HomeMy WebLinkAboutAttch 2a Axis Community Health~
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12-15-09P03:36 RCVD
CITY OF DUBLIN
Fiscal Year 2010-2011
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CITY OF DUBLIN
Fiscal Year 2010-2011
APPLICATION "FOR- FUNDS
i. Please select one;expei~'se category: ? Capital ~ operating
2. ApplicantInfor•niation:
Organization/:~.gency Name Axis ~~;~mmunit_~ Health
4361 Railrc~i:~ Avenue P1eac~anron, CA 94566
Mailin~* :-~ddress
Street Address sa"`- as dk~~v~
City same `as above _ 'S1~U~ _ 'Lip 94566
Sue Compton 9~5 ~'O1 6005. scomptonc~axishealth.org
Executive Director/Chairperson Work Ph~~nc - Email
Janes ~~xson ~~~~-:734-651(; jamesChacE-n~? .org
BoardPresident (if applicable) «r~~~l.`Ph~u~c Email
Please list the Primacy Project Contact Persvu wily would be~xble ~o answer questions about this application and
projecbprogram dmang the funding period.
Carol Beddome' Development Director
Contact Person for ProjectlPi-ogram Job Title
925-201-6068 cbeddcel~~axshealth.org 925-417-1503
Work Phone Email Fax
Federal Tax Identification No. (required) 9 4- 2 2 3 2 3 9 4
City of Dublin Business License No. (required) "10 8 3 2
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City of Dublin
Fiscal Year 2010-2011
Application for Funds
3. Proposed Project/Pro~ram Inf~~rrnation_m~ not describe organization.)
Amount of Funds Requested $ ' ~~~"n ~ ~ ~
(Maximum $25,00 prl project. i
Proposed ProjecttYrogram°Name:
Access to Health Care foi Uninsured Lou:-Income Dublin Families
Proposed Project/Progran~ Date(sl: Start ~Ol X10 and;End 06 ~~G X11
nun. d,iv vr. m~,. ~1a~~ ~ r.
Please Hole: Cite Council Grant;Fun~l~ ~u~c ~listribu~c~i un a rrir7~hur~~ment.basis. If your ~,«cncy
nee~i~ I f)i~% disbursement at the hcginning cif the f~i~~cal fear, please indicate this
hcl~~w~an~l provide justification f~~r this need.
? A~ cncY'~~ r~yu~~ting 100°Ie disbur~cment ~~t the bc~~innin~~ ofthe Fiscal Yctir.
~if ~c~le~tin~~ this option, please pro~id~ ju~titir~~ti~~u i~ the blank space b~ 1~~~~.
C~ Agencyis r~c~t requesting 100°Io ~lisbur~~emenr at thr heyinning of the Fiscal Year.
Rlease pr~>vide the frequency Thal rcimhur~ements will be submitted t~~ she Ci<< iu the
blank helr~~~~: c.~., monthly;quar~erl~~, ac project completi~~n. r~r.
We will send a bill on a yuarterll~ basis based on the number
of Dublin families we enroll izlto publicly supported health
plans.
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City of Dublin
Fiscal Year 2010-2011
Application for Funds
a. How would the requested funds be used?
¦ Describe, in detail, the PROPOSED-PROTECT/PROGRAM (not the Agency).
¦ Bulleted text is acceptable.
¦ Identify if the proposed project/,program i~ nc~~ Service, or extension of an
existing one.
¦ An additional page nri~~ b~ a~i~ird, if needed.
Axis is seel~~izg $9,000 in support for its innovative Enrollment and
Eligibilit,.r service 'which is making health care available for many
low income Dublin families who do not have access to medical services.
With your support, we will be able t~ eT,_roll 243 Dubin'residents
in publicly supported health insurance"plans which will give them full
access to medical care. v?~ ~zr seekinc: support t,, continue a .25FTE
Enro~llmert ~~~ecialist posit:icn. icontinued)
b. _Ho~~ ~ti~nuld the PROPOSED PRO.JI:LT/YROGlt~1.M addre~~ an u~~niet cummunity
need and improve the quality ~~f 1'ite for Dublin residents. Why is phis project/program
needed? (Additional~page~may he added, if~ needed r.
Liviz~~~ ~raitho~~lt he Atli insura~_c~ forces :people to gc~ without medical
ca~~. ~~h`ronic illzi~s:=e ~~o .without. tz~atment. Chi1d-~~r. ~z
unimmunized. Minor health issues arr left untreated and become
significant~~health issues.-Research has'-found that those whQ are
uninsured do not seek health care until they are cri ically"ill.
This results in .going to`the emergencli room, where ca=~~ is expensive
and hospitals are left with unpaid bills--a cost that is_(continued)
e. What-documantation/datalrecords support the need for this PROPOSED
PROJECT/PROGRAM? Please-identify„your data sources.,(Additional page may be
added, if needed.)
- County of Alameda. Uninsured Sur~-~lr, ..September '?001
- The Relationship Between Health Insurance Coverage and
Clinical Outcomes Among Women Witri Breast Cancer," New England
Journal of Medicine
- The Kaiser Commission on Medicaid and the Uninsured, September
2009, The Henry J. Kaiser Family Foundation
- California Healthcare Foundation Report California's Uninsured, 2008
- Tri-Valley Needs Assessment, May 2003, Cities of Livermore and
Pleasanton.
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City of Dublin
Fiscal Year 2010-2011
Application for Funds
d. Specify the PROPOSED PROJECT/PRO(::R:~M-population to be served.
This program targets Dublin familie. that are low income and
uninsured. C?~.-er the course c,L rl;e one-year project period, we
anticipate that our Enrollment Specialist-wil'1 enroll 243 uninsured
Dublin residents... in publicly supposed health plans . Demographic
data from o~,ir current servi;~e.show that 96% of these families have
an income th=?t ~`i=s in HUD's "extremely low" category .
e. Pr~~jert~/probrams must be evaluated to determine i F they are being carried out efficiently
~m~l if project/program n~ril ~ are heirs,-~ met. ~Pleu~e de~crihe how you plan to monitor
y~>tirpcoject/program~~ ~ucce~~ anti i~T~pact.
¦ ' Ate additional page may be, ~~~lcfed, ifneeded.
The goal of this project ~ s s decreaee th_ n,~~<<~l ~r ~ ~ ow ..income
Dublin residents who do not have lie:zlth insurancE. This wily result
in access to health care, wr~ich in turn, decreases ,c r~~~li~atiohs of
chronic diseases-and pzevents a wide ~~-a~iet-; of acute anal chronic
illnesses,among Dublin :residents. It~aiso his a hugely t~ositive effect
amc~~a- ~hi~'dren, as immunizat`io:irates increase, ~ minor' illnes~cs do
not becom` serious illn~.sses, anti obesity` and diabetes `r ztcs are
minimized. This program ~~lso decreases. the rate of unc~>mpensated
care in i~c~~ emergency zooms and urgent care centers,....f;~`~ntinued)
f. Specify numbers of clients served by a~cnc~. than by FROPOSED
PROJECT/PROGR~M:
I ;11;ex?cY Particd~ant Int'd??~m~tit?n ~ _ - - ~ t
Total Number of Particiants S~r~~c~l b~ ;~~;enc~~ ~ i [ a liable)
Total Number of Duhlin Residents Ser~~cd h~_1~;enc~- (if applicable) 1, 200
- - _ _ _
Pro'ecUhr~a~;r~an~ Partac~p~?r~t I~afor?nalior~ _ _
Total Pro osed Partici ants Served by this Project/Program 2 , 5 0 0
Total Number of Dublin Residents Served b this Project 243
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City of Dublin '
Fiscal Year 2010-2011
Application for Funds
b. Revenue Budget
F~' 2~~1 ~-2(?l l
I~l?i'i1~i;F I3L'Df~FT ~?12(:~~~;ifA'Tli)ti P[~z),lE(~T/PltO(;~,~,:tV
C~~s~a~tiit~edJRtsta~~~tetl f~~zYdti
ecify scn~rce
St~~.te of California $580,8~~.;~0
Federal' ~$~717,OC~~.00
Alameda County $2,309,310.00
Fees Private Pay Insurance 3,836,406.00
~1Q~r~-~`o~iir~~tt~~d/F~egt~-i~ted ~+~zad5
I s ~~cifv source)
lJV J . VV
Foundation. ~3, 000.00 Yam„ ~OO.IOIO`
Community Danaticns $50,500.00 $~----,0,00:^`!
T~rAL $7, 649, e70. 00 $198, 806 .40
Further CommentsBxplanations (if necessary):
The revenue projections are at risk, as we anticipate decreases
in reimbursement rates `from Medical and other publicly funded
programs, as state officials develop plans to alleviate the
current state budget crisis. If this project does not receive
funding support we may have to cut back the program hours.
