AAPCHO Board of Directors Call

November 19, 2019

1:00 – 2:00 pm Pacific Time

Table of Contents

AGENDA ...... 2

Minutes, August 2019 BOD Mtg ...... 3 Minutes, September 2019 BOD Audit Mtg ...... 17

Policy 1 – Report Public Charge – Nov 2019 ...... 20 Policy 2 – PC Resources ...... 21 Policy 3 – Policy Update – Nov 2019 ...... 28 Policy 4 – CQ Stopgap Funding Bill ...... 30 Policy 5 – 400+ Group Sign on Comment HC Proclamation Final ...... 31 Policy 6 – CPCA Proclamation Comment Letter Final ...... 41 Policy 7 – COFA Act ...... 46 Policy 8 – 2019 COFA Medicaid Restoration Support Letter for Sign on ...... 50 Policy 9 – Fact Sheet HEAL Act 2019 ...... 52 Policy 10 – New Deal for New Americans Act Selection by Selection ...... 54 Policy 11 – CONNECT for Health Act of 2019 Final ...... 60 Policy 12 – Impact of Shifting Immigration Policy on Medicaid Enrollment and Utilization of Care ...... 62

Draft Financial Statements for Year End Sept 30, 2019 Statement of Financial Position ...... 73 Schedule of Functional Expenses ...... 74 Statement of Activities...... 75 Statement of Cash Flows ...... 76 Draft 990 for Year End Sept 30, 2018 ...... 77

ED Report Sept 2019 ...... 175 ED Report Oct 2019...... 178

VIPR Report Nov 2019 ...... 181 Development/Fundraising Snapshot Nov 2019 ...... 182 Digital Communications Metrics Report ...... 183

Schedule of Upcoming Board Mtgs/Events ...... 188

AAPCHO Board of Directors Meeting Zoom Video Conference Call

November 19, 2019 1:00 -2:00pm Pacific Time AGENDA v.1

Order of Business Reporting Action I. Welcome & Call to 1:00 pm Darrin Order II. Review Aug. Minutes 1:02 Darrin Vote III. Review Sept. Audit 1:03 Darrin Vote Minutes IV. Policy & Advocacy 1:05 Adam Report / Discussion updates V. Finance update 1:40 Peter Report VI. ED Report 1:50 Jeff Report a. Upcoming advocacy / Report / Discussion research activities b. Pacific Initiative update Report c. Fundraising update Report d. Upcoming meetings & Announcements Board Retreat VII. Adjourn 2:00 Darrin

2 AAPCHO Board Meeting Minutes August 17, 2019 Hyatt Regency , Columbus KL

AAPCHO Board Members: Teresita Batayola, Jane Eng, Rich Bettini, Darrin Sato, Sherry Hirota, Eddie Chan, Gildas Cheung, Nena Tolenoa (remote), Mary Oneha (remote), Andrea Carcostis (remote), Elaine Tso (remote)

AAPCHO Staff: Jeff Caballero, Adam Carbullido, Albert Ayson, Joe Lee, Rosy Chang Weir, Beverly Quintana, Peter (remote), Jen Lee, Kristine Alarcon

Other Guests: ● AHS: Thu Quach, Julia Liou; Waianae: Vija Seghal, Ginger Fuata; ICHS: Hiroshi Nakano, Gildas Cheung; Charles B. Wang: Betty Cheng

Time Agenda Item Reporting Action Notes

2:00 Welcome & Darrin 1. Ginger from WCCHC representative at NACHC Announcement 2. Recognized Jane Eng pending retirement 3. Jane: Thanks AAPCHO for long history and good work. Will miss everyone.

2:10 Call to Order Darrin 1. Andrea, Nena, Mary, and Elaine on phone line. Meeting is being recorded for staff use.

2:15 Review Agenda Darrin 1. Move to change agenda (i.e., to move up items earlier because Rich will need to leave the meeting early). a. Vote i. Motion: Teresita: Make changes to Board of Directors’ Meeting Agenda: Move Budget, review Policy & Procedures, and review of Consumer at Large By-laws changes to the beginning of the agenda.

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3 ii. Second Rich iii. Aye: All iv. Nay: 0

2:20 Minutes Darrin Vote 1. Add Eddie Chan’s name

2:25 FY20 Budget Presentation Peter / Vote 1. Motion to approve master budget Rich a. Vote: No discussion; Passed unanimously i. Motion: Rich ii. Second: Sherry iii. Discussion: No iv. Aye: All v. Nay: 0 2. Darrin requested information on large subcontracts line item. Peter explained this is largely due to PI sites unfamiliar with federal contracts. 3. Rich Qs: a. Is there additional funding/grant that is expected that is not included in this accrual presentation that will make up the accrual deficit? JC A: Yes, CDC TB b. Is there a funder that will penalize if we don’t have a balanced budget? JC A: No 4. Membership Dues Status a. Jane Q: Is there an indication if the remaining $19K will come in? JC/PH A: There are ongoing discussions and outreach happening to try and secure remaining dues

2:45 Review Proposed Peter Vote 1. Board Qs: Financial Policies & a. Teresita Q: The two signatories are not mentioned in policies Procedures Update and procedures? PH A: Yes there are on bank statements b. Darrin Q: Who are signatories? PH A: Peter, Darrin, Sherry are authorized

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4 c. Teresita Q: Is there a threshold that requires board signature/review i. Darrin: Agree but what tiers? We should also review the authorized signatories annually. d. Teresita: Signatories checks beyond payroll?; PH: All checks require two signatures e. Teresita: What’s the average check amounts? PH: dependent on the items, checks could range from 3,000 - 30,000 f. Teresita proposes a board signatory for checks above 5 - 10 K. g. Jane: Having a CPA do bank reconciliation is expensive. It would be more cost-effective to have another staff member do so. h. Darrin: Who signs checks written to reimburse the Executive Director? Peter response: Jeff has ability to sign. i. Jane: Board member or staff member to sign the checks/approve reimbursements j. Darrin request to take the topic offline to integrate recommendations. 2. Vote a. Motion: Jane moves to approve policies with conditions to change; Darrin suggests “pending” the changes: 5 K expense limit; 3 executive signatories; Teresita change “pending” to “conditioned” on the changes - PH make ​ ​ changes. Revised Motion: Jane - Policy and Procedures ​ approved on condition of AAPCHO working with Board President to revise the Financial Policy and Procedures to add: $5000 expense limit requiring Board Signatory, having three executive signatories that are to be reviewed annually, and examining staff performing Bank Reconciliation instead of Accountant. b. Second: Sherry

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5 c. Discussion: No d. Aye: All e. Abstain: 0 f. Nay: 0

3:03 Review Peter, Vote 1. Change 1: for each consumer member to have a 3-year term and Consumer-at-Large Rep Darrin remove term limits. By-Laws changes a. Teresita Q: How long of a notice for this change? Jeff A: Clarified that notice for change was sent one week prior. 2. Change 2: Add another Board seat for a second consumer member a. Teresita agrees, but how do we assure that other health centers can bring on consumer members? I.e., WCCHC, ICHS, Waimanalo have been the only sites who have held this position. b. Sherry: How do you build in mechanism for representation diversity- (rotation)? It’s a valid concern but does not need to be settled now. c. Gildas: Rotation is healthy. Acknowledges that he can outreach better to other potential consumer board members. 3. Peter Q: Any edits or questions related to language on Article IV, Section 3, Part B, Part i 4. Peter clarified that although there are no term limits, consumer board member would need to be re-elected after a 3-year term to promote rotation. 5. Vote a. Motion: Jane Eng- motion to approve bylaws. b. Second: Eddie Chan c. Discussion: No d. Aye: All e. Abstain: Gildas f. Nay: 0

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6 3:12 Minutes Darrin Vote 1. Vote: a. Motion: Eddie with condition to add his name because he attended b. Second: Jane c. Discussion:None d. Aye: All e. Abstain: f. Nay: 0

3:15 Policy & Advocacy Adam Discuss 1. Public charge updates ion a. Darrin Q: Does it mean they would never be able to or just ● Public Charge very difficult to get green card? ○ One Nation i. AC A: It would be very difficult. Public charge test can ○ Deportation be used against those seeking citizenship. ○ Mobilization b. Jane Q: - Residents aren’t legal residents? ● Other i. AC - COFA can live and travel without visa. But without ○ Health for All legal status. Quasi-status. Without legal status, they ○ Health Center are not elligible for any federal program. Reauthorization c. Jane - A special legal . … ○ SANAM i. AC - Not. Their passport is sufficient to enter. Relationship goes both ways. d. Darrin Q: They won’t be subject to deportation? i. AC A: It’s not a difference. Not a deportation rule. Expecting a deportation rule. Only thing finalized is inadmissibility. Only applicable to those outside US requesting to come in or requesting change in status. Once a legal permanent resident, no longer applicable. e. Jane Q: Any other legal resident category? i. AC A: No. Sometimes green cards need to be renewed but that’s not a change in status. If you have a green card, you’re a legal permanent resident.

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7 ii. Julia Liou: If you travel for 180 days or more outside US, you are subject to public charge test. iii. AC: Correct. If you are legal permanent resident, abroad 180 days or more, subject to question when coming back. f. Betty Chen: Already have clients/patients calling in to use Medicaid and want to know impact. They will not know how to explain what Adam just explained. What do CHCs do about that? i. AC - People who have medicaid .education campaign. … One Nation 14 different languages. Knowing when the admissability rule apply. Medical Legal Partnership. Resources for attorneys. Fact Sheets will be available to front line staff ii. Teresita: many different States have different rules iii. Sherry: Front line staff will have a very difficult job. We have weekly staff education workshops, but still a challenge for staff. We are partnering with Asian Legal Aid for staff to consult. Overall, it will be very challenging for clinics. iv. Eddie: Should we encourage these folks to pursue citizenship resources? v. Sherry: That is one strategy, however we are in an urgent immediate situation and also a need to shift the conversation/narrative. Ex. During 187 vi. Julia Liou - We also conducted media training. vii. Sherry: Have statements. Translated for ethnic press. One Nation - knew it was going to drop, how to best use resources/efforts. Decision was to focus on having a report (expected in Sept/edited by Helen Zia) in magazine format (for accessibility) having information of immigrants being a net benefit to the country. Can

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8 be pulled out in pieces and translated for ethnic press. Tool to be used in fighting. 60 days period. Injunction. Moving from response for patients to the fight back. viii. AC: it is the importance of fighting back and mobilization is important. Documenting the harm. Prohibit USCIS from implementing rule. Political effort to bring that about very difficult (congress and signing by President). Significant pushback. Make this an issue for the election. To mobilize voters. Even if patients can’t vote, they may have family and associates who do. Communicate this on the federal and state level. All helps in the national conversation, to combat chilling effect. ix. Darrin: have any states .Don’t know what those … options are. x. AC: if you are in a state that extends medicaid, having state officials that have policies that can be enacted, can be used to base policy on. Long term game. Attack on legal immigration, if we don’t change political balance in 2020. Public charge is one of the most reckless policies, but not the only one. Senator Hirono intro House Companion for no federal funds .For folks … on in HI, talk to Senators to cosponsor. xi. JC: Shared at One Nation, ...put together state workgroup to protect at state level. Will be available in the next couple of weeks. xii. Julia Liou: This is a critical time to collect stories to highlight. xiii. Darrin: CA clarification re: state-covered Medicaid. xiv. Sherry: NInez Ponce has data on how immigrants are a positive for the insurance pool. Either insurance

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9 companies will absorb the cost of everyone who will pull out of the plans or pursue alternatives. xv. Darrin:same thing as when COFA switched xvi. Teresita: share the same feelings. But as nonprofits we can’t take a position on elected officials xvii. Sherry: we have many aspects of the community that we work with. Kevin Kwon. Many people have that same concern/sentiment. Corporate/Business sector can also stand up without partisan concern. Make the rest of the community aware of how it affects them. xviii. JC: acknowledge One Nation. How fortunate we have for them and efforts, being proactive and helping people rise up. Support of local leadership. Thank One Nation Leadership xix. Sherry: recognize everyone is stepping up. . New . Even if having 10 people rise. Asians don’t always get recognized. 10 people in an area that normally doesn’t can be a lot. xx. Teresita: ICHS upcoming meeting. Coordinate efforts with ACRS. What about coordinating with other ethnic communities (e.g., Latino)? xxi. JC: Other communities also represented but voices not being recognized. They don’t have a group like One Nation. xxii. Sherry: Funders. Fight back is a Latino issue. Asians not being recognized. When hearing about funding, products are usually in Spanish. La Clinica de la Raza, single plaintive. Support them but acknowledge there is going to be some backlash. Come out as a united front is the only thing that will turn this around. There is an aspect that the fightback are centered on legal strategy and emphasis on the chilling effect, made it difficult to

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10 understand what the strategy would be. Now that it’s real, xxiii. JC: Mary Elena, leadership on the Hispanic ethnic groups, has been relying on OneNation for resources. xxiv. Darrin: is it getting more coordinated? xxv. AC: we see a more coordinated effort. Spread out efforts. Still siloed between different groups. Desire for more and synergy. Making sure we talk to each other more. xxvi. Sherry: CHCs coordinating on the local level. xxvii. AC: grassroots advocacy and movement at the local level combating the chilling effect. More the national groups and members of congress see people speaking out and voicing their concerns, the more they’ll be aware. Now that it’s “real”, the more info we can pump out into the community and force hand of elected officials. More impactful. xxviii. Teresita: get more pragmatic. Talked to Senator , we … are encouraging staff and patients to get their services in before October 15th. Can’t count on lawsuits to get in on a timely matter. Medicaid over 60%. Using language as a proxy. Large portion. If we can’t figure out how to survive financially Not laying this on … AAPCHO. There are very pragmatic things we need to take care of to ensure our health centers stay sustainability - i.e. how the sliding fee scale will be impacted. xxix. Betty Cheng: We need to be pragmatic. We already have patients that are asking for visits to be changed to weekends assuming that INS will not be working on weekends. We need to make sure that one group needs to work on frontline organization and another can work

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11 on the larger advocacy efforts. It’s very complicated how we talk to families who will be impacted with citizen children and how they will navigate their care. They are going to listen to their lawyers more than us. xxx. Julia Liou: Jim MCRae suggested we collect data on impact (patients/encounters decreases, amount of time spent on additional translations, amount of time for staff education and impact on staff capacity. xxxi. AC: Please collect this information for us to share back with Jim, when we are in DC meeting with MoCs, etc. What is the economic impact for your health centers xxxii. Jane: other programs affected xxxiii. AC: shows the far reaching effects. HUD. DOJ. Threats to Language Access. Section 1557. All a part of a broader narrative on the assaults of people of color and low income. Starting to push more. Not just immigrants. Get more stories to push that narrative.

2. Other - AC notes highlights ​ ​ i. Health for All ii. Health Center Reauthorization iii. Territories Medicaid Fiscal Cliff iv. COFA Medicaid v. SANAM 1. Julia Liou: BPHC meeting made it clear that we need to continue to keep this on their radar, especially because Jim indicated flexibility regarding proxies for service area. Push the LEP factor. 2. Darrin Q: Is there a deadline for the agency? 3. JC A: No

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12 4. Julia: It may be related to their strategic planning process. Creating a one-size-fits-all .and that’s a … problem. 5. Darrin: if that’s the case, wait until political climate changes then look at this issue. 6. JC: earliest time to look at this is next summer. 7. Julia: what it means to be a service area. Behooves us to raise this issue as LEP. Not being raised at all. 8. JC: Jim also talked about special population issue (homeless/housing). Immigrant should also be put in this as well but no political will. An issue to be explored. Service Area as a statutes for health center. 9.

ED Report Jeff Report 1. Acknowledged staff achievements in moving Strategic Plan ● Strategic Plan forward status 2. Strategic Plan Status ● Payment Reform a. Sustainability ● Trainings/Services i. Membership target criteria triangulated between UDS ● Development AA and NHPI numbers, ACS AA and NHPI population activities growth, and political considerations ii. Also referring to T/TA needs assessment b. Payment Reform - JC ​ c. SDOH Recent Developments i. JC - last six days . … ii. AAPCHO market leader because of PRAPARE. Being used in more...than any other. Health plan folks. Trust for America. iii. AAPCHO needs more guidance from Members. iv. At intelligence collection phase. More info to members soon.

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13 v. Gildas: IP from a few meetings ago. Update? vi. JC: some IP updates. PRAPARE in partnership between AAPCHO,OPCA, NACHC. OCHIN a part of OPCA but also has a competing tool. Opportunities for enabling services. Conversations with attorneys specify that so much of work was through govt grants. Tease out what is government and what is AAPCHOs. vii. Darrin: Training tools developed? viii. JC: Government funded ix. Teresita: x. JC: IP piece is critical. As soon as we can determine what is valuable. d. Other Key Issues Ahead i. Public charge and deportability rule ii. 2020 Census iii. Voter registration and engagement iv. Planning and date for 2021+ strategic plan v. 35th Anniversary Event - 2021 fundraising event vi. Teresita A: Immigration Reform? 1. JC: Part of the long term plan. Aiming at 2025. Part of long game plan (see visual) 2. vii. Teresita: Should we be working on encouraging citizenship as Eddie mentioned? 1. Darrin: the questions are very hard. Exam is 4.5 times longer. 2. JC: 3. Eddie: should put some effort to education health centers. Be more proactive, not procrastinate to apply. 4. JC: Change voter engagement to “civic engagement” to appease Coulter

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3. AAPCHO is completing audit process and we need to convene a Board session in `September 17 a.

