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HomeMy WebLinkAbout8.1 Axis Health Care Exh 2COMMUNITY GROUP/ORGANIZATION APPLICATION FOR FUNDS COVER PAGE AGENCY NAME: AXIS COMMUNITY HEALTH PROPOSED PROJECT/PROGRAM NAME: ACCESS TO HEALTH CARE FOR UNINSURED AND LOW- INCOME DUBLIN RESIDENTS FUNDING AMOUNT REQUESTED: X7,500 SECTION 2 Page 1 of 11 EXHIBIT '~ CITY OF DUBLIN Fiscal Year 2009-2010 APPLICATION FOR FUNDS 1. Please select one expense category: ^ Capital X Operating 2. Applicant Information: Organization/Agency Name: Axis Community Health Mailing Address: 4361 Railroad Avenue, Pleasanton, CA 94566 Street Address: 4361 Railroad Avenue City: Pleasanton ~ State: CA 7i1~: 94566 Sue Compton _,_.925-20J-6005 scom~ton rr~asishealth.org Executive_Director/Chairperson Work Phone Email James Paxson x)25-734-6510 lames hacienda.org Board President (if applicable) Work Phone Email Please list the Primary Project Contact Person who would be able to answer questions about this application and project/program during the funding period. Carol Beddome Development Director Contact Person for Project/Program Job Title 925-201-6068 cbeddome(~axishealth.org 925-417-1503 Work Phone Email Fax Federal Tax Identification No. (required) 94-2232394 City of Dublin Business License No. (required) 10832 SECTION 2 Page 2 of 11 ~~ a. City of Dublin Fiscal Year 2009-2010 Application for Funds 3. Proposed Project/Program Information (Do not describe organization.) Amount of Funds Requested: ~ 7,500 (Maximum $25,000 per project.) Proposed Project/Program Name: Access to Health Care for Uninsured Low-Income Dublin Families Proposed Project/Program Date(s): Start07 / O1 l09 and End 06 / 30 l10 ' mo. day yr. mo. day yr. Please note: City Council Grant Funds are distributed on a reimbursement basis. If your Agency needs a 100% disbursement afthe beginning of the Fiscal Year, please indicate this below and please provide justification for this need. ^ Agency is requesting 100% disbursement at the beginning of the Fiscal Year. If selecting this option, pleaseprovide justification in the blank space below. x Agency is not requesting 100°lo disbursement at the beginning of the Fiscal Year. Please provide the frequency that reimbursements will be submitted to the City in the blank space below; ~e.g., monthly, quarterly, at project completion, etc. SECTION 2 Page 3 of 11 . City of Dublin Fiscal Year 2009-2010 Application for Funds a. How would the requested funds be used? ^ Describe, in detail, the PROPOSED PROJECT/PROGRAM (not the Agency) ^ Bulleted text is acceptable. ^ Identify if the proposed project/program is a new service, or extension of an existing one. ^ An additional page maybe added, if needed. Axis Community Health is seeking $7,500 in support for its innovative Enrollment and Eligibility 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 to enroll 206 Dublin residents in publicly-supported health insurance plans which will give them full access to medical care. We are seeking support to continue a 0.20 FTE position. We project that a 0.20 FTE Enrollment Specialist will be able to enroll 206 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 4.0 FTE Enrollment Specialists, we provided over 4,81:4 visits helping low income Tri-Valley residents enroll in health care plans, and over 480 of these visits were to enroll Dublin resider] s in publicly-supported health care plans. b. How would the PROPOSED PROJECT/PROGR:~Iti1 address an unmet' community need and improve the quality of life for Dublin residents. Why is this `project/program needed? (Additional page may be added, if needed): Living without health insurance forces people to_ go without medical care. Chronic illnesses go without treatment. Children are unimmunized. Minor health issues are left untreated and