SECTION 2
Page 8 of 16
City of Dublin
Fiscal Year 2010-2011
Application for Funds
5. Financial Information -Operating Budget
a. Ex ense Bud et
Y 2@r~8-2009 "Chas pl~~,lti;~~~t~/
E~_~1~,~,~~t~>~tn3c~r.~~~ Oi~can[~.a~r[t~v P'lt~)c~i2:!]~l ~~:~~~r ~t;~cl~.~~r
Pe~~~sonnci C'os~ts
Em}~I~~}~e< Salaries ~C I3en~~lit~ ~(~,O~~,(~~?.QO ~ 1 9~,~O(~.-~U ~~),(IUU.(I(1
R~~~-t'erg~a~l~el 1?aSEs
Contracted Services $226,003.00
Occupancy $397,775.00
Consumable Supplies $562,775.00
Other (insurance/fees/dues/record $689,451.00
storage/pagers/telephone/training/tr
avel/equipment/equipment
maintenance/uniforms
Ca ~~~t~ ~'~~t~
GM Clinic Renovation $100,000.00
Clinic Conversion $250,000.00
TOTAL $8,274,686.00 $198,806.40 $9,000.00
Enrollment and Eligibility Specialist ($9,000)
Axis is requesting $9,000 in support to continue a 0.25FTE position. Based on an hourly
salary of $15.00 and 18% fringe benefits ($36,816 annually). He/she will be responsible
for enrolling families into publicly support health plans. Axis's Enrollment and
Eligibility Department is currently staffed with 5.4 FTE Enrollment Specialists.
City of Dublin
Fiscal Year 2010-2011
Application for Funds
6. General Agency Information
® Past grant applicants~may check this box in lieu of completing item 6(a-d) if the
program organizational descn~~tion on`~file with the Cit1 i~ correct and current.
a. List all~~~~e~us that Organization I~a~~ prey iuu~~l~ received City of Dublin funding (not
Community,Development Ble>ck Grant - CDk~Gi:
b. .Describe the p~~F~ulation(s) served by the Organization.
e. Describeall the services the Organization currently Pr~wides to Dublin residents.
Anadditional page may be added,=il~ needed.
d. Has your agency ever previously received funds from the-City of Dublin? If yes,
please specify in what Fiscal Years and the `aalount received each year.
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City of Dublin
Fiscal Year 2010-2011
Application for Funds
Section A. How would the requested funds be used? (continued)
In June 2009, in an effort to expand and to make our Enrollment and Eligibility services
more convenient for Dublin residents, we entered into an agreement with the Dublin
Library to provide office space to Axis in order to provide Enrollment and Eligibility
services one day each week at the Dublin Library. Funding will be used to offset the
salary and fringe benefit costs of the 0.25FTE Enrollment Specialist who will be
stationed at the Dublin Library one day each week.
We project that a 0.25 FTE Enrollment Specialist will be able to enroll 243 low income
Dublin residents in health plans in the twelve month project period. The cost of this
service is $36.36 per person. Our Enrollment and Eligibility Specialists work. directly
with each family to first identify programs where they meet eligibility requirements, and
then to enroll family members in appropriate programs.
Our Enrollment and Eligibility service is making a difference. Last year (July 1 -June
30, 2008) with a staff of 5.4 FTE Enrollment Specialists, we provided over 3,086 visits
helping low income Tri-Valley residents enroll in health care plans, and over 300 of these
visits were to enroll Dublin residents in publicly-supported health care plans.
City of Dublin
Fiscal Year 2010-2011
Application for Funds
Section B. How would the proposed project/program address an unmet community need
and improve the quality of life for Dublin residents. Why is this project/program needed?
(continued)
ultimately borne by the public.
Research bears this out. More than one third of uninsured adults in Alameda County who
have asthma are untreated (County of Alameda Uninsured Survey, September 2001).
Uninsured women who develop breast cancer are twice as likely to die as women who
have coverage ("The Relationship Between Health Insurance Coverage and Clinical
Outcomes Among Women with Breast Cancer," New England Journal of Medicine).
Uninsured children are 70% more likely than insured children to not receive medical care
for common conditions such as ear infections, and 30% less likely to receive medical
attention when they are injured (The Kaiser Commission on Medicaid and the Uninsured,
Feb. 2002, The Henry J. Kaiser Family Foundation).
Public health data consistently shows that those who do not have health insurance do not
get health care. This is an issue that is acutely felt in the Tri-Valley, where the local
emergency room provides several million dollars of uncompensated care annually for
uninsured patients. Most of these emergency room visits could have been prevented if
these patients had had access to primary care medical services. The cost of a typical
emergency room visit for an acute asthma attack approaches $2,000. This compares to an
average visit cost of $175 at a community clinic, where the same patient receives
medications and educational services that prevent or minimize future asthmatic episodes.
These savings in health care costs are far greater when heart attacks and strokes are
prevented in adults and when communicable diseases are prevented in children. There
are also enormous, but unquantifiable, costs in human suffering.
Even more troubling is that over the past 20 years, the percent of uninsured Californians
under age 65 continues to rise as employer-sponsored health insurance has declined.
Between 1987 and 2007, employer-sponsored health insurance has declined. Although
Medicaid and individually purchased coverage partially offsets that decline, more than 20
percent of Californians remain uninsured. The problem, though national, is more
prominent in California, which has a lower percentage of individuals with,j employer-
sponsored coverage and a higher proportion of uninsured. Ina 2008 report,~released'; by
California Healthcare Foundation (CHCF) it was found that the number of people living
in California without insurance is the highest in the nation, with nearly 60 percent of the
state's uninsured are Latino. In light of current economic conditions in California; with
companies large and small laying off workers and government considering cuts to health
care programs to help lessen burgeoning budget deficits, the ranks of uninsured are likely
to grow in the coming year. Based on Dublin's current estimated population ~of 46 934
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this CHCF report would indicate that there are more than 9,200 Dublin residents without
health insurance.
According to the Tri-Valley Needs Assessment Survey in May 2003, the local health care
infrastructure is not meeting the needs of the Tri-Valley's growing population. Axis is
the sole provider of medical services for local residents who are indigent and uninsured.
To stem the tide of uninsured residents in the Tri-Valley Axis established an Enrollment
and Eligibility department which provides direct assistance for low income families to
enroll in publicly-supported health care programs such as Medi-Cal, Medi-Cal managed
care plans, Healthy Families, CHDP-Gateway. The vast majority of the families we work
with are completely overwhelmed with the complexities of the health care network. They
are not aware of existing programs and cannot navigate the complicated enrollment
processes that most plans require. The enrollment processes are complicated because
many programs are limited to very specific services (such as the Breast Cancer Detection
program), so it is common for patients to be enrolled in two or more plans. Additionally,
many plans serve only children. As a result, it is common for a single family to be
enrolled in three or more different plans. In addition to the complexities involved in the
initial enrollment processes, most plans require frequent re-enrollment processes which,
if not completed correctly and according to established timeframes, result in dis-
enrollment from the health plan. More than 60% of the families we serve do not speak
English, which makes it yet more difficult to navigate the enrollment process. Once
residents are enrolled in health plans, they have immediate access to medical care. We
track emergency room and urgent care center use of our patients and have found that the
rate of inappropriate use of emergency services is less than 1 We have also
documented dramatic declines in the use of emergency room services by our patients who
have asthma, diabetes and other chronic illnesses.
Our Enrollment and Eligibility services bring about a demonstrable I decrease in health
care costs in our community. More importantly, by making health care available for low
income residents, we are able to improve the lives of many people while also improving
the overall health of the community. ~ „
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City of Dublin
Fiscal Year 2010-2011
Application for Funds
Section E. Projects/programs must be evaluated to determine if they are being carried out
efficiently and if project/program goals are being met. Please describe how you plan to
monitor your project/program's success and impact. (continued)
The success of this program is based upon decreasing the number of uninsured residents.
Evaluation is performed by maintaining statistical data regarding the number of persons
served, the number of enrollments completed and the number of re-enrollments
completed. We also monitor emergency room and urgent care center usage to ensure that
utilization of these services is appropriate; if we find that the use of these facilities was
not appropriate, we provide follow-up with the patient to make certain that they
understand how to use the medical system and we re-educate them regarding the
availability of our triage nurse for medical advice.
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City of Dublin
Fiscal Year 2010-2011
Application for Funds
7. Required Attachments:
o On1V one (1) conv ..per 1~ency ofeach of the follm~in,~ i~ required, even ~sith multiple
projects/prugrams submitted.
o Applecations ~~ithout the following documents «ill nol be re~ic~~e[1 fur funding.
o Please label attachmeut5: A, B, C, etc.
? A. ?Names of Governin<~ 13uard: idcntif~~ ~urrci7t Board officers.
B. Current total Or~aniza~ion~~uratin« hud«~~~, including reven~i~.
¦ ClearlylabeUi~lcntif~y the pru«ram that inelude~5 the PROPUSI?U
PR(l.~E('"I'/PkOGR;~1i.