Executive Session Darrin Discuss ion

Adjourn Darrin

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15 APPENDIX

FY 20 Master Budget

Financial Policy and Procedure Update

Consumer Director By-laws update (page 221)

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16 ASSOCIATION OF ASIAN PACIFIC COMMUNITY HEALTH ORGANIZATIONS Executive Director’s Report September 2019

The following activities reported per strategic priority areas:

Goal 1: Sustainability Strategic Priority Area

• Membership: No updates this month. ▪ We are in the process of implementing a new CDC TB project in partnership with APIAHF and Hep B Foundation. The new grant totals $350K/year with AAPCHO receiving $100K/year. ▪ A new AAPCHO & NACHC partnership proposal has been selected by RWJ Foundation for reward. The new project proposes to utilize PRAPARE tool to strengthen services and capacities of health center in partnerships with social service CBOs to respond to patient and community SDOH. The new project is anticipated to begin November 1st. ▪ SDOH Payment Learning Collaborative – With the PRAPARE Risk Stratification Learning Collaborative half-way completed, staff are developing plans for new trainings and services for health centers and health care plans. One desired outcome of the new information is to develop tools that will help health centers negotiate better payments from respective state Medicaid plans. ▪ AAPCHO Technical Assistance & Training staff are continuing to pursue fee-for-service contracts for supplementary Enabling Services trainings and PRAPARE trainings to several PCAs around the country. ▪ Recently released BPHC National Cooperative Agreement announcement provides AAPCHO an opportunity to increase annual BPHC funding by $100K for new optional services.

Goal 2: Advocacy/Policy Strategic Priority Area

• Public Charge: Senator and 26 Democratic senators introduced legislation to prevent DHS from implementing the public charge rule. The bill is similar to Rep. Judy Chu's No Federal Funds for Public Charge Act that was introduced in June. Both bills are unlikely to be enacted in the current political environment but are still important to signal Congressional opposition to public charge. Also, as a result of CHI public charge related meetings with BPHC and health center, AAPCHO is in discussions with GW and RCHN for strengthening efforts to document harm of public charge policy on health centers.

17 2019 Sept ED Report Page - 2

• Deportation rule: Office of Management and Budget continues to take meetings on the DOJ public charge deportation rule. AAPCHO, CPCA, and AHS will meet with OMB on October 4 to provide the health center perspective opposing this rule. Additionally, legislation is being prepped by Rep. Veronica Escobar’s office to mirror the No Federal Funds for Public Charge Act if/when the deportation rule is published. Please sign on to endorse the bill by September 25th using this form. You can see an unofficial version of the bill here, not for wide sharing, but only for purposes of reviewing for organizational endorsement.

• Appropriations: the House passed a continuing resolution on Thursday, September 19 extending government funding until November 21. The measure maintains level funding for most government operations and includes a temporary extension for community health center funding and other health extenders. Also included was an extension of 100 percent FMAP for the territories Medicaid programs. The Senate is expected to pass the bill next week. Congressional leaders will still need to negotiate a long-term spending agreement and extensions of health center and other health extenders for after November 21.

• Prescription drugs: Speaker Pelosi and House Democrats unveiled their prescription drug plan on Thursday, September 19. The bill would require the Secretary of Health and Human Services to negotiate drug prices for at least 25 and up to 250 medicines. The plan includes provisions supported by the Trump administration and included in the Sen Grassley's proposal. It is not intended to impact the 340B program. You can read a summary of the plan here and a title summary here.

Goal 3: Pacific Islander Initiative Strategic Priority Area

▪ Staff are still going through numerous applicants for PI Development Coordinator. This new position will be securing new resources and partnerships to implement the PI Center of Excellence plan. ▪ Staff are in discussions with Pacific Islander Health Officers Association (PIHOA) and Pacific Islander PCA (PIPCA) to explore

18 2019 Sept ED Report Page - 3 new opportunities, increase resources, and strengthen TA efforts for organizations serving PI communities.

Goal 4: Strengthening Infrastructure Strategic Priority Area • Staff Stay (satisfaction) Survey is being integrated into annual staff review schedule and development planning. The Stay Survey will have 2 parts, an anonymous portion for general organizational use and a personal portion for individual development planning with each staff’s supervisor. • Jeff and Darrin are still planning to conduct another Board survey for reporting at March 2020 Board meeting. • 2020 Board retreat and staff retreat are still being scheduled.

Travel Updates The following reflects upcoming staff leadership travel & activities:

• Jeff will be attending CDC AANHPI Communications Institute in , on Sept. 24-26th. The Communications Institute provides an opportunity to strengthen relationships with relevant CDC career staff and learn about new CDC opportunities. • AAPCHO TA Team will be presenting at Community Healthcare Association of Dakotas’ on Oct. 1-2nd. • AAPCHO TA Team will be attending and presenting at PCA conference on Oct. 16-17th. • AAPCHO Research Staff will be presenting PRAPARE at Root Cause Coalition Conference in on Oct. 20-22nd. • Adam and Jeff will be attending National Immigration Integration Conference in , MI on Oct. 19-22nd.

19 AAPCHO Board of Directors Report

Report Topic: Public Charge Update Submitted by: Adam Carbullido Date: November 12, 2019 Background/Summary: Federal courts have blocked the DHS public charge rule on inadmissibility and DOS public charge rule on visa processing from going into effect. OMB is no longer accepting meetings on the yet to be released DOJ public charge rule on deportability.

Issue(s) or Highlights: DHS Inadmissibility Rule The DHS public charge rule on inadmissibility has been blocked with three federal courts issuing nationwide injunctions and four issuing limited injunctions. The rule cannot go into effect so long as one of the nationwide injunctions remains in effect. The Trump Administration filed notices that it will appeal the injunction in each of the lawsuits. AAPCHO will continue to monitor these lawsuits as they move forward.

On October 29, One Nation released its report, “Build on the Strength of Immigrants,” during a press conference on Capitol Hill co-hosted by the Congressional Tri Caucus. Representatives Barbara Lee, Judy Chu, and Reuben Gallego joined One Nation commissioners in denouncing the public charge rule and applauding the report illustrating the fact that immigrants are a benefit to the economy and society.

Legislation in Congress continues to gain support. The No Federal Funds for Public Charge Act (H.R. 3222) in the House currently has 115 cosponsors, and the Protect American Value Act (S. 2482) in the Senate has 27 cosponsors.

DOS Interim Final Rule The Department of State issued an interim final rule that would align the State Department’s criteria on how consular officers will determine whether an individual is ineligible for a visa with the now-blocked public charge rule issued by the Department of Homeland Security. While the DHS rule was blocked by the courts, the rulings only apply to the DHS rule; however, litigators will challenge the rule if/when it becomes final. AAPCHO submitted comments opposing the interim final rule and will continue to monitor it has it moves through the regulator process.

DOJ Deportability Rule The Office of Management and Budget is no longer accepting meetings on a DOJ public charge on deportability. It remains uncertain when/if DOJ will issue a proposed rule in the federal register, and it is possible that the ongoing litigation on the DHS rule has slowed progress on the rule. AAPCHO, CPCA, and AHS met with OMB officials on October 4 to express our opposition to expanding the public charge parameters for deportation purposes and the impacts it will have on AAPCHO member health centers. We continue to monitor DOJ and will provide recommendations for advocacy, including a comment strategy, when the rule is released. Action Requested: Discussion, continued advocacy on DHS and DOJ advocacy

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November 2019 10 Facts About Access to Health Insurance for Immigrants and Their Families

OVERVIEW Changes in immigration policy have created fear among immigrants and their families, causing eligible people to go without access to health care and other important supports. The Affordable Care Act’s marketplace open enrollment period presents a great opportunity to fight back and make sure immigrants and their families understand what recent threats mean for them as they seek health coverage.

KEY FACTS

The Trump Administration’s ongoing efforts to restrict immigration is increasing fear

and confusion among immigrants and their families. According to reports, enrolment is declining among immigrants and their families who are eligible for health insurance affordability programs (including Medicaid, the Children's Health Insurance Program (CHIP), and ACA marketplace coverage with tax credits/subsidies). Last year, one in seven adults in immigrant families reported avoiding public benefits out of fear. Nearly half of community health centers report that, during the past year, immigrant patients declined to enroll themselves in Medicaid. And nearly 40 percent of health centers report parents have declined coverage for their children. With one in four children living with an immigrant parent, the damaging consequences affect millions of people in immigrant families and their communities.

Immigrants’ eligibility for health insurance affordability programs has not changed. Many immigrants are eligible to enroll in Medicaid, CHIP, and subsidized health insurance plans through the ACA marketplace. Most lawfully present immigrants with low and moderate incomes qualify for health insurance affordability programs, such as tax credits,

that help offset premium costs for ACA marketplace plans, Medicaid, or CHIP. For more information on eligibility rules, check out this fact sheet.

Open enrollment for ACA marketplace coverage is happening NOW! For 2020 coverage, the open enrollment (OE) period for HealthCare.gov runs from November 1 through December 15. Several state-run marketplaces have announced they will hold longer OE periods this year. Once the OE period ends, individuals and families will not be able to enroll in marketplace health plans until the next OE period (unless they qualify for a special enrollment period). Individuals can apply for Medicaid and CHIP all year long.

The Trump Administration wants immigrants and their families to be afraid of enrolling in health coverage. In addition to pushing for a physical border wall, the Trump Administration has pursued a wide range of policy changes to create an “Invisible Wall” that makes it harder for immigrants with low and moderate incomes to navigate the immigration system. It also prevents or deters them from accessing basic needs programs. These efforts are part of Trump’s government-wide assault designed to send immigrant families one message: you are not welcome in the United States.

21 You can fight back by ensuring that immigrants know their rights and can make the best decisions for themselves and their families. Health care access helps families thrive. It’s essential that families make decisions based on facts, not on fear. We’ve created a fact sheet on immigrants’ rights when accessing health care services and enrolling in health insurance affordability programs, along with a guide that answers questions about “public charge.” If you are someone who helps immigrants and their families enroll in health coverage, we recommend checking out these webinars on immigrant eligibility and working with immigrants. Every family’s situation is different. In some cases, it may be best to seek immigration legal assistance in your area.

Courts have blocked the Trump Administration from using rules that could penalize immigrants with low and moderate incomes for using Medicaid. In October 2019, multiple federal courts blocked President Trump’s “public charge” rule from going into effect. The rule would be a radical change to immigration policy, making it difficult for people who are not already wealthy to become lawful permanent residents. With the rule blocked, Medicaid receipt will not count against individuals who have immigration applications processed in the United States. As long as the court orders remain in effect, only the use of cash assistance (e.g. TANF, SSI, or state general assistance funds) and long-term institutional care funded by the federal government can be considered in the public charge test. Even if the rule moves forward in the future, receipt of CHIP or ACA marketplace tax credits/subsidies will not be considered.

Immigrants who do not qualify for health insurance affordability programs for themselves can still apply for their children and other family members who are eligible. During the application process, the person completing the application will state which household members are applying for coverage. People not applying (“non-applicants”) may need to include information such as their income and plans for tax filing, but they are not required to provide information about their immigration or citizenship status.

Applying for health insurance will not put undocumented family members at risk. Federal and state laws protect the privacy of people who apply for or receive health care coverage or other public benefits. Under these rules, Medicaid, CHIP and marketplace agencies may share information with other government agencies only for purposes of administering their programs, with limited exceptions such as when there is a court order. The HealthCare.gov website says that information provided by applicants will not be used for immigration enforcement purposes.

The president’s health insurance requirement does not apply to all immigrants. Separately from the “public charge” rules, the president recently issued an order on health insurance that would restrict entry visas to the United States by people who are uninsured and cannot pay the costs of their health care. Under the order, subsidized ACA plans are not an acceptable form of coverage. However, this order does not apply to immigrants already in the United States who will not have immigration applications processed abroad. People who are eligible to enroll in subsidized coverage through the health care marketplace—like HealthCare.gov—should not avoid enrollment based on fear of this new policy.

A nationwide network of advocates are united to protect and defend access to health care and other social services programs for immigrants and their families. The Protecting Immigrant Families (PIF) Campaign has fought back against multiple threats the Administration created to increase fear and avoidance of health and other social services programs. PIF organized a massive effort to delay and derail the proposed public charge rule. We won't stop fighting to ensure immigrant families can access health care without fear. And it’s a fight that, together, we can win. Join hundreds of organizations working to protect immigrant families and advance our shared vision for a just future. Find out how you can get involved.

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INVISIBLE WALL TALKING POINTS AND MESSAGING GUIDANCE November 12, 2019

For the public & the press: ● Donald Trump’s invisible wall is real — and public charge is just one brick ​ ​ ​ ○ Muslim and refugee bans ○ Census citizenship question ○ Raids separating children from their parents on the first day of school ○ Health insurance proclamation ○ Fee waiver rule ● These attacks have nothing to do with immigration — they’re about race and class, designed to send one message: if you’re not white and you’re not wealthy, you’re not ​ welcome ● The real damage is being done by the “chilling effect” resulting from the Administration's deliberate and coordinated efforts to terrorize families of color ○ Uninsured rate up for the first time in a decade ○ Uninsurance among children up by 400,000 under ​ ​ Trump ○ Kids are going without food and health care nationwide ● But we won't stop fighting to protect immigrant families — and it’s a fight that, together, we can win ○ We won the fight to block Trump’s illegal Census ​ ​ citizenship question ○ We won the fight for the hearts and minds of the ​ ​ American people, delivering a record-breaking 266,000 comments on the public charge proposal ○ We’ve won the first legal battle, with multiple ​ ​ injunctions blocking the public charge regulation ○ And we’re winning the fight in Congress, with growing support for legislation to ​ ​ defund Trump’s abuses ● We must tear down every brick in Trump’s invisible wall — only then can we truly protect immigrant families

23

For families: ● It’s understandable that families are worried. Whether it’s the Muslim ban or efforts to separate children from their families, Trump is trying to send the message that immigrant families don’t belong here. ● We won't stop fighting for immigrant families — and it’s a fight that, together, we can win ○ We won the fight for the hearts and minds of the American people, delivering a record-breaking 266,000 comments on the public charge proposal ○ We’ve won the first legal battle, with multiple injunctions blocking the public charge regulation ○ We won the fight to block Trump’s unlawful Census citizenship question ○ And we’re winning the fight in Congress, with growing support for legislation to stop Trump’s abuses ● With tough fights on all fronts, Trump is trying to scare you into giving up the help that your children need to grow and learn and thrive ● The best way to fight back is by knowing your rights and making the best decisions for you and your loved ones. ○ Public charge rules do not apply to every immigrant ○ Immigrant families should keep going to the doctor and keep feeding their kids. ​ ​ ​ ​ ○ Use of public benefits alone won’t make someone a public charge ○ Federal courts have halted DHS’s Public Charge rule from going into effect. For now, ​ Public Charge rules in the U.S. have not changed. ○ Using Medicaid, SNAP, & housing assistance won’t count against immigration ​ applications processed in the U.S. ○ You don’t have to provide your immigration status if you are applying for benefits for your children or a family member. ○ Your personal information is protected. Laws protect ​ ​ ​ the privacy of people who apply for or receive health care and nutrition assistance and other public benefits. ○ Participating in the census makes sure that our communities have the power and representation they deserve ○ All citizens should register and vote ​ ● Together, we’re strong, and together, we can build a country where nobody has to live in fear and all families can thrive

24

25 NATION WIDE INJUNCTION - 10/11 (Related Litigation re: FAM, Healthcare (This means the new rule will not take effect PUBLIC CHARGE until/unless all three national injunctions are proclamation (BLOCKED 11/2) is on the reversed) LITIGATION TRACKER second sheet)

Nickname SF/Santa Clara Counties 14-state (WA AG) 4-state + DC (CA AG) La Clinica de la Raza NY/NYC/CT/VT (NY AG) Plaintiffs Santa Clara County; ; ; California, , , LA CLINICA DE LA RAZA; CALIFORNIA STATE OF , CITY OF NEW County ; ; ; , DC PRIMARY CARE ASSOCIATION; YORK, STATE OF , and ; ; MATERNAL AND CHILD HEALTH STATE OF ; ; ; ACCESS; FARMWORKER JUSTICE; ; NEW ; RHODE COUNCIL ON AMERICAN ISLAMIC ISLAND; (additional state RELATIONS-CALIFORNIA; AFRICAN plaintiff added on 9/5/19) COMMUNITIES TOGETHER; LEGAL AID SOCIETY OF SAN MATEO COUNTY; CENTRAL AMERICAN RESOURCE CENTER, and KOREAN RESOURCE CENTER USDC N.D. CA USDC, E.D. WA USDC N.D. CA USDC N.D. CA USDC S.D. N.Y. Jurisdiction Filed Appellate - 9th Circuit Appellate - 9th Circuit Appellate - 9th Circuit Appellate - 9th Circuit Appellate - 2nd Circuit Judge Phyllis Hamilton as of 8/28 ( Judge Rosanna Malouf Peterson Judge Phyllis Hamilton as of 9/3 Judge Phyllis Hamilton as of 9/5 Judge George B. Daniels (appointed Judge nominated in 2000 by Clinton) (Obama appointee) (nominated in 2000 by Clinton) (nominated in 2000 by Clinton) by Clinton in 2000) Status Filed complaint 8/13/19 Filed complaint 8/14/19 Filed complaint 8/16/19 Filed complaint 8/16/19 Filed complaint 8/20/19 Preliminary injunction motion filed on 8/26, hearing 10/2 (9:00am).

PI motion filed 8/28/19, hearing PI Motion filed 9/6/19, hearing Case management conference Preliminary injunction motion filed on Preliminary injunction motion filed 10/2 (9:00am) 10/3/2019 (10:00 AM) 11/14/2019. 9/4, hearing 10/2 (9:00am) 9/9. Oral argument held October 7.

