2023-10-27T18:26:19-05:00 2022-12-31 910189318 MOSS ADAMS LLP 2882 PROSPECT PARK DR STE 300 RANCHO CORDOVA CA 95670 990 2022-01-01 275349262 DISTRICT HOSPITAL LEADERSHIP FORUM DIST 9165527590 1215 K STREET 700 SACRAMENTO CA 95814 CRYSTAL FELIX TREASURER 9165527590 2023-10-27 1 CRYSTAL FELIX 999009999 1 TRACY S PAGLIA P00366884 9165038100 2023-10-02 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z X DONNA HEFNER 1215 K STREET 700 SACRAMENTO CA 95814 1954161 0 X WWW.CADHLF.ORG X 2011 CA SEE SCHEDULE O 32 32 0 0 0 0 150000 112442 1851655 1839688 1024 2031 0 0 2002679 1954161 431 3464 0 0 0 0 0 0 0 1799689 1914755 1800120 1918219 202559 35942 1610339 1698358 962852 1014929 647487 683429 X SEE SCHEDULE O 0 0 THE ESTABLISHMENT OF, AND THEN OPERATIONAL ASPECTS OF VARIOUS MEDICAID SUPPLEMENTAL PAYMENT PROGRAMS THAT PROVIDE SIGNIFICANT DOLLARS TO CALIFORNIA'S DISTRICT AND MUNICIPAL PUBLIC HOSPITALS. THE ADVOCACY AT BOTH THE STATE AND FEDERAL LEVELS (LEGISLATIVE AND REGULATORY) TO ENSURE CONTINUED FUNDING OF THE MEDICAID SUPPLEMENTAL PROGRAMS AND RECOGNITION OF THE ROLES THAT CALIFORNIA'S DISTRICT AND MUNICIPAL PUBLIC HOSPITALS HAVE IN SERVING/MEETING THE HEALTHCARE NEEDS OF THEIR LOCAL COMMUNITIES. ENSURING THAT THE INTERESTS OF CALIFORNIA'S DISTRICT AND MUNICIPAL PUBLIC HOSPITALS IS BEING CONSIDERED BY BOTH THE FEDERAL AND STATE GOVERNMENT WITH RESPECT TO POLICIES THAT ARE BEING CREATED THAT IMPACT HTE MEMBER HOSPITALS FROM A FINANCIAL PERSPECTIVE. 0 1 0 1 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 4 0 1 0 0 0 0 0 0 0 0 0 X 32 32 1 0 0 0 1 1 0 1 1 0 0 1 1 1 1 0 0 0 0 0 CA X JENNIFER NEWMAN 9164437401 1215 K STREET SUITE 700 SACRAMENTO CA 95814 X JOHN MCCORMICK PRESIDENT 2.00 X X 0 0 0 DONNA HEFNER VICE PRESIDENT 2.00 X X 0 0 0 GARY HERBST TREASURER 2.00 X X 0 0 0 PETE DELGADO SECRETARY 2.00 X X 0 0 0 STEVE DIETLIN AT LARGE 2.00 X 0 0 0 CHRIS HENRY AT LARGE 2.00 X 0 0 0 SANDRA ANAYA DIRECTOR 2.00 X 0 0 0 STEVE BARRON DIRECTOR 2.00 X 0 0 0 CHRIS BJORNBERG DIRECTOR (AS OF 01/22) 2.00 X 0 0 0 STEVE BOLINE DIRECTOR 2.00 X 0 0 0 WILLIAM BILL BOSTOC DIRECTOR (THRU 04/22) 2.00 X 0 0 0 MARY CASILLAS DIRECTOR (AS OF 11/22) 2.00 X 0 0 0 LONIEL CHADWICK DIRECTOR (AS OF 12/22) 2.00 X 0 0 0 KELLI DAVIS DIRECTOR (THRU 07/22) 2.00 X 0 0 0 ADOLPHE EDWARD DIRECTOR (THRU 11/22) 2.00 X 0 0 0 FRANCES HANNAH DIRECTOR (AS OF 04/22) 2.00 X 0 0 0 STEVEN HANNAH DIRECTOR (THRU 10/22) 2.00 X 0 0 0 DIANE HANSEN DIRECTOR 2.00 X 0 0 0 CHARLIE HARRISON DIRECTOR (THRU 02/22) 2.00 X 0 0 0 KIMBERLY HARTZ DIRECTOR 2.00 X 0 0 0 JOHN HENNELLY DIRECTOR 2.00 X 0 0 0 DAVID KLEIN DIRECTOR 2.00 X 0 0 0 KEVIN KRAMER DIRECTOR 2.00 X 0 0 0 LARRY LEWIS DIRECTOR (THRU 11/22) 2.00 X 0 0 0 MATTHEW MATTHIESSEN DIRECTOR 2.00 X 0 0 0 DOUG MCCOY DIRECTOR 2.00 X 0 0 0 TIM MCGLEW DIRECTOR 2.00 X 0 0 0 EDWARD MIRZABEGIAN DIRECTOR 2.00 X 0 0 0 TOM PARKER DIRECTOR 2.00 X 0 0 0 SCOTT PHILIPS DIRECTOR (AS OF 11/22) 2.00 X 0 0 0 STEPHEN POPKIN DIRECTOR 2.00 X 0 0 0 EVAN RAYNER DIRECTOR 