT POLICY - FORM 990,PART VI,LINE 12C:
CARE ALLIANCE HAS IDENTIFIED THE CHIEF FINANCIAL OFFICER (CFO) AS THE INDIVIDUAL RESPONSIBLE FOR MONITORING AND ENFORCING COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. THE CFO REVIEWS THE ANNUAL DISCLOSURE FORMS OF COVERED PERSONS AND COMPILES AND MAINTAINS A LIST OF POTENTIALLY CONFLICTED ENTITIES AND INDIVIDUALS. THE CFO FOLLOWS THE PROCEDURES OF THE POLICY TO DETERMINE WHETHER A CONFLICT OF INTEREST EXISTS AND THE PROCEDURES FOR ADDRESSING IT. THE CFO DOCUMENTS THE DECISIONS RELATED TO TRANSACTIONS INVOLVING AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST AND THE APPROPRIATE ACTION TAKEN. SUCH DECISIONS ARE MADE BY INDIVIDUALS WHO DO NOT HAVE A CONFLICT WITH RESPECT TO THE TRANSACTION.
COMPENSATION REVIEW AND APPROVAL - FORM 990, PART VI, LINE 15:
CARE ALLIANCE'S BOARD OF TRUSTEES ENGAGED AN OUTSIDE CONSULTANT IN JULY OF 2014 TO PERFORM A MARKET-BASED COMPENSATION ASSESSMENT FOR ALL POSITIONS. THE COMPENSATION REPORT NOTED THAT THE COMPENSATION FOR THE EXECUTIVES OF CARE ALLIANCE WAS BELOW MARKET AND THAT THE ALTRUISTIC MISSION WAS A BENEFICIAL FACTOR IN ATTRACTING AND RETAINING QUALIFIED EMPLOYEES. ANNUAL COMPENSATION DECISIONS FOR EXECUTIVES ARE MADE BY A SUB-COMMITTEE OF THE BOARD OF TRUSTEES BASED ON THE COMPENSATION SURVEY AND PERFORMANCE EVALUATIONS. MEMBERS OF THE SUB-COMMITTEE ARE INDEPENDENT OF THE INDIVIDUALS WHOSE COMPENSATION IS BEING DETERMINED.
AVAILABILITY OF DOCUMENTS - FORM 990, PART VI, LINE 19:
THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST.
SUPPLEMENTAL PROGRAM SERVICES INFORMATION - FORM 990, PART III, LINE 4:
CARE ALLIANCE HEALTH CENTER WAS ESTABLISHED IN 1985 AS ONE OF THE ORIGINAL ROBERT WOOD JOHNSON FOUNDATION HEALTH CARE FOR THE HOMELESS PROJECTS AND IN 1994 BECAME AN INDEPENDENT NONPROFIT ORGANIZATION. THE MISSION OF CARE ALLIANCE IS TO "PROVIDE HIGH QUALITY, COMPREHENSIVE HEALTH CARE, PATIENT ADVOCACY, AND RELATED SERVICES TO PEOPLE WHO NEED THEM MOST, REGARDLESS OF THEIR ABILITY TO PAY." TODAY, CARE ALLIANCE IS A WELL-RESPECTED AND INTEGRAL MEMBER OF THE LOCAL SYSTEM OF SAFETY NET HEALTH CARE PROVIDERS WITH OVER TWENTY-FIVE YEARS OF EXPERIENCE PROVIDING HIGH QUALITY, COMPREHENSIVE HEALTH AND DENTAL SERVICES TO INDIVIDUALS AND FAMILIES WHO ARE EXPERIENCING HOMELESSNESS, LIVING IN PUBLIC HOUSING, LOW INCOME AND UNINSURED. AS THE ONLY HEALTH CARE PROVIDER IN CLEVELAND THAT FOCUSES ON THE UNIQUE HEALTH CARE NEEDS OF INDIVIDUALS AND FAMILIES WHO ARE EXPERIENCING HOMELESSNESS, CARE ALLIANCE HAS DEVELOPED A VERY STRONG RAPPORT WITH THIS POPULATION AND OTHER SERVICE PROVIDERS THROUGHOUT THE COMMUNITY THAT ALSO SERVE THIS POPULATION. DEDICATED TO THE THEME, "BECAUSE EVERYONE DESERVES QUALITY HEALTH CARE", CARE ALLIANCE OPERATES THREE CLINICS, STRATEGICALLY