~ C. Mr}st;rea:nl audit rcpr>rl or ta.r' return (i1~ applicablrl.
u D. Re~nlution. lctt~r or other doc~um~nt providin~~ c~ idenc~~ of
I3oard/Organization approval i)I~ application, and date apps al was granted.
BOacd/(>r~~~anizati~~n appro~~al may bz pen~in~.
1. nrganization'~ certificate ~~t in~uirunr~~ ~ho~~ing coverage fur liahilit~~ and
~tiorkers' compensation.
F. ,application Verification Urrlaratiun Signature Page..
u G. Si~~ncd affida.~it f~~rm fre~m ~~arh c~~lla.boratin~ a~_~~n~~~ nam~~~l in proposed
project/program plan (iI appli~~ahlc).
? H. Copy uf~ IKS Letter of I~etrrmination in~lic~itin~~ tai r.~.empt status.
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Axis Community Health
Board of Directors
2009
Officers
Name Positlon/Committees Phone E-Mall
James Paxson, General Manager Chair (hm) (510) 524-0679 jamesCa~hacienda.oro
Hacienda Owners Association Finance (wk) (925) 734-6510
4473 Willow Road, Suite 105 Facility ~
Pleasanton, CA 94588
Ted Kaye, Ph.D. Vice Chair , (hm) (925) 417-1201 tkave a(~laspositascolleae.edu
Las Positas College Foundation Goverance (wk) (925) 424-1010
4131 Garibaldi Place Nominating
Pleasanton, CA 94566
Aida White Secretary (hm) (925) 455-4708 awhite ancapeheadstart.org
CAPE/Head Start Finance (wk) (925) 443-3434
6125 Augusta Way (home address) Audit
Livermore, CA 94550
Bert Brook Treasurer (hm) (925) 846-0789 bertbrook@comcast.net
852 Castlewood Place Finance
Pleasanton, CA 94566 Foundation
Facility
Members
Yolanda Brown PatienUClient Adv. (hm) (925) 485-4459 yolanda.r.brown(a~kp.org
3128 Paseo Granada (wk) (925) 243-2740 Yrooks onaol.com
Pleasanton, CA 94566 (cell) (925) 699-3754
Yolanda De Santillan Arias PatienUClient Adv. (hm) (925) 719-2978 vabrvl[a~hotmail.com
2323 Santa Rita Road, #9
Pleasanton, CA 94566 ,
Mark Eaton Finance (hm) (925) 373-9249 markleatonCa~comcast.net
2109 Fourth Street Audit (wk) (925) 373-3455
Livermore, CA 94550
Thelma Fones Nominating (hm) (925) 443-7320 tfonesCcillivermore.kl2.ca.us
Livermore School District (wk) (925) 454-5596
750 Del Mar Avenue
Livermore, CA 94550
Michael Fraser, Chief of Police Goverance (hm) (925) 846-8847 mfraserCcilci.pleasanton.ca.us
Pleasanton Police Department (wk) (925) 931-5100
4833 Bernal Avenue
Pleasanton, CA 94566
L. James Ghilardi, MFT Governance (hm) (925) 484-2449 volvosaoCcilaol.com
Arroyo Counseling Audit (wk) (925) 462-0220
4713 First Street, #250
Pleasanton, CA 94566
Frank A. Hunter, Ph.D. PatienUClient Adv. (hm) (925) 449-1714 hunterfrankalex@yahoo.com
1550 Springtown Blvd., Apt. 18G Marketing (cell) (925) 518-3253
Livermore, CA 94551 Audit
Rhenae Keyes PatienUClient Adv. (hm) (925) 339-8548 keves2thecap(a~aol.com
6700 Dougherty Rd. # 101
Dublin, CA 94568
Gladys Montalvo-Campo (hm) (925) 479-9314 _gladys montalvoCn)hotmail.com
3115 Finnian Way #311 (cell) (925) 427-0070
Dublin, CA 94568
Farzana (Farzi) Najeeb Marketing (hm) (925) 399-5131 farzinaieeb(a~vahoo.com
9302 Benzon Drive
Pleasanton, CA 94588
Jeri Steiger Governance (hm) (925) 484-3699 pizzarobCcilaol.com
3819 Vineyard, #68 PatienUClient Adv (wk) (925) 846-2520
Pleasanton, CA 94566
Staff
Sue Compton, CEO (wk) (925) 201-6005 scomoton@axishealth.org
Joe Flaherty, CFO (wk) (925) 201-6012 iflahertvC~axishealth.org
Meena Rijhwani, MD, Medical Director (wk) (925) 201-6097 mrihiwani onaxishealth.orq
Sandy English, Executive Assistant (wk) (925) 201-6017 senolish(a axishealth.oro
AXIS COMMUNITY HEALTH
FY 2009- 2010 CONSOLIDATED BUDGET SUMMARY
Clinic BH WIC Total
REVENUE:
CONTRACTS 2,635,316 766,010 562,550 3,963,876
MEDICAL SERVICES-PATIENT/CLIENT FEES 2,800,965 0 0 2,800,965
COUNSELING SERVICES-PATIENT/CLIENT FEES 0 738,829 0 738,829
FOUNDATION 90,000 3,000 0 93,000
DONATIONS 50,000 500 0 50,500
OTHERS 2,500 0 0 2,500
TOTAL REVENUE 5,578,781 1,508,339 562,550 7,649,670
EXPENSES:
DIRECT ~
PERSONNEL 3,825,026 1,005,236 385,185 5,215,448
CONTRACTED SERVICES 148,435 35;800 32,468 216,703
OCCUPANCY 126,670 181,265 73,300 381,235
CONSUMABLE SUPPLIES 497,000 34,000 18,400 549,400
_ OTHER 517,215 113,395 21,850 652,460
TOTAL DIRECT EXPENSES 5,114,347 1,369,696 531,203 7,015,246
INDIRECT S
PERSONNEL 575,538 230,278 27,417 833,234
CONTRACTED SERVICES 6,500 2,800 0 9,300
OCCUPANCY 11,390 5,150 0 16,540
CONSUMABLE SUPPLIES 9,500 3,875 0 13,375
OTHER 26,330 10,661 0 36,991
TOTAL INDIRECT EXPENSES 629,258 252,764 27,417 909,440
TOTAL EXPENSES 5,743,605 1,622,460 558,621 7,924,686
NET OPERATING INCOME (LOSS) BEFORE DEPRECIATION {164,824} (114,121) 3,929 {275,016
DEPRECIATION EXPENSES (96,797) (38,150) - (134,947)
NET.OPERATING INCOME (LOSS) AFTER DEPRECIATION EXPEN {261,621} {152,271) 3,929 (409 963}
G~9 CLI<JIG Rero~~tion
Fun--.ling, ~ ~ 100,000 100,000
Exp~.~nses (100,000} ~ (100,000)
Clirnc Cor3~~e~sion
Funding 250,000 250,000
Expenses (250,000) {250,000)
TOTAL PROJECT BALANCE 0 0 0 0
TOTAL BUDGET (164,824) (114,121) 3,929 (275,016)
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AXIS COMMUNITY HEALTH, INC.
AUDITED FINANCIAL STATEMENTS
FOR THE YEAR ENDED JUNE 30, 2008
AXIS COMMUNITY HEALTH, INC.
TABLE OF CONTENTS
PAGE
INDEPENDENT AUDITOR' S REPORT 1
FINANCIAL STATEMENTS:
Statement of Financial Position 2
Statement of Activities 3
Statement of Cash Flows 4
Notes to Financial Statements 5-12
SUPPLEMENTARY INFORMATION
Statement of Units of Service for County of Alameda Grants 13-14
Statement of Expenditures for County of Alameda Grants 15-16
Schedule of Expenditures of Federal Awards 17
INDEPENDENT AUDITOR'S REPORT ON INTERNAL CONTROL
OVER FINANCIAL REPORTING AND ON COMPLIANCE AND OTHER
MATTERS BASED ON AN AUDIT OF FINANCIAL STATEMENTS
PERFORMED IN ACCORDANCE WITH GOVERNMENTAUDITING
STANDARDS 18-19
INDEPENDENT AUDITOR'S REPORT ON COMPLIANCE WITH
REQUIREMENTS APPLICABLE TO EACH MAJOR PROGRAM AND ON
INTERNAL CONTROL OVER COMPLIANCE IN ACCORDANCE WITH
OMB CIRCULAR A-133 20-21
SCHEDULE OF FINDINGS AND QUESTIONED COSTS 22-23
STATUS OF PRIOR YEAR FINDINGS AND RECOMMENDATIONS 24
Patel &
Associates Telephone: (510) 452-5051
2G6 17'h Street, Suite 200 Fax: (510) 452-3432
Certified Public Accountant Oakland, California 94612-4124 e-mail: ramesh(F~patelcpa.com
INDEPENDENT AUDITOR'S REPORT
The Board of Directors
Axis Community Health, Inc.