2.00 X 0 0 0 JODEE READ DIRECTOR 2.00 X 0 0 0 MATT REES DIRECTOR 2.00 X 0 0 0 AARON ROGERS DIRECTOR 2.00 X 0 0 0 DAMON SORENSON DIRECTOR (AS OF 10/22) 2.00 X 0 0 0 MARK TURNER DIRECTOR (AS OF 02/22) 2.00 X 0 0 0 LOUIS WARD DIRECTOR (THRU 01/22) 2.00 X 0 0 0 HARRY WEIS DIRECTOR 2.00 X 0 0 0 DAN WOODS DIRECTOR 2.00 X 0 0 0 0 0 0 0 0 0 0 STEVE CLARK & ASSOCIATES 950 GLENN DRIVE SUITE 250 FOLSOM CA 95630 PROGRAM/ADMIN SUPPORT 1309070 CHARITY BRACY 2304 WINCHESTER STREET OCEANSIDE CA 92054 LOBBYING 258854 DELGADO GOVERNMENT AFFAIRS LLC 1415 L STREET SUITE 1200 SACRAMENTO CA 95814 LOBBYING 180915 THE CALIFORNIA SAFETY NET INSTITUTE 70 WASHINGTON ST STE 215 OAKLAND CA 94607 GRANT WORK 108444 4 112442 112442 MEMBERSHIP DUES 561499 1839688 1839688 1839688 2031 2031 1954161 1839688 0 2031 X 3464 1228 47773 373405 1330446 2315 500 4324 44461 1859 SNI PROJECT 108444 1918219 1604339 1695170 0 3188 6000 0 1610339 1698358 58322 62322 904530 952607 962852 1014929 X 609929 670987 37558 12442 647487 683429 1610339 1698358 35942 0 X 0 1 X 1 0 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 1839688 373405 373405 373457 -52 0 X 1954161 0 1954161 0 1954161 1918219 0 1918219 0 1918219 PART X, LINE 2: DHLF IS A NONPROFIT PUBLIC BENEFIT CORPORATION AND IS EXEMPT FROM INCOME TAXES UNDER INTERNAL REVENUE CODE SECTION 501(C)(6) AND CALIFORNIA REVENUE AND TAX CODE SECTION 23701E. ACCORDINGLY, NO PROVISION FOR INCOME TAXES HAS BEEN INCLUDED IN THE ACCOMPANYING FINANCIAL STATEMENTS. IN THE EVENT DHLF HAD A TAX PROVISION THAT WAS UNCERTAIN OF BEING SUSTAINED, DHLF WOULD APPLY THE MINIMUM PROBABILITY THRESHOLD TO DETERMINE WHETHER A FINANCIAL STATEMENT LIABILITY OR BENEFIT SHOULD BE RECOGNIZED. THERE WERE NO UNCERTAIN TAX POSITIONS AS OF DECEMBER 31, 2022 AND 2021. FORM 990, PART I, LINE 1 TO IMPROVE SERVICE DELIVERY OPPORTUNITIES ON BEHALF OF CALIFORNIA'S DISTRICT AND MUNICIPAL HOSPITALS THROUGH ACCESSING PUBLIC AND PRIVATE FUNDING OPPORTUNITIES AT BOTH THE FEDERAL AND STATE LEVELS. FORM 990, PART III, LINE 1: THE MISSION OF DHLF IS TO IMPROVE SERVICE DELIVERY OPPORTUNITIES ON BEHALF OF CALIFORNIA'S DISTRICT AND MUNICIPAL HOSPITALS THROUGH ACCESSING PUBLIC AND PRIVATE FUNDING OPPORTUNITIES AT BOTH THE FEDERAL AND STATE LEVELS. THE MOST SIGNIFICANT ACTIVITIES FOR ACCOMPLISHING THIS OBJECTIVE ARE THROUGH ESTABLISHING INNOVATING REIMBURSEMENT APPROACHES FOR ACCESSING THESE FUNDING PROGRAMS. ADDITIONALLY, THE DHLF ADVOCATES AT BOTH THE REGULATORY AND LEGISLATIVE LEVELS FOR ITS MEMBERS' FAIR SHARE OF FUNDING THAT IS AVAILABLE TO ALL OF CALIFORNIA'S HOSPITALS. CALIFORNIA'S HEALTH CARE DISTRICTS ARE ORGANIZED AND OPERATING PURSUANT TO DIVISION 23 OF THE CALIFORNIA HEALTH AND SAFETY CODE, SECTION 32000 ET SEQ. FORM 990, PART VI, SECTION A, LINE 1A SEVEN MEMBERS OF THE BOARD OF DIRECTORS ARE CHOSEN BY THE BOARD TO SERVE AS THE PRESIDENT, VICE PRESIDENT, SECRETARY, TREASURER, AND THREE AT-LARGE EXECUTIVE COMMITTEE MEMBERS. THESE SEVEN MEMBERS OF THE BOARD OF DIRECTORS COMPRISE