Attach to Form 990 or Form 990-EZ.
Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
| (i)Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 9 above (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
| Total | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any unusual grants.) .... | 9,649,495 | 7,301,272 | 8,317,280 | 6,783,570 | 9,676,534 | 41,728,151 |
| 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 | 9,649,495 | 7,301,272 | 8,317,280 | 6,783,570 | 9,676,534 | 41,728,151 |
| 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).. | 457,920 | |||||
| 6 | Public support. Subtract line 5 from line 4. | 41,270,231 | |||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 9,649,495 | 7,301,272 | 8,317,280 | 6,783,570 | 9,676,534 | 41,728,151 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | 2,366 | 1,795 | 5,766 | 15,123 | 20,801 | 45,851 |
| 9 | Net income from unrelated business activities, whether or not the business is regularly carried on.. | ||||||
| 10 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.).. | 0 | |||||
| 11 | Total support. Add lines 7 through 10. | 41,774,002 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (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.) | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (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 VI.) .. | ||||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | ||||||
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e |
Discount claimed for blockage or other factors (explain in detail in Part VI): |
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| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). | 4 | ||||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | ||||
| 6 | Multiply line 5 by .035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | ||
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
||
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | ||
| 4 Amounts paid to acquire exempt-use assets | ||
| 5 Qualified set-aside amounts (prior IRS approval required) | ||
| 6 Other distributions (describe in Part VI). See instructions | ||
| 7Total annual distributions. Add lines 1 through 6. | ||
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
||
| 9 Distributable amount for 2015 from Section C, line 6 | ||
| 10 Line 8 amount divided by Line 9 amount | ||
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2015 |
(iii) Distributable Amount for 2015 |
|
|---|---|---|---|---|
|
1
Distributable amount for 2015 from Section C, line 6 |
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|
2
Underdistributions, if any, for years prior to 2015 (reasonable cause required--see instructions) |
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| 3 Excess distributions carryover, if any, to 2015: | ||||
| a | ||||
| b | ||||
| c | ||||
| d From 2013....... | ||||
| e From 2014....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2015 distributable amount | ||||
|
i
Carryover from 2010 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | ||||
| 4Distributions for 2015 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2015 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from 4. | ||||
|
5
Remaining underdistributions for years prior to 2015, if any. Subtract lines 3g and 4a from line 2 (if amount greater than zero, see instructions) |
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|
6
Remaining underdistributions for 2015. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions) |
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|
7 Excess distributions carryover to 2016. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a | ||||
| b | ||||
| c Excess from 2013....... | ||||
| d From 2014....... | ||||
| e From 2015....... | ||||
| Facts And Circumstances Test |
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| Return Reference | Explanation |
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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 4D | OTHER PROGRAM SERVICES: MISSOURI COALITION FOR PRIMARY HEALTH CARE ALSO PROVIDES THE FOLLOWING SERVICES: -SUPPORT, TRAINING, AND TECHNICAL ASSISTANCE TO COMMUNITY HEALTH CENTERS -SUPPORT TO PRIMARY CARE PROVIDERS AND OTHER HEALTH CARE PROFESSIONALS IN ADOPTING ELECTRONIC HEALTH RECORDS (EHR) AND UTILIZING HEALTH INFORMATION TECHNOLOGY EFFECTIVELY TO IMPROVE THE QUALITY OF HEALTH CARE IN MISSOURI -SUPPORT FOR ADOPTION, IMPLEMENTATION, AND UPGRADE OF ELECTRONIC HEALTH RECORDS SYSTEMS, APPLICATION AND PAYMENT OF HIT MEANINGFUL USE INCENTIVES AND LEVERAGING PATIENT DATA FOR CLINICAL QUALITY IMPROVEMENT -SUPPORT FOR SUBLICENSING OF DATA WAREHOUSE/CLINICAL QUALITY MEASURES REPORTING SYSTEM TO MEMBERS. -PRACTICE COACHING SUPPORT TOWARD ACHIEVEMENT OF NATIONAL COMMITTEE FOR QUALITY ASSURANCE (NCQA) RECOGNITION AS PATIENT CENTERED MEDICAL HOMES -CLINICAL QUALITY MEASURES REPORTING TO MO HEALTHNET DIVISION AND TO PROVIDERS PARTICIPATING IN THE MISSOURI PRIMARY CARE HEALTH HOME INITIATIVE |