Pleasanton, California
We have audited the accompanying statement of financial position of Axis Community Health, Inc. (a
Nonprofit Organization) as of June 30, 2008 and the related statements of activities and cash flows for the
year then ended. These financial statements are the responsibility of Axis Community Health, Inc.'s
management. Our responsibility is to express an opinion on these financial statements based on our audit.
We conducted our audit in accordance with auditing standards generally accepted in the United States of
America and the standards applicable to financial audits contained in Government Auditing Standards, issued
by the Comptroller General of the United States. Those standards require that we plan and perform the audit
to obtain reasonable assurance about whether the financial statements are free of material misstatement. An
audit includes examining, on a test basis, evidence supporting the amounts and disclosures in the financial
statements. An audit also includes assessing the accounting principles used and significant estimates made by
management, as well as evaluating the overall financial statement presentation. We believe that our audit
provides a reasonable basis for our opinion.
In our opinion, the financial statements referred to above present fairly, in all material respects, the financial
position of Axis Community Health, Inc. as of June 30, 2008 and the changes in its net assets and its cash
flows for the year then ended in conformity with accounting principles generally accepted in the United States
of America.
In accordance with Government Auditing Standards, we have also issued our report dated December 18, 2008
on our consideration of Axis Convnunity Health, Inc.'s internal control over financial reporting and our tests
of its compliance with certain provisions of laws, regulations, contracts, and grant agreements and other
matters. The purpose of that report is to describe the scope of our testing of internal control over financial
reporting and compliance and the results of that testing, and not to provide an opinion on the internal control
over financial reporting or on compliance. That report is an integral part of an audit performed in accordance
with Government Auditing Standards and should be considered in assessing the results of our audit.
Our audit was performed for the purpose of forming an opinion on the basic financial statements of Axis
Community Health, Inc. taken as a whole. The accompanying supplementary information is presented for
purpose of additional analysis. Also, the accompanying schedule of expenditures of federal awards is
presented for purposes of additional analysis as required by U.S. Office of Management and Budget Circular
A-133, Audits of States, Local Gover~rments, and Non-Profit Organizations, and is not a required part of the
basic financial statements. Such information has been subjected to the auditing procedures applied in the audit
of the basic financial statements and, in our opinion, is fairly stated, in all material respects, in relation to the
basic financial statements taken as a whole.
Oakland, California
December 18, 2008
1
AXIS COMMUNITY HEALTH, INC.
STATEMENT OF FINANCIAL POSITION
JUNE 30, 2008
ASSETS
Current assets:
Cash and cash equivalents $ 1,411,440
Accounts receivable -net (Note 3) 921,835
Grants and contracts receivable (Note 5) 528,200
Prepaid expenses 41,415
Total current assets 2,902,890
Property and equipment -net (Note 6) 1,503,307
Total assets $ 4,406,197
LIABILITIES AND NET ASSETS
Current liabilities:
Accounts payable $ 166,291
Accrued liabilities 401,929
Unemployment reserve (Note 7) 37,959
Current portion of note payable (Note 8) 17,717
Total current liabilities 623,896
Long term portion of note payable (Note 8) 667,804
Total liabilities I ,291,700
NET ASSETS:
Unrestricted 3,087,644
Temporarily restricted 26,853
Total net assets ~ 3,114,497
Total liabilities and net assets $ 4,406,197
The accompanying notes are an integral part of these financial statements.
2
AXIS COMMUNITY HEALTH, INC.
STATEMENT OF ACTIVITIES
JUNE 30, 2008
Temporarily Permanently
Unrestricted Restricted Restricted Total
Support:
Grants and contracts (Note 4) $ 2,950,958 $ $ $ 2,950,958
Contributions (Note 12) 102,483 25,000 127,483
Tota] support 3,053,441 25,000 3,078,441
Revenue:
Patient fees (Net) 3,705,350 3,705,350
Interest income 21,169 21,169
Other 22,427 22,427
Total revenue 3,748,946 3,748,946
Total support and revenue 6,802,387 25,000 6,827,387
Net assets released from restrictions:
satisfaction of program resMctions 67,475 (67,475)
Total support and revenue 6,869,862 (42,475) 6,827,387
Expenses (Note 17):
Program services 5,357,190 5,357,190
Management and general 886,815 886,815
Total expenses 6,244,005 6,244,005
Revenue over expenses 625,857 (42,475) 583,382
Net assets, beginning of the year 2,461,787 69,328 2,531,115
Net assets, end of year $ 3,087,644 $ 26,853 $ $ 3,114,497
The accompanying notes are an integral part of these financial statements.
3
AXIS COMMUNITY HEALTH, INC.
STATEMENT OF CASH FLOWS
FOR THE YEAR ENDED JUNE 30, 2008
Cash flows from operating activities:
Change in net assets $ 583,382
Adjustments to reconcile change in net assets to net cash
provided by operating activities:
Depreciation 238,954
Decrease/(Increase) in:
Accounts receivable (306,366)
Grants and contracts receivable 95,326
Prepaid expenses (17,229)
Increase/(Decrease) in:
Accounts payable 8,470
Accrued liabilities 75,079
Net cash provided by operating activities 677,616
Cash flows from investing activities:
Purchase of property and equipment (52,784)
Net cash used by investing activities (52,784)
Cash flows from financing activities:
Repayment of long term loans (16,695)
Net cash used by financing activities (16,695)
Net increase in cash and cash equivalents 608,137
Cash and cash equivalents at beginning of year 803,303
Cash and cash equivalents at end of year $ 1,411,440
Supplemental disclosures:
Interest paid $ 45,544
The accompanying notes are an integral part of these financial statements
4
AXIS COMMUNITY HEALTH, INC.
NOTES TO FINANCIAL STATEMENTS
YEAR ENDED JUNE 30, 2008
NOTE 1: GENERAL
Axis Community Health, Inc. (Axis) is a private nonprofit 501(c)(3) community
clinic that has been serving the residents of the Tri-Valley area since 1972. Axis's
mission is to foster the physical, emotional and social well-being of individuals,
families and the Tri-Valley community through the provision of services which
promote wellness and a positive quality of life. Axis operates from four sites that are
located in Pleasanton, Livermore and Dublin. Axis's services include pediatrics,
adult internal medicine, women's health care, mental health counseling, drug and
alcohol services, WIC nutrition services and community health education.
NOTE 2: SUIVIMARY OF SIGNIFICANT ACCOUNTING POLICIES
Basis of Accountinu
The accompanying financial statements have been prepared on the accrual basis of
accounting in accordance with accounting principles generally accepted in the United
States of America. Net assets, revenues and expenses are classified on the existence
or absence of donor-imposed restrictions. Accordingly, net assets of Axis and
changes therein are classified and reported as follows:
Unrestricted net assets -Net assets are those currently available for use and are not
subject to donor-imposed stipulations.
Temporarily restricted net assets -Net assets subject to donor-imposed stipulations
that may or will be met, either by actions of Axis and/or the passage of time. When a
restriction expires, temporarily restricted net assets are reclassified to unrestricted net
assets and reported in the statement of activities as net assets released from
restrictions.
Permanently restricted net assets -Net assets subject to donor-imposed stipulations
that they be maintained permanently by Axis. There were no permanently restricted
net assets as of June 30, 2008.
Property and Equipment '
Property and equipment is stated at cost at the date of acquisition. Depreciation of
property and equipment is computed on the straight-line method over the estimated
useful lives of the individual assets. The lives of the assets range from 5 years to 30
years. Repairs and maintenance are charged to operations and major improvements
are capitalized. Donated assets are recognized at market value at the time of donation.
Expenses for assets in excess of $1,000 are capitalized and assets purchased with
government grants are expended in accordance with government program guidelines.
5
Support and Revenue
Support for government contracts is recognized when earned, primarily as
expenditures are incurred. Support from unrestricted sources including grants and
contributions is recognized when received. Revenue from patient fees is recognized
when services are provided. Axis receives revenues from third-party payors and
patients. Axis has agreements with third-party payors that provide for payments at
amounts different from its established rates. Payment arrangements include
prospectively determined rates per discharge, reimbursed costs and discounted
charges. Net patient service revenue is reported at the estimated net realizable
amounts from patients, third-party payors, and others for services rendered. Cash
received in advance of earnings is reported as deferred revenue.
Contributions and Promise to Give
Contributions, including unconditional promise to give, are recorded as made. All
contributions are available for unrestricted use unless specifically restricted by the
donor. Conditional promises to give are recognized when the conditions on which
they depend are substantially met.
In Kind Contributions
Axis records in kind support including contributed assets and professional services.
Contributed professional services are recognized if the services received (a) create or
enhance anon-financial asset or (b) require specialized skills, are provided by
individuals possessing those skills, and would typically need to be purchased if not
provided by donation. Contributions of tangible assets are recognized at fair market
value when received.