Government moved to stay Government moved to stay injunction Government moved to stay Government moved to stay injunction Government moved to stay injunction pending appeal 10/25 pending appeal 10/25 injunction pending appeal 10/25 pending appeal 10/25 injunction pending appeal 10/25

Government filed notice of Appeal Government filed notice of Government filed notice of Appeal Government filed notice of Appeal Government filed notice of 10/30 Interlocutory Appeal 10/30 10/30 10/30 Interlocutory Appeal 10/30 Pleadings SF SC County Complaint WA et al complaint CA et al Complaint NILC et al complaint NY et al complaint SF SC County PI Motion WA Preliminary Injunction Brief CA PI Brief Preliminary Injunction Brief NY PI Brief CALIFORNIA, OREGON, DC, MAINE, CALIFORNIA, OREGON, DC, MAINE, CALIFORNIA, OREGON, DC, MAINE, Orders PENNSYLVANIA WIDE INJUNCTION NATION WIDE PRELIMINARY PENNSYLVANIA WIDE INJUNCTION PENNSYLVANIA WIDE INJUNCTION 10/11 INJUNCTION 10/11 10/11 10/11 NATION WIDE PRELIMINARY INUNCTION 10/11

Amicus Curiae Cities Child and Maternal Health Asian Pacific Islander Asian Pacific Islander Child and Maternal Health Survivors of Domestic Violence and Congressional Tri-Caucus Members Sexual Assault Justice in Aging Seniors and Older Americans Asian Pacific Islander Asian Pacific Islander People with Disabilities Congressional Tri-Caucus Members Public Health People with Disabilities Seniors and Older Americans Economic Impact Members of Congress- Judy Chu Economic Impact Health Care Advocates Health Care Advocates American Hospital Association [NOT Hospitals ACCEPTED] Housing and Nutrition Health Law Advocates [NOT Seniors and Older Americans ACCEPTED] Seniors and Older Americans American Academy of Pediatrics [NOT ACCEPTED] Public Health Anti-Domestic Violence [NOT ACCEPTED] Congressional Tri-Caucus Members Fiscal Policy Institute [NOT ACCEPTED] People with Disabilities [NOT ACCEPTED] Morten Rosenberg [NOT ACCEPTED] National Housing Law Project [NOT National Housing Law Project [NOT National Housing Law Project [NOT ACCEPTED] ACCEPTED] ACCEPTED]

Listed Lead Plaintiff Attorney Herrera (City Attorney) Bob Ferguson (WA AG) XAVIER BECERRA (CA AG) Nicholas Espíritu NILC LETITIA JAMES AG of New York Key Claims 2 counts 4 counts 6 counts 4 counts 5 counts APA - contrary to various cited APA - contrary to various statutes: statutes inlcuding INA, IIRIRA, Contrary to law, INA and IIRIRA - Contrary to INA (public charge) def in APA - exceeds statutory authority INA and SNAP PRWORA, Sec. 504, SNAP beyond public charge language statute (public charge provisions)

APA: arbitrary and capricious and APA - ultra vires by extending public Arbitary and capricious or not in abuse of discretion for various charge to extension of stay or change accordance with law for several APA- not in accordance with law: bases of status Contrary to law, section 504 reasons 504, SNAP, PRWORA

APA - arbitrary and capricious, list 20+ Contrary to law, state health care Equal protection (5th amend) based on APA - arbitrary and capricious for specific aspects discretion animus against non-white immigrants various bases

Equal protection (5th amend), APA- without observance of discrimination motivated on the basis Arbitrary and capricious, not Issued by an unlawfully appointed procedure required by law, includes of race, ethnicity, or national origin sufficient reasons agency director not quantifying harm

Equal protection (5th amend) based Equal protection (5th Amend), on race and in another count based motivated by discriminatory animus on animus against a politically toward Latinos and immigrant unpopular group communities of color

Relief Sought Declaratory and injunctive relief Vacate rule, enjoin rule Declaratory and injunctive relief Declaratory and injunctive relief Declaratory and injunctive relief

26 Last Updated November 6, 2019

Know something we don't? Reach out to Liz Schott at [email protected] or Kristen Tully at [email protected]

Nickname Make the Road Casa de Maryland Cook County Plaintiffs MAKE THE ROAD NEW YORK, CASA de Maryland, Inc. Cook County and the Illinois MAYOR AND CITY COUNCIL OF AFRICAN SERVICES ANGEL AGUILUZ and MONICA Coalition for Immigrant and BALTIMORE; CITY OF COMMITTEE, ASIAN AMERICAN CAMACHO Refugee Rights (ICIRR) GAITHERSBURG, MARYLAND; STATE FEDERATION, PEREZ SENATOR JEFF WALDSTREICHER; CATHOLIC CHARITIES COMMUNITY FRIENDS OF IMMIGRANTS; JEWISH SERVICES COMMUNITY RELATIONS COUNCIL (ARCHDIOCESE OF NEW YORK), and OF GREATER WASHINGTON; THE CATHOLIC JEWISH COUNCIL FOR PUBLIC LEGAL IMMIGRATION NETWORK, INC. AFFAIRS

USDC S.D. NY USDC MD USDC N.D. IL USDC MD Jurisdiction Filed Appellate - 2nd Circuit Appellate - 4th Circuit Appellate - 7th Circuit Appellate - 4th Circuit Judge George B. Daniels (appointed Paul W Grimm (appointed in 2012 by Gary Feinerman (appointed in 2010 Peter Jo Messitte (Clinton Judge by Clinton in 2000) as of 9/10 Obama) by Obama) appointee 1993) Status Filed complaint 8/27/19 Filed complaint 9/16 Filed complaint 9/24/19 Filed complaint 9/27

Preliminary injunction motion filed Preliminary injunction motion filed 9/16. Hearing on PI on October 10, 9/9. Oral argument held October 7. 2019 at 2:00 in Baltimore PI hearing: October 11

Government moved to stay injunction Government moved to stay injunction Government moved to stay pending appeal 10/25 pending appeal 10/25 injunction pending appeal 10/25

Government filed notice of Government filed notice of Appeal Government filed notice of Appeal Interlocutory Appeal 10/30 10/30 10/30 Pleadings NY Group Complaint Casa de Maryland Complaint Cook County Complaint Baltimore Complaint NY Group PI Brief Casa de Maryland PI Brief Cook County PI Brief Ruling on complaint DEFERRED in Orders NATION WIDE PRELIMINARY NATIONWIDE PRELIMINARY ILLINOIS-WIDE PRELIMINARY light of nationwide Preliminary INJUNCTION 10/11 INJUNCTION GRANTED 10/14 INJUNCTION 10/14 Injunctions

Amicus Curiae Child and Maternal Health Health Law Advocates

Asian Pacific Islander AntiDomestic Violence Advocates People with Disabilities American Public Health Association Economic Impact Health Care Advocates

Housing and Nutrition

Justice in Aging

Public Health

Congressional Tri-Caucus Members

Johnathan H. Hurtzwitz at Paul Weiss; Listed Lead Ghita Schwarz at Center for Jonathan L. Backer, Institute for Plaintiff Attorney Constitutional Rights; Susan Welber at Constitutional Advocacy and Kimberly Fox, Cook County's Illinois Harvey Reiter at Stinson Leonard Legal Aid Society Protection State Attorney Street, LLP Key Claims 4 counts 4 Counts 4 Counts 6 Counts APA - arbitrary, capricious, abuse of power, contrary to definition of public APA - Not in Accordance with Law APA - arbitrary and capricious - charge found in INA and Beyond Statutory Authority APA - exceeds statutory authority inadequately justified APA - not in accordance with law: Section 504 of the Rehabilitation APA - arbitrary and capricious - Act of 1973, PRWORA, IIRIRA, SNAP APA - claim that the notice-and- including failure to respond/consider statute, INA definition of public comment was procedurally arbitrary adequetly the comments on the charge in sections 212(a)(4), APA - arbitrary and capricious - and capricious proposed rule 202(a)(1), and 212 (a)(1). inadequate cost benefit analysis APA - arbitrary and capricious - not APA - arbitrary and capricious - 5th amendment, violates due process a reasoned analysis for the change counter to the evidence before the APA - exceeds statutory authority in because it is so vague as to be or a reasoned response to the agency, disregards material facts the INA unconstitutional comments submitted and evidence 5th amendment equal APA- arbitrary and capricious - protectionbecause the rule was (Just Plaintiff ICIRR) 5th amendment failed to meaninfully address motivated at least in equal protection, discriminates on comments re: credit reports not 5th Amendment Due Process and part by an intent to discriminate on the basis of race, disparately being a reliable basis for Equal Protection (discriminated based the basis of race, ethnicity, and impacts latino and non-white determining self-reliance of on national orgin, ethnicity, and race) national origin. immigrants immigrants APA - without observance of procedure required by law - rulemaking must give notice of terms/substance of rule and an opportunity to participate, then the rule must be a logical out-growth APA and 5th Amendment - denying equal protection of the law, discriminates on the basis of race, ethnicity, national origin, and nationality Relief Sought declaratory and injuctive relief declaratory and injunctive relief Declaratory and injunctive relief Declaratory and injunctive relief

27 AAPCHO Board of Directors Report

Report Topic: Policy Update Submitted by: Adam Carbullido Date: November 12, 2019 Background/Summary:

Issue(s) or Highlights: Appropriations and Health Extenders The continuing resolution that extended government funding into fiscal year 2020 expires on November 21. House and Senate leaders are expected to unveil a short-term CR that will extend government funding until December 20, 2019, giving appropriators additional time to negotiate funding levels for the remainder of fiscal year 2020. President Trump has signaled that he is open to supporting a short-term CR conditioned that it does not place additional restrictions on transfer authority. AAPCHO will continue to monitor Congressional appropriations and we continue to advocate for AAPCHO funding priorities, including for health extenders for community health centers and the territories’ Medicaid programs and viral hepatitis B programs.

Presidential Proclamation The U.S. District Court in Portland, Oregon has temporarily blocked the presidential proclamation that would have required would have required prospective immigrants to prove that they will obtain health insurance coverage within 30 days of entering the U.S. or demonstrate that they have the financial resources to pay for “reasonably foreseeable medical costs.” The temporary restraining order (TRO) that blocked the proclamation is in effect until November 30. Litigators are working to receive a preliminary injunction that will halt the proclamation as the lawsuit moves through the courts. AAPCHO joined over 400 organizations to oppose the proclamation as a whole, as well as an emergency comment period for the State Department’s proposed form.

Immigration Legislation Covering Our FAS Allies Act Senator Mazie Hirono (D-HI) and Representative Tony Cardenas (D-CA) reintroduced the Covering Our Freely Associated States Allies (COFA) Act (S. 2218 and H.R. 4821) to restore Medicaid eligibility to Freely Associated States (FAS) (Marshall Islands, Palau, and the Federated States of Micronesia) citizens, who are living in the U.S. under the Compacts of Free Association. COFA citizens in the U.S. have been ineligible for Medicaid since the 1996 welfare reform removed them from most federal benefits programs. Without Medicaid coverage, many FAS citizens do not have basic access to health care, despite them paying federal taxes that fund the program and serving in the military at disproportionately high rates per capita. AAPCHO co-led a sign-on letter with APIAHF and COFA leaders urging Congress to restore COFA Medicaid eligibility.

HEAL for Immigrant Women and Families Act Representatives Pramila Jayapal (D-WA) and Deb Haaland (D-NM) introduced the HEAL for Immigrant Women and Families Act of 2019 to 1) increase eligibility for Medicaid and Children’s Health Insurance Program, 2) increase access to health insurance coverage, and 3) restore Medicaid eligibility for COFA

28 migrants. AAPCHO joined the National Asian Pacific American Women’s Forum and other immigrant rights groups to lead revisions to the bill prior to its reintroduction. We continue working with Members of Congress to encourage co-sponsorship of the bill as a progressive stance on immigrant access to care.

New Deal for New Americans Act Representatives Grace Meng (D-NY), Pramila Jayapal (D-WA), and Jesús “Chuy” García (D-IL) introduced the New Deal for New Americans Act (H.R. 4982) to create the National Office of New Americans. The Office oversee efforts to reduce obstacles to U.S. citizenship and support the integration of immigrants and refugees into the U.S. The bill would also amend the Immigration and Nationality Act to no longer allow deportation of an individual deemed to have become a public charge. AAPCHO endorsed this bill

Action Requested: None, status update

29 CQ NEWS Nov. 11, 2019 Stopgap funding bill likely to run through Dec. 20 Nov. 11, 2019 – 11:08 a.m. By Jennifer Shutt and Paul M. Krawzak, CQ

Congressional leaders are tentatively eyeing a temporary spending bill to last through Friday, Dec. 20, according to sources familiar with the talks.

That date wasn't set in stone and wouldn't be finalized until later in the week, when lawmakers return to Washington. But leaders on both sides of the aisle have been pressing for a year-end wrapup of the 12 fiscal 2020 appropriations bills, as opposed to punting into early next year to avoid getting tangled up in the impeachment process.

House Majority Leader Steny H. Hoyer, D-Md., told rank-and-file Democrats on a call last week that they should be prepared to remain in session an extra week past the current Dec. 12 target adjournment date.

White House officials have also signaled openness to a December continuing resolution, telling lawmakers that President Donald Trump is prepared to sign a short-term spending bill as long as it doesn't place additional strings on administrative transfer authority for border wall funding.

The current stopgap funding law (PL 116-59) expires Nov. 21. Trump has said he's not interested in another shutdown, though he's also said "we'll see what happens." Senate Minority Leader Charles E. Schumer, D- N.Y., has said repeatedly in recent days that he fears Trump's willingness to shut the government down because of impeachment, though a shutdown would not hinder lawmakers' ability to continue that process.

"In our opinion, leaders of both parties in Congress want to avoid a government shutdown so we think one is a long shot," analysts at investment advisory firm Keefe, Bruyette & Woods wrote to clients Monday. "However, we cannot rule out an impulsive decision by President Trump to reject a spending bill and threaten a shutdown, especially if he feels aggrieved by the impeachment process."

The four leaders of the House and Senate Appropriations committees have been preparing to meet Tuesday to take stock of remaining hurdles. Due to scheduling conflicts just House Appropriations Chairwoman Nita M. Lowey, D-N.Y., and Senate Appropriations Chairman Richard C. Shelby, R-Ala., will be at the meeting, according to a source familiar with the discussions.

None of the 12 spending bills for the fiscal year that began Oct. 1 have become law due to disputes over funding levels and policy riders.

The biggest hangup has been how to divvy up $1.37 trillion in available resources among the dozen bills. Senate Republicans wrote their spending measures to match the July budget caps deal (PL 116-37), but Democrats oppose their initial allocations as too generous for border security and the wall, and not enough for health care, education and other domestic programs.

Doug Sword contributed to this report.

30 Department of State, Office of Information and Regulatory Affairs, Office of Management and Budget Department of State’s Bureau of Consular Affairs, Office of Visa Services Docket Number: DOS-2019-0039

Re: Emergency Submission Comment on Immigrant Health Insurance Coverage

October 31, 2019

To whom it may concern:

The undersigned organizations write in response to the Emergency Submission Comment on Immigrant Health Insurance Coverage. This 48-hour comment period—and the entire underlying proclamation—is not an emergency. This is just the latest brick in your administration’s “invisible wall” that puts an extremist racial and political agenda ahead of the nation’s interests and the law of the land.

We support a nation where all are truly equal, immigration is recognized as a strength, and individuals have access to the essentials of life without regard to where they were born. As part of this vision, we support access to comprehensive, affordable health care—and efforts to strengthen and protect the hospitals, community health centers, and providers who work tirelessly to deliver high quality care to their patients. Unfortunately, due largely to the policies of this administration, the number of people in the United States without health insurance increased last year for the first time in more than a decade.

We specifically oppose the collection of information on health insurance status as proposed in this Emergency Submission Comment. In fact, we strongly oppose the underlying October 4, 2019 proclamation mandating that visa applicants abroad buy health insurance. This proclamation is not about improving access to health care or making sure hospitals are paid. Instead, it serves as yet another constraint on legal immigration, imposing a wealth test that will disproportionately harm people of color. Like the Muslim ban or the public charge regulation, it sends one message: if you're not white and wealthy, you're not welcome here.

The proclamation actually threatens to undermine the nation’s health. It restricts immigrants’ ability to purchase comprehensive health insurance available through the Affordable Care Act (ACA) marketplaces. Congress elected to make lawfully residing immigrants eligible for subsidized marketplace coverage because doing so advances the health of our nation. The proclamation puts the nation’s health at risk by ignoring Congress and instead requiring individuals to buy costly and less comprehensive health coverage.

Notably, the proclamation allows short-term plans, which do not comply with the Affordable Care Act’s consumer protections, to qualify as “acceptable” coverage. Frequently referred to as “junk plans,” short-term plans lack comprehensive coverage and can be prohibitively expensive for individuals with pre-existing conditions. This isn’t promoting health insurance—this is putting a barrier between individuals and the coverage for which they are eligible. In fact, forcing immigrants to avoid comprehensive insurance could increase uncompensated care costs for providers, when patients can’t afford needed health care that is not covered by these bare- bones plans.

There is still time to protect the nation’s health before the proclamation goes into effect. We call on you to rescind this proclamation before it goes into effect.

