2019-04-26T18:19:58-05:00 2018-06-30 910189318 MOSS ADAMS LLP 101 SECOND STREET SUITE 900 SAN FRANCISCO CA 94105 990 2017-07-01 941744108 LA CLINICA DE LA RAZA INC LACL 5105354000 PO BOX 22210 OAKLAND CA 946232210 SUSAN MOORE CFO 5105354000 2019-04-25 1 MICHAEL LUMSDEN P01262236 4159561500 2019-04-17 12.129.7.100 2019-04-25 18:04:06 PD P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 32BFBF1104AA8EEBC72962A0CCB0C2C16BC479E3 2017 2019-02-21 02:37:17Z JANE C GARCIA PO BOX 22210 OAKLAND CA 946232210 115803779 0 X WWW.LACLINICA.ORG X 1971 CA COMPREHENSIVE MEDICAL SERVICES TO INDIVIDUALS IN NEED, REGARDLESS OF RACE, AGE OR ABILITY TO PAY. 16 16 1350 260 0 95367 29427380 40433770 70580875 74855234 414080 442077 532874 -43953 100955209 115687128 0 0 0 0 74799767 77770420 0 0 220127 25580248 25975143 100380015 103745563 575194 11941565 72900655 84747296 30391277 30985344 42509378 53761952 X TO IMPROVE THE QUALITY OF LIFE OF THE DIVERSE COMMUNITIES WE SERVE BY PROVIDING CULTURALLY APPROPRIATE, HIGH QUALITY, AND ACCESSIBLE HEALTH CARE FOR ALL. 0 0 86602746 0 74855234 LA CLINICA DE LA RAZA, INC. (THE ORGANIZATION") IS A NONPROFIT COMPREHENSIVE COMMUNITY HEALTH CENTER. IT PROVIDES A FULL RANGE OF SERVICES, WHICH INCLUDE MEDICAL, DENTAL, OPTICAL, MENTAL HEALTH, HEALTH EDUCATION, NUTRITION, SOCIAL SUPPORT, PHARMACY, LABORATORY, AND RADIOLOGY. LOCATED IN OAKLAND, SAN LEANDRO, AND SAN LORENZO IN ALAMEDA COUNTY; PITTSBURG, OAKLEY, AND CONCORD IN CONTRA COSTA COUNTY; AND VALLEJO IN SOLANO COUNTY, THE ORGANIZATION SERVED 91,750 PATIENTS DURING THE 6/30/2018 FISCAL YEAR. THE ORGANIZATION OPERATES AT MORE THAN THREE DOZEN LOCATIONS, INCLUDING THE FOLLOWING CLINICS: MEDICAL, DENTAL, AND BEHAVIORAL HEALTH CLINICS AT LA CLINICA DE LA RAZA (AT THE FRUITVALE TRANSIT VILLAGE) WHICH INCLUDES PHARMACY, LABORATORY, AND RADIOLOGY; LA CLINICA DE LA RAZA DENTAL (ON FRUITVALE AVENUE); CASA DEL SOL (MENTAL HEALTH CLINIC) I, II, AND III; CLINICA ALTA VISTA (A TEEN CLINIC); SAN ANTONIO NEIGHBORHOOD HEALTH CENTER, WHICH INCLUDES PHARMACY; FAMILY OPTICAL (EYE CLINIC); TWO WOMEN INFANTS AND CHILDREN ("WIC") PROGRAMS, ONE IN THE SAN ANTONIO NEIGHBORHOOD HEALTH CENTER AND ONE AT A FREE-STANDING SITE; A DENTAL CLINIC NEAR CHILDREN'S HOSPITAL OAKLAND; DAVIS PEDIATRICS, A PEDIATRIC PRACTICE ON FOOTHILL BOULEVARD; A MEDICAL CLINIC IN PITTSBURG; A DENTAL CLINIC IN PITTSBURG; A MOBILE DENTAL CLINIC SERVING CONTRA COSTA COUNTY; A MEDICAL, DENTAL, AND OPTICAL CLINIC IN CONCORD; A MEDICAL CLINIC IN OAKLEY; THREE MEDICAL CLINICS IN VALLEJO; AND A DENTAL CLINIC IN VALLEJO. THE ORGANIZATION ALSO RUNS EIGHT SCHOOL-BASED CLINICS: HAWTHORNE ELEMENTARY SCHOOL-BASED CLINIC, ROOSEVELT HEALTH CENTER, TIGER HEALTH CLINIC (AT FREMONT HIGH), SAN LORENZO HIGH HEALTH CENTER, TECHNICLINIC (AT OAKLAND TECHNICAL HIGH), HAVENSCOURT HEALTH CENTER, YOUTH HEART HEALTH CENTER (AT DOWNTOWN EDUCATIONAL COMPLEX), AND FUENTE WELLNESS CENTER (AT REACH ASHLAND YOUTH CENTER). 