During the fiscal year, Axis received a significant amount of contributed services
from non-professional volunteers to assist in the program services and fund raising
activities. No amounts have been recognized in the statement of activities because
they did not meet the ;two criteria described above.
Cash and Cash Eauivalents
Cash and cash equivalents include short-term highly liquid investments with original
maturities of three months or less:
Functional allocation of Expenses
The costs of providing the, various programs and other activities -have been
summarized on a functional basis in the statement of activities. Accordingly, certain
costs have been allocated among the programs and supporting services benefited.
Use of Estimates
The preparation of financial statements in conformity with accounting principles
generally accepted in the United States of America requires management to make
estimates and assumptions that affect certain reported amounts of assets grid
disclosures. Accordingly, actual result could differ from those estimates.
6
Income Taxes
Axis is exempt from Federal Taxes under Section 501 (c) (3) of the Internal Revenue
Code as amended and Section 23701 (d) of the Revenue and Taxation Code of the
State of California. Accordingly, no provision for Federal and Franchise taxes has
been recognized in the financial statements.
NOTE 3: ACCOUNTS RECEIVABLE
Accounts receivable totaled $921,835 and a provision of $74,581 has been made for
doubtful accounts.
NOTE 4: GRANTS AND CONTRACTS REVENUE
Axis is funded primarily by Federal, State and County grants/contracts, which
generally restrict the use of such funds to cover the operating expenses directly
related to providing primary care and special services. Grants/contracts are
recognized as revenue over the period specified in the related grant award
agreements. The grants and contracts are as follows:
State WIC $ 506,201
Alameda County General Fund 1,478,684
Alameda County Immunization Project 20,000
Alameda County Homeless 28,454
Alameda County-CYS 61,424
Alameda County ODF (Drug and Alcohol) 192,099
Alameda County Drug and Alcohol Teens 213,975
Alameda County Primary Prevention 157,668
Alameda County Prop 36 162,085
Alameda County SSA 31,891
CDBG Pleasanton -Women's Clinic 23,030
Pleasanton City Grant -Clinic 24,370
State EAPC 17,089
AHC- General Medicine 23,485
Livermore City Grant -Clinic 10,503
$ 2,950,958
' 7
NOTE 5: GRANTS AND CONTRACTS RECEIVABLE
Grants and Contracts receivable balances are as follows:
Alameda County Measure A $
Alameda County SSA 13,805
Alameda County Homeless 5,740
State -WIC 89,760
Immunization Project 1,667
Alameda County General Fund 337,497
Alameda County ODF 11,574
Alameda County Primary Prevention 10,512
Alameda County Teens 20,381
Alameda County Prop 36 3,931
Alameda County CYS (Comprehensive Youth Services) 10,237
Pleasanton Primary Care 1,371
Pleasanton CDBG -Women's clinic 21,725
$ 528,200
NOTE 6: PROPERTY AND EQUIPMENT
Property and equipment is summarized as follows:
Land $ 210,460
Buildings 1 486 776
Leasehold improvements 462,982
Furniture and office equipment 666,362
Medical equipment 81,615
Computers 347 660
3,255,855
Less: accumulated depreciation (1,752,548)
Net book value $ 1,503,307
NOTE 7: UNEMPLOYMENT RESERVE
Axis has established aself-funded unemployment benefit fund, electing not to
participate in the California State Unemployment Insurance Plan. Axis has
recognized accrued unemployment benefits liability of $37,959 in the fiscal year
2008.
8
NOTE 8: NOTE PAYABLE
Note payable consist of the following:
Note Payable to Mt. Diablo National Bank, secured by real
property, bearing interest at 6.5% per annum, payable in monthly
principal and interest installments of $4,887. The entire unpaid
balance is due on October 1, 2010. $ 681,921
Unsecured note Payable to City of Livermore, non-interest bearing,
payable in monthly principal and interest installments of $300. The
maturity date is June, 2010. 3,600
Total Note Payable 685,521
Less: Current Portion (17,717)
Long-Term Portion $ 667,804
Following are maturities of long-term debt for each of the next three years:
Year ending June 30,
2009 $ 17,717
2010 15,077
2011 652,727
$ 685,521
NOTE 9: LEASE COMIVIITMENTS
Axis leases office space for its Programs located in Pleasanton, Livermore and
Dublin California, under operating leases expiring in various years through 2010.
Minimum future rental payments under noncancelable operating leases having
remaining termsin excess of one year as of June 30, 2008, for each of the next two
years are:
Year ending June 30:
2009 $ 28,200
2010 28,200
Total minimum future rental payments $ 56,400
The rental expense for the year ended June 30, 2008 was $107,086.
9
NOTE 10: PENSION PLAN
Axis has established a 401(K) retirement plan to provide eligible employees with
retirement benefits. All employees over age 21 and after completion of 3 months of
employment service are eligible for the retirement contribution. All eligible
employees may elect to have employee elective deferrals of not less than $200
annually contributed to the plan. Axis did not contribute to the plan during the year
ended June 30, 2008.
NOTE 11: CONTINGENT LIABILITIES
Grant Expenditures
Conditions contained within the various contracts awarded to Axis are subject to the
funding agencies criteria and regulations under which expenditures may be charged
against and are subject to audits under such regulations and criteria. Occasionally,
such audits may determine that certain costs incurred against the grants may not
comply with the established criteria that govern them. In such cases, Axis could be
held responsible for repayments to the funding agency for the costs or be subject to
the reductions of future funding in the amount of the costs.
Management does not anticipate any material questioned costs for the contracts and
grants administered during the period.
NOTE 12: CONTRIBUTIONS
Contributions are generally from foundations and are as follows:
Tri-Valley Community Foundation $ 18,750
Alameda Health Consortium/Alta-Bates Summit Foundation 32,300
Blue Shield California Foundation 30,000
Kaiser Foundation 25,000
Foresters bf Amer7ca 5,000
Wellness Foundation/Alameda Health Consortium ' 1,883
Others 14;550
$ 127,483
NOTE 13: COMPENSATED ABSENCES
Axis encourages employees to take their vacation during the year it is earned. When
this is not possible, employees may accumulate time up to the limits according to
their length of service in the organization. The employees do not gain a vested right
to accumulated sick leave. The accumulated employee sick leave benefits are not
recognized as liabilities of Axis since payment of such benefits are recorded as
expenditures in the period sick leave is taken.
10
NOTE 14: RELATED PARTY TRANSACTIONS
Community Health Center Network (CHCN) is a partnership between seven health
service organizations to provide a comprehensive range of professional health care
and social services in a manner respectful of the community values and traditions.
Incorporated in 1996, CHCN introduced the managed care business to its member
clinics by serving as a network of management service organization which
administers a risk sharing arrangement between the member clinics. Under the risk
sharing arrangement Axis receives capitated payments from CHCN by providing
Primary Care Physician services to its covered patients. Axis periodically receives
cash payments under the risk sharing arrangement, and a certain amount of cash
receipts are withheld on behalf of the member clinics to pay their respective
outstanding claims for services. At June 30, 2008, the expenditure incurred in excess
of revenue received was $13,752. The management feels that the net resultant
amount is not material and accordingly, no due to/from CHCN at June 30, 2008 has
been recorded. In addition, Axis received $293,676 towards risk pool and surplus
distribution.
NOTE 15: LINE OF CREDIT: '
The facility has a line of credit with Wells Fargo Bank for $150,000. No amount was
drawn and outstanding at June 30, 2008.
NOTE 16: AXIS COMMUNITY HEALTH FOUNDATION
Axis Community Health Foundation was created to enhance community support for
Axis, carrying out a variety Hof activities that generate support for the organization.
There were no significant transactions between the two organizations during the year.