31 Sincerely,

Access Living Action Together Walpole ADAPT Advocates for Basic Legal Equality, Inc. Advocates for Youth African Communities Together African Services Committee AIDS Foundation of Chicago Arise Alameda Health Consortium Alliance for African Assistance American Federation of Teachers API Chaya APLA Health AR Hunger Relief Alliance Arab American Association of NY Coalition to End Sexual and Domestic Violence Asian & Pacific Islander American Health Forum Asian American Federation (AAF) Asian American Legal Defense and Education Fund (AALDEF) Asian Americans Advancing Justice - LA Asian Americans Advancing Justice | Chicago Asian Americans Advancing Justice| AAJC Asian Health Services Asian Law Alliance Asian Pacific American Labor Alliance, AFL-CIO Asian Pacific Institute on Gender-Based Violence Asian Pacific Policy and Planning Council Asian Services In Action, Inc. (ASIA, Inc.) Association for Community Living in Boulder & Broomfield Counties Association of Asian Pacific Community Health Organizations (AAPCHO) Association Of Moroccan Immigrant Network (A.M.I.N) Association of Nurses in AIDS Care Austin Region Justice for Our Neighbors Autistic Self Advocacy Network Bay Area Regional Health Inequities Initiative Bellingham Deaf and Disability Justice Collective Berkeley Journal of Employment and Labor Law Berkshire Immigrant Center BIDMC Immigration Advocacy Team BiNet USA Black Alliance for Just Immigration (BAJI) Bread for the World BronxCare Hospital/Mt. Sinai Hospital Brooklyn Defender Services Cabrini Immigrant Services of NYC California Alliance for Retired Americans California Association of Food Banks

32 California Food Policy Advocates California Immigrant Policy Center California Pan-Ethnic Health Network California Partnership to End Domestic Violence California Primary Care Association California Reinvestment Coalition California Teachers Association Californians Together Campaign for New York Health Cape Cod Coalition for Safe Communities Caritas of Waco Catholic Charities Catholic Charities Diocese of Monterey Catholic Charities Hawaii Center Against Sexual & Domestic Abuse, Inc. Center for Health Policy and Law at Northeastern University School of Law Center for Health Progress Center for Independence of the Disabled, NY Center for Law and Social Policy (CLASP) Center for Public Policy Priorities Center for Reproductive Rights Center for the Study of Social Policy CenterLink: The Community of LGBT Centers Central American Resource Center of California (CARECEN LA) Centro Latino Americano Changing The Future Outcome Charlotte Center for Legal Advocacy Chhaya Community Development Organization Chicago Alliance Against Sexual Exploitation Child Care Law Center Children First for Oregon Children's Defense Fund - Children's Defense Fund-New York Children's HealthWatch Chinese American Planning Council Chinese for Affirmative Action Chinese-American Planning Council Christian Reformed Church Office of Social Justice Church World Service Citizen Action of City of Tucson, Arizona Clinicians for Progressive Care Coalition Ending Gender-Based Violence Coalition for Asian American Children and Families Coalition for Disability Health Equity Colorado Cross-Disability Coalition Colorado Developmental Disabilities Council Colorado Fiscal Institute Colorado Foundation for Universal Health Care Columbia Legal Services

33 Community Action Board of Santa Cruz County, Inc. Community Action Marin Community Action Partnership of SLO County Community Catalyst Community Clinic Association of County Community Clinic Consortium of Contra Costa and Solano Community Growth Center Community Health Care Association of New York State (CHCANYS) Community Healthcare Network Community Legal Aid Society Inc. Community Resource Center Compass Family Services Connecticut Institute for Refugees and Immigrants Connecticut Oral Health Initiative, Inc. Council for Global Equality Council on American-Islamic Relations, San Diego Office CRLA Foundation CT Shoreline Indivisible Daya inc Dayle McIntosh Center DC-MD Justice For Our Neighbors Detroit Disability Power Disability Community Resource Center, Inc. Disability Rights Education & Defense Fund Disability Rights Pennsylvania Disciples Refugee & Immigration Ministries Doctors for America DQIA: disabled queers in ACTION! Education and Leadership Foundation El Centro, Inc. Emerald Isle Immigration Center Empire Justice Center Empower Empowering Pacific Islander Communities (EPIC) End Domestic Abuse Wisconsin: The Wisconsin Coalition Against Domestic Violence Entre Hermanos Equality California Equality EverThrive Illinois Fair Immigration Reform Movement (FIRM) Faith Action Network Families Belong Together Families USA Family Advocates, Inc. Family Equality Family Voices of Feeding Texas First 5 Marin Children and Families Commission First Focus Campaign for Children First Parish Immigration Justice Task Force

34 Health Justice Project Florida Impact to End Hunger Florida Policy Institute Food for People, the Food Bank for Humboldt County Food Research & Action Center Freedom Network USA Gay Men’s Health Crisis (GMHC) ADAPT Georgians for a Healthy Future GirlForward Greater Coalition Against Hunger Guadalupe Centers High School Gulfcoast Legal Services, Inc. Guttmacher Institute Hand in Hand: The Domestic Employers Network Health & Medicine Policy Research Group Health Care For All Health Care for All New York Health Care for America Now (HCAN) Health Law Advocates Healthy House Within A MATCH Coalition Heartland Alliance Heights Friends of Immigrants HIAS Pennsylvania Hispanic Federation Hispanic Health Council Homeless and Housing Coalition of Housing Action Illinois Immigration Legal Services Collaborative Hunger Free Vermont Voices for Children Illinois Coalition Against Domestic Violence Illinois Coalition for Immigrant and Refugee Rights Immigrant and Refugee Community Organization Immigrant Connection Immigrant Law Center of Minnesota Immigrant Legal Advocacy Project Immigrant Legal Resource Center Immigrant Rights Action Immigrants Contribute Immigration Justice Task Force - First Parish in Concord In Our Own Voice: National Black Women's Reproductive Justice Agenda Coalition for Human Services Indivisible Eastside -WA Interfaith Anti Bias Task Force International Community Health Services InterReligious Task Force on Central America and Colombia (IRTF ) Coalition Against Domestic Violence (ICADV) Irish International Immigrant Center Japanese American Social Services, Inc.

35 Jefferson County Immigrant Rights Advocates Jewish Family & Children's Service Jewish Family Service of Los Angeles Jewish Vocational Service, Jubilee Immigration Advocates Just Harvest Justice Center of Southeast MA Justice for Our Neighbors Michigan Justice in Aging Kentucky Equal Justice Center Kentucky Voices for Health KIAC Kitsap Immigrant Assistance Center Bremerton, WA Kids for College Korean American Family Services (KFAM) Korean Community Center of the East Bay Korean Community Services of Metropolitan NY Inc. La Casa Norte La Clinica de La Raza La Union del Pueblo Entero Lana’i Community Health Center Latino Coalition for a Healthy California Law Foundation of Silicon Valley LeadingAge Legal Aid Society of San Mateo County Legal Council for Health Justice Lenox Hill Neighborhood House Linda Vista United Methodist Church Literacy Volunteers Winchester Area Long Island Activists Long Island Inclusive Communities Against Hate Long Island Language Advocates Coalition Los Angeles Christian Health Centers Lutheran Social Services of New York Make the Road New York Maryland Citizens' Health Initiative Education Fund Inc. Maryland Hunger Solutions Massachusetts Immigrant and Refugee Advocacy Coalition Massachusetts Law Reform Institute Maternal and Child Health Access Maxwell Street Legal Clinic McLennan County Hunger Coalition Metro New York Health Care for All MI Disability Rights Coalition Mi Familia Vota Michigan Coalition to End Domestic & Sexual Violence Michigan Immigrant Rights Center Michigan League for Public Policy Migrant and Immigrant Community Action Project MinKwon Center for Community Action Minnesota Budget Project

36 Mississippi Center for Justice Missouri AILA Chapter Member MLPBprimary Modern Military Association of America MomsRising Montana Primary Care Association Muslim Public Affairs Council (MPAC) NASTAD National Asian Pacific American Women's Forum National Asian Pacific Center on Aging (NAPCA) National Association for the Education of Young Children (NAEYC) National Association of Pediatric Nurse Practitioners National Association of Social Workers National Center for Law and Economic Justice National Center for Transgender Equality National Coalition Against Domestic Violence National Coalition for the Homeless National Consumer Law Center National Council of Jewish Women National Employment Law Project National Hispanic Council on Aging National Immigrant Justice Center National Immigration Law Center National Justice for Our Neighbors National Latina Institute for Reproductive Health National LGBTQ Task Force National Low Income Housing Coalition National Partnership for Women & Families National WIC Association National Women's Law Center NC Child Appleseed Nebraska Coalition to End Sexual and Domestic Violence NETWORK Lobby for Catholic Social Justice Center on Law and Poverty New York Immigration Coalition New York Justice for Our Neighbors New York Legal Assistance Group NM Voices for Children North Carolina Justice Center North County Immigrant Task Force North East Medi-Cal Services (NEMS) North Suburban Legal Aid Clinic Northwest Harvest Northwest Health Health and Human Rights Northwest Health Law Advocates NYC Coalition to Dismantle Racism in the Health System NYCD16 Indivisible Oasis Legal Services Ohio Domestic Violence Network

37 Policy Institute OneAmerica Opening Doors International Services, Inc. Operation Access Oregon Food Bank Pacific Asian Counseling Services Pan Asian Volunteer Health Clinic Parent Possible Partnership for America's Children Pax Christi Illinois Pennsylvania Immigration and Citizenship Coalition PFLAG National Physicians for a National Health Program - NY Metro Placer Independent Resource Services Planned Parenthood Affiliates of California Planned Parenthood Federation of America Positive Women's Network-USA Presentation Sisters at Caminando Juntos Prevention Institute Progressive Doctors Project IRENE Protect Our Care Illinois Coalition Public Health Justice Collective Public Justice Center Rainbow House Domestic Abuse Services, Inc. RefugeeOne RESULTS Robert F. Kennedy Human Rights Rosie's Place Safe Horizon Immigration Law Project SAGE San Diego Immigrant Rights Consortium San Francisco Latino Democratic Club Sauti Yetu Center for African Women and Families Seattle/King County Coalition on Homelessness SEIU Services, Immigrant Rights & Education Network (SIREN) Sexuality Information and Education Council of the United States (SIECUS) Show Up Long Island Shriver Center on Poverty Law Silver State Equality-Nevada Snohomish Immigration Advocacy Social Justice Task Force, San Mateo County Democracy for America Solano CountySupervisor District 2 South Asian Fund For Education, Scholarship and Training (SAFEST) South Asian Network South Bronx United Appleseed Legal Justice Center Southeast Asia Resource Action Center (SEARAC) Southern Poverty Law Center

38 Southwest Center for Independence St. Paul Community Literacy Consortium Statewide Poverty Action Network Student National Medical Association (SNMA) SYL Foundation TakeAction Minnesota Tennessee Justice Center The Achievable Foundation The Black Women's Health Imperative The Children's Partnership The Coelho Center for Disability Law, Policy and Innovation The Fenway Institute The Inland Empire Immigrant Youth Collective The Leadership Conference on Civil and Human Rights The Legal Aid Society The Right to Immigration Institute Tiburcio Vasquez Health Center, Inc. Together We Will Long Island Treatment Action Group (TAG) Ujima Inc.: The National Center on Violence Against Women in the Black Community UnidosUS Union for Reform Judaism Union of North American Vietnamese Student Associations United African Organization United Cambodian Community Unity Health Care Universal Health Care Action Network Universal Health Care Foundation of Connecticut University YMCA New American Welcome Center UPLAN (United Parent Leaders Action Network) Utahns Against Hunger UURISE - Unitarian Universalist Refugee and Immigrant Services and Education Valley Settlement Vermont Affordable Housing Coalition Vermont Legal Aid Vermont Network Against Domestic and Sexual Violence Violence Free Colorado Violence Free Minnesota Virginia Garcia Memorial Health Center Wallingford Indivisible Washington State Coalition Against Domestic Violence (WSCADV) Wayne Action for Racial Equality We Are One, Inc. - www.WeAreOne.cc - WAO WeCount! Welcome Project Inc West Valley Neighborhoods Coalition West Virginians for Affordable Health Care West Virginians Together for Medicaid Western Center on Law & Poverty Whitman-Walker Health

39 Wisconsin Faith Voices for Justice World Relief WV FREE YWCA Pierce County

40

To: Office of Management and Budget, State Desk Officer in the Office of Information and Regulatory Affairs The Department of State’s Bureau of Consular Affairs, Office of Visa Services

Re: Public Notice: 10934. Notice of Information Collection Under OMB Emergency Review: Immigrant Health Insurance Coverage (Docket Number: DOS–2019–0039)

To whom it may concern:

The undersigned organizations representing health centers in California and Nationwide, write in response to the Emergency Submission Comment on Immigrant Health Insurance Coverage. As safety net providers to nearly 7 million patients in California and 29 million patients nationwide, we are deeply concerned about how this proclamation will impact our communities and patients. Already, community health centers (CHCs) have seen an increase in mental health concerns in our patient population due to fear and confusion about hurtful immigration policies that this Administration has proposed. Given that the form we are asked to use for comment was just made public late yesterday, we strongly request that the proclamation be rescinded in its entirety, and ask that a proper public comment period be provided.

CHCs are the backbone of the care delivery system in California and the nation, ensuring access to medical, behavioral, oral health, and social services for the most vulnerable populations, including 1 out of every 3 Medi-Cal (Medicaid) beneficiaries. CHCs provide healthcare services to California’s most vulnerable populations, including over 340,000 homeless patients. By mission CHCs focus on providing culturally and linguistically diverse services to low income and non-English speaking communities regardless of their ability to pay and immigration status. Health centers are also rooted in their communities and have a history of implementing models of care that are responsive to their community’s needs, particularly through integration of primary care and behavioral health services. However, this and other policies being promulgated by this Administration have created significant barriers in our patients’ access to health care services and benefits.

The undersigned in this letter are representing the needs and concerns of community health centers and their patients. CaliforniaHealth+ Advocates, the advocacy affiliate of the California Primary Care Association, advocates on behalf of California’s 1,330 community health centers that provide high-quality, comprehensive care to nearly 7 million people in California each year.

The undersigned strongly oppose the underlying October 4, 2019 proclamation mandating that those granted a visa from abroad show that they will be covered by insurance within 30 days after entering into the country for the following reasons: 1. The proclamation increases barriers to healthcare access 2. The proclamation will Increase healthcare costs 3. The information collection is not necessary for the proper function of the Department of State (Department) & the Department has no expertise in implementing a health insurance mandate, which does not furthers the objectives of the Department. 4. We have serious concerns about the validity of the methodology used for data collection and the assumptions made. 5. This is an improper use of Emergency Comment Submission41

Proclamation Increases Barriers to Healthcare Access This proclamation is not about improving access to health care or making sure hospitals, health centers and healthcare providers are paid since, according to a report by One Nation Coalition, the “immigrants in the United States are less likely to use public benefits than U.S. born individuals.”1 More specifically, in California where we have decided to expand access to health benefits for our immigrant populations, we see that 70 percent of Medicaid / Medi-Cal enrollees are U.S. born citizens.2 Given this data, we believe this proclamation is responding to a non- existing issue. Instead, it serves as yet another constraint on legal immigration, imposing a wealth test that will disproportionately harm people of color.

This new policy—which is slated to take effect just days after the Affordable Care Act’s marketplace open enrollment period starts—is likely to create additional fear and confusion among families that include immigrants and may prevent some from enrolling. Some people who are not subject to this assessment may fear that signing up for coverage with ACA premium tax credits or Medicaid will negatively impact their families’ immigration goals. For example, a family may not sign their children up for Medicaid because they fear it could leave a parent unable to immigrate to the United States. As a result, the proclamation will raise uninsured rates among lawfully present immigrants and potentially their U.S. citizen family members. That, in turn, will increase uncompensated care costs, exacerbating the very problem the proclamation purports to address.3

Proclamation could Increase Healthcare Costs The proclamation threatens to undermine the health of U.S. citizens as well as the stability of the healthcare delivery system. It restricts immigrants’ ability to purchase comprehensive health insurance available through the Affordable Care Act (ACA) marketplaces. Congress elected to make lawfully residing immigrants eligible for subsidized marketplace coverage because doing so advances the health of our nation. The proclamation puts the nation’s health at risk by ignoring Congress and instead requiring individuals to buy costly and less comprehensive health coverage.

Notably, the proclamation allows short-term plans, which do not comply with the ACA’s consumer protections, to qualify as “acceptable” coverage. Frequently referred to as “junk plans,” short-term plans lack comprehensive coverage and can be prohibitively expensive for individuals with pre-existing conditions. This is not promoting health insurance—this is putting a barrier between individuals and the coverage for which they are eligible. In fact, forcing immigrants to avoid comprehensive insurance could increase uncompensated care costs for providers, when patients cannot afford needed health care that is not covered by these bare-bones plans. If individuals opt for such a plan and they get sick or injured, they may not be able to afford out-of-pocket expenses. With consumers unable to pay out of pocket expenses, costs will rise for all, as medical providers and the health system will be left to carry the burden.

Evaluating the Information Collection Process per Department’s Request Per the Department’s request, below are some thoughts on the information collection process. We strongly believe that the Department is underestimating the burden of this request to both the applicant and Department itself.

Evaluate whether the proposed information collection is necessary for the proper functions of the Department.

The information collection is not necessary for the proper function of the Department. The information collection is implementing a policy that will create a health insurance mandate for certain individuals seeking lawful immigration to the United States. This in no way advances any legitimate objective of the State Department, and the policy in fact undermines some of its stated objectives.