86602746 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 375 0 1 1350 1 1 1 0 0 0 0 1 1 0 0 0 0 X 16 16 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X SUSAN MOORE 5105352924 1450 FRUITVALE AVENUE THIRD FLOOR OAKLAND CA 94601 JILL ELIZABETH NOONAN JD RN PRESIDENT 1.00 0.00 X X 0 0 0 DANIEL AYALA VICE PRESIDENT (THROUGH 9/2017) 1.00 0.00 X X 0 0 0 AISHA HAMPTON-BOWSER VICE PRESIDENT (START 9/2017) 1.00 0.00 X X 0 0 0 NORMA GUADALUPE GUERRERO SECRETARY (THROUGH 9/2017) 1.00 0.00 X X 0 0 0 YVONNE HUDSON-HARMON SECRETARY (START 9/2017) 1.00 0.00 X X 0 0 0 PAUL MARRIOTT SWENSON MBA TREASURER 1.00 0.00 X X 0 0 0 MARIA DE LOS ANGELES ESPINOZA PARLIAMENTARIAN 1.00 0.00 X X 0 0 0 FRANCISCA AVALOS DIRECTOR (THROUGH 12/2017) 1.00 0.00 X 0 0 0 SOPHIA BUCHELI DIRECTOR 1.00 0.00 X 0 0 0 ELIZABETH DIAZ DIRECTOR 1.00 0.00 X 0 0 0 DORA ECKENFELDER DIRECTOR 1.00 0.00 X 0 0 0 RACHEL HARRALSON DIRECTOR 1.00 0.00 X 0 0 0 ROBERT CALVIN KATTER DIRECTOR 1.00 0.00 X 0 0 0 REVEREND RODNEY J LEGGETT DIRECTOR 1.00 0.00 X 0 0 0 CHRIS OHMAN DIRECTOR 1.00 0.00 X 0 0 0 ANDREW PETERSON JR DIRECTOR (THROUGH 1/2018) 1.00 0.00 X 0 0 0 RAMON TERRAZAS MD MPH DIRECTOR 1.00 0.00 X 0 0 0 MARIA TSAKLANOS DIRECTOR 1.00 0.00 X 0 0 0 JANE C GARCIA CEO 40.00 0.00 X 276415 0 82568 ALBERTO DIAZ CFO (THROUGH 12/2017) 40.00 0.00 X 209509 0 1812 SUSAN MOORE CFO (START 3/2018) 40.00 0.00 X 0 0 0 PAUL J BAYARD CHIEF MEDICAL OFFICER 40.00 0.00 X 211776 0 28175 JORGE S SIOPACK PHYSICIAN - OB 40.00 0.00 X 305456 0 2425 SUSAN SYKES OB-GYN, ASSOCIATE MEDICAL DIRECTOR 40.00 0.00 X 251145 0 27886 LISA MONTANG PHYSICIAN, ASSOCIATE MED. DIRECTOR 40.00 0.00 X 217927 0 28252 JOHN MURPHY MEDICAL INFORMATION OFFICER 40.00 0.00 X 199024 0 2175 CHARLES SOM CONTRA COSTA REG. MED. DIRECTOR, DO 40.00 0.00 X 198589 0 29727 1869841 0 203020 111 0 1 0 TOWNSHIP BUILDING SERVICES INC 26 PAMARON WAY SUITE A NOVATO CA 94949 JANITORIAL SERVICES 894624 SECURITY ENFORCEMENT ALLIANCE PO BOX 2279 NAPA CA 94558 SECURITY SERVICES 810341 QUALITY SYSTEMS INC PO BOX 511449 LOS ANGELES CA 90051 SOFTWARE MAINTENANCE 716437 MED TECH SOLUTIONS 25060 AVENUE STANFORD SUITE 250 VALENCIA CA 91355 SOFTWARE MAINTENANCE 655357 QUEST DIAGNOSTICS PO BOX 50368 LOS ANGELES CA 90074 OUTSTIDE LAB SERVICES 579359 18 242388 