11
NOTE 17: TOTAL EXPENSES
The total expenses incwred for the year are detailed as follows:
SUPPORTING
- PROGRAM SERVICES SERVICES
General Women Total
Clinical Drug and Mental Infants Program Management
Services Alcohol Health Children Expenses & General Total
EXPENSES
.Salaries $ 2,204,805 $ 634,471 $ 157,790 $ 297,456 $ 3,294,522 $ 662,552 $ 3,957,074
Fringe benefits 152,995 60,357 11,065 30,739 255,156 85,087 340,243
Contractors 14,941 165 135 150 15,391 29,564 44,955
Professional services 6,426 2,110 1,055 21,350 30,941 3,438 34,379
Janitorial services 14,965 4,201 2,584 3,890 25,640 2,175 27,815
Laboratory 67,570 5,114 72,684 72,684
Other contracted services 353,792 18,056 10,256 13,995 396,099 8,246 404,345
Rent/mortgage interest 63,629 31,439 6,831 27,616 129,515 23,115 152,630
Repairs and maintenance 16,010 2,251 1,469 4,489 24,219 678 24,897
Utilities 39,596 11,267 5,843 2,743 59,449 3,925 63,374
Office supplies 37,586 5,428 2,344 7,973 53,331 5,573 58,904
Postage 5,143 1,286 778 2,450 9,657 1,181 10,838
Medical supplies 77,019 10,598 270 87,887 87,887
Pharmacy _ 234,425 234,425 234,425
Maintenance supplies 3,925 1,160 773 305 6,163 376 6,539
Other supplies 35,521 6,060 6,879 4,584 53,044 1,249 54,293
- Insurance 67,512 21,140 10,865 15,931 (15,448 16,790 132,238
Telephone/pagers 58,354 20,125 10,404 2,230 91,113 8,578 99,691
Equipment maintenance contracts 55,105 14,054 7,083 1,672 77,914 77,914
Travel 4,922 2,783 31 2,029 9,765 4,508 14,273
Fees & dues - - - 19,655 13,184 3,760 2,458 39,057 1,169 40,226
Conferences/training - 3,617 1,331 255 2,400 7,603 3,549 11,152
Bad debts 23,927 469 2,495 26,891 26,891
Other 23,030 23,030 1,167 24,197
Depreciation 177,773 23,197 14,089 215,059 23,895 238,954
- - _ , _ _ Miscellaneous 2,140 930 117 3,187 3,187
_ _ _ -Total expenses _ - ~ . _ $ 3,764;383_ _ 891,176 $ 256,901 $ 444,730 $ 5,357,190 $ 886,81.5 $ 6,244,005
I2
SUPPLEMENTARY INFORMATION
AXIS COMMUNITY HEALTH, INC.
STATEMENT OF UNITS OF SERVICE FOR COUNTY OF ALAMEDA GRANTS
FOR THE YEAR ENDED JUNE 30.2008
Program Homeless Program
Contract Number C-93-0689
Contract Period 7!1/07- 6!30!08
Contract Amount $ 41,450
NUMBER RATE TOTAL
TYPE OF SERVICE OF UNITS PER UNIT
Medical 347 $ 82.00 $ 28,454
Amount Reimbursed by County $ 28,454
13
AXIS COMMUNITY HEALTH, INC.
STATEMENT OF UNITS OF SERVICE FOR COUNTY OF ALAMEDA GRANTS
FOR THE YEAR ENDED JUNE 30, 2008
Program SSA-Children & Family services
Contract Number C-93-0916
Contract Period 7/1/07- 6/30/08
Contract Amount $ 36,000
NUMBER RATE TOTAL
TYPE OF SERVICE OF UNITS PER UMT
Drug testing 682 $ 30.00 $ 20,460
Group session 209 25.00 5,225
Intake 3 60.00 180
Individual 8 60.00 480
Case Management 36 39.61 1,426
Lab-Drug Testing 70 40.00 2,800
Additional Lab 1,320
Amount Reimbursed by County $ 31,891
14
AXIS COMMUNITY HEALTH, INC.
STATEMENT OF EXPENDITURES FOR COUNTY OF ALAMEDA GRANTS
FOR THE YEAR ENDED JUNE 30, 2008
Program : Homeless Case Comprehensive Immunization
Management Youth Services
Contract Number : C-93-0689 C-99-497 C-93-0689
Contract Period : 7/1/07 - 6/30/08 7/1/07 - 6/30/08 7/1/07-6/30/08
Contract Amount : $ 28,454 $ 59,635 $ 20,000
Expenditures
Salaries and Employee Benefits $ 28,454 $ 59,635 $ 20,000
Total 28,454 59,635 20,000
Amount Reimbursed by County $ 28,454 $ 59,635 $ 20,000
15
AXIS COMMUNITY HEALTH, INC.
STATEMENT OF EXPENDITURES FOR COUNTY OF ALAMEDA GRANTS
FOR THE YEAR ENDED NNE 30, 2008
Contract Name Alcohol and Drug
Contract Number C-93-0689
Contract Period 7/1/07-6/30/08
Contract Amount $ 513,865
210 200
Primary Outpatient 202 200
Prevention AlcohoUDrues Teen Prop 36 Total
Expenditures:
Services and Supplies $ 132,393 $ 191,222 $ 137,611 $ 162,640 $ 623,866
Amount Reimbursed by County $ 132,393 $ ]91,222 $ 137,611 $ 162,640 $ 623,866
16
AXIS COMMUNITY HEALTH, INC.
SCHEDULE OF EXPENDITURES OF FEDERAL AWARDS
FOR THE YEAR ENDED JUNE 30, 2008
Federal Pass-Through
FEDERAL GRANTOR/PASS-THROUGH CFDA Entity Identifying Federal
GRANTOR/PROGRAM OR CLUSTER TITLE Number Number Expenditures
U.S. Department of Agriculture:
Pass-Through Program From:
State Department of Health & Human Services -
Supplemental Food Program -WIC 10.557 99-12345&99-85771 $ 506,201
Total U.S. Department of Agriculture 506,201
U.S. Department of Health and Human Services;
Pass-Through Programs From:
Alameda County -Health Care Service Agency
- Homeless Program 93.151 C-93-0689 28,454
Alameda County-Department of Public Health
- Alcohol and Drug 93.959 C-93-0689 110,041
- Drug Medical 93.778 C-93-0689 6,488
- Drug and Alcohol Treatment and Substance Abuse Counseling 93.645 C-93-0689 18,000
Total U.S. Department of Health and Human Services 162,983
U.S. Department of Housing and Urban Development:
Pass-Through Programs From:
City of Pleasanton
Community Development Block Grants
- Pleasanton Woman's Health Center 14.218 N.A. 23,030
City of Livermore
Community Development Block Grants
- Access to Healthcare for Uninsured Liv. Fam. 14.218 N.A. 8,500
- Defibrillator 14.218 N.A. 2,003
Total U.S. Department of Housing and Urban Development 33,533
Total Expenditures of Federal Awards $ 702,717
N.A.: Not Available
Note: The above schedule of expenditures of federal awards is prepared on an accrual basis of
accounting. The information in this schedule is presented in accordance with the requirements of
OMB Circular A-133, Audits of States, Local Governments, and Non-Profit Organizations. Therefore,
some amounts presented in this schedule may differ from amounts presented in, or used in the
preparation of, the basic financial statements.
17
Patel &
Assoclates Telephone: (510) 452-505 ]
266 17ih Street, Suite 200 Fax: (510) 452-3432
Certified Public Accountant Oakland, California 946 1 2-41 24 a-mail: rameshCpatelcpa.com
INDEPENDENT AUDITOR'S REPORT ON INTERNAL CONTROL OVER FINANCIAL
REPORTING AND ON COMPLIANCE AND OTHER MATTERS BASED ON AN AUDIT
OF FINANCLAL STATEMENTS PERFORMED IN ACCORDANCE WITH
GOVERNMENT AUDITING STANDARDS
The Board of Directors
Axis Community Health, Inc.
Pleasanton, California -
We have audited the financial statements of Axis Community Health, Inc. (A Non-profit
Organization) as of and for the year ended June 30, 2008, and have issued our report thereon dated
December 18, 2008. We conducted our audit in accordance with auditing standards generally
accepted in the United States of America and the standards applicable to financial audits contained
in Government Auditing Standards, issued by the Comptroller General of the United States.
Internal Control Over Financial ReQortine
In planning and performing our audit, we considered Axis Community Health, Inc.'s internal control
over financial reporting as a basis for designing our auditing procedures for the purpose of
expressing our opinion on the financial statements, but not for the purpose of expressing an opinion
on the effectiveness of Axis Community Health, Inc.'s internal control over financial reporting.
Accordingly, we do not express an'opinion on the effectiveness of Axis Community Health, Inc.'s
internal control over financial reporting.
A control deficiency exists when the design or operation of a control does not allow management or
employees, in the normal course of performing their assigned functions, to prevent or detect
misstatements on a timely basis. A significant deficiency is a control deficiency, or combination of
control deficiencies, that adversely affects Axis Community Health, Inc.'s ability to initiate,
authorize, record, process, or report financial data reliably in accordance with generally accepted
accounting principles such that there is more than a remote likelihood that a misstatement of Axis
Community Health, Inc.'s financial statements that is more than inconsequential will not be
prevented or detected by Axis Community Health, Inc.'s internal control
A material weakness is a significant deficiency, or combination of significant deficiencies, that
results in more than a remote likelihood that a material misstatement of the financial statements will
not be prevented or detected by Axis Community Health, Inc.'s internal control.
is
{ ~ ~ .
Our consideration of internal control over financial reporting was for the limited purpose described
in the first paragraph of this section and would not necessarily identify all deficiencies in internal
control that might be significant deficiencies or material weaknesses. We did not identify any
deficiencies in internal control over financial reporting that we consider to be material weaknesses,
as defined above.