1 One Nation Commission. One Nation Built on the Strength of Immigrants. October 2019. 2 Nowrasteh A, Orr R. Immigration and the Welfare State: Immigrant and Native Use Rates and Benefits Levels for Means- Tested Welfare Entitlement Programs. Ma 10, 2018. Cato Institute. https://www.cato.org/publications/immigration-research- policy-brief/immigration-welfare-state-immirant-native-use-rates. 3 Brief of Amici Curiae, City and County of San Francisco and County of Santa Clara v. U.S. Citizenship and Immigration Services, et al., No. 4:19-CV-04717, https://www.aha.org/system/files/media/file/2019/09/amici-curiae-brief-of-aha-hospital- groups-on-dhs-public-charge-rule-9-11-1019.pdf 42

The Department has no expertise in implementing a health insurance mandate and the mandate serves no purpose that furthers the objectives of the Department. Design and implementation of mandates to obtain health insurance is extremely complicated, as evidenced by the extensive deliberations and rule-making the Department of the Treasury, the Department of Health and Human Services, and other agencies undertook over several years to implement the Affordable Care Act. The Department lacks the expertise that those agencies relied upon and thus is certainly incapable of designing a workable mandate without a meaningful opportunity for public comment to enlighten it about the various choices involved.

Evaluate the accuracy of our estimate of the time and cost burden of this proposed collection, including the validity of the methodology and assumptions used.

The undersigned have serious concerns about the validity of the methodology used for data collection and assumptions used. Consular officers will be required to ask immigrant visa applicant verbally whether they will be covered by health insurance within 30 days of entry into the United States and to also provide details of such coverage (identify insurance plan, date coverage will begin and other information about the insurance the consular deems necessary.) Problems with this method include:  Many consumers will not be able to enroll in health insurance coverage until they enter and begin residing in the state in which they will obtain coverage. o This means they are unlikely to have detailed information about the coverage when they are applying for their status. For example, in most cases they won’t be able to provide an accurate effective date since their insurance start date will be contingent on the move to the state in which they will enroll in coverage.

 The method gives consular officers discretion on requesting other information that is related to the insurance. o These officers are not health insurance experts and are unlikely to know what would be a reasonable and not reasonable request for information related to coverage, or how to evaluate information they are given. Requiring them to make judgments in areas where they have neither expertise nor information will result in arbitrary, inconsistent decisions.

 It’s especially troubling that this information gathering process depends on a verbal collection and assessment of information. o For those visa applicants that do have information about expected coverage, it will be unclear to them what information they should be prepared to provide when verbally asked for the information. o Decisions made in this verbal data collection will also be difficult to challenge if a visa applicant feels he/she was improperly denied or delayed entry. o Consular officers, with the best of intentions, may make erroneous decisions based on miscommunications with applicants that neither party can detect from what they recall of a verbal request. Health insurance policies, and important transactions relating to those policies, are almost uniformly conducted in writing precisely because of the complexity of these issues and the high potential for error. When consular officers, rather than health insurance professionals, are involved the risk of error increases.

Additionally, your estimate of the burden of this information collection seems erroneous for several reasons.  First, because of the likelihood of miscommunications and misunderstandings, many applicants will have to supply information several times. o The lack of coherent standards for consular officers to rely upon in assessing what applicants supply means that many are likely to request additional information several times before making a decision.

 Second, ten minutes is an optimistic estimate of the amount of time each applicant will be required to spend on these requests. o Most insurance will not be available until the applicant arrives sometime in the future. Proving the likelihood of future insurance that is contingent on the immigrant’s arrival likely will require collecting numerous documents not otherwise within the applicant’s control, such as detailed conditional offers of employment and the health insurance policies of prospective employers. o Gathering this information will require hours or days, not minutes.

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 Third, those seeking to qualify on the basis of having sufficient funds to cover treatment for pre-existing illnesses may need to obtain detailed information about their diagnoses, the costs of treatment in the U.S. (which may be very different than those with which they are familiar in their country of origin), and the policies of prospective health care providers. o Many health care providers have multiple rate structures: one for Medicare, another for Medicaid, still more for various private health insurance plans, and even more for persons seeking to pay out-of-pocket. They will undoubtedly face difficulty determining which rate structure the provider will apply to them, which would require time-consuming back-and-forth interactions with these prospective providers.

Improper Use of Emergency Comment Submission We also strongly object to OMB allowing this notice of information collection to have a 48-hour comment period under an emergency review process. Emergency processing is intended to be used in cases when events outside of the control of an agency require immediate action that will not allow for compliance with the normal comment process. Such examples include: responding to a natural disaster, meeting a deadline required by law or a court ruling, or preventing severe harm to the public if the completion of the process is delayed.4 In this case, the government had full control over the date it issued the Proclamation and the implementation date it selected.

The agency has offered no argument for why the Proclamation must take effect immediately or what harm would result from delaying implementation to allow for a more reasonable comment period. The extremely short comment period has not allowed for experts in the field who might provide valuable insight to the government or stakeholders that will be directly and indirectly impacted by this new information collection process to fully analyze or understand the problems it will create. With additional time, we anticipate that we would identify additional ways the proposed process is burdensome and unworkable for both individuals and agency staff.

Impact to Communities To be clear, this rule does not only impact those abroad attempting to enter the country; it also impacts our patients who may be sponsoring family members, and possibly those forced to leave and reenter the country through their green card applications. We appreciate the intent of lowering health costs, but this proclamation does the exact opposite. It benefits health insurance corporations, especially those selling “junk plans,” while leaving the health care safety net to cover the remaining costs. Already we have had patients express fear and concerns in using services due to confusion of this proclamation and how it may impact their ability to sponsor a family member or obtain their green card.

As organizations representing the needs of safety net providers of whom this proclamation claims to be helping, we ask that the Administration NOT move forward with implementation, and rescind this proclamation in its totality. The proclamation will help to increase, not decrease, health care costs while also possibly encouraging more illegal immigration since this would create yet another obstacle to legally immigrating to this country.

Sincerely,

- CaliforniaHealth+ Advocates - Asian Health Services - San Francisco Community Clinic Consortium - Association of Asian Pacific Community Health Organizations - Foothill Community Health Center - Washington Association for Community Health - North East Medical Services - Nevada Primary Care Association - Community Health Network of Washington - Maple City Health Care Center - Kheir Clinic - International Community Health Services

4 5 CFR § 1320.13 - Emergency processing. 44

- Community Clinic Association of Los Angeles County - HealthRIGHT 360 - Clinica Romero - Venice Family Clinic - AltaMed - Salud Para La Gente

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Senators Hirono, Schatz Reintroduce Legislation to Restore Health Care Access for COFA Citizens

July 24, 2019

WASHINGTON, D.C. –Today, Senators Mazie K. Hirono (D-Hawaii) and Brian Schatz (D-Hawaii) reintroduced the Covering our FAS Allies Act, which would reinstate Medicaid coverage, also known as Med-QUEST in Hawaii, for citizens of the Freely Associated States (FAS) living in the United States under the Compacts of Free Association (COFA).

As a long-standing advocate for COFA citizens, Senator Hirono stated, “Health care is a human right, and for far too long, COFA citizens have not had equal access to essential care and services through Medicaid. The Compacts are critical to our national security interests in the Pacific and we must uphold our end of the bargain. Thousands of COFA individuals and families live in the United States and we have an obligation to reinstate Medicaid coverage for these allies living in Hawaii and across our country.”

“This bill is about the federal government taking more responsibility and ensuring access to health care for all COFA citizens,” Senator Schatz said. “Too often, Hawaii shoulders the cost of care for these residents. But at the end of the day, the U.S. government – through Medicaid – should provide coverage to all COFA citizens.”

“This month marks the 54th anniversary of Medicaid, a program that provides cost- effective health coverage to more than 75 million people. However, hardworking COFA citizens are locked out of this important safety net when federal law inadvertently removed their eligibility,” Kathy Ko Chin, President and CEO of the Asian and Pacific Islander American Health Forum, said. “We are pleased that Senators Hirono and Schatz have introduced legislation to correct a nearly 25-year-old error, and we encourage Congress to restore Medicaid access that COFA citizens are entitled to.”

The Compacts between the U.S. and the governments of the Republic of the Marshall Islands, Republic of Palau, and the Federated States of Micronesia provide COFA citizens with the right to freely enter, live, and work in the United States, and prior to 1996, access certain benefits, including Medicaid. However, in 1996, the Personal Responsibility and Work Opportunity Reconciliation Act inadvertently excluded COFA citizens from the list of legally present non-citizens eligible to qualify for certain federal benefits. Since then, COFA citizens have been excluded from qualifying for Medicaid, denying them access to much-needed care and leaving states like Hawaii with large populations of COFA citizens to shoulder the costs of uncompensated care.

46 On Tuesday morning during a U.S. Senate Energy and Natural Resources committee hearing, Senator Hirono continued her advocacy for reinstating Medicaid coverage for COFA citizens. According to the Assistant Secretary for Insular and International Affairs, Douglas Domenech, at least 38,000 COFA citizens live in U.S. territories and Hawaii, with 16,680 COFA citizens residing in Hawaii.

In February during a U.S. Senate Energy and Natural Resources Committee hearing to examine the state of U.S. Territories, Senator Hirono highlighted the serious economic impact lost Medicaid eligibility has on FAS citizens.

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47 Cárdenas, Radewagen, Gabbard, Womack, Case, Sablan Introduce the Covering Our FAS Allies Act

Oct 23, 2019

WASHINGTON, DC – Today, Congressman Tony Cárdenas (CA-29), along with Representatives Amata Coleman Radewagen (R-AS), Tulsi Gabbard (D-HI), Steve Womack (R-AR), Ed Case (D-HI), and Gregorio Sablan (D-MP) introduced the Covering Our FAS Allies (COFA) Act. This bipartisan bill would reinstate Medicaid eligibility for citizens of the Freely Associated States (FAS) – the Republic of the Marshall Islands, the Federated States of Micronesia, and the Republic of Palau.

Under the Compacts of Free Association with the FAS member nations, The United States has exclusive military use rights in these island nations that enable critical access in the Asia-Pacific region. In exchange, COFA citizens may enter into the United States to live, work, and study without a visa. For years, FAS citizens residing in the United States were eligible for federal benefits, including Medicaid, as they were considered “permanently residing under the color of the law”. However, the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA) established comprehensive limitations and requirements on the eligibility of all noncitizens for means-tested federal assistance, including Medicaid.

“Reinstating Medicaid eligibility for FAS citizens residing in the United States is the strategically and morally right thing to do,” said Congressman Cárdenas. “The United States has long enjoyed a strategic agreement with island nations that allowed us to have a military presence there that is critical to our national security. We must honor our promise and follow through on our commitment to the people of these countries. We have ignored this problem for too long, and it is time we fixed it.”

“Our Compacts of Free Association with the Federated States of Micronesia and the Republics of Palau and the Marshall Islands are of critical importance to all of our countries, but the burdens of the Compacts fall disproportionately on a very few jurisdictions including Hawai’i,” said Congressman Ed Case (HI-01). “The unreimbursed costs of the Compacts to the people of Hawai’i are estimated in the hundreds of millions of dollars annually and have materially worsened since Compact residents became ineligible for Medicaid, and Hawai’i assumed much of that burden. It is only fair that Medicaid eligibility be reinstated to ensure Compact residents can continue to access the care they need for themselves and for their families without jurisdictions like Hawai’i being asked to bear a disproportionate burden.”

48 “On behalf of the Federated States of Micronesia (FSM), we applaud Rep. Cardenas (D-CA) for his leadership in introducing the Covering our FAS Allies Act to restore Medicaid coverage for citizens of the Federated States of Micronesia, the Republic of Palau, and the Republic of the Marshall Islands, who are living in the United States. This important bill will help to ensure that FSM citizens who are lawfully residing, working and paying taxes in the U.S. will be provided with much needed access to medical care and will help to improve existing healthcare disparities for our citizens,” said President David W. Panuelo of the Federated States of Micronesia.

Today, at least 61,000 FAS citizens reside in the United States. They are integral members of their communities; they pay federal taxes and serve in the United States military at a rate higher than that of American citizens. Many come to the United States because of health care needs – COFA citizens have disproportionately high rates of chronic diseases like obesity and diabetes, as well as high rates of some cancers. These conditions may be related to contamination from the 67 nuclear weapons tests conducted by the United States in the Marshall Islands between 1946 and 1958. The COFA Act honors our commitment to the citizens of these Island nations and reinstates their Medicaid eligibility that they rightfully deserve.

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[DATE]

The Honorable Charles Grassley The Honorable Chairman Ranking Member Senate Finance Committee Senate Finance Committee 219 Dirksen Senate Office Bldg. 219 Dirksen Senate Office Bldg. Washington, D.C. 20510 Washington, D.C. 20510

The Honorable Frank Pallone The Honorable Greg Walden Chairman Ranking Member House Energy & Commerce Committee House Energy & Commerce Committee 2125 Rayburn House Office Bldg 2322 A Rayburn House Office Bldg. Washington, D.C. 20515 Washington, D.C. 20515

Dear Chairmen Grassley and Pallone and Ranking Members Wyden and Walden:

As organizations, businesses and community groups working to remove barriers to healthy living, we urge Congress to fix a legislative oversight that has led to inequitable access to health care for thousands of Pacific Islanders in the United States. Since the passage of the Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA), people residing in the U.S. under the Compacts of Free Association (COFA) have been categorically ineligible for Medicaid. This has caused thousands of Pacific Islanders in the U.S. to be denied basic access to health care, undermining the U.S. relationship with our COFA allies and causing worse health outcomes for COFA families in the U.S.

The Compacts of Free Association are critical U.S. national security and economic agreements with the Federated States of Micronesia, the Republic of the Marshall Islands, and the Republic of Palau (collectively referred to as the Freely Associated States or FAS). Under the provisions of these agreements, citizens of the FAS may travel to, live, and work in the U.S. in exchange for the U.S. military’s exclusive use of and access to these nation’s lands, territorial waters, and airspace in the Pacific.

Before 1996, COFA citizens in the U.S. had access to Medicaid through their designation as legally residing non-citizen natiDRAFTonals. Unfortunately, PRWORA stripped COFA communities living in the U.S. of their eligibility for most means-tested federal benefits, including Medicaid. By all accounts, when passing PRWORA, Congress unintentionally excluded this important population from the category of “qualified immigrants” for purposes of federal benefits eligibility.

As a result, over 61,000 COFA individuals and families living in the U.S. and its Pacific territories have struggled to access essential care, despite paying taxes and serving in the U.S. military at per capita rates higher than most U.S. states. Many face serious chronic conditions and health disparities, due to dependency on the U.S., as well as the effects of military activity in the FAS, including nuclear testing. These conditions, such as elevated rates of cancer and diabetes, grow more severe if left untreated.

50 In August 2019, Secretary of State Mike Pompeo noted that the COFA nations are “great friends of the United States,” during his visit to the FAS. Given this friendship, it is time for Congress to act to ensure that COFA communities are not excluded from health insurance. We applaud Senators Hirono (D-HI) and Schatz (D-HI), and Representatives Cárdenas (D-CA), Radewagen (R-AS), Gabbard (D-HI), Womack (R-AR), Case (D-HI), and Sablan (D-MP) for introducing S. 2218 and H.R 4821, respectively, the Covering Our FAS Allies (COFA) Act. We also appreciate the actions by some states, including Oregon, Washington, Hawaii, and , to use limited state resources to extend health coverage to the community.

To honor the spirit of the Compacts of Free Association and rectify a legislative mistake made nearly 25 years ago, Congress must restore Medicaid eligibility for COFA residents.

Sincerely,

Asian & Pacific Islander American Health Forum Association of Asian Pacific Community Health Organizations

DRAFT

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The Health Equity and Access under the Law (HEAL) for Immigrant Women and Families Act of 2019

What is the Problem? As the Trump Administration continues to limit access to affordable, comprehensive health insurance and attacks immigrants’ rights, the health, safety, and wellbeing of immigrants and their families are in jeopardy. The five-year bar on Medicaid and CHIP enrollment, in addition to other restrictions, mean that immigrants must navigate a complicated patchwork of care that often forces them to pay out-of-pocket for basic health care.

These onerous barriers disproportionately harm immigrant women, who are the majority of immigrants and particularly likely to be low-income, young, and uninsured. According to the Guttmacher Institute, one-third of noncitizen immigrant women ages 15-44 are uninsured. For women in that group who are also low income, that proportion grows to almost half.1 Obtaining healthcare is not a reality for these women if it is not affordable.

Now more than ever, the basic human needs and rights of the nation’s immigrants must be elevated in policymaking.

What does the HEAL for Immigrant Women & Families Act of 2019 do? The Health Equity & Access under the Law (HEAL) for Immigrant Women & Families Act of 2019 removes political interference and restores coverage so immigrants in the United States can participate in the health care programs their tax dollars support. By ensuring that all immigrants can access affordable coverage for which they are otherwise eligible, this bill will allow immigrant women and their families to receive the health care they need, and create healthier communities and a stronger economy. Specifically, the bill:

• Restores enrollment to full-benefit Medicaid and the Children’s Health Insurance Program (CHIP) to all federally authorized immigrants who are otherwise eligible. The bill removes the discriminatory legal barriers to health coverage for immigrants imposed by the Personal Responsibility and Work Opportunity and Reconciliation Act (PRWORA). Specifically, the bill eliminates that 1996 law’s restrictive five-year waiting period and outdated list of “qualified” immigrants for Medicaid and CHIP eligibility. Through these changes, the bill ensures all individuals granted federally authorized presence, including Deferred Action for Childhood Arrivals (DACA) recipients, are eligible for federally funded health care programs.

• Removes the unjustifiable exclusion of undocumented immigrants from accessing health insurance coverage on the Affordable Care Act’s Health Insurance Exchanges. The bill would allow all individuals’ immediate eligibility to purchase qualified health insurance coverage, obtain premium tax credits and cost-sharing reductions, and enroll in the Basic Health Program, in accordance with existing income eligibility requirements. This access would be available for everyone, regardless of their documentation or status.

• Ensures access to public and affordable health coverage for Deferred Action for Childhood Arrivals (DACA) recipients, and ensures that those who will gain new forms of administrative relief via a deferred action program will not be similarly excluded from the health care programs their tax dollars support.