become significant health issues. Research has found that those who are uninsured do not seek health care until they are critically ill. This results in going#o the emergency room, where care is expensive and hospitals are left with unpaid bills--a cost that is 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). SECTION 2 Page 4 of 11 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 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 #o 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 43,960, this CHCF report would indicate that there are more than 8 792 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 he families we work with are completely overwhelmed with the complexities of the health care network. They are not aware of exisfng 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. SECTION 2 Page 5 of 11 City of Dublin Fiscal Year 2009-2010 Application for Funds Our Enrollment and Eligibility services bring about a demonstrable 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. e. What documentation/data/records suppcnrt ehe need for this PROPOSED PROJECTIPROGRAM? Please identify your data sources. (Additianal page maybe added, if needed.) ^ County of Alameda Uninsured Survey, September 2001 • The Relationship Between Health Insurance Coverage and Clinical Outcomes Among Women with. Breast Cancer," New England Journal of Medicine • The Kaiser Commission on Medicaid and the Uninsured, Feb; 2002, The Henry J. Kaiser Family Foundation ^ California Healthcare Foundation Report California's Uninsured, 2008 • Tri-Vailey Needs Assessment, May 2003. d. Specify the PROPOSED PROJECTIPROGRA:i\l population to be served. This program targets Dublin families that are low income and uninsured. Over the course of the one-year project period, we anticipate that our Enrollment Specialist will enroll 206 low income Dublin residents in health care plans. Demographic data from our current service show that 96% of these families have an income that is in HUD's "extremely low" category and 4% are in the "very low" category. Over 60% of the families do not speak English, with Spanish being the predominant language,.(Latinos have the sad and unique distinction of being the ethnic group with the highest workforce participation. rates, yet the lowest rates of health insurance coverage.) 25% are children under the age.of twelve, 10°1° are teens, and 4% are seniors. Approximately 3% are homeless. SECTION Z Page 6 of 11 City of Dublin Fiscal Year 2009-2010 Application for Funds 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. ^ An additional page may be added, if needed. The goal of this project is to decrease the number of low income Dublin residents who do not have health insurance. This will result in access to health care, which, in tum, decreases complications of chronic diseases and prevents a wide variety of acute and chronic illnesses among Dublin residents. It also has a hugely positive effect among children, as immunization rates increase, minor illnesses do not become serious iNnesses, and obesity and diabetes rates are minimized. This program also decreases the rate of uncompensated care in local emergency. rooms and urgent care centers, which is a cost that is passed on to the public. 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. VVe 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 haw to use the medical system and we re-educate them regarding the availability of our triage nurse for medical advice. f. Specify numbers of clients served by agency, then by PROPOSED `' PROJECT/PROGRAM: ~~~ . ~~ ~ - Agene~articipants ~------ - Total Number of Partici ants Served by A ency (if ap licable) Total Number of Dublin Residents Served b~~ AQenc~~ (if applicable) 1,200 Pr~cdPra~ram Participants Total Proposed Participants Served by this Pro'ect/Pro ram 2,500 Total Number of Dublin Residents Served b this Project 206 SECTION 2 Page 7 of 11 Application for Funds 5. Financial Information -Operating Budget a. Expense Budget F"~ 2{~Q9-~~ 1~ EAPENSE BUDGET ORGANIZATION ~'II1S PRt3~EUT/ PROGRA~'I GRANT REQCES'IT Personnel Costs Emplr~`ee Salaric.