| FORM 990, PART VI, SECTION A, LINE 2 | DIRECTOR BUSINESS RELATIONSHIPS: ANDY GRIMM, DAVE BARBER, ROBERT MASSIE, DWAYNE BUTLER, GLORIA CRULL, RON CAMP, AND DON MCBRIDE ALL SHARE A BUSINESS RELATIONSHIP. |
| FORM 990, PART VI, SECTION A, LINE 6, 7A, & 7B | MEMBERS, STOCKHOLDERS, OR OTHER PERSONS: MEMBERSHIP IN THE CORPORATION SHALL BE LIMITED, NOT AS TO NUMBER, BUT AS TO PERSONS REPRESENTING ORGANIZATIONS AND INTEREST PERTINENT TO THE INTEREST/BUSINESS OR GOVERNANCE OF PRIMARY CARE ORGANIZATIONS OR AS OTHERWISE DEFINED IN THE BYLAWS OF THE CORPORATION. ORGANIZATIONAL OR VOTING MEMBERSHIP SHALL INCLUDE ONE REPRESENTATIVE FROM EACH OF THE SECTION 330 FEDERALLY FUNDED HEALTH CENTERS IN THE STATE OF MISSOURI THAT DESIRES TO HAVE A MEMBER. EACH MEMBER SHALL BE ENTITLED TO ONE VOTE ON EACH MATTER SUBMITTED TO A VOTE OF MEMBERS. EACH OF THE MEMBERS MAY APPOINT ONE DIRECTOR TO THE BOARD OF DIRECTORS TO SERVE A ONE YEAR TERM. |
| FORM 990, PART VI, SECTION B, LINE 11B | 990 REVIEW POLICY: 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. THE CFO AND CEO REVIEW THE FORM 990 AND EMAIL IT TO THE BOARD OF DIRECTORS FOR REVIEW. ONCE ALL COMMENTS AND QUESTIONS HAVE BEEN RESOLVED, THE CEO SIGNS THE RETURN. |
| FORM 990, PART VI, SECTION B, LINE 12C | CONFLICT OF INTEREST POLICY: ANNUALLY, MEMBERS AND EMPLOYEES ARE REQUIRED TO SIGN A DISCLOSURE CONCERNING CONFLICT OF INTEREST FORM. IF THERE IS A CONFLICT OF INTEREST, AN ATTACHED STATEMENT IS TO BE MADE WITH THE DISCLOSURE FORM. DISCLOSURE FORMS ARE REVIEWED BY THE CEO OR HIS DESIGNEE, OR THE BOARD PRESIDENT IN SPECIAL SITUATIONS, TO DETERMINE WHETHER ANY CONFLICTS OF INTEREST ARE DISCLOSED. IN THE EVENT CONFLICTS ARE DISCLOSED, THE DISCLOSURE CONCERNING CONFLICT OF INTEREST FORM LAYS OUT COURSES OF ACTION TO TAKE. |
| FORM 990, PART VI, SECTION B, LINE 15A | COMPENSATION REVIEW: THE PROCESS FOR DETERMINING THE COMPENSATION OF THE ORGANIZATION'S CEO INCLUDES AN ANNUAL REVIEW IN MARCH BY THE BOARD MEMBERS WHICH IS EVALUATED BY THE EXECUTIVE COMMITTEE. THE EXECUTIVE COMMITTEE TAKES INTO ACCOUNT JOB PERFORMANCE FOR THE PREVIOUS YEAR AS WELL AS COMPARABILITY DATA OF OTHER COMPARABLE-SIZED ORGANIZATIONS. THE EXECUTIVE COMMITTEE'S DELIBERATION AND DECISION ARE CONTEMPORANEOUSLY SUBSTANTIATED AND A RECOMMENDATION IS MADE TO THE BOARD. THE COMPENSATION PACKAGE IS ULTIMATELY APPROVED BY THE ENTIRE BOARD. DURING THE YEAR ENDED MARCH 31, 2016, THE BOARD ENGAGED A CONSULTING FIRM TO RESEARCH EXECUTIVE COMPENSATION AND MAKE A RECOMMENDATION FOR A SALARY RANGE FOR MPCA'S CHIEF EXECUTIVE AS WELL AS ITS OPERATING OFFICER, FINANCE OFFICER, AND ONE OTHER UPPER LEVEL MANAGEMENT POSITION. |
| FORM 990, PART VI, SECTION C, LINE 19 | DOCUMENT DISCLOSURE: ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | OTHER FEES FOR SERVICES: THE BREAKOUT OF OTHER FEES FOR SERVICES IS AS FOLLOWS: SUBRECIPIENT/CONSORTIA COST: $5,016,395 HEALTH INITIATIVE SERVICES 943,355 PROGRAMS FOR WOMEN & MINORITY HEALTHCARE 628,535 FQHC/CMHC MENTAL HEALTH AND PRIMARY CARE INTEGRATION 73,050 CHRONIC DISEASE COLLABORATIVE 49,286 NACHC MILLION HEARTS HYPERTENSION 8,000 RCHN GATEWAY TO MARKETPLACE ----------- $6,718,621 TOTAL SUBRECIPIENT/CONSORTIA COST CONTRACTED SERVICES: $ 717,149 MO PC HEALTH HOME INITIATIVE 338,547 DRVS (AZARA) 193,364 HEALTH CENTER CONTROLLED NETWORKS 158,841 CHC PRIMARY CARE AND MENTAL HEALTH INTEGRATION 93,062 BASE (BPHC) 68,259 HEALTH INITIATIVE SERVICES 47,187 CHRONIC DISEASE COLLABORATIVE 45,988 MU CHRONIC PAIN ECHO 2 35,468 DELTA SERVICES 28,050 MISSOURI HEALTH+ (IPA) 27,066 MPCA MEMBERSHIP 24,873 MU CHRONIC PAIN ECHO 24,251 MFH POPULATION HEALTH CHRONIC PAIN 19,948 HCFGKC ROADMAP TO PAYMENT REFORM 14,792 NACHC MILLION HEARTS HYPERTENSION 13,354 MFH ROADMAP TO PAYMENT REFORM 6,435 MOQUIN SERVICES 3,522 MO CLINICAL & QUALITY CONFERENCE (OH & MED) 2,970 PRIMO 5,082 MISCELLANEOUS PROGRAMS ----------- $1,868,208 TOTAL CONTRACTED SERVICES $8,586,829 TOTAL OTHER FEES FOR SERVICES |
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