• Reinstates Medicaid eligibility for COFA migrants, or citizens of the Republic of the Marshall Islands, Federated States of Micronesia, and the Republic of Palau, who were inadvertently barred from the Medicaid program by the 1996 welfare law. Compact of Free Association (COFA), an international agreement between the US and these three Pacific Islands, originally allowed their citizens to receive federally funded health care coverage.

1 Guttmacher Institute, Immigrant women need health coverage, not legal barriers, December 4, 2018, https://www.guttmacher.org/infographic/2018/immigrant-women-need-health-coverage-not-legal-barriers-0. Low-income women are those in families with incomes under the federal poverty level ($20,420 for a family of three in 2017). Data include some information on undocumented immigrants, although that information is generally acknowledged to be a considerable undercount of that population group.

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Why should you support the HEAL for Immigrant Women & Families Act of 2019? • Health should not depend on immigration status. Every individual deserves to be healthy and to obtain affordable health care with dignity, regardless of how long they have been in the US or the status they have been granted.

• This is important for women and families. When women are healthy, their entire family benefits. Immigrant women are often the decision-makers regarding health care for their families and the backbones of their communities.

• Under current law, immigrants must navigate a complicated patchwork of care that often forces them to pay out-of-pocket for basic health care, particularly if a community health center or employer-sponsored health insurance is not available to them. Obtaining healthcare is not a reality for immigrant women if it is not affordable.

• From threats to health care and nutrition to affordable housing, to separating families at the border and mass deportation, the Trump administration has been relentless in attempting to strip away agency and dignity from immigrant families. In light of these threats and constant attacks, we need bold and impactful legislation that expands access to the basic care that immigrant women and their families need and deserve.

How can you support the HEAL for Immigrant Women & Families Act of 2019? • To cosponsor, contact Stephanie Kang with Rep. Pramila Jayapal: [email protected] or Linda Antinone with Rep. Deb Haaland at [email protected]

53 New Deal for New Americans Act Reps. Grace Meng, Pramila Jayapal, and Jesús G. “Chuy” García

The intent of this bill is to establish the National Office of New Americans, to reduce obstacles to United States citizenship, and to support the integration of immigrants and refugees into the social, cultural, economic and civic life of our shared Nation.

SECTION BY SECTION Section 1: Short Title and Purposes Section 2: Table of contents

Title I: New Americans and Integration Section 101. National Office of New Americans Establishes the National Office of New Americans (NONA) in the Executive Office of the President.

Section 102. NONA Appointments and Functions NONA shall be led by a Director, nominated by the President and confirmed by the Senate, and supported by individuals with expertise in citizenship, inclusion, and workforce. This section lays out the responsibilities and powers of the Director, who would also chair the Federal Initiative on New Americans (FINA). NONA shall promote and support immigrant and refugee integration and inclusion in society; ensure access to U.S. citizenship, quality English language learning and workforce development programs; coordinate the efforts of Federal, State, and local entities to support the effective social, economic, linguistic, and civic integration of immigrants and refugees; and evaluate federal government efforts on integration and report on such to the President and Congress.

Section 103. Federal Initiative on New Americans Chaired by the Director of NONA, the Federal Initiative on New Americans (FINA) would compose of heads of several federal agencies. FINA would work with executive agencies to coordinate a Federal response to address issues that affect the lives of new immigrants and refugees and local communities with growing immigrant and refugee populations, including naturalization and civic engagement, English language learning, adult education, workforce training and economic development; access to legal services and immigration assistance. FINA shall report to Congress on its work, challenges in integration faced by states and localities, its analysis of pending legislation and executive branch policy proposals that impact immigrants and refugees, and policy recommendations to strengthen integration.

Title II: Programs to Promote Citizenship, Integration, and Prosperity Section 200. Sense of Congress Regarding Access to Counsel It is the sense of Congress that due to the complexity of immigration law and the immigration system, any individual subject to proceedings or appeal before an immigration judge or the Attorney General should have the right of being represented by counsel.

Section 201. Legal Services and Immigration Assistance Grants Creates legal services grants for community-based organizations to provide legal assistance, education, outreach, and translation services to immigrants and refugees. Individuals are eligible to receive such services if they are seeking to become a lawful permanent resident or U.S. citizen or is seeking relief from removal. Each grant recipient is required to submit an annual report and evaluation. There are authorized to be appropriated to carry out this section $100,000,000 for fiscal years 2021 and 2022.

Section 202. English as a Gateway to Integration Grants The U.S. Department of Education, in consultation with the Director of NONA, shall award English as a Gateway to Integration grants to private organization, educational institution, community-based or nonprofit organization that provide English instruction to adult English language learners. Such instruction shall support and promote the social, 1

54 economic and civic integration of adult English language learners and their families; equip adult English language learners for ongoing, independent study; and help students develop digital literacy skills. There are authorized to be appropriated to carry out this section $100,000,000 for fiscal years 2021 and 2022.

Section 203. Workforce Development and Prosperity Grants This section includes a declaration of policy that all adults, including immigrants, refugees and others who may not be fully proficient in English, shall have equitable access to education and workforce programs that help them learn basic skills in reading, writing, math and the English language and equip them with occupational skills needed to secure or advance in employment, to fill employer needs, and support themselves and their families.

The U.S. Department of Education (DOE), in consultation with the Director of the National Office of New Americans, shall award Workforce Development and Prosperity grants to state and local governments or other qualifying entities (educational institutions, private organizations, CBOs and nonprofits). Entities eligible to receive a grant: support and promote the economic integration of immigrants and refugees and their families; and have expertise in workforce development and adult education. DOE is required to provide technical assistance grantees on how to provide integrated education and training. Grantees must submit an annual report and evaluation. There are authorized to be appropriated to carry out this section $100,000,000 for fiscal years 2021 and 2022.

Section 204. Appropriations Authorized for Existing Citizenship Grants There are authorized to be awarded by the Department of Homeland Security to public or private nonprofit organizations for the purpose of Citizenship Education and Training an amount not less than $25,000,000.

Section 205. Consideration of Grant Recipients Grants awarded by the Department of Homeland Security shall not require or consider the enrollment in or use by such grant applicants of E-Verify.

Section 206. Establishment of United States Citizenship and Integration Foundation DHS, acting through U.S. Citizenship and Immigration Services and in coordination with National Office of New Americans, is authorized to establish a nonprofit corporation which shall be known as the “United States Citizenship and Integration Foundation.”

Section 207. Gifts to the Foundation The Foundation may solicit, accept, and make gifts of money and other property and accept, hold, administer, invest, and spend any gift, devise, or bequest of real or personal property made to the Foundation.

Section 208. Purposes The purposes of the Foundation are to spur innovation in the promotion and expansion of citizenship preparation programs for lawful permanent residents; to evaluate and identify best practices in citizenship promotion and preparation and to make recommendations about how to bring such best practices to scale; to support direct assistance for noncitizens seeking lawful permanent resident status or citizenship; and to coordinate immigrant integration with state and local entities.

Section 209. Authorized Activities This section enumerates the authorized activities of the Foundation and includes the awarding of grants to state and local governments and other qualifying entities.

Section 210. Council of Directors Establishes membership of the Council of Directors of the Foundation.

Section 211. Powers This section lays out the powers of the Executive Director of the Foundation. 2

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Section 212. Effective Date The Foundation shall be established and operational within 12 months of enactment of this Act.

Section 213. Authorization of Appropriations There is authorized to be appropriated for the first two fiscal years $10,000,000 to establish the Foundation and the pilot program described in the next section. Thereafter the Foundation’s activities shall be paid for out of the investments made and the gifts and property received by the Foundation.

Section 214. Pilot Program to Promote Immigrant Integration at State and Local Levels The Chief of the U.S. Citizenship and Immigration Services’ Office of Citizenship, in coordination with the National Office of New Americans, shall establish a pilot program for state and local governments or collaborations with State and local governments to support the integration of immigrants and refugees, with or without New Immigrant Councils. This section lays out requirements for the grant application, the priorities for awarding grants including matching funds, and the activities authorized under the grant. New American Councils shall consist of between 15 and 19 individuals from business, faith-based organizations, civic organizations, philanthropic organizations, nonprofit organizations, key education stakeholders, state adult education offices, public libraries and state or local governments and meet at least once each quarter. Grantees may provide subgrants and/or develop and carry out a comprehensive plan to integrate new immigrants through improving English language skills, engaging caretakers in their child’s education, expanding access to workforce training, etc. Grantees shall also submit an annual report and evaluation.

Title III: Reducing Barriers to Citizenship Section 301. Immigration Service Fees This section directs USCIS to retain application fees as of the date of introduction of this Act and change fees only in accordance with the new criteria in this section. INA Section 286(m) is revised to make clear that USCIS may, but not must, set fees to cover all direct and indirect costs of processing applications. USCIS is required to submit any cost and fee study to the House and Senate Judiciary Committees 60 days before publishing proposed fee changes in the Federal Register. Such study shall detail costs in adjudications, including direct, indirect, overhead, enforcement and national security costs. It shall also identify the costs allocable to providing premium processing services to business customers, the extent to which fees charged for such processing is set at a level that recovers those costs and the amount that is allocated for improvements in adjudications and customer-service.

Immigration fees cannot be used for the civil revocation of naturalization, ‘Operation Second Look’, ‘Operation Janus’, for enforcement activities of ICE, CBP or HSI or any other activity that is not directly related to adjudications for immigration benefits.

It is the Sense of Congress that fees should cover direct costs of processing an application and that indirect costs should be covered through appropriations pursuant to authorizations granted in this section. Congress should also appropriate to DHS funds to cover the adjudication of refugee and asylum processing, the costs of administering the Systematic Alien Verification for Entitlements (SAVE) Program, the adjudication of naturalization applications not covered in full by the fees paid by applicants, the reduction or elimination of fees granted to fee waiver applicants; and grants to public and private nonprofits for the purposes of citizenship and training.

DHS shall report to Congress on a quarterly basis a report on backlogs and delays in when processing times exceed USCIS’ stated processing goals.

Fee waivers are made available for all benefits applications (except employment-based petitions and those associated with premium processing) according to the following: where an applicant has an income of less than 150 percent of the Federal poverty line, no fee shall be charged. Where an applicant has an income that is less than 250 percent of the Federal poverty line, not more than 50 percent of the applicable fee shall be charged. In the case of an applicant suffering financial hardship due to extraordinary expenses to the degree that he or she is unable to pay the fee, no fee shall be 3

56 charged. DHS is also required to accept the applicant’s receipt of a means-tested benefit as proof of eligibility for a fee waiver.

Authorized are such sums as are necessary to cover the amount equal to the difference between the fees collected and the cost of providing the immigration services and such sums as may be necessary to carry out the reports authorized in this section.

Section 302. Reduce Financial Obstacles to Naturalization The Secretary of Homeland Security shall impose a fee of no more than $50 for the consideration of an application for naturalization.

Section 303. Waiver of English Requirement for Qualifying New Americans Amend the English and civics requirements for naturalization to exempt: individuals based on a physical, developmental or mental impairment; individuals over 65 years who has lived in the U.S. as an LPR for at least five years; individuals over 60 years of age who have lived in the U.S. as an LPR for at least 10 years; individuals over 55 years of age who have lived in the U.S. as an LPR for at least 15 years; Individuals over 50 years of age who have lived in the U.S. as an LPR for at least 20 years.

Section 304. Naturalization for Certain United States High School Graduates LPR students will be deemed to have satisfied the English and civics requirements if they graduated from a high school in the U.S.

Section 305. Family Integration Reduce the age of citizens who are able to petition eligible family members from 21 years old to 18 years old.

Section 306. Revision of Grounds of Deportation “Public charge” is eliminated as a ground for deportation.

Section 307. Waiver to Ensure Access to Citizenship Establish a waiver for false claims to citizenship.

Section 308. Naturalization Ceremonies Requires the Chief of the Office of Citizenship to increase awareness of naturalization ceremonies and to report to Congress the progress made.

Section 309. National Citizenship Promotion Program Establishes the “Proud to be a U.S. Citizen Program” by conducting outreach to and education of eligible lawful permanent residents to encourage them to apply for citizenship; issuing public service announcements, paid advertising, and other media to promote citizenship; information about where to get free or low-cost assistance to apply for naturalization and to prepare for the English and civics exams. Ten million dollars are authorized to carry out this section.

Section 310. Mission of United States Citizenship and Immigration Services The mission of USCIS shall read, “USCIS secures America’s promise as a nation that welcomes immigrants and refugees by providing accurate and useful information to our customers, granting humanitarian, immigration and citizenship benefits, promoting an awareness and understanding of citizenship, and ensuring the integrity of our immigration system.”

Section 311. Automatic Registration of Eligible Individuals Mandates the automatic registration, through a system established between state and local election boards and DHS, of newly naturalized U.S. citizens to vote if they affirmatively choose to be registered to vote. Incorporates protections from prosecution of individuals ineligible to vote but automatically registered to vote in error. DHS is prohibited from collecting, retaining or disclosing information--except to State election officials—information related to an individual’s decision 4

57 register to vote or not. Election officials are prohibited from publicly disclosing sensitive voter information or any information not necessary to voter registration.

Section 312. Department of Homeland Security Assistance in Registration This section outlines specific instructions on the role of DHS in automatic registration and how it is carried out.

Section 313. Voter Protection and Security in Automatic Registration This section protects individuals who were erroneously registered to vote and prohibits public disclosure of sensitive voter information.

Section 314. Effective Date Sections 311, 312, and 313 shall go into effect beginning January 1, 2021.

Section 315. Authorization of Appropriations There is authorized to be appropriated such sums as may be necessary to carry out this Act.

Title IV: Refugee Resettlement and Integration Section 401. Minimum Number of Refugees to be Admitted Mandates that beginning in 2019, the Presidential Determination on Refugee Admissions shall be set at a number not less than 110,000.

Section 402. Pre-Arrival English Language and Work Orientation Training for Approved Refugee Applicants Directs the Department of State to establish overseas refugee training programs, including English as a Second Language classes and work orientation training, for those refugees approved to be admitted to the United States. These programs would need to occur within the normal refugee processing times and not delay the departure of refugees who have been approved to go to the United States. A GAO report is mandated to study the implementation of this section.

Section 403. Update of Reception and Placement Grants Requires that the Department of State, when setting the amount of Reception and Placement Grants, adjust the grant amount to account for initial refugee resettlement needs, including amounts for inflation and costs of living. In addition, this section requires the Department of State to ensure that funding is provided to national resettlement agencies at the beginning of the fiscal year to serve the initial resettlement needs of refugees.

Section 404. Case Management Establishes a grant program for the creation of a case management system to assist refugees in accessing services and benefits for which they are eligible. Case management would generally be available to refugees from the time they are eligible for resettlement assistance until one year after they are no longer eligible to receive resettlement assistance. In exceptional circumstances, case management can be provided for up to three years after refugees are no longer eligible to receive resettlement assistance.

Section 405. Increase in Cash Payments Requires the Office of Refugee Resettlement to provide a minimum of twelve months of cash payments, subject to available appropriations.

5

58 The New Deal for New Americans Act has been endorsed by the following organizations and individuals:

• National Partnership for New Americans (NPNA) • Make the Road • Academy of Medical & Public Health Services • Massachusetts Immigrant and Refugee Advocacy Coalition • Alabama Coalition for Immigrant Justice • Mayor , • America's Voice • Mayor Jacob Frey, , Minnesota • Arkansas Coalition of Marshallese • Mayor Jenny A. Durkan, Seattle, Washington • Arkansas United • Mayor Lori E. Lightfoot, Chicago, Illinois • Asian Pacific American Labor Alliance • Mayor Melvin Carter, City of Saint Paul, Minnesota • Association of Asian Pacific Community Health Organizations • Mayor Robert Garcia, Long Beach, California • Campaign-Urbana Public Health District • Mayor Sylvester Turner, Houston, Texas • CASA • Mayor Tim Keller, City of Albuquerque, New Mexico • Causa • Mayor’s Office, , Colorado • Center for Popular Democracy • Mi Familia Vota • Church World Service • Michigan United • Coalition for Human Immigrant Rights • Mobile Pathways • Colorado Immigrant Rights Coalition • Montana Organizing Project • Colorado People’s Alliance • Movement of Immigrants in America • Commissioner Pete Gerken, Lucas County, Ohio • National Korean American Service & Education Consortium • Commissioner Tina Wozniak, Lucas County, Ohio • Nebraska Appleseed • Community Change • NETWORK Lobby • Comunidades Unidas • New American Leaders • Consejo de Federaciones Mexicianas • Alliance for Immigrant Rights • Crossways Consulting • New York Immigration Coalition • El Centro de Igualdad y Derechos • Office of Immigrant and Refugee Affairs, City of Albuquerque • Fair Immigration Reform Movement • OneAmerica • Farmworker Justice • Pennsylvania Immigration and Citizenship Coalition • Florida Immigrant Rights Coalition • People’s Action • Georgia Latino Alliance for Human Rights • Pineros y Campesinos Unidos del Noroeste • Global Cleveland • Pious Ali, City Councilor At-Large, Portland, Maine • Global Detroit • Progressive Leadership Alliance of Nevada • Greater Portland Immigrant Welcome Center • Promise Arizona • Healthy Illinois Campaign • River City Federal Credit Union • HIAS Pennsylvania • Rural Women's Health Project • Hispanic Interest Coalition of Alabama • Services, Immigrant Rights, and Education Network • Homies Unidos • Somos Un Pueblo Unido • Idaho Community Action Network • SPLC Action Fund • Illinois Coalition for Immigrant and Refugee Rights • Sunflower Community Action • Immigration Hub • Tennessee Immigrant and Refugee Rights Coalition • IMPRINT • The Legal Clinic (Justice for Our Neighbors Hawaii) • International Council for Refugees and Immigrants • The Next100 • International Rescue Committee • The Resurrection Project • Iowa Citizens for Community Improvement • Treetops Collective • James F. Kenney, Philadelphia, Pennsylvania • UnidosUS • Junta for Progressive Action • Unite Oregon • Justice for Our Neighbors - Michigan • United Farm Workers Foundation • Kentucky Refugee Ministries • Voces de la Frontera • Latin American Coalition • WashingtonCan! • Lutheran Immigration and Refugee Service • We Are All America • Madeline Rogero, Knoxville, Tennessee • Workers Defense Project • Maine People’s Alliance • World Education Services

59 CONNECT for Health Act of 2019

Sens. Schatz (D-HI), Wicker (R-MS), Cardin (D-MD), Thune (R-SD), Warner (D-VA), & Hyde-Smith (R-MS) and Reps. Thompson (D-CA), Welch (D-VT), Schweikert (R-AZ), & Johnson (R-OH) The CONNECT for Health Act of 2019 promotes higher quality of care, increased access to care, and reduced spending in Medicare through the expansion of telehealth services.