23700957 16490425 1275026 40433770 NET PATIENT REVENUE 621400 63010051 63010051 CAPITATION REVENUE 621400 6770243 6770243 PHARMACY - 340B PROG REV 621400 2394758 2394758 OTHER OPERATING REV 621400 2310442 2310442 MEANINGFUL USE INCENTIVES 621400 369740 369740 74855234 442077 442077 71368 242388 116532 -45164 -45164 1330 119 1211 1211 115687128 74855234 0 398124 764138 233629 530509 59708748 50769682 8839694 99372 1659861 1370268 288069 1524 11383181 9550520 1818204 14457 4254492 3581172 666203 7117 217452 8963 208489 131700 5600 126100 7168939 5544472 1577103 47364 2040 1587 453 3835516 2571100 1240271 24145 1648941 1648941 3468910 2728156 740633 121 175997 92310 65541 18146 36612 33624 2988 310697 310697 1521422 1248186 273236 347681 30221 317460 MEDICAL SUPPLIES 4998958 4993276 5682 IN-KIND DONATIONS 1275026 1275026 TAXES & FEES 339652 146786 184985 7881 EQUIPMENT LEASE 209540 172470 37070 286060 286060 103745563 86602746 16922690 220127 336809 360063 17528020 23550433 6122046 5577964 7531374 10610205 195861 207212 598062 716292 52210783 21772132 27657655 30438651 12441867 12443597 488961 842879 72900655 84747296 10271537 10633840 6852504 5490572 7421566 7030021 2159501 1903253 3686169 5927658 30391277 30985344 X 41632249 46334922 877129 7427030 42509378 53761952 72900655 84747296 X 11941565 -385308 -303683 X 0 1 X 1 1 1 X 28547818 26883134 28382966 29427380 40433770 153675068 28547818 26883134 28382966 29427380 40433770 153675068 246154 153428914 449994 387301 347027 414080 442077 2040479 147392 129958 1211 278561 544915 1590860 423742 402916 2962433 158956541 343280903 0.96520 0.96000 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: OTHER INCOME - 2013 AMOUNT: $ 544,915. 2014 AMOUNT: $ 1,590,860. 2015 AMOUNT: $ 423,742. 2016 AMOUNT: $ 402,916. 2017 AMOUNT: $ 0. 1 0 0 0 0 0 0 0 0 0 0 PART II-B, LINE 1: VOLUNTEERS OF THE ORGANIZATION SPENT TIME IN AN ATTEMPT TO INFLUENCE PUBLIC OPINION ON LEGISLATIVE MATTERS. 2326503 2326503 36218016 13867861 22350155 9126828 7904271 1222557 4539436 4539436 30438651 ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS 5927658 5927658 X 115388923 -385308 274135 -303683 -414856 115803779 -116651 -116651 115687128 104136349 274135 116651 390786 103745563 0 103745563 PART X, LINE 2: THE ORGANIZATION IS A NONPROFIT CORPORATION UNDER INTERNAL REVENUE CODE SECTION 501(C)(3) AND HAS BEEN GRANTED TAX-EXEMPT STATUS BY THE INTERNAL REVENUE SERVICE AND THE CALIFORNIA REVENUE AND TAXATION CODE. AS OF JUNE 30, 2018 AND 2017, THE ORGANIZATION HAD NO UNRECOGNIZED TAX POSITIONS OR UNCERTAIN TAX POSITIONS REQUIRING ACCRUAL. THEREFORE, NO