Compliance and other Matters
As part of obtaining reasonable assurance about whether Axis Community Health, Inc.'s financial
statements are free- of material misstatement, we performed tests of its compliance with certain
provisions of laws, regulations, contracts, and grant agreements, noncompliance with which could
have a direct and material effect on the determination of financial statement amounts. However,
providing an opinion on compliance with those provisions was not an objective of our audit, and
accordingly, we do not express such an opinion. The results of our tests disclosed no instances of
noncompliance or other matters that are required to be reported under Government Auditing
Standards.
This report is intended solely for the information and use of the management, the audit committee,
board of directors, others within the organization, regulatory body, federal awarding agencies 'and
pass-through entities and is not intended to be and should not be used by anyone other than these
specified parties.
Oakland, California
December 18, 2008
19
Patel &
Associates Telephone: (510)452-5051
266 17ih Street, Suite 200 Fax: (510)452-3432
Certified Public Accountant Oakland, California 94C 12-4124 e-mail: ramesh@patelcpa.com
INDEPENDENT AUDITOR'S REPORT ON COMPLIANCE WITH REQUIREMENTS
APPLICABLE TO EACH MAJOR PROGRAM AND ON INTERNAL CONTROL OVER
COMPLIANCE IN ACCORDANCE WITH OMB CIRCULAR A-133
The Board of Directors
Axis Community Health, Inc.
Pleasanton, California
Compliance
We have audited the compliance of Axis Community Health, Inc. with the types of compliance
requirements described in the U.S. Office of Management and Budget (OMB) Ci~•cular A-133
Compliance Supplement that are applicable to each of its major federal programs for the year
ended June 30, 2008. Axis Community Health, Int.'s major federal programs are identified in
the summary of auditor's result section of the accompanying schedule of findings and questioned
costs. Compliance with the requirements of laws, regulations, contracts, and grants applicable to
each of its major federal programs is the responsibility of Axis Community Health, Int.'s
management. Our responsibility is to express an opinion on Axis Community Health, Int.'s
compliance based on our audit.
We conducted our audit of compliance in accordance with auditing standards generally accepted
in the United States of America, the standards applicable to financial audits contained in
Government Auditing Standards, issued by the Comptroller General of the United States; and
Office of Management and Budget (OMB)' Circular A-133, Audits of States, Local Governments,
and Nonprofit Organizations. Those standards and OMB Circular A-I33 require that we plan
and perform the audit to obtain reasonable assurance about whether noncompliance with the
types of compliance requirements referred to above that could have a direct and material effect
on a major federal program occurred. An audit includes examining, on a test basis, evidence
about Axis Community Health, Inc.'s compliance with those requirements and performing such
other procedures as we considered necessary in the circumstances. We believe that our audit
provides a reasonable basis for our opinion. Our audit does not provide a legal determination of
Axis Community Health Inc.'s compliance with those requirements.
In our opinion Axis Community Health, Inc. complied, in all material respects, with the
requirements referred to above that are applicable to each of its major federal programs for the
year ended June 30, 2008.
Internal Control Over Compliance
The management of Axis Community Health, Inc. is responsible for establishing and maintaining
effective internal control over compliance with the requirements of laws, regulations, contracts,
and grants applicable to federal programs: Tn planning and performing our audit; we considered
Axis Community Health, lnc.'s internal control hover'compliance with requirements ,that could
have a direct and material effect on a major federal program in order :,to; determine our',auditing
1J
h,
Is i ~
~ . I'! i
procedures for the purpose of expressing our opinion on compliance, but not for the purpose of
expressing an opinion on the effectiveness of internal control over compliance. Accordingly, we
do not express an opinion on the effectiveness of Axis Community Health, Inc.'s internal control
over compliance.
A control deficiency in Axis Community Health, Inc.'s internal control over compliance exists
when the design or operation of a control does not allow management or employees, in the
normal course of performing their assigned functions, to prevent or detect noncompliance with a
type of compliance requirement of a federal program on a timely basis. A significant deficiency
is a control deficiency, or combination of control deficiencies, that adversely affects Axis
Community Health, Inc.'s ability to administer a federal program such that there is more than a
remote likelihood that noncompliance with a type of compliance requirement of a federal
program that is more than inconsequential will not be prevented or detected by Axis Community
Health, Inc.'s internal control.
A material weakness is a significant deficiency, or combination of significant deficiencies, that
results in more than a remote likelihood that material noncompliance with a type of compliance
requirement of a federal program will not be prevented or detected by Axis Community Health,
Inc.'s internal control.
Our consideration of internal control over compliance was for the limited purpose described in
the first paragraph of this section and would not necessarily identify all deficiencies in internal
control that might be significant deficiencies or material weaknesses. We did not identify any
deficiencies in internal control over compliance that we consider to be material weaknesses, as
defined above.
This report is intended solely for the information and use of the management, the audit
committee, board of directors, others within the organization, regulatory body and federal
awarding agencies and pass-through entities and is not intended to be and should not be used by
anyone other than these specified parties.
Oakland, California
December 18, 2008
' ~ i
' r
~ ~
AXIS COMMUNITY HEALTH, INC.
SCHEDULE OF FINDINGS AND QUESTIONED COSTS
FOR THE YEAR ENDED JUNE 30.2008
SECTION I -SUMMARY OF AUDITOR'S RESULTS
Financial Statements
Type of auditor's report issued: Unqualified
Internal control over financial reporting:
• Material weaknesses identified? No
• Significant deficiencies identified that are not considered to be
material weaknesses? No
Noncompliance material to financial statements noted? No
Federal Awards
Internal control over major programs:
• Material weaknesses identified? No
• Significant deficiencies identified that are not considered to be
material weaknesses? No
Type of auditor's report issued on compliance for major programs: Unqualified
Any audit findings disclosed that are required to be reported in
accordance with section 510(a) of Circular A-133? No
Identification of major programs:
CFDA Number Name of Federal Program
10.557 Supplemental Food Program -WIC
93.959 Alcohol and Drug Program
Dollar threshold used to distinguish between type A and type B
programs: $300,000
Auditee qualified as low-risk auditee? Yes
22
AXIS COMMUNITY HEALTH, INC.
SCHEDULE OF FINDINGS AND QUESTIONED COSTS
FOR THE YEAR ENDED JUNE 30, 2008
SECTION II -FINANCIAL STATEMENT FINDINGS
No matters were reported.
SECTION III -FEDERAL AWARD FINDINGS AND OUESTIONED COSTS
No matters were reported. '
23
AXIS COMMUNITY HEALTH, INC.
STATUS OF PRIOR YEAR FINDINGS AND RECOMMENDATIONS
FOR THE YEAR ENDED JUNE 30.2008
There were no material findings reported in the prior year.
24
•
S
coi~~ ~Y~ Ld rail v }t~arr<l.t:h
Board Resolution
Board of Directors
RESOLUTION
The Board of Directors of Axis Community Health endorses and approves
this application to the City of Dublin requesting support to provide access to
health care for uninsured and low income Dublin residents.
James Paxson, Chair
Axis Community Health
Board of Directors
Dated: ~2 ~ ~i
4361 Railroad Avenue, Pleasanton, CA 94566 ¦ Tel: 925.462.5544 ¦ Fax: 925.417.1503 ¦ www.axishealth.org
-~a~~~ ~
Axis Community Health
Insurance Information
Axis Community Health maintains full insurance coverage at all times (see attached
Certificate of Insurance), which includes:
Commercial General Liability $1,000,000
Professional Liability $1,000,000
Automobile Liability $1,000,000
Workers' Compensation $1,000,000
Certificates of current coverage will be submitted to the City of Dublin as requested.