~ ~~ Benrtits ~j,219,-t5> ~1=~7,~(~-~ `~7,~0O Non-Personnel Costs Direct Contracted Services 197,200 0 0 Occupancy $287,077 0 0 Consumable Supplies $440,250. - 0 0 Other 369,350 0 0 Indirect Contracted Services 11,223 0 0 Occupancy 18,913 0 0 Consumable Supplies $9,575 0 0 Other $32,641 0 0 TOTAL $6,585,684 $147,264 $7,500 Further Ccimments/Explanations (if necessary): SECTION 2 Page 8 of 11 8 City of Dublin Fiscal Year 2009-2010 Application for Funds b. Revenue Budget FY 2009-2010 REVENUE BUDGET ORGANIZATION FR~J~CTIFROGRA~l C+~mmitted/~testricted Funds s eCify source) State of California: WIC X520,869 $0 State of California: EAPC $52,921 $0 Alameda Count CMSP & ACE $1,613,133 $0 Alameda County: Day Laboxers $37,SQ0 $0 Alameda County: Homeless $41,450 $0 Alameda County: Imrr~unizations $18,000 ~ $0 ~' Alameda Count : CYS $61,424 $0 Alameda County:`ODF $542,215 $0 Alameda County: Primary Prevention $157,668 $0 Alameda Count.: Pro 36 $176,607 $0 Alameda Count ;SSA $40,000 $0 Fees/Private Pa /Insurance $3,152,221 $0 Citv of Dublin $3,488 $0 Non-ComniittedlR.~stt-icted ~l~unds (s ecifsource) City of Livermore $40,000 $20,000 City of Pleasanton $25,000 $5,000 City of Dublin $7,500 $7,500 Foundation $87,300 $82,000 Community $52,500 $32,764 TOTAL $6,629,796 $147,264 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. SECTION 2 Page 9 of 11 City of Dublin Fiscal Year 2009-2010 Application for Funds 6. General Agency Information X Past grant applicants may check this box in lieu of completing item 6 (a-d) if the program organizational description on file with the City is correct and current. a. List all years that Organization has previously received City of Dublin funding (not Community Development Black Grant - CDBG). b. Describe the populations} served by the Organization. c. Describe all the services the Organization currently provides to Dublin residents. ^ An additional page maybe added, if needed. d. Has your agency ever previously received funds from the City of Dublin? If yes, please specify in what Fiscal Years and the amount received each year. SECTION 2 Page 10 of 11 City of Dublin Fiscal Year 2009-2010 Application for Funds 7. Required Attachments: O Only one (1) copy per Agency of each of the following is required, even with multiple projects/programs submitted. o Applications without the following documents will not be reviewed for funding. O Please label attachments: A. B C etc. ^ ' A. Names of Governing Board; identify current Board officers. B. Current total Organization operatin budget, including revenue. ^ Clearly labcli"identify the program that includes the PROPOSED PROJECTIPROGRAM. o C. Most recent audit report or tax return,(il: ~Ypplicable). o D. Resolution, letter or other docume~tproviding evidence of Board/Organization approval of application, and date approval was granted. ^ BoardlOrgani~ation approval may be pendi~~g. ^ E. Organization's certificate of insurance showing coverage for liability and workers' compensation. ^ F. Application Verification Declaration Signature Page. ^ G. Signed affidavit form from each collaborating agency named in proposed project/program plan (if applicable). ^ H. Copy of IRS Letter of Determination indicating tax exempt status. SECTION 2 Page 11 of 11 i ~~ ~ Axis Community Health Board of Directors 2009 Officers Name James Paxson, General Manager Hacienda Owners Association 4473 Willow Road, Suite 105 Pleasanton, CA 94588 Ted Kaye, Ph.D. Las Positas College Foundation 4131 Garibaldi