PROVISION FOR INCOME TAXES HAS BEEN PROVIDED IN THE FINANCIAL STATEMENTS. PART XI, LINE 2D - OTHER ADJUSTMENTS: REVERSAL OF PRIOR YEAR CONTRIBUTIONS -303,683. PART XI, LINE 4B - OTHER ADJUSTMENTS: FUNDRAISING EVENT EXPENSES -116,532. GAMING EXPENSES -119. PART XII, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EVENT EXPENSES 116,532. GAMING EXPENSES 119. ALL THAT JAZZ (& SUSHI) 313756 242388 71368 19000 70244 27288 313756 242388 71368 19000 70244 27288 116532 -45164 X X 0 1 0 0 0 0 0 0 0 JANE C GARCIA CEO 276415 0 0 0 0 0 60182 0 22386 0 358983 0 0 0 ALBERTO DIAZ CFO (THROUGH 12/2017) 197312 0 0 0 12197 0 1812 0 0 0 211321 0 0 0 PAUL J BAYARD CHIEF MEDICAL OFFICER 211776 0 0 0 0 0 3182 0 24993 0 239951 0 0 0 JORGE S SIOPACK PHYSICIAN - OB 305456 0 0 0 0 0 2324 0 101 0 307881 0 0 0 SUSAN SYKES OB-GYN, ASSOCIATE MEDICAL DIRECTOR 251145 0 0 0 0 0 2705 0 25181 0 279031 0 0 0 LISA MONTANG PHYSICIAN, ASSOCIATE MED. DIRECTOR 217927 0 0 0 0 0 3182 0 25070 0 246179 0 0 0 JOHN MURPHY MEDICAL INFORMATION OFFICER 199024 0 0 0 0 0 2175 0 0 0 201199 0 0 0 CHARLES SOM CONTRA COSTA REG. MED. DIRECTOR, DO 198589 0 0 0 0 0 2080 0 27647 0 228316 0 0 0 PART I, LINE 4B JANE C. GARCIA PARTICIPATES IN A SUPPLEMENTAL, NONQUALIFIED 457(F) RETIREMENT PLAN. DURING THE 2017 CALENDAR YEAR, CONTRIBUTIONS TO THE PLAN TOTALLED $57,000, WHICH HAS BEEN REPORTED AS "DEFERRED COMPENSATION" IN SCHEDULE J, PART II, COLUMN (C); THERE WERE NO DISTRIBUTIONS OR AMOUNTS TREATED AS TAXABLE COMPENSATION DUE TO SUBSTANTIAL RISK OF FORFEITURE FROM THE PLAN. A ABAG FINANCE AUTHORITY FOR NONPROFIT CORPORATIONS 943130123 00037CQV5 2010-12-30 3855000 FINANCING OF MONUMENT HEALTH CLINIC IN CONCORD, CA 0 0 0 B CALIFORNIA ENTERPRISE DEVELOPMENT AUTHORITY 352273601 NONEAVAIL 2013-03-20 12421875 REFUND OF BONDS DATED 12/20/2001 AND 9/28/2007 0 0 0 A 1005000 3855000 3855000 2011 0 0 1 1 B 1064979 5245000 248438 4996562 1 0 1 1 A 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 1 0 0 1 0 0 0 1 B 0 1 0 0 1 0 0 0 1 A 1 B 1 PART I, LINE B, COLUMN (E) AND PART II, COLUMN B, LINE 3: THE FORM 8038 WHICH WAS FILED FOR BOND B INDICATED A TOTAL ISSUE PRICE OF $12,421,875, WHICH REPRESENTS THE TOTAL AMOUNT OF FUNDS THE ORGANIZATION WAS APPROVED TO BORROW, AND IS REFLECTED ON PART I, LINE B, COLUMN (E). THE ORGANIZATION ONLY BORROWED $5,245,000 OF THE ISSUE PRICE, WHICH IS REFLECTED IN THE "TOTAL PROCEEDS OF ISSUE" IN PART II, LINE 3. PART IV, LINE 2A: THE ORGANIZATION HAS NOT YET PERFORMED A REBATE COMPUTATION FOR EITHER THE 2010 OR 2013 BOND; AFTER THE FILING OF THIS RETURN, THE ORGANIZATION WILL BE DETERMINNG IF A REBATE