2024-11-08T17:30:27-06:00 2023-12-31 135565207 KPMG LLP MISSION TOWERS I 3975 FREEDOM CIRCLE DR SANTA CLARA CA 95054 990 2023-01-01 911788973 JOHN MUIRMT DIABLO COMMUNITY HEALTH FUND JOHN 9259413100 5003 COMMERCIAL CIRCLE 275 CONCORD CA 94520 RUJA MANGHANI MD CHAIR 9259413100 2024-10-22 1 0 X CAREY MCKEE P01281067 4083675764 2024-10-22 2023 2024-10-15 13:58:12Z JELISSA PARHAM 5003 COMMERCIAL CIRCLE SUITE 275 CONCORD CA 94520 1408194 0 X WWW.JOHNMUIRHEALTH.COM/CHF X 1998 CA THE JOHN MUIR/MT. DIABLO COMMUNITY HEALTH FUND ("CHF") IS A TAX EXEMPT 501(C)(3) SUPPORTING ORGANIZATION TO JOHN MUIR HEALTH ("JMH") FOCUSING ON POPULATIONS WHO ARE UNINSURED OR UNDER-INSURED AND MOST LIKELY TO EXPERIENCE DISPARITIES IN HEALTH CARE. 9 9 2 10 0 0 1470344 1408194 0 0 0 0 0 0 1470344 1408194 1006110 859000 0 0 346988 386351 0 0 0 117246 113374 1470344 1358725 0 49469 336661 171321 234250 19441 102411 151880 X THE JOHN MUIR/MT. DIABLO COMMUNITY HEALTH FUND SUPPORTS HEALTH INITIATIVES THAT ADDRESS CURRENT AND EMERGING HEALTH CARE NEEDS. TO DO SO, WE DISTRIBUTE GRANTS TO AND PARTNER WITH THE LEADERS OF THESE INITIATIVES: COMMUNITY-BASED, NONPROFIT ORGANIZATIONS THAT PROVIDE EITHER HIGH QUALITY, AFFORDABLE PRIMARY, SPECIALTY, DENTAL AND BEHAVIORAL HEALTH CARE OR INNOVATIVE WELLNESS AND SUPPORT PROGRAMS THAT CONTRIBUTE TO GOOD HEALTH. 0 0 1295504 859000 0 THE JOHN MUIR COMMUNITY HEALTH FUND IS THE COMMUNITY BENEFIT GRANTMAKING ARM OF JOHN MUIR HEALTH. OUR GRANTS FOSTER SYSTEMATIC CHANGES IN HOW HEALTH CARE SERVICES ARE PROVIDED TO IMPROVE THE HEALTH OF PEOPLE IN CENTRAL AND EAST CONTRA COSTA COUNTY. OUR GRANTS FOCUS ON POPULATIONS WHO ARE UN- OR UNDER-INSURED, HAVE LIMITED ACCESS TO HEALTH CARE, ARE MOST AT-RISK FOR POOR HEALTH, AND ARE MOST LIKELY TO EXPERIENCE HEALTH CARE DISPARITIES. OUR FUNDING PROCESS NURTURES LONG-TERM PARTNERSHIPS WITH AND AMONG COMMUNITY-BASED HEALTH CARE ORGANIZATIONS, LEADING TO VISIONARY HEALTH INITIATIVES THAT BUILD AND SUSTAIN THE CAPACITY TO DELIVER ON THE PROMISE OF GOOD HEALTH AND AFFORDABLE HEALTH CARE FOR ALL. 1295504 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 0 0 1 2 1 0 0 0 0 0 0 0 0 0 0 0 0 X 9 9 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 0 1 0 0 CA X X JESSICA PARHAM 9259413100 5003 COMMERCIAL CIRCLE STE 275 CONCORD CA 94520 GAIL CRISTANCHO CHAIR 5.00 0.00 X X 0 0 0 RUJA MANGHANI MD VICE CHAIR 5.00 0.00 X X 0 0 0 RAYMOND BARBOUR SECRETARY 5.00 0.00 X X 0 0 0 MATTHEW RINN TREASURER 5.00 0.00 X X 0 0 0 AN VU PHD DIRECTOR 5.00 0.00 X 0 0 0 ARTHUR SHINGLETON DIRECTOR 5.00 0.00 X 0 0 0 CAROLYN FONG RN NP PHD DIRECTOR (THRU 12/31/23) 5.00 0.00 X 0 0 0 ERNESTO AVILA DIRECTOR (THRU 12/31/23) 5.00 0.00 X 0 0 0 NIKO ANAGNOSTOPOULOS DIRECTOR (THRU 11/18/23) 5.00 0.00 X 0 0 0 TASHA JOHNSON DIRECTOR 