Quick Facts Bill Summary

Numerous studies on telehealth—the use of Sec. 1 – Table of contents. telecommunications technologies to furnish Sec. 2 – Findings and sense of Congress. health care services remotely and in real-time Sec. 3 – Provides the HHS Secretary authority to waive telehealth restrictions when certain criteria are met. —have shown benefits for quality of care, Sec. 4 – Removes geographic restrictions and adds the access to care, and reduced spending. [1] home as an originating site for mental health services. Telehealth increases access to care in areas Sec. 5 – Removes geographic restrictions on certain with workforce shortages and for individuals originating sites for emergency medical care services. who have barriers to accessing care. Sec. 6 – Requires CMS’ process to add telehealth However, current statutory restrictions—such services to better consider how telehealth can improve as geographic and originating site access to care. Sec. 7 – Removes geographic restrictions on Federally requirements that only permit beneficiaries to qualified health centers (FQHCs) and rural health clinics receive telehealth services if they are in (RHCs) and allows FQHCs and RHCs to furnish certain rural areas and at certain clinical sites— telehealth services as distant sites. create barriers that limit the use of telehealth Sec. 8 – Removes the geographic and originating site in Medicare. restrictions for facilities of the Indian Health Service or These restrictions result in low utilization of Native Hawaiian Health Care Systems. telehealth—only 0.25 percent of Medicare Sec. 9 – Allows for the waiver of telehealth restrictions during national and public health emergencies. beneficiaries use telehealth services. [2] Sec. 10 – Allows for the use of telehealth in the Several provisions of the CONNECT for recertification of a beneficiary for the hospice benefit. Health Act of 2017 were enacted in the Sec. 11 – Clarifies that the provision of technologies to a Bipartisan Budget Act of 2018, and CMS has Medicare beneficiary for the purpose of furnishing also made advances in covering remote services using technology is not considered patient monitoring services and other virtual “remuneration” under fraud and abuse laws. services. Sec. 12 – Requires MedPAC to study how different payers cover the home as an originating site and what The CONNECT for Health Act of 2019, based services would be suitable for the home to be an on extensive input from stakeholders across originating site under Medicare. the health care system, aims to build on these Sec. 13 – Requires an analysis of the impact of telehealth successes to further advance the use of waivers in CMS Innovation Center models. telehealth in Medicare. Sec. 14 – Authorizes a model to test allowing additional health professionals to furnish telehealth services. [1] https://www.cchpca.org/resources/research-catalogues Sec. 15 – Encourages the CMS Innovation Center to test [2] https://www.cms.gov/About-CMS/Agency- Information/OMH/Downloads/Information-on-Medicare-Telehealth-Report.pdf telehealth models in Medicare. 60 Endorsed by over 120 organizations

AARP Healthcare Leadership Council ACT | The App Association Hillrom Advanced Medical Technology Association InHome Healthcare Services Alliance for Aging Research InSight Telepsychiatry Alliance for Connected Care Intel Alliance for Home Dialysis International OCD Foundation Alzheimer's Foundation of America InTouch Health AMDA Society for Post-Acute and Long-Term Care Medicine The Jewish Federations of North America America’s Essential Hospitals Kaiser Permanente American Academy of Audiology Lanai Community Health Center American Academy of Hospice and Palliative Medicine LeadingAge American Academy of Neurology LeadingAge Center for Aging Services Technologies American Academy of Sleep Medicine Lincare American Association for Respiratory Care Medical Group Management Association American Association of Diabetes Educators Michigan Medicine American Association of Neurological Surgeons National Alliance on Mental Illness American College of Emergency Physicians National Alliance to Advance Adolescent Health American College of Preventive Medicine National Association for Healthcare Quality American Group Psychotherapy Association National Association for Home Care & Hospice American Heart Association National Association for Rural Mental Health American Hospital Association National Association for the Support of Long Term Care American Medical Association National Association of ACOs American Medical Group Association National Association of Community Health Centers American Medical Rehabilitation Providers Association National Association of Rural Health Clinics American Nurses Association National Council for Behavioral Health American Occupational Therapy Association National Council of State Boards of Nursing American Osteopathic Association National Health Care for the Homeless Council American Physical Therapy Association National Health IT Collaborative for the Underserved American Psychiatric Association National MS Society American Psychological Association National Partnership for Hospice Innovation American Society of Nephrology National Register of Health Service Psychologists American Speech-Language-Hearing Association Nemours Children's Health System American Telemedicine Association NewYork-Presbyterian American Well No Health without Mental Health America's Health Insurance Plans NTCA-The Rural Broadband Association Anxiety and Depression Association of America OCHIN Association for Behavioral Health and Wellness Ochsner Health System Association for Executives in Healthcare Information Applications Oliver Wyman's Health & Life Sciences Association for Executives in Healthcare Information Technology Otsuka America Pharmaceutical Association of Asian Pacific Community Health Organizations Personal Connected Health Alliance Blue Cross Blue Shield Association Pillsy BluePath Health Providence St. Joseph Health Center for Telehealth and e-Health Law Public Health Institute Centerstone PursueCare Children’s Health Remote Cardiac Services Provider Group Children's Health Fund Schizophrenia and Related Disorders Alliance of America Children's National Hospital Strategic Health Innovation Exchange Collaborative CICONIX Teladoc Health Cleveland Clinic Health System Telecommunications Industry Association College of Healthcare Information Management Executives Texas Health Information Management Association Congress of Neurological Surgeons The MAVEN Project Connected Health Initiative Third Way Connected Home Living TouchPointCare Depression and Bipolar Support Alliance Tourette Association of America E-Consult Workgroup Treatment Communities of America Electronic Health Record (EHR) Association United Spinal Association Federation of American Hospitals University of Hawaii System Federation of State Medical Boards University of Mississippi Medical Center, Center for Telehealth FreeState Connect University of Virginia, Center for Telehealth Global Partnership for Telehealth UPMC Health System GO2 Foundation for Lung Cancer Wisconsin Hospital Association Health Innovation Alliance CONNECT forZip noHsis ealth Act of 2019 Healthcare Association of Hawaii 2020 Mom Healthcare Information and Management Systems Society (HIMSS) Please contact Meghan O’Toole 61 (meghan_o’[email protected]) with questions.

October 2019 | Issue Brief

Impact of Shifting Immigration Policy on Medicaid Enrollment and Utilization of Care among Health Center Patients

Jennifer Tolbert, Olivia Pham, and Samantha Artiga

Executive Summary On August 14, 2019, the Trump administration published a final rule to broaden the programs the federal government will consider in public charge determinations to include Medicaid coverage for non-pregnant adults and certain previously excluded nutrition and housing programs. To learn about the possible early effects of the public charge rule and other immigration policies on patients at community health centers, this brief draws on interviews and survey data to capture health center directors’ and staff’s perceptions of changes in coverage and service use among their patients who are immigrants. Key findings include:

 Health centers reported that, in recent months, immigrant patients have declined to enroll or reenroll themselves and/or their children in Medicaid for fear of public charge. At some health centers interviewed, these changes were widespread with many patients dropping Medicaid while at others, the changes were occurring among only a small number of patients. Respondents noted those dropping Medicaid include immigrants not subject to the public charge rule, such as pregnant women.  Health center respondents reported patients are confused about the new rule and are afraid to provide identifying information. Patients are not sure which programs the new rules apply to and who is subject to them. Respondents also noted immigrant patients are hesitant to provide any identifying information that could jeopardize their status.  According to respondents, the public charge rule is creating a “chilling” effect, leading to decreased enrollment in other programs not subject to public charge. Health centers reported that in addition to declining to sign up for Medicaid, patients are also not signing up for WIC and other state and local food assistance programs which are not subject to the public charge rule.  About half of health centers reported a drop in utilization by immigrant patients, especially among pregnant women. They noted declines in use of services by patients with chronic conditions, such as diabetes and HIV, and those needing preventive care. Health centers expressed particular concerns regarding pregnant women, who they say are initiating prenatal care later in pregnancy and are attending fewer prenatal care visits due to fears around public charge.  Health centers are training staff to answer questions on public charge and are working to ensure access to care for their patients. Some respondents said they are now providing home visits and free medication delivery to ensure their patients continue to get care.

62 Introduction Since taking office, the Trump Administration has implemented a range of policy changes focused on enhancing immigration enforcement and limiting immigration. Most recently, on August 14, 2019, the administration published a final rule to change “public charge” policies that govern how the use of public benefits may affect individuals’ ability to enter the U.S. or adjust to legal permanent resident (LPR) status (i.e., obtain a “green card”). The rule, which was proposed in October 2018, broadens the programs that the federal government will consider in public charge determinations to include previously excluded health, nutrition, and housing programs, including Medicaid coverage for non-pregnant adults for a wide range of health care needs. The rule will likely lead to decreased enrollment in Medicaid, CHIP, and other programs broadly among immigrant families, beyond individuals directly impacted by the rule. Prior to this final rule, there were growing reports of individuals disenrolling or choosing not to enroll themselves or their children in Medicaid and CHIP due to growing fears and uncertainty stemming from the shifting immigration policy environment.1 The final rule was scheduled to go into effect on October 15, 2019, but on October 11th a nationwide preliminary injunction was issued, blocking implementation.

Community health centers are often on the front lines of policy changes affecting Medicaid coverage. They serve a diverse, predominantly low-income patient population, including low-income immigrants in many communities, and nearly three-quarters of health center patients are covered by Medicaid or are uninsured. Given their role serving immigrant families, the experiences of health centers and their patients can provide early insight into the potential effects the public charge rule and other immigration policies are having on health coverage and use of services by immigrant patients.

To learn about these possible early effects, this brief draws on interviews and survey data to capture health center directors’ and staff’s perceptions of changes in coverage and service use among patients who are immigrants. It relies on interviews with 16 directors and senior staff at health centers in four states—California, Massachusetts, Missouri, and New York-- conducted in September 2019, after the final public charge rule was issued. The interviews asked about perceived trends in health coverage of immigrant patients and their families as well as changes in utilization of health care and social services. It also includes results from the 2019 KFF/George Washington University Community Health Center Survey about perceived changes in Medicaid enrollment and health care use among immigrant patients and their families. The survey of staff from 511 health centers was fielded from May through July 2019, after the administration had released the proposed rule to make changes to public charge policy but prior to it being finalized.

Key Findings CHANGES IN MEDICAID ENROLLMENT Based on findings from the health center survey, nearly half (47%) of health centers reported that many or some immigrant patients declined to enroll themselves in Medicaid in the past year (Figure 1). In addition, nearly one-third (32%) said that many or some immigrant patients disenrolled from or declined to renew Medicaid coverage. Health centers also report enrollment declines among children in

Impact of Shifting Immigration Policy on Medicaid Enrollment63 and Utilization of Care among Health Center Patients 2 immigrant families. More than a third of (38%) health centers reported that many or some immigrant patients were declining to enroll their children in Medicaid over the past year, while nearly three in ten (28%) reported many or some immigrant patients were disenrolling or deciding not to renew Medicaid coverage for their children.

Follow-up interviews with health center staff are consistent with these survey findings of declining Medicaid enrollment among immigrant patients and their families. Staff at all health centers reported that, in recent months, immigrant patients have declined to enroll or reenroll themselves and/or their children in Medicaid. Health centers do not collect data on immigration status of patients, so these observations (as well as the survey results) are based on health centers’ perceptions of who they believe to be immigrant families using available information. Immigrant families generally view health center staff as a trusted resource, and in turn, are willing to discuss their immigration status with these staff and clinicians. In addition, enrollment staff who assist patient in applying for Medicaid and other coverage have access to this information as part of the application process. At some health centers interviewed, these changes were widespread with many patients dropping Medicaid while at others, the changes were occurring among only a small number of patients. Health center directors at two health centers cited shifts in their payer mix data, with the share of uninsured health center patients increasing, as possible evidence of these changes. Others cited data and information reported by frontline enrollment staff. Even health center directors who noted few patients at their health centers were dropping coverage recounted conversations they had with patients who declined to enroll in Medicaid. Health centers serving smaller shares of immigrant patients were more likely to report that only a few patients were choosing not enroll in Medicaid.

Impact of Shifting Immigration Policy on Medicaid Enrollment64 and Utilization of Care among Health Center Patients 3 Our patient navigation team which is multilingual and multiethnic used to work with upwards of 10 people a day to get them signed up for coverage… men, women, children, etc. Now they’re down to 2 to 3 clients a day if they’re lucky. (Health Center CEO, MO)

Our insurance companies… we have Healthfirst at all of our sites to enroll folks. And they’re seeing that folks aren’t re-enrolling. They’re actually coming up to our sites to do a public charge information session for all the folks because they’re seeing disenrollments. (Health Center President, NY)

We had one lady who came in and she said, ‘I’m going to apply for my children because they are citizens, but I’m not, so I am not going to apply.’ (Intake/Outreach Supervisor, MA)

According to health center interview respondents, immigrant patients are confused by the new rules and many are receiving misinformation. All respondents reported confusion among their immigrant patients over new the new rules. They said patients are asking questions of health center staff and noted that many patients are not sure which programs the new rules apply to and who is subject to them. Based on reports from patients and their own conversations with advocates and the legal community, several health center directors noted that some of the confusion stems from some immigration lawyers advising clients to avoid all public programs and services out of an abundance of caution. At the same time, they also said rumors and misinformation spread quickly through communities. For example, a health center director in California recounted how misinformation was quickly spread through WeChat, a social media and messaging app which is commonly used in the predominantly Asian immigrant community served by the health center.

What we have heard from our staff on the front line, the folks who interface with our patients around the enrollment, they are hearing that people are afraid around disclosing more information about their families who would not even be impacted, but because there’s a lot of misinformation out in the community… they’re not clear in terms of how that’s going to impact them. (Health Center Compliance Officer, CA)

Health center respondents reported that immigrant patients are increasingly afraid to disclose personal information. Interview respondents across all health centers reported that some immigrant patients have become reluctant to disclose any personal information out of fear that the health center would share that information with authorities. This information is necessary not only to assess eligibility for Medicaid and other federal programs, but also for state and local social services programs. According to respondents, the fear stems from multiple sources—fear of deportation among immigrants who lack legal status and fear that sharing any information could jeopardize their or a family member’s efforts to obtain a green card or citizenship.

The reason provided is fear and uncertainty related to immigration and customs enforcement agents potentially showing up and carting them away as they enter or leave the building or the federal government getting the information they provide us. (Health Center President, MO)

Impact of Shifting Immigration Policy on Medicaid Enrollment65 and Utilization of Care among Health Center Patients 4 People are not generally going to feel comfortable providing their name and information, so we’re going to be thoughtful about how we collect that information from our patients, so that we’re not also making them afraid to give information about their own status – we’ll serve them regardless. (Health Center CEO, CA)

Health center interview respondents reported that the patients disenrolling or declining to enroll in Medicaid are a broader group of immigrants than those targeted by the public charge rule. Health center respondents reported that some patients declining to enroll in Medicaid already have Lawful Permanent Status (LPR), and therefore would not be subject to the new public charge rule. They noted these decisions may stem from fear that the patients will lose their current lawful status or that they may be barred from applying for citizenship if they receive any services. Another explanation offered is that these patients are concerned that they will jeopardize the safety or status of a family member. Respondents also reported that patients have expressed concerns that enrolling their children in these programs, even if their children were born in the United States, may jeopardize their status or the status of family members. In addition, although pregnant women are categorically eligible for Medicaid and would be unaffected by public charge if they enroll in Medicaid, health center respondents reported that pregnant women are declining to enroll in Medicaid or disenrolling, in some cases out of fear of risking future opportunities for residency or citizenship.

Approximately 10% of those foreign born women who were pregnant will tell us they do not intend to, they do not want to apply for Medicaid… because they are afraid. Their fears range from being deported, to future opportunities for residency or citizenship. It’s a wide range of things they are afraid of, but ultimately it’s jeopardizing their status. (Health Center Vice President, MO)

Fear of public charge implications extends beyond Medicaid to other health and social service programs, including some that are not included in the public charge rule. In addition to helping patients enroll in Medicaid and other health coverage programs, most health centers also assist patients with enrollment in a range of social service programs, including food and housing assistance programs, job training programs, and education programs. Based on this enrollment assistance experience, some interview respondents reported immigrants are avoiding housing and food assistance programs. While the public charge rule includes some housing assistance programs and the Supplemental Nutrition Assistance Program (SNAP), it does not include other key nutrition programs such as WIC and school lunch. A major concern among respondents was data suggesting that immigrant pregnant women are refusing WIC services. Several respondents noted that their WIC caseloads are down and attributed the trend to public charge fears. Respondents in California and Missouri also noted that immigrant patients are declining to enroll in or accept referrals for state and local food assistance programs, even though these programs are not subject to public charge. A health center serving reported that patients with HIV or AIDS are hesitating to enroll in or are disenrolling from the city-run HIV/AIDS Services Administration (HASA) program out of fear that the program’s services fall under the public charge rule.