Place Pleasanton, CA 94566 Aida White CAPE/Head Start 6125 Augusta Way (home address) Livermore, CA 94550 Bert Brook 852 Castlewood Place Pleasanton, CA 94566 Members Yolanda Brown 3128 Paseo Granada Pleasanton, CA 94566 Mark Eaton 2109 Fourth Street Livermore, CA 94550 Thelma Fones Livermore School District 750 Del Mar Avenue Livermore, CA 94550 Michael Fraser, Chief of Police Pleasanton Police Department 4833 Bernal Avenue Pleasanton, CA 94566 L. James Ghilardi Arroyo Counseling 4713 First Street, #250 Pleasanton, CA 94566 Frank A. Hunter, Ph.D. 1550 Springtown Blvd., Apt. 18G Livermore, CA 94551 Rhenae Keyes 6700 Dougherty Rd. # 101 Dublin, CA 94568 Farzana (Farzi) Najeeb 9302 Benzon Drive Pleasanton, CA 94588 Rebecca Silva, Executive Director CAPE/Headstart 34864 Rumford (home address) Union City, CA 94587 Jeri Steiger 3819 Vineyard, #68 Pleasanton, CA 94566 Laura Torres 4804 Marcella Ct. Livermore, CA 94550 Position/Committees Phone E-Mail Chair (hm) (510) 524-0679 jamestu'~hacienda.org Finance (wk) (925) 7346510 Facility Vice Chair (hm) (925) 417-1201 tkaveCa~lasoositascollege.edu Goverance (wk) (925) 4241010 Nominating Secretary (hm) (925)455-4708 awhiteancapeheadstart.oro Finance (wk) (925)443-3434 Audit Treasurer (hm) (925) 846-0789 berfbrookCa2comcast.net Finance Foundation Facility PatientlClient Adv. (hm) (925) 485-4459 yolanda.r.brown@ko.org (wk) (925) 243-2740 YrooksCa.aol.com (cell) (925) 699-3754 Finance (hm) (925) 373-9249 markleaton@comcast.net Audit (wk) (925) 373-3455 Nominating (hm) (925) 443-7320 tfones _livermore.kl2.ca.us (wk) (925)454-5596 Goverance (hm) (925) 846-8847 mfraser ci.oleasanton.ca.us (wk) (925)931-5100 Governance (hm) (925) 4842449 volvosgo@aol.com Audit (wk) (925) 462-0220 Patient/Client Adv. (hm) (925) 449-1714 hunterfrankalexCa~vahoo.com Marketing (cell) (925) 518-3253 Audit Patient/Client Adv. (hm) (925) 339-8548 keves2thecap<cilaol.com Marketing (hm) (925) 399-5131 farzinajeebCcilyahoo.com Medical Leave (hm) (510) 487-7769 rsilvaCcDcaoeheadstart.org (wk) (925)443-9380 Governance (hm) (925) 484-3699 Patient/Client Adv (wk) (925) 846-2520 (hm) (925) 2944144 (wk) (925)606-4724 pizzarobCa~aol.com ItomesCc~livermore. k 12.ca. us Staff Sue Compton, CEO (wk) (925) 201-6005 scomoton@axishealth.or9 Sandy English, Executive Assistant (wk) (925) 201-6017 sen lish .axishealth.orq ~~ ~ AXIS Community Health FY 2008-2009 Budget REVENUE: Federal: State County Local Fees/Private Pay/Insurance Foundations Donations Other TOTAL REVENUE: EXPENSES: DIRECT PERSONNEL CONTRACTED SERVICES OCCUPANCY CONSUMABLE SUPPLIES OTHER TOTAL DIRECT EXPENSES INDIRECT PERSONNEL CONTRACTED SERVICES OCCUPANCY CONSUMABLE SUPPLIES OTHER TOTAL INDIRECT EXPENSES TOTAL EXPENSES NET OPERATING INCOME (LOSS) (Before Depreciation) PROJECTS Behavior Health Relocation Funding Expenses WOMEN'S CLINIC CONSTRUCTION Funding Expenses Chronic Disease Mgmt (i2i ~ Implementation Shortfall Software/Hardware Implementation Contractor support TOTAL PROJECT BALANCE TOTAL BUDGET AXIS Total Clinic Budget BH Budget WIC Budget Budget 50,000 0 520,869 570,869 1,614,169 820,246 2,434,415 52,000 500 52,500 2,757,796 669,916 3,427,712 87,300 3,000 90,300 50,000 1,500 51,500 2,500 0 - 2,500 4,613,765 1,495,162 520,869 6,629,796 3,156,205 945,309 373,053 4,474,566 135,000 30,400 31,800 197,200 127,670 120,057 39,350 287,077 382,000 35,750 22,500 440,250 234,700 111,500 23,150 369,350 4,035,575 1,243,016 489,853 5,768,443 499,774 215,015 30,100 744,889 7,500 3,723 0 11,223 12,692 6,221 0 18,913 6,500 3,075 0 9,575 22,480 10,161 0 32,641 548,946 238,195 30,100 817,241 4,584,520 1,481,211 519,953 6,585,684 29,245 13,951 91 44,111 108,570 108,570 {128,570) {128,570) 487,697 487,697 {516,575) {516,575) {20,000} (20,000) {20,000} {20,000) {10,000) {10,000) (7s,s7s} (20,000} o (sa,s7s) (49,633) (6,049) 916 (54,767) We are projecting our clinic budget to operate at a deficit in 2008/2009 with capital shortfalls in needed infrastructure expansions (Women's Health Clinic and Behavioral Health Relocation) and a steady increase in the number of uncompensated medical visits which is occurring as our patient visits increase at a rate that exceeds our current contracts and grants. The revenue projections are at risk, as we are anticipating decreases in reimbursement rates from Medical and other publicly funded programs, as state officials develop plans to alleviate the current state budget deficit. 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 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 Certified Public Accountant The Board of Directors Axis Community Health, Inc. Pleasanton, California 266 17ih Street, Suite 200 Oakland, California 94612-4124 INDEPENDENT AUDITOR'S REPORT Telephone: (510) 452-5051 Fax: (510) 452-3432 e-mail: ramesh[tipatelcpa.com 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 Community Health, Ine.'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 GoverrTments, 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 AXIS COMMUNITY HEALTH, INC. STATEMENT OF FINANCIAL POSITION JUNE 30, 2008 ASSETS Current assets: Cash and cash equivalents Accounts receivable -net (Note 3) Grants and contracts receivable (Note 5) Prepaid expenses Total current assets Property and equipment -net (Note 6) Total assets LIABILITIES AND NET ASSETS Current liabilities: Accounts payable Accrued liabilities Unemployment reserve (Note 7) Current portion of note payable (Note 8) Total current liabilities Long term portion of note payable (Note 8) Total liabilities NET ASSETS: Unrestricted Temporarily restricted Total net assets Total liabilities and net assets The accompanying notes are an integral part of these financial statements. $ 1,411,440 921,835 528,200 41,415 2,902,890 1,503,307 $ 4,406,197 $ 166,291 401,929 37,959 17,717 623,896 667,804 1,291,700 3,087,644 26,853 3, 114,497 $ 4,406,197 2 AXIS COMMUNITY HEALTH, INC. STATEMENT OF ACTIVITIES JUNE 30, 2008 Support: Grants and contracts (Note 4) Contributions (Note 12) Total support Revenue: Patient fees (Net) Interest income Other Total revenue Total support and revenue Net assets released from restrictions: satisfaction of program restrictions Total support and revenue Expenses (Note 17): Program services Management and general Total expenses Revenue over expenses Net assets, beginning of the year Net assets, end of year Temporarily Unrestricted Restricted $ 2,950,958 $ 102,483 25,000 3,053,441 25,000 3,705,350 21,169 22,427 3,748,946 6,802,387 25,000 67,475 (67,475) 6,869,862 (42,475) 5,357,190 886,815 6,244,005 625,857 (42,475) 2,461,787 69,328 $ 3,087,644 $ 26,853 Permanently Restricted Total $ $ 2,950,958 127,483 3,078,441 3,705,350 21,169 22,427 3,748,946 6,827,387 6,827,387 5,357,190 886,815 6,244,005 583,382 2,531,115 $ $ 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, Ina (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: SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES Basis of Accountin 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. Tem orarily 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. Pronerty and Equi ment 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. Sunnort 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 Equivalents 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 and disclosures. Accordingly, actual result could differ from those estimates. 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. 