THE EXECUTIVE COMMITTEE AND ARE RESPONSIBLE FOR THE DAY TO DAY OPERATIONS OF DHLF. FORM 990, PART VI, SECTION A, LINE 1A ONE DISTRICT HOSPITAL MEMBER HAS TWO INDIVIDUALS THAT SERVE ON THE BOARD OF DIRECTORS, HOWEVER, ONLY ONE VOTE IS PERMITTED ON MATTERS BEFORE THE BOARD FOR THIS DISTRICT HOSPITAL MEMBER. FORM 990, PART VI, SECTION A, LINE 2 KIMBERLY HARTZ AND CHRIS HENRY - BUSINESS RELATIONSHIP FORM 990, PART VI, SECTION A, LINE 6 DISTRICT HOSPITAL LEADERSHIP FORUM IS COMPRISED OF ONE CLASS OF VOTING MEMBERS: LOCAL HEALTH CARE DISTRICTS ORGANIZED AND OPERATING PURSUANT TO DIVISION 23 OF THE CALIFORNIA HEALTH & SAFETY CODE, SECTION 32000 THAT OPERATE A LICENSED ACUTE CARE HOSPITAL WITHIN ITS HEALTH CARE DISTRICT, SUBMIT ELIGIBILITY INFORMATION TO BE A VOTING MEMBER, AND PAY THE APPLICABLE DUES, ASSESSMENTS, AND FEES ESTABLISHED BY DHLF. FORM 990, PART VI, SECTION A, LINE 7A EACH VOTING MEMBER APPOINTS A REPRESENTATIVE WHO MEETS THE QUALIFICATIONS SET FORTH BY THE DHLF BYLAWS TO SERVE AS A MEMBER OF THE BOARD OF DIRECTORS OF DHLF. FORM 990, PART VI, SECTION B, LINE 11B A COPY OF THE FORM 990 WAS PROVIDED TO THE BOARD OF DIRECTORS BEFORE FILING. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY COVERS ANY DIRECTOR, PRINCIPAL OFFICER, OR MEMBER OF A COMMITTEE WITH BOARD DELEGATED POWERS, OR EMPLOYEE WITH SIGNIFICANT DECISION MAKING AUTHORITY. IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICT OF INTEREST, AN INTERESTED PERSON MUST DISCLOSE THE EXISTENCE OF THE FINANCIAL INTEREST AND BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE DIRECTORS AND MEMBERS OF COMMITTEES WITH BOARD DELEGATED POWERS CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. AFTER DISCLOSURE OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE INTERESTED PERSON, HE/SHE SHALL LEAVE THE BOARD OF DIRECTORS OR COMMITTEE MEETING WHILE THE DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON. THE REMAINING BOARD OR COMMITTEE MEMBERS SHALL DECIDE IF A CONFLICT OF INTEREST EXISTS. THE MINUTES OF THE BOARD AND ALL COMMITTEES SHALL CONTAIN THE NAMES OF THE PERSONS WHO DISCLOSED OR OTHERWISE WERE FOUND TO HAVE A FINANCIAL INTEREST IN CONNECTION WITH AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, THE NATURE OF THE FINANCIAL INTEREST, ANY ACTION TAKEN TO DETERMINE WHETHER A CONFLICT OF INTEREST WAS PRESENT, AND THE BOARD OR COMMITTEE'S DECISION AS TO WHETHER A CONFLICT OF INTEREST IN FACT EXISTED AS WELL AS THE NAMES OF THE PERSONS WHO WERE PRESENT FOR DISCUSSIONS AND VOTES RELATING TO THE TRANSACTION OR ARRANGEMENT, THE CONTENT OF THE DISCUSSION, INCLUDING ANY ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT, AND A RECORD OF ANY VOTES TAKEN IN CONNECTION WITH THE PROCEEDINGS. FORM 990, PART VI, SECTION C, LINE 19 DHLF MAKES COPIES OF ITS GOVERNING DOCUMENTS, TAX RETURNS, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G ADMINISTRATIVE SUPPORT 1,122,647. QPI SUPPORT - HOSPITAL QUALITY PROGRAM 157,500. OTHER FEES FOR SERVICES 50,299.