CERTIFICATE OF LIABILITY INSURANCE OP ID pC DATE(MIWDD/YYYY)
Axxsc-1 li 25 os
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Chapman ONLY AND CONFERS NO R[aHTS UPON THE CERTIFICATE
License ~ 0522024 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
P . O. Box 5455 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Pasadena CA 91117-0455
phone: 626-405-8031 Fax: 626-405-0585 INSURERS AFFORDING COVERAGE NAIC#
INSURED 1NSURERA: NORCAL
INSURER B: riaauey a GpoaiC Co Itrrylsr,d
Axis Communityy Health INSURER c: Everest National
4361 Railroad Ave. INSURER D: U.5. S ecialt
Pleasanton CA 94566
INSURER E: xraval.ra pr rt c cuuslC
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THB POLK:Y PEA100 INDICATED. NOTWITHSTANDINp
_ ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WFTH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OA
MAV PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TEAMS, EXCLUSION3 AND CONOITiONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
LTR NSR TYPE OF INSURANCE POLICYNUMBEq DA E MFVDDIYYY DATE M6VDD/YYY t16QTS
GENERALIJABR.ITY EACH OCCURRENCE $ lOOOOOO
E X COMMERCIALGENEAALLIABILITY 660693X4827TCT09 11/29/09 11/29/10 PREMISES {Eaacurence § 100000
CLAIMS MADE OCCUR MEDEXP(Arryoneperson) §SOOO
A X Professional 610371 04/01/09 O4/O1/lO PERSONALBADVINJURY S IOOOOOO
E X Liquor Liability 660693X4827TCT09 11/29/09 11/29/10 GENERAL AGGREGATE s 3000000
GEN'LAGGREpATELIMITAPPL[ESPER: PRODUCTS-COMPIOPAGG S 3000000
X POLICY LOC
AUTOM061LELIABILITY COMBINED SINGLE LIMIT {S l,000OOO
E ANYAUro 660693X4827TCT09 11/29/09 11/29/10 (Eaacadenl) ,
' ALL OWNED AUTOS BODILY INJURY
- SCHEDULED AUTOS (Per person) §
' X HIRED AUTOS ~ ~ ~ - ~ -
' ~ 8001LY INJURY § '
' X NON-OWNED AUTOS (Per axider>h ,
. ~ ~ PROPERTY DAMAGE §
(Per aaldenq
GARAGE LIABILITY AUTO ONLY- EA ACCIDENT ~ S
ANY AUTO OTHER THAN ~ ACC E "
_ AUTO ONLY: AGG §
EXCESS/UMBRELLA WABILri'Y EACH OCCURRENCE ' § lr OOO, OOO
E X OCCUR ~ CLAIMSMADE Ct7P198OT4O2O9 11/29/09 11/29/10 AGGREGATE s 1 000 000
§
DEDUCTIBLE ~ ~ §
X AETENTK7N §SO, OOO § -
WOAKE S CO PF-NSATION
AND ENPLOYEAS' LIABILRY Y 1 N TORY LIMR3 ER
ANY PROPRIETORfPARTNERIEXECUTIVr~ 6600000176091 10/01/09 lO/Ol/lO EL. EACH ACCIDENT S lOOOOOO
OFFICEFVMEMBER EXCLUDEDT LI EL. DISEASE - EA EMPLOY S 1 OOOOOO
(Mandatory in NH) ~ '
II yes, describe under
SPECIAL PROVISIONS below EL DISEASE-POLICY LIMB § IOOOOOO
OTHER
B Crime Section CCP1152338-16 10/01/09 20/O1/lp Emp Dish 400000
D DirectorslrOfficers ZT70930914 08/01./09 OB/O1/10 Limit 2000000
DESCRIPTH)N OF OPERATIONS 1 LOCATEONS 1 VEHICLES /EXCLUSIONS ADDED 8Y ENDORSEMENT /SPECIAL PROVISIONS
Evidence of coverage. 10 days notice of cancellation for non-payment of
prenutlm.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED PQLK:IES BE CANCELLED BEFORE THE EXPIRATK)N
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3O DAYS WRTrtEN
NOTK:E TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LUIBILTTY OF ANY K1kD UPON THE INSURER, ITS AGENTS OA
I REPRESENTATIVES.
City of Dublin Au RREDR PRESENTATNE
100 Civic Plaza
tlblin CA 94568
ACORD 25 (2009/01) ®1988-2009 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
IMPORTANT
!f the certificate holder is an ADDITIONAL INSURED, the policy(ies} must be endorsed. A statement
on this certificate does no# confer rights to the certificate holder in Ifeu of such endorsement(s).
If SUBROGATION f5 WAIVED, subject to the terms and conditions of the policy, certain policies may
require an endorsement. A statement on this certificate does not confer rights to the certificate
holder in lieu of such endorsement(s).
DISCLAIMER
This Certificate of Insurance does not constitute a contract between the issuing insurers},.authorized
representative or producer, and the certificate holder, nor does it affirmatively or negatively amend,
extend or alter the coverage afforded by the policies listed thereon.
ACORU 25 (2009101)
ac~~~~ ~
L°
City of Dublin
Fiscal Year 2010-2011
Application for Funds
.a PPLICATION VERIFICATION
I attest that the information runtaine~i in this Fy 2010-ZU 1 1 ~rr<int application i~ accurate and that
the funds requested ~~~il~lrn>t supplant am ether monie< ~ecure~i b~~the ur~~ani~atiun.
Attached is a resulu~i~m, letter, or other dc~~~urnen~ pro~~iding evidence that the 13o~ud of Directors
approv~;d the application as submitted. Successful applir~u~ts ~~re required to submit a summary
report as upon a~~ p~~ssible after suhmittin« the rcimhur~cment request, but nc>t I,~tcr than At?gust
31, 2O I I . Failure t~~ ~uhmi< a report ~~~ill result in incli~~ihilit~ f~~~r future fun~lin~~.
Si~uatures:
r
F.xecutir~e Director Dale
2 ~t `'l
Bo~ud President/Chairpersan Date
s
B, !L
City of Dublin
k'iscal Xear 2010-2011
Application for Funds
CO~.LABQRAT7gI~3N
llllrE~1CY
qty ~'~AFFIDA
IVIT I+~ORM ~ '
tc ~ ~ ~ F ' r Y
o This forp~iis ~o~be completed hy~each~collaborahn~:orgatuza~ron~as~amed by the _
applicdnt agency in tlie,proposed proe~~progrant: ` t; f
o Couipletedorins Ynust be subrtuti~,t at h~i~
of applicahona ~ ~,j ~ ~ q! ~ _4 ,
~t ! tg ii' ~ ~ ds vx4 ~g t ' fit.
Collaborattng~A~ency, Name: n ~ ,'T ~ ~ t ; L t r ,
Dubl in ~ rar-~ a ~";,,A ' ir.. i',= ` ?t
E ~ t
I
Agent-~~Di~sion(Departmet~t:~:~=_~;~_~ ~ ~ ~ ~ t ,
n. ~ 8 i E a;} ...7 ~ " ro.,? ¢Trt7r s,~ 3rr
Pro~ecl/Pro Title ~-;Access t:~b',ti'e~.Xt~ axe rfo~ TJninsured and LOWr,~Y€came
gtiarn ~ 15 .t
~ '
"i' t ~ Dub 1 in ` Fzes,ident s~~ ~ ~ -~~'=:r~ ~ r'
r,`.. ` ' r ' ~ f u.-a~- 4eEt` h Pe-~+ E~ thy' i ~
Pro~ect/P,cogram Ro~Ie De~i'tton ~a e,~, fac~ty space~,stalf su~~orl.,,et~)r '+rr f~ 4 i
r' , d U 1 f e R
,o ~provi~e .~'ac~.i~y,: ~pace.~:one ay~eaoh wee~~ . ;r : >I .t
1,
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- ,y'}a Ji iti::. :~1q.it tn4 r~Et.. -.....r:~„~'~.~ a-~ 3_..: , . f.,:j E,~
I' I -rax M. 'Y- ~ en 1' ~ ''4,f"~ f ~ ~ * ~..-N ar s.
Agency ~rc~ec~'rogram Contaet Personx~ Lee Jouthas tt r t ~
a P' 1 3 ~ c a
Duel%~'~f~3brary Manager ~ ~
Title ~ z, q d a. s l t ~ t ~ !~r
tz r2~F„ ~ "~W4cc'-o`r ~~d_ - 3 cry' yy _ - Sr
925x,_ $0.3 7266 ~ l~ot~t;has@aclzbrary org a' ;;s
Phone Erriail_
...t J..
i L; r .:rte ~'E- - ~ y t' if v q, Ix,'~ -
I attest that the~appli~ant agency and~~o~-~organizanon~agree to~~Yvo%,~ c~bllaborati~iely to implement
the pr osed pro1ect~proas dent ]n the-FY24f~1 ~i l~ $?~fchiig<a~~plication.
.r,~ - r.r'" 34'x''
Executive Due ~ -
~..4
Project/Program Contact Person Date
a',r.
acln av~o~°~
Internal Revenue Service
Department of the Treasury
P. O. Box 2508
Date: July 21, 2006 Cincinnati, OH 45201
Person to Contact:
P;X1S COMMUNITY HEALTH INC Ms. Wallace 31-04021
4361 RAILROAD AVE Customer Service Specialist
PLEASANTON CA 94566-6611 619 To11 Free Telephone Number:
877-829-5500
Federal Identification Number:
94-2232394
Dear Sir or Madam:
This is in response to your request of July 21, 2006, regartling your organization's tax-
. exempt status.
In December 1972 we issued a determination letter that recognized your organization as
exempt from federal income tax. Our records indicate that your organization is currently
exempt under section 501(c){3} of the Internal Revenue Code.
Our records indicate that your organization is also classified as a public charity under
sections 509(a)(1) and 170(b)(1)(A}(vi} of the internal Revenue Code.
Our records indicate that contributions to your organization are deductible under section
170 of the Code, and that you are qualified to receive tax deductible bequests, devises,
transfers or gifts under section 2055, 2106 or 2522 of the Internal Revenue Code.
if you have any questions, please call us at the telephone number shown in the heading of
this letter.
Sincerely;
Janna K. Skufca, Director; TE/GE
Customer Account Services