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 Ciry 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 NOTE 9: LEASE COMMITMENTS $ 685,521 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 terms in 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 of America 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 of activities that generate support for the organization. There were no significant transactions between the two organizations during the year. 11 W z a w d' H O F r, W F O z ri O w N .~ N .d yN W N .5.. L W '~ v 3 .~ a A 0 H W U a Pr W .`~- cn W Chi W ¢~¢ ~G ~. ~I ~ M Vl O~ ~/1 ~ V1 O l~ d' 7 00 l~ V1 O~ M 00 7 M \O N ~ 7 [~ V'~ l~ et vl [~ 00 7 M O~ l~ O M 00 N M O~ M O~ [~ N v1 O~ 01 v1 00 O O N C1 M 00 ~O M ~O 00 M O~ 00 00 ~ vl N N ~O G1 N N ^~ 00 ..~ 01 ~"~ O ~ r O 7 7 l~ N 7 N 7 M 00 O l~ 7~ 7 N T l~ 7 0 ^~ ~O ~ 00 M 7 I V1 N ~O Vl ~-• 00 ~ M 01 [~ ~--~ 7 ^~ N N N M ~' M N [~ ~ ~ N O N 69 69 N N l~ 7 00 ~ ~ V1 CO vl M ~ Q1 O 00 00 Q1 ~ ~ M vl C3 vi o0 ~O M l~ d' ~-• ~ N ~ 00 n 7 G1 l~ O ~O et ~O O~ ~--~ ~ y ~!1 O Vl 7 ~-• N •--~ ~O O~ V~ ,-. M N l~ Vl ul .-+ ~!1 ~-• 00 00 ~~ N ~/1 01 M N 00 M M Vl ~ •-'~ ~ W 7 ti M .-y M ~O ~ ~ ~ 00 N N ~--~ N ~ ~ ~ N ~ O 701 Vi O~ 01 .--i ~ ~ ~ M 7 00 M ~ Ul h M O Q~ l~ O y ~ N v1 O~ d' 7 00 ~ ..r 7 M vl 00 N ~ 7 7 ,-r ~O M O T M ~ 00 O~ y vl '-. M~ \O ~ O~ N 7 M ~D 00 7 ~--~ O 7 ..~ G1 r O b 00 O O ~-'~ ~ ~ }}--~~ A [~ 01 01 ~ \O M vl M !{ vj v'i O vi N ~O O\ 7 ~ M G; l 7 ~ M Vl l~ H 0~ ~~ 01 n M N N N N •--~ M N l~ M N N V1 ~!1 00 N N M py W M V1 b9 69 C y ~+, ~ ,C1 0 0 O vl ~D O~ M M O O vl ~ .-~ O N CT o0 O ' O y Ul M ul V ) 01 O1 00 7 (~ Vl (~ O 00 M M l~ N h 0 M ~ ,II ~ n .~ M 00 01 ~ ~ r 01 ~ N M ~ 01 N ~ O 7 ~ l ~ ~ O N M M N CF N l~ N 7 U1 N ~--~ N N N ~ ~ 3 '. r, N 69 EA O Vl Vl h ~' ~ ~--~ Q~ M ~ 00 M O~ ul 7 M •-+ O ul V1 O\ ~ ~ ,~" 01 ~D M ~ 00 V'1 M ~O 7 ~ l~ l~ [~ ~O O 00 M \O Vl 01 00 ~--~ O ~ l~ O ~ O vl N o0 7 00 M t~ h 00 00 7 O l~ N ~ O -~ ~ ~ ~ G~ ~y ..-. [ N O ~D ~ U1 N ~D O O t M N ~ .-y ~ ~ rG .Ti . -~ N 69 6R l~ V1 O 7 ~O O~ .-. ~ 00 ~ 00 O O O ~ 7 M er .--~ O~ l~ O ~O -~ l~ M ~ ~•-~ O •--~ V'1 M h ~D N 00 01 ~O ~O 7 Vl 00 00 M ~ ~ M N r ~, O R . -i ~ M ~--~ --~ N ~--~ O 7 N N 7 N v~ ~--~ O ~ O ~ --~ M eF ~--~ O~ t O N ~ i O 7 N ~ " + ~ --~ b- U v N ~ vi .. O ~-- e o0 •- ~ •-- m ~ ~ ~ ~-. M ,-~ ^i N N •-• N ~ Q Q 64 69 ~1 V1 ~D vl O N 01 O ~O ~O M 01 vY V1 N~ v1 N h r~ O M O M y O Q+ ~ N ~O t~ 01 N .-~ O\ 00 ~ N N N ~--~ v1 O N ~ N M [~ ~ 00 ~ eC ~ 00 CT O1 7 01 v) h ~O O ~n ~ .-~ O 7 01 V1 ~ M .~ O~ `D ~O 01 O l~ ~ M N V .•V• ~ 7 N d' ~ 7 l~ M M lp 01 l~ ~ l~ ~ M vi l~ 00 vl 7 ~ M M M l~ N 7 ~ L '. ~ O ~/1 ~--~ ~-+ ~O vl ~D M M l~ M M ~O ~ ~/1 N N ~ ~ • y C..) M 69 69 Vi U a'".i O y N VUy V U U y ~ y U N d d ~ ~ ~ a „ •~ ~ a cs. ~ ~ ~ w .° .°o °~' a a.:^ ~ ~ ,•°, ~ •~ ,~ y °~~' '~ ~ a ~ -moo " a .~ ~ w vawUa ~a0ar~~0a°. ~a~O~E"wE=w~i~OA~ F~- SUPPLEMENTARY INFORMATION AXIS COMMUNITY HEALTH, INC. STATEMENT OF UNITS OF SERVICE FOR COUNTY OF ALAMEDA GRANTS FOR THE YEAR ENDED JUNE 30, 2008 Program Contract Number Contract Period Contract Amount TYPE OF SERVICE Medical Amount Reimbursed by County Homeless Program C-93-0689 7/1/0'7- 6/30/08 $ 41,450 NUMBER RATE OF UNITS PER UNIT 347 $ 82.00 13 TOTAL 28,454 $ 28,454 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 UNIT 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 JUNE 30, 2008 Contract Name Contract Number Contract Period Contract Amount Alcohol and Drug C-93-0689 7/1/07-6/30/08 $ 513,865 210 200. Primary Outpatient 202 200 Prevention Alcohol/Dnxes Teen Prop 36 Total Expenditures: Services and Supplies Amount Reimbursed by County $ 132,393 $ 191,222 $ 137,611 $ 162,640 $ 623,866 $ 132,393 $ 191,222 $ 137,611 $ 162,640 $ 623,866 16 AXIS COMMUNITY HEALTH, INC. SCHEDULE OF EXPENDITURES OF FEDERAL AWARDS FOR THE YEAR ENDED NNE 30, 2008 FEDERAL GRANTOR/PASS-THROUGH GRANTOR/PROGRAM OR CLUSTER TITLE U.S. Department of Agriculture: Pass-Through Program From: State Departement of Health & Human Services - Supplemental Food Program -WIC Total U.S. Department of Agriculture U.S. Department of Health and Human Services: Pass-Through Programs From: Alameda County -Health Care Service Agency - Homeless Program Alameda County-Department of Public Health - Alcohol and Drug - Drug Medical - Drug and Alcohol Treatment and Substance Abuse Counseling Total U.S. Department of Health and Human Services U.S. Department of Housing and Urban Development: Pass-Through Programs From: City of Pleasanton Community Development Block Grants - Pleasanton Woman's Health Center City of Livermore Community Development Block Grants - Access to Healthcare for Uninsured Liv. Fam. - Defibrillator Total U.S. Department of Housing and Urban Development Total Expenditures of Federal Awards Federal Pass-Through CFDA Entity Identifying Federal Number Number Expenditures 10.557 99-12345&99-85771 $ 506,201 506,201 93.151 C-93-0689 28,454 93.959 C-93-0689 110,041 93.778 C-93-0689 6,488 93.645 C-93-0689 18,000 162,983 14.218 N.A. 23,030 14.218 N.A. 8,500 14.218 N.A. 2,003 33,533 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-Profzt Organizations. Therefore, some amounts presented in this schedule may differ from amounts presented in, or used in the preparation of, the basic financial statements. $ 702,717 17 Patel & Assoclates Telephone: (Sl0)452-5051 266 17'^ Street, Suite 200 Fax: (510) 452-3432 Certified Public Accountant Oakland, California 94612-4124 a-mail: ramesh@patelcpa.com INDEPENDENT AUDITOR'S REPORT ON INTERNAL CONTROL OVER FINANCL~L 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 Reporting 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 fmancial 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 Board Resolution Attachment D Board of Directors RESOLUTION The Board of Directors of Axis Community Health endorses and approves this application to the City of Dublin for support for providing access to health care for uninsured and low-income Dublin residents. a s Paxson, Chair Community Health Board of Directors Dated: ~. 2 ~. ~d ~ 4361 Railroad Avenue, Pleasanton, CA 94566 ^ Tel: 925.462.5544 ^ Fax: 925.417.1503 ^ www.axishealth.org Insurance Information Attachment E 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 Pleasanton as requested 4361 Railroad Avenue, Pleasanton, CA 94566 ^ Tel: 925.462.5544 ^ Fax: 925.417.1503 ^ www.axishealth.org APPLICATION VERIFICATION Attachment F I attest that the information contained in this FY 2009-2010 grant application is accurate and that the funds requested will not supplant any other monies secured by the organization. Attached is a resolution, letter, or other document providing evidence that the Board of Directors approved the application as submitted. Successful applicants are required to submit a summary report as soon as possible after submitting the reimbursement request, but not later than August 31, 2010. Failure to submit a report will result in ineligibility for future funding. Signatures: v~.,c ~i-a-~.-, Executive Director B and Pre dent/Chairperson 1 • ~ y~ Date ~• ~i~ Z4~0 ~1 Date 4361 Railroad Avenue, Pleasanton, CA 94566 ^ Tel: 925.462.5544 ^ Fax: 925.417.1503 ^ www.axishealth.org ~- h~.e:~- ~- Internal Revenue Service Date: July 21, 2006 ,4XIS COMMUNITY HEALTH INC 4361 RAILROAD AVE PLEASANTON CA 94566-6611 619 Department of the Treasury P. O. Box 2508 Cincinnati, OH 45201 Person to Contact: Ms. Wallace 31-04021 Customer Service Specialist To11 Free Telephone Number: 877-829-5500 Federai identification Number: 94-2232394 Dear Sir or Madam: This is in response to your request of July 21, 2006, regarding 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 Intemal 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 Intemal Revenue Cade. 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 `~