LOCATED THROUGHOUT CLEVELAND WHERE INDIVIDUALS AND FAMILIES EXPERIENCING HOMELESSNESS MAY OBTAIN SERVICES. CARE ALLIANCE'S PRIMARY CLINIC IS LOCATED DOWNTOWN NEAR THE LARGEST HOMELESS SHELTERS IN THE CITY, AND CARE ALLIANCE'S EAST AND WEST SIDE CLINICS ARE LOCATED WITHIN PUBLIC HOUSING FACILITIES, DESIGNED TO BE ACCESSIBLE TO THOSE LIVING IN AND AROUND PUBLIC HOUSING. IN ADDITION TO OFFERING PRIMARY HEALTH CARE AND ORAL HEALTH SERVICES, CARE ALLIANCE OFFERS HIV TESTING, TREATMENT AND COUNSELING; DIABETES MANAGEMENT; CASE MANAGEMENT; SHORT-TERM SUBSTANCE ABUSE AND BEHAVIORAL HEALTH COUNSELING; OUTREACH TO PEOPLE LIVING ON THE STREET; AND WOMEN'S HEALTH SERVICES. IT IS ESTIMATED THAT ON ANY GIVEN NIGHT IN CLEVELAND, THERE ARE OVER FOUR THOUSAND INDIVIDUALS EXPERIENCING HOMELESSNESS; SLEEPING IN SHELTERS, ON THE STREETS, IN ABANDONED HOUSES, OR DOUBLING UP WITH FRIENDS AND RELATIVES. THE SIZE OF THE HOMELESS POPULATION IS ANTICIPATED TO CONTINUE TO GROW. IN 2014 ALONE, CARE ALLIANCE SERVED 9,954 PATIENTS, GENERATING OVER 32,630 ENCOUNTERS. OF THE PATIENTS SERVED, NINETY-SIX PERCENT (96%) WERE LIVING BELOW THE FEDERAL POVERTY LINE AND FIFTY PERCENT (50%) HAD NO FORM OF HEALTH INSURANCE. FIFTY-NINE PERCENT (59%) WERE CONSIDERED HOMELESS AND FORTY-ONE PERCENT (41%) WERE PUBLIC HOUSING RESIDENTS. IN 2008, CARE ALLIANCE BECAME A PART OF THE BETTER HEALTH GREATER CLEVELAND (BHGC) INITIATIVE: AN ALLIANCE OF HOSPITALS, FEDERALLY QUALIFIED HEALTH CENTERS, FREE CLINICS AND MANAGED CARE ORGANIZATIONS COMMITTED TO IMPROVING HEALTH BY SETTING HIGH REGIONAL QUALITY INDICATORS. THROUGH THIS PARTNERSHIP, CARE ALLIANCE'S PATIENT HEALTH OUTCOMES ARE COMPARED AND CONTRASTED TO THOSE OF OTHER REGIONAL MAJOR MEDICAL PROVIDERS. ADDITIONALLY, CARE ALLIANCE CONTINUES TO PARTICIPATE WITH THE LOCAL SAFETY NET CLINICIANS' STRATEGIC ALLIANCE AND THE NATIONAL HEALTH DISPARITIES COLLABORATIVE, FOCUSING ON DIABETES. INTERNALLY, CARE ALLIANCE'S QUALITY IMPROVEMENT/RISK MANAGEMENT COMMITTEE LOOKS AT INDICATORS RELEVANT TO CHRONIC CARE INCLUDING: BLOOD PRESSURE FOR INDIVIDUALS WITH HYPERTENSION AND DIABETES, HEMOGLOBIN A1C LEVELS, CHOLESTEROL, AND ANNUAL FOOT EXAMS. DESPITE THE UNIQUE CHALLENGES THAT OUR PATIENTS FACE IN OBTAINING AND MAINTAINING GOOD HEALTH, CARE ALLIANCE IS CONSISTENTLY RANKED AMONG THE LEADING HEALTH CARE PROVIDERS IN PATIENT OUTCOMES THROUGHOUT CLEVELAND. STAY INVOLVED WITH CARE ALLIANCE: WWW.CAREALLIANCE.ORG SIGN-UP FOR OUR NEWSLETTER: WWW.CAREALLIANCE.ORG/NEWSLETTER.HTML TAKE PART IN OUR ANNUAL FUNDRAISER: HTTP://LETSTALKTURKEY.EVENTBRITE.COM BECOME OUR FRIEND ON FACEBOOK: WWW.FACEBOOK.COM/CAREALLIANCE FOLLOW US ON TWITTER! HTTP://TWITTER.COM/CAREALLIANCE WATCH OUR VIDEOS ON YOUTUBE: WWW.YOUTUBE.COM/CAREALLIANCE
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.