5.00 0.00 X 0 0 0 JELISSA PARHAM EXECUTIVE DIRECTOR (AS OF 8/14/23) 40.00 0.00 X 74272 0 6720 LILLIAN ROSELIN EXECUTIVE DIRECTOR (THRU 9/1/23) 40.00 0.00 X 123295 0 36254 197567 0 42974 1 0 1 0 0 1408194 1408194 1408194 0 0 0 859000 859000 197567 177800 19767 98657 88792 9865 28253 25428 2825 39159 35243 3916 22715 20443 2272 500 500 87442 65687 21755 7337 7337 4049 4049 WRITING & COMMUNICATION 8225 8225 TRAINING 2400 2400 DUES & SUBSCRIPTIONS 765 765 LICENSES & TAXES 240 0 240 2416 335 2081 1358725 1295504 63221 0 237846 3611 0 0 98815 167710 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 336661 171321 234250 19441 0 0 0 0 0 0 0 0 0 0 0 0 0 0 234250 19441 X 102411 151880 102411 151880 336661 171321 49469 0 X 0 1 X 1 0 X X 1 JOHN MUIR HEALTH 941461843 3 1 1408194 0 1 1408194 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 X 1 1 PART-I LINE-12G SCH A, PART I, LINE 12G, COLUMN VI JOHN MUIR/MT. DIABLO COMMUNITY HEALTH FUND (CHF) DIRECTLY PERFORMS ONE OF JOHN MUIR HEALTH'S MOST IMPORTANT COMMUNITY BENEFIT FUNCTIONS WHICH IS TO CREATE SUSTAINABLE HEALTH INITIATIVES THAT EXPAND AND ENHANCE HEALTH CARE SERVICES FOR UNINSURED AND UNDERSERVED POPULATIONS. BUT FOR THE INVOLVEMENT OF CHF, THESE ACTIVITIES WOULD NORMALLY BE ENGAGED IN BY JOHN MUIR HEALTH. CHF PROVIDES DIRECT SERVICES TO JOHN MUIR HEALTH TOTALING $1,295,504. IN ADDITION, CHF AWARDS AND MONITORS COMMUNITY GRANTS THAT DELIVER CRITICAL HEALTH CARE SERVICES, SUPPORTING THE JOHN MUIR HEALTH MISSION. SEE SCHEDULE O FOR ADDITIONAL DETAIL REGARDING THESE PROGRAMS. PART-IV, SECTION A LINE 6 SUPPORT PROVIDED TO OTHER THAN SUPPORTED ORGANIZATIONS GRANTS PROVIDED TO OTHER ORGANIZATIONS MUST ALIGN WITH JOHN MUIR/MT. DIABLO COMMUNITY HEALTH FUND AND JOHN MUIR HEALTH'S MISSIONS. FUNDS ARE USED CONSISTENT WITH THE 501(C)(3) PURPOSES AS DESCRIBED IN SECTION 170(C)(2)(B). PART-IV LINE-SECTION D LINE 2 ORGANIZATION'S OFFICERS, DIRECTORS OR TRUSTEES THE JOHN MUIR/MT. DIABLO COMMUNITY HEALTH FUND BYLAWS SPECIFY THAT ITS BOARD OF DIRECTORS CONSISTS OF TEN (10) MEMBERS, WITH FIVE (5) APPPOINTED BY JOHN MUIR ASSOCIATION, THREE (3) APPOINTED BY THE CONCORD/PLEASANT HILL HEALTH CARE DISTRICT, AND TWO (2) APPOINTED BY THE CITY OF PLEASANT HILL. LEADERSHIP TEAMS CHF AND JMH LEADERSHIP TEAMS COMMUNICATE ON A REGULAR BASIS. THE CHF EXECUTIVE DIRECTOR SUBMITS THE CHF BOARD APPROVED ANNUAL BUDGET TO JMH'S CFO FOR JMH BOARD APPROVAL. TO KEEP JOHN MUIR HEALTH LEADERS APPRISED OF THE CHF'S GRANTMAKING ACTIVITIES, THE CHF EXECUTIVE DIRECTOR MEETS QUARTERLY WITH JOHN MUIR HEALTH'S COMMUNITY IMPROVEMENT DIRECTOR AND GOVERNANCE & COMMUNITY AFFAIRS MANAGER . JOHN MUIR SENIOR LEADERSHIP IS NOTIFIED VIA EMAIL AS GRANTS ARE APPROVED THROUGHOUT THE YEAR. ACCURATE REPORTING OF THE CHF'S CONTRIBUTIONS ARE HIGHLIGHTED IN JMH'S ANNUAL COMMUNITY BENEFIT REPORT. CHF STAFF WORKS WITH JMH FINANCE TO COMPLETE AND FILE THE CHF'S ANNUAL TAX RETURN. PART-IV LINE-SECTION E LINE 2A SUPPORTED ORGANIZATIONS THE JOHN MUIR/MT. DIABLO COMMUNITY HEALTH FUND CARRIES OUT A UNIQUE COMMUNITY BENEFIT FUNCTION FOR JOHN MUIR HEALTH: DISTRIBUTING GRANTS TO NONPROFIT ORGANIZATIONS WORKING TO IMPROVE THE HEALTH AND WELL-BEING OF MEDICALLY UNINSURED, UNDERINSURED, UNDERSERVED, AND VULNERABLE POPULATIONS MOST AT-RISK FOR POOR HEALTH IN CENTRAL AND EAST CONTRA COSTA COUNTY. OUR GOVERNING BOARD'S MISSION IS TO CREATE LASTING HEALTH AND HEALTH CARE IMPROVEMENTS FOR THESE INDIVIDUALS AND COMMUNITIES. OUR MOST VALUABLE CONTRIBUTION HAS BEEN FOSTERING THE START-UP AND EXPANSION OF PROGRAMS AND SERVICES THAT ACHIEVE THIS MISSION. THE JOHN MUIR/MT. DIABLO COMMUNITY HEALTH FUND SUPPORTS HEALTH INITIATIVES THAT SUSTAINABLY ADDRESS CURRENT AND EMERGING HEALTH CARE NEEDS. TO DO SO, THE CHF DISTRIBUTES GRANTS TO AND PARTNERS WITH COMMUNITY-BASED, NONPROFIT ORGANIZATIONS THAT PROVIDE HIGH QUALITY, AFFORDABLE PRIMARY, SPECIALTY, DENTAL, AND BEHAVIORAL HEALTH CARE OR ANCILLARY WELLNESS AND SUPPORT SERVICES THAT CONTRIBUTE TO GOOD HEALTH. PART-IV LINE-SECTION E LINE 2B SUPPORTED ORGANIZATION ACTIVITIES JOHN MUIR HEALTH MAKES ITS COMMUNITY BENEFIT CONTRIBUTIONS THROUGH THREE AVENUES: THE JOHN MUIR/MT. DIABLO COMMUNITY HEALTH FUND, COMMUNITY HEALTH IMPROVEMENT, AND ITS PATIENT FINANCIAL ASSISTANCE PROGRAM. THIS APPROACH EXTENDS JOHN MUIR HEALTH'S REACH BY SUPPORTING COMMUNITY-BASED ORGANIZATIONS AND FIRMLY CONNECTS OUR HOSPITAL AND CLINICAL EXPERTISE TO COMMUNITY PROGRAMS. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1408194 0 1408194 0 1408194 1358725 0 1358725 0 1358725 1 OPPORTUNITY JUNCTION 3102 DELTA FAIR BLVD ANTIOCH CA 94509 680459131 501 (C)(3) 125500 0 N/A N/A HCP IMPLEMENTATION/ EVALUATION CONTRA COSTA CRISIS CENTER 307 LENNON LANE WALNUT CREEK CA 94598 941747227 501 (C)(3) 135000 0 N/A N/A COCO SERVICES NETWORK IMPLEMENTATION DENTISTS ON WHEELS 1 STONEGATE DRIVE ALAMO CA 94507 842234407 501 (C)(3) 35000 0 N/A N/A ECCC DENTAL CLINIC IMPLEMENTATION LA CLNICA DE LA RAZA PO BOX 22210 OAKLAND CA 94623 941744108 501 (C)(3) 126500 0 N/A N/A MENTAL HEALTH STIGMA INITIATIVE PEOPLE WHO CARE 2231 RAILROAD AVENUE PITTSBURG CA 94565 161634099 501 (C)(3) 75500 0 N/A N/A ECCC PROGRAM EXPANSION PLANNING & IMPLEMENTATION LOAVES AND FISHES OF CONTRA COSTA 835 FERRY STREET MARTINEZ CA 94553 680018077 501 (C)(3) 75500 0 N/A N/A MEAL DELIVERY IMPLEMENTATION VILLAGE KEEPERS 2024 VILLA DRIVE APT 106 BAY POINT CA 94565 800362057 501 (C)(3) 75500 0 N/A N/A IMPLEMENT AFRICAN AMERICAN FAMILY WELLNESS CENTER GANAS COMMUNITY ORGANIZATION 4425-C TREAT BLVD UNIT 357 CONCORD CA 94521 874011867 501 (C)(3) 8000 0 N/A N/A PLANNNING & COACHING RAINBOW COMMUNITY CENTER 2380 SALVIO STREET SUITE 301 CONCORD CA 94520 680375857 501 (C)(3) 15000 0 N/A N/A EXECUTIVE SEARCH HIJAS DEL CAMPO 144 CONTINENTE AVE STE 120 BRENTWOOD CA 94513 863224204 501 (C)(3) 16000 0 N/A N/A PLANNING MIGRANT/SEASONAL FARMWORKER INITIATIVE EMPOWERED AGING 2255 CONTRA COSTA BLVD PLEASANT HILL CA 94523 680237191 501 (C)(3) 36000 0 N/A N/A BOARD & STAFF RETREAT & COACHING CANCER SUPPORT COMMUNITY 3276 MCNUTT AVE WALNUT CREEK CA 94597 680157858 501 (C)(3) 25000 0 N/A N/A CSC/WCRC EAST CCC EXPANSION PLANNING LA CONCORDIA WELLNESS CENTER 1070 CONCORD AVE STE 200 CONCORD CA 94520 883030525 501 (C)(3) 30000 0 N/A N/A WELLNESS CENTER PLANNING MEALS ON WHEELS DIABLO REGION 1300 CIVIC DRIVE WALNUT CREEK CA 94596 942822559 501 (C)(3) 80500 0 N/A N/A PROGRAM DIRECTER/SR RSRC CHALLENGE GRANT 14 0 PART I, LINE 2: GRANT MONITORING PROCESS THE COMMUNITY HEALTH FUND (CHF) HAS ESTABLISHED PROCEDURES FOR MONITORING THE PERFORMANCE OF FUNDED ORGANIZATIONS. THIS INCLUDES REQUIRING WRITTEN REPORTS DESCRIBING PROGRAM ACHIEVEMENTS AS WELL AS BUDGET REPORTS ON THE USE OF GRANT FUNDS. IN ADDITION, STAFF AND BOARD MEMBERS FROM CHF MEET FACE TO FACE WITH STAFF AND BOARD MEMBERS FROM FUNDED ORGANIZATIONS AT LEAST TWICE A YEAR. THESE MEETINGS FACILITATE THE DISCUSSION OF PROGRESS ACHIEVED IN ACCOMPLISHING GOALS AND IMPLEMENTING PLANS FOR SUSTAINING THE FUNDED PROGRAMS. THERE IS A GRANT FILE FOR EACH GRANT RECIPIENT WHICH CONTAINS A PROPOSAL, FINANCIAL STATEMENTS, 501(C)(3) DOCUMENTATION, GRANT AWARD LETTER, MID & YEAR END NARRATIVE PROGRAM REPORTS, BUDGET COMPARISON REPORTS AND OTHER MATERIALS THAT DOCUMENT THE CHARITABLE USE OF CHF FUNDS. X X X 0 0 0 0 0 0 0 0 0 LILLIAN ROSELIN EXECUTIVE DIRECTOR (THRU 9/1/23) 112249 0 4293 0 6753 0 24388 0 11866 0 159549 0 4293 0 FORM 990, PART V, LINE 2A: COMMON PAYMASTER THE FORM 1096 AND RELATED FORM 1099'S, FORM W-3 AND RELATED FORM W-2'S ARE ISSUED BY JOHN MUIR HEALTH UNDER EIN 94-1461843. JOHN MUIR HEALTH IS THE SOLE CORPORATE MEMBER AND SUPPORTED ORGANIZATION OF JOHN MUIR/MT. DIABLO COMMUNITY HEALTH FUND. FORM 990, PART VI, SECTION A, LINE 6 MEMBERS OR STOCKHOLDERS JOHN MUIR HEALTH IS THE SOLE CORPORATE MEMBER OF JOHN MUIR/MT. DIABLO COMMUNITY HEALTH FUND. FORM 990, PART VI, SECTION A, LINE 7A POWER TO ELECT OR APPOINT MEMBERS OF GOVERNING BODIES THE JOHN MUIR/MT. DIABLO COMMUNITY HEALTH FUND BYLAWS SPECIFY THAT ITS BOARD OF DIRECTORS CONSISTS OF TEN (10) MEMBERS, WITH FIVE (5) APPOINTED BY JOHN MUIR ASSOCIATION, THREE (3) APPOINTED BY THE CONCORD/PLEASANT HILL HEALTH CARE DISTRICT, AND TWO (2) APPOINTED BY THE CITY OF PLEASANT HILL. FORM 990, PART VI, SECTION A, LINE 7B GOVERNANCE DECISIONS SUBJECT TO APPROVAL BY THE MEMBER THE MEMBER SHALL HAVE THE RIGHT TO APPROVE ANY MERGER AND ITS PRINCIPAL TERMS AND ANY AMENDMENT OF THOSE TERMS AND APPROVE ANY ELECTION TO DISSOLVE THE CORPORATION. IN ADDITION, THE MEMBER SHALL APPROVE ANY AMENDMENTS TO THE ARTICLES OR THESE BYLAWS OF JOHN MUIR/MT. DIABLO COMMUNITY HEALTH FUND. FORM 990, PART VI, SECTION B, LINE 11B REVIEW OF FORM 990 BY THE GOVERNING BODY THE COMPLETED FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS SUFFICIENTLY IN ADVANCE OF THE FILING DEADLINE TO ENABLE A DETAILED AND CONSCIENTIOUS REVIEW BY ALL MEMBERS. AN OVERVIEW OF THE FORM 990, WITH SUFFICIENT DETAIL, IS PRESENTED TO THE BOARD WITH THE COMPLETED FORM 990. ALL QUESTIONS AND CONCERNS OF THE BOARD OF DIRECTORS WILL BE ADDRESSED AND INCORPORATED INTO THE FORM 990 AS APPROPRIATE. AFTER ALL THE INPUT FROM THE BOARD OF DIRECTORS HAS BEEN APPROPRIATELY ADDRESSED, SENIOR MANAGEMENT OF THE JOHN MUIR/MT. DIABLO COMMUNITY HEALTH FUND WILL FILE THE FINAL FORM 990 AS REQUIRED. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST POLICY THE BOARD HAS APPROVED CONFLICT OF INTEREST POLICIES AND PROCEDURES. BOARD MEMBERS FILE ANNUAL STATEMENTS WHICH REQUIRE THEM TO IDENTIFY ANY CONFLICTS. THE BOARD REGULARLY ENFORCES THE POLICIES. FORM 990, PART VI, SECTION B, LINE 15A EXECUTIVE COMPENSATION THE BOARD HAS ESTABLISHED POLICIES AND PROCEDURES FOR EVALUATING THE EXECUTIVE DIRECTOR, SETTING THE COMPENSATION, AND ASSESSING COMPARABLE SALARIES LOCALLY. THE COMPENSATION COMMITTEE'S EXECUTIVE DIRECTOR EVALUATION REPORT IS REVIEWED BY THE BOARD AND DELIBERATIONS ARE DOCUMENTED AND FINAL DECISION REGARDING COMPENSATION ARE RECORDED IN MINUTES OF A BOARD MEETING. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS AVAILABLE TO THE PUBLIC THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. JOHN MUIR HEALTH FOUNDATION 1400 TREAT BOULEVARD WALNUT CREEK CA 94597 942650855 FUNDRAISING CA 7 501(C)(3) JM HEALTH 1 JOHN MUIR BEHAVIORAL HEALTH 1400 TREAT BOULEVARD WALNUT CREEK CA 94597 680249685 HEALTHCARE CA 3 501(C)(3) JM HEALTH 1 JOHN MUIR PHYSICIAN HEALTH 1400 TREAT BOULEVARD WALNUT CREEK CA 94597 680360801 CLINIC SRVS CA 12A, III-FI 501(C)(3) JM HEALTH 1 JOHN MUIR HEALTH 1400 TREAT BOULEVARD WALNUT CREEK CA 94597 941461843 HEALTHCARE CA 3 501(C)(3) N/A 0 JOHN MUIR MAGNETIC IMAGING 1400 TREAT BOULEVARD WALNUT CREEK CA 94597 680202020 DIAG IMAGING CA N/A 0 0 BAY AREA SURGICAL VENTURES 30 S WACHER DRIVE SUITE 2302 CHICAGO IL 60606 203052802 MED SERVICES CA N/A 0 0 WALNUT CREEK CANCER CENTER 1400 TREAT BOULEVARD WALNUT CREEK CA 94597 941461843 MED SERVICES CA N/A 0 0 JOHN MUIRMT DIABLO PARENT COMPANY 1400 TREAT BOULEVARD WALNUT CREEK CA 94597 900060434 INACTIVE CA N/A 0 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 JOHN MUIR HEALTH C 1408194 CASH RECIEVED