| FORM 990, PART VI, SECTION B, LINE 11B |
THE FORM 990 IS SENT VIA EMAIL TO ALL BOARD MEMBERS FOR COMMENTS. COMMENTS ARE SENT BACK AND INCORPORATED INTO THE 990 PRIOR TO ISSUANCE. AFTER ANY BOARD CHANGES ARE MADE, THE PRESIDENT/CEO AND CHIEF FINANCIAL OFFICER REVIEW THE 990 BEFORE FILING WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C |
EACH BOARD MEMBER AND OFFICER IS REQUIRED TO COMPLETE A CONFLICT OF INTEREST ATTESTATION ANNUALLY. THE PRESIDENT/CEO AND CORPORATE COMPLIANCE OFFICER REVIEW THE COMPLETED CONFLICT STATEMENTS AND DETERMINE WHETHER A CONFLICT EXISTS. IF A CONFLICT ARISES, IT WILL BE INVESTIGATED ON AN INDIVIDUAL BASIS. THE OUTCOME OF THE INVESTIGATION WILL DETERMINE WHAT ACTION WILL BE REQUIRED. IF IT IS DETERMINED THAT A CONFLICT DOES EXIST, THEN THE INDIVIDUAL WITH THE CONFLICT WILL ABSTAIN FROM VOTING ON ANY RELATED ISSUES AND RECUSE HIMSELF FROM ALL DISCUSSIONS. |
| FORM 990, PART VI, SECTION B, LINE 15 |
THE LONG ISLAND FQHC PURCHASED INDUSTRY-SPECIFIC COMPENSATION DATA AND USED THIS DATA TO DETERMINE COMPENSATION FOR THE PRESIDENT/CEO. FINAL APPROVAL WAS PROVIDED BY THE LONG ISLAND FQHC BOARD OF DIRECTORS AND DOCUMENTED IN PERSONNEL FILES AND BOARD MINUTES. LIFQHC REVIEWS INTERNAL AND EXTERNAL MARKET DATA USING INFORMATION AVAILABLE. THE ORGANIZATION USES EXTERNAL DATA AVAILABLE THROUGH 990S OF OTHER COMPARABLY SIZED NON-PROFITS AS WELL AS DATA AND REPORTS FROM LOCAL STAFFING COMPANIES INCLUDING ROBERT HALF ASSOCIATES, ALLIED HEALTH GROUP AND EXECU-SEARCH. THE COMPENSATION OF ALL OTHER OFFICERS IS REVIEWED BY THE PRESIDENT/CEO AND THE VP OF HUMAN RESOURCES. |
| FORM 990, PART VI, SECTION C, LINE 19 |
THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE ON REQUEST. |
| FORM 990, PART IX, LINE 11G |
LABORATORY & RADIOLOGY FEES: PROGRAM SERVICE EXPENSES 964,345. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 964,345. NUMC LEASED MEDICAL SERVICES: PROGRAM SERVICE EXPENSES 6,708,237. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,708,237. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 319,610. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 319,610. PURCHASED MAINTENANCE & SECURITY SERVICES: PROGRAM SERVICE EXPENSES 1,021,893. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,021,893. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 194,528. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 194,528. CONTRACTED HRHC SERVICES: PROGRAM SERVICE EXPENSES 1,338,741. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,338,741. PROFESSIONAL PENSION FEES: PROGRAM SERVICE EXPENSES 17,000. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 17,000. |
| FORM 990, PART XI, LINE 9: |
CHANGE IN ACCOUNTING PRINCIPAL -43,764. |
Attach to Form 990 or 990-EZ.