COMPUTATION IS OR WAS DUE FOR EITHER BOND, AND WILL BE REMEDYING THE SITUTATION IF SO. X 1 1275026 SELLING PRICE 0 0 1 0 PART I, COLUMN (B): THE ORGANIZATION IS REPORTING THE NUMBER OF CONTRIBUTIONS RECEIVED IN SCHEDULE M, PART I, COLUMN (B). FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY AN INDEPENDENT TAX PREPARER IN CONJUNCTION WITH THE ORGANIZATION'S FINANCE AND ACCOUNTING DEPARTMENT. UPON REVIEW AND APPROVAL BY THE FINANCE AND ACCOUNTING DEPARTMENT, THE FORM 990 IS THEN REVIEWED BY THE AUDIT COMMITTEE OF THE BOARD AND THEN SENT ELECTRONICALLY TO ALL MEMBERS OF THE BOARD PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS A CONFLICT OF INTEREST POLICY WHICH COVERS DIRECTORS, OFFICERS, AND EMPLOYEES WHO CAN INFLUENCE THE ACTIONS OF LA CLINICA; ALL SUCH INDIVIDUALS ARE REQUIRED TO COMPLETE A "CONFLICT OF INTEREST QUESTIONNAIRE & DISCLOSURE STATEMENT" ANNUALLY. IN THE EVENT A CONFLICT OF INTEREST IS IDENTIFIED, DISCLOSURE SHOULD BE MADE TO THE COMPLIANCE OFFICER (OR IF SHE OR HE IS THE ONE WITH THE CONFLICT, THEN TO THE BOARD CHAIR), WHO SHALL BRING THE MATTER TO THE ATTENTION OF THE AUDIT AND COMPLIANCE COMMITTEE OF THE BOARD. TRANSACTIONS WITH PARTIES WITH WHOM CONFLICTING INTEREST EXISTS MAY BE UNDERTAKEN ONLY IF ALL THE FOLLOWING ARE OBSERVED: (I) THE CONFLICTING INTEREST IS FULLY DISCLOSED; (II) THE PERSON WITH THE CONFLICT OF INTEREST IS EXCLUDED FROM THE DISCUSSION AND APPROVAL OF SUCH TRANSACTION; (III) A COMPETITIVE BID OR COMPARABLE CALCULATION EXISTS, AND IS ACCORDANCE WITH LA CLINICA'S PROCUREMENT POLICY; AND (IV) THE BOARD OR A DULY CONSTITUTED COMMITTEE THEREOF, HAS DETERMINED THAT THE TRANSACTION IS IN THE BEST INTEREST OF THE ORGANIZATION. THE DECISION OF THE BOARD OR COMMITTEE IS DOCUMENTED WITHIN THE BOARD/COMMITTEE MEETING MINUTES. FORM 990, PART VI, SECTION B, LINE 15 THE SALARY FOR THE CEO IS DETERMINED BY THE MEMBERS OF THE BOARD OF DIRECTORS, WHICH CONSISTS ENTIRELY OF INDEPENDENT PERSONS. SALARIES FOR OTHER OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION IS DETERMINED BY THE CEO. BOTH THE BOARD OF DIRECTORS AND THE CEO UTILIZE COMPARABILITY DATA WHEN MAKING COMPENSATION DECISIONS, AND ALSO TAKE INTO ACCOUNT THE SIZE AND COMPLEXITY OF THE COMPARABLE ORGANIZATIONS, THE EMPLOYEE'S TENURE, AND OTHER SUCH INFORMATION. FORM 990, PART VI, SECTION C, LINE 19 THE AUDITED FINANCIAL STATEMENTS ARE DISTRIBUTED UPON REQUEST. THE GOVERNING/ORGANIZING DOCUMENTS ARE AVAILABLE ON THE WEBSITE AT WWW.LACLINICA.ORG. THE CONFLICT OF INTEREST POLICY IS AVAILABLE ON REQUEST. FORM 990, PART XI, LINE 9: REVERSAL OF PRIOR YEAR CONTRIBUTIONS -303,683.