Impact of Shifting Immigration Policy on Medicaid Enrollment66 and Utilization of Care among Health Center Patients 5 We began to see a decline in people coming in for their basic health screenings, for nutrition services. Even if they were hungry, they were not telling us, so we had to change. As we saw the WIC numbers [decline]… we started asking questions as part of their visit. (Health Center President, MA)

CHANGES IN HEALTH CARE UTILIZATION According to the survey, nearly three in ten (28%) health centers reported declines among many or some adult immigrant patients in seeking health care in the past year. Over one in five (22%) reported reductions in health care use among some or many children in immigrant families (Figure 2).

The findings from the interviews were consistent with findings from the health center survey about changing utilization among immigrant patients and their families. For example, health center directors in Massachusetts and Missouri described significant drops in utilization as evidenced by an increase in appointment cancellations and no shows by immigrant patients. Another health center director noted that, while their patient base remains strong, patient encounters have declined, so much so that their clinicians are working at only about 80% capacity. At the same time, other health center directors in Massachusetts and Missouri have observed little change in service use by their immigrant patients. A health center director in California said, while they are seeing utilization changes, it is too early to attribute those changes solely to the public charge rule and that other factors, including increased ICE enforcement activities, may be playing a role.

We are extremely worried about the trend we’ve noticed over the last 6-8 months, which is that people are afraid to keep their appointments, to sign up for appointments, to come into the buildings or the

Impact of Shifting Immigration Policy on Medicaid Enrollment67 and Utilization of Care among Health Center Patients 6 various clinical sites and fill out basic paperwork, or even provide their address or ID or other personal information. (Health Center President, MO)

Our overall number of patients we serve remains pretty steady. Our actual encounters have gone down… In the past, say 5 years ago, you couldn’t get an appointment because we were so packed. Now, I would say the majority doctors are 80 percent full. (Health Center President, CA)

Health center interview respondents reported that pregnant women are delaying prenatal care or seeking care less frequently. Nearly all respondents that provide obstetric care noted that immigrant pregnant women are initiating prenatal care later in their pregnancies. They indicated that efforts to educate pregnant women often are insufficient to overcome fears about enrollment and that many women continue to decline to enroll in Medicaid or access care even after being told they are exempt from the public charge rule. Respondents expressed particular concerns about the potential consequences of this trend on health outcomes, noting that it was eroding years of work and progress to encourage pregnant women to access prenatal care early in their pregnancies.

We have a seen a decline in our pregnant visits… insured or otherwise. When we drill down and actually talk to them - “Why did you wait until your sixth month to come in?” they say ,”Oh because I’m afraid.” (Health Center CEO, NY)

Health center directors reported that some of their patients with chronic conditions are foregoing care and others are not getting preventive care. In particular, respondents whose programs offer group sessions for diabetes patients noted a drop in participation in their Spanish-language group sessions. A health center in New York reported a decline in the use of PrEP among their immigrant patients at risk for exposure to HIV. Respondents also suggested that fear of using services may prevent patients with acute care needs from getting care. One respondent pointed out that, during the height of the flu season last winter, visits at an urgent care clinic in California dropped significantly and coincided with rumors related to the public charge rule spreading on social media.

One of the central tenets of diabetes care for example is that, in addition to managing the person’s medical condition, we do group education sessions for them to teach them how to shop healthy, eat healthy… that is critical to the health status outcomes to the diabetes patients. We have seen a steady drop in attendance and participation (Health Center CEO, MO)

This action [public charge] totally undermines the work that we’re trying to do around managing population health. I think when you’re really going to see it is around flu season. (Health Center CEO, CA)

EFFECTS ON HEALTH CENTER PATIENTS, STAFF AND OPERATIONS Health center interview respondents reported their staff are observing increased rates of anxiety and stress-related conditions among their immigrant patients. As a result, behavioral health counselors are getting more requests for counseling and therapy. Respondents also expressed significant

Impact of Shifting Immigration Policy on Medicaid Enrollment68 and Utilization of Care among Health Center Patients 7 worries about the effects on children, describing their pediatric patients as being traumatized by what is happening to their families and in their communities.

The children are terrified… One pediatrician relayed his conversation with a 7-year-old when the mother went outside to take a phone call. The child said, “Can you give something to my mother because she’s afraid all the time. She doesn’t want to let me out…” (Health Center CEO, NY)

Several respondents said they were implementing new protocols and services to ensure the highest need patients continue to receive care despite growing fears. A health center director in Massachusetts reported that case managers will contact the highest risk patients and will arrange for home visits and free delivery of medications if patients are too afraid to come to the clinic. A health center in New York serving a large migrant community sends staff out to farms in rural areas to deliver babies and treat injuries for patients who will not come to the health center or other providers out of fear of jeopardizing their ability to continue working in the US.

They had a person that was severely injured on the farm and they could not get him to go to the hospital because of the fear of going out there… (Health Center President, NY)

Nearly all health center interview respondents said they are training staff, starting with frontline staff, but working through the organization to include clinicians and others, to ensure they understand the new rules and can respond accurately to patient questions. Respondents operating large programs noted the difficulty associated with training all staff and worried about patients potentially getting conflicting information from different staff, which could possibly lead to an erosion of trust between the patient and the health center. At the same time, several respondents voiced concerns over the effect of the challenging environment facing immigrants on their staff, many of whom are immigrants themselves and live in the communities served by the health centers.

We can’t get information out fast enough to alleviate the fears. Just getting our own staff trained to understand all the nuances of this, it’s incredibly difficult. (Health Center President, CA)

Giving staff lists on what public benefits are impacted, frequently asked questions so they can orient both the patients and they can orient themselves on what they can tell our patients and not continue the fear and chill factor that we’re seeing. We’re also going to do trainings with our HSF folks, the frontline level staff so they feel comfortable responding to these questions. (Health Center Compliance Officer, CA)

Several health center interview respondents reported the decline in patients covered by Medicaid combined with an increase in the number of uninsured patients and an overall drop in patient visits has led to revenue losses. For some, the revenue declines have been manageable, but two respondents reported experiencing operating losses this year that they attribute to immigration policies. A respondent in Missouri noted that as patients drop Medicaid and move onto the sliding fee scale, they often struggle to make those payments, increasing financial pressures on the families and on the health

Impact of Shifting Immigration Policy on Medicaid Enrollment69 and Utilization of Care among Health Center Patients 8 center. Respondents were clear in noting that not all of these effects are attributable solely to the public charge and that there are multiple factors.

Because of what’s going on and the reluctance of people to sign up for Medicaid even when they are fully eligible… they are switching to self-pay. That means that percentage of self-pay is going up. That hits our bottom line. If the [percentage of] self-pay comes up to 50 percent, you know your health center is suffering financially... We’re not making enough to pay our own bills. (Health Center CEO, MO)

My revenue is down so significantly because… the lack of reenrollment for Medicaid benefits and uptick in uninsured visits is one-to-one. What we realized is that … patients are coming in, but they’re not coming in and using their Medicaid benefits. (Health Center CEO, NY)

Conclusion Consistent with other recent research, these findings reporting the perceptions and experiences of community health centers suggest that shifting immigration policies are leading to decreased participation in Medicaid among some immigrant families and their children who use services at community health centers. Health center directors and staff reported that declines in Medicaid coverage are occurring broadly among immigrant patients and their children, beyond those targeted by the public charge rule and including those who are explicitly exempt, such as pregnant women. These findings also indicate that growing fear and uncertainty among immigrant families in response to shifting immigration policy are contributing to declines in health care use among some immigrant patients and their families, including among pregnant women. Decreased coverage and declines in health care use could have a negative impact on the health and well-being of families and children, and will likely have longer-term consequences. Moreover, these changes carry the potential for broader, community-wide implications as decreases in coverage increase financial strain on health centers, thereby adding to challenges to providing care.

Impact of Shifting Immigration Policy on Medicaid Enrollment70 and Utilization of Care among Health Center Patients 9 Methods

The findings in this brief are based on structured phone interviews with health center directors and senior staff conducted by Kaiser Family Foundation in four states: California, Massachusetts, Missouri, and New York. In total, we conducted interviews with 16 health centers across the four states—two each in California, Massachusetts, and Missouri, and ten in New York. Health centers were selected to represent a mix of characteristics, including location in urban vs. rural areas, size, and share of immigrant patients served. The health centers’ patient populations ranged in size from 15,000 - 91,000 total patients and estimates of immigrant patients served ranged from 10% to over 80%. The interviews were conducted in September 2019.

The brief also reports findings from the 2019 Kaiser Family Foundation/George Washington University Survey of Community Health Centers. The survey was designed and analyzed by researchers at KFF and GWU, and conducted by the Geiger Gibson Program in Community Health Policy at GWU. It was fielded from May to July 2019 and was emailed to 1,342 CEOs of federally funded health centers in the 50 states and the District of Columbia identified in the 2017 Uniform Data System. The response rate was 38%, with 511 responses from 49 states and DC.

Additional support for the survey was provided by the RCHN Community Health Foundation as part of its ongoing research collaborative with the Geiger Gibson Program.

2019 Survey of Community Health Centers (Questions 1-15 and 17-34 reserved for future release)

Q16. Over the past year, has your health center noticed any of the following among your immigrant patients and their family members?

Please indicate whether the following have been seen among many patients, some patients, a few patients, no patients, not applicable, or don’t know.

Patients who refuse to enroll in Medicaid for themselves Patients who refuse to enroll in Medicaid for their children Patients who disenroll or refuse to renew their own Medicaid coverage Patients who disenroll or refuse to renew Medicaid coverage for their children A reduction in the number of adult patients seeking care from the health center A reduction in the number of patients seeking care for their children from the health center

Impact of Shifting Immigration Policy on Medicaid Enrollment71 and Utilization of Care among Health Center Patients 10 Endnotes

1 Samantha Artiga and Petry Ubri, Living in an Immigrant Family in America: How Fear and Toxic Stress are Affecting Daily Life, Well-Being, & Health, (Washington, DC: Kaiser Family Foundation, December 2017), https://www.kff.org/disparities-policy/issue-brief/living-in-an-immigrant-family-in-america-how-fear-and-toxic- stress-are-affecting-daily-life-well-being-health/; Samantha Artiga and Barbara Lyons, Family Consequences of Detention/Deportation: Effects on Finances, Health, and Well-Being (Washington, DC: Kaiser Family Foundation, September 2018),https://www.kff.org/disparities-policy/issue-brief/family-consequences-of-detention-deportation- effects-on-finances-health-and-well-being/; and Hamutal Bernstein, Dulce Gonzalez, Michael Karpman, and Stephen Zuckerman, With Public Charge Rule Looming, One in Seven Adults in Immigrant Families Reported Avoiding Public Benefit Programs in 2018, (Washington, DC: Urban Institute, May 2019), https://www.urban.org/urban-wire/public- charge-rule-looming-one-seven-adults-immigrant-families-reported-avoiding-public-benefit-programs-2018

Impact of Shifting Immigration Policy on Medicaid Enrollment72 and Utilization of Care among Health Center Patients 11 ASSOCIATION OF ASIAN/PACIFIC COMMUNITY HEALTH ORGANIZATIONS DRAFT STATEMENT OF FINANCIAL POSITION September 30, 2019

ASSETS

CURRENT ASSETS Cash and cash equivalents $ 383,826 Receivables Direct federal awards 505,889 Contracts 211,253 Foundation grants 50,000 Membership fee, net of allowance 33,521 Receivable from APPEAL 649 Other 8,524

Total Receivables 809,836

Prepaid expenses 17,114

Total current assets 1,210,775

FIXED ASSETS Office equipment 23,529 Less: accumulated depreciation (23,529)

-

DEPOSITS 19,705

Total Assets $ 1,230,479

LIABILITIES AND NET ASSETS

CURRENT LIABILITIES Accounts payable $ 473,411 Contracts payable to member organizations 61,960 Accrued vacation 45,763 Other accrued liabilities 30,395

Total Current Liabilities 611,529

NET ASSETS Without Donor Restrictions Undesignated 186,645 Designated by Board for Endowments -

Total Net Assets without Donor Restrictions 186,645

With Donor Restrictions Purpose Restricted 432,305 Perpetual in nature -

Total Net Assets with Donor Restrictions 432,305

Total net assets 618,950

Total Liabilities and Net Assets $ 1,230,479 73 ASSOCIATION OF ASIAN/PACIFIC COMMUNITY HEALTH ORGANIZATIONS DRAFT STATEMENT OF FUNCTIONAL EXPENSES For the Year Ended September 30, 2019

Program Services Public Management Education and General Total Expenses Salaries 642,706 157,440 223,835 1,023,981 Payroll taxes and fringe benefits 104,623 25,077 110,587 240,287 Subcontractors 492,340 - - 492,340 Consultants 146,317 48,321 82,519 277,157 Travel 100,213 8,182 34,905 143,299 Conference and seminars 172,541 8,921 23,147 204,609 Printing and publication 1,649 115 3,026 4,789 Rent 11,750 75 87,829 99,654 Supplies 17,642 2,060 16,653 36,356 Telecommunication - - 17,109 17,109 Postage 12,837 - 2,609 15,446 Insurance - - 7,906 7,906 Equipment rental - - 3,864 3,864 Advertising and promotion - 575 1,575 2,150 Publications and subscriptions 5,258 - 14,710 19,968 Dues and membership 750 25 3,814 4,589 Training and development 17,525 - 1,174 18,699 Bad debts - - - - Miscellaneous - - 94 94

Total Expenses $ 1,726,151 $ 250,791 $ 635,356 $ 2,612,297

74 ASSOCIATION OF ASIAN/PACIFIC COMMUNITY HEALTH ORGANIZATIONS DRAFT STATEMENT OF ACTIVITIES For the Year Ended September 30, 2019

Without Donor With Donor Restrictions Restrictions Total

SUPPORT AND REVENUES Support - Federal grants / contracts $ 1,903,812 $ 1,903,812 Foundation and other grant 213,465 150,000 363,465 Donations 2,045 2,045

Total Support 2,119,323 150,000 2,269,323

Revenues Service Fee 188,524 188,524 APPEAL contract - - Memebership dues 235,968 235,968 Interest income 77 77 Other 13,400 13,400

Total Revenue 437,969 - 437,969

Satisfaction of donor restrictions 63,699 (63,699) -

Total Support and Revenue 2,620,991 86,301 2,707,292

EXPENSES Program services: Education 1,726,151 1,726,151 Public relations 250,791 250,791 Supporting services: Management and general 635,356 635,356

Total expenses 2,612,297 - 2,612,297

Change in Net Assets 8,694 86,301 94,994

Net Assets at beginning of year 186,633 346,004 532,637

Net Assets at end of year $ 195,327 432,305 $ 627,631

75 ASSOCIATION OF ASIAN/PACIFIC COMMUNITY HEALTH ORGANIZATIONS STATEMENT OF CASH FLOWS For the Year Ended September 30, 2019

CASH FLOWS FROM OPERATING ACTIVITIES Changes in net assets $ 94,994

Adjustments to reconcile changes in net assets to net cash provided by operating activities: (Increase) decrease in: Receivables Direct federal awards (195,798) Contract (99,926) Membership fee (10,858) APPEAL (242) Other (3,002) Prepaid expenses 17,982 Other assets - Increase (decrease) in: Accounts payable 169,335 Contracts payable to member organizations 61,960 Accrued vacation (5,926) Other accrued liabilities (8,794)

Net Cash used in Operating Activities 19,726

NET INCREASE IN CASH AND CASH EQUIVALENTS 19,726

CASH AND CASH EQUIVALENTS - BEGINNING OF YEAR 364,100

CASH AND CASH EQUIVALENTS - END OF YEAR $ 383,826

76 2017 TAX RETURN

CLIENT COPY

Client: AAPCHO Prepared for: ASSOCIATION OF ASIAN PACIFIC COMMUNITY HEALTH ORGANIZATION 101 CALLAN AVENUE #400 SAN LEANDRO, CA 94577 (510) 272-9536

Prepared by: SUSAN MOSTAJO WUHOOVER & CO LLP 1510 FASHION ISLAND BLVD SAN MATEO, CA 94404 650-212-3888

Date: NOVEMBER 8, 2019

Comments:

DRAFT

Route to:

FDIL2001L 07/05/17 77 2017 Exempt Org. Return prepared for: ASSOCIATION OF ASIAN PACIFIC COMMUNITY HEALTH ORGANIZATION 101 CALLAN AVENUE #400 SAN LEANDRO, CA 94577

WuHoover & Co LLP 1510 Fashion Island Blvd San Mateo, CA 94404 DRAFT

78 WUHOOVER & CO LLP Client AAPCHO 1510 FASHION ISLAND BLVD November 8, 2019 SAN MATEO, CA 94404 650-212-3888

ASSOCIATION OF ASIAN PACIFIC COMMUNITY HEALTH ORGANIZATION 101 CALLAN AVENUE #400 SAN LEANDRO, CA 94577 (510) 272-9536

FEDERAL FORMS

Form 990 2017 Return of Organization Exempt from Income Tax Schedule A Organization Exempt Under Section 501(c)(3) Schedule B Schedule of Contributors Schedule D Schedule D Schedule F Activities Outside U.S. Schedule I Grants and Other Assistance Inside U.S. Schedule J Schedule J Form 8879-EO IRS e-file Signature Authorization

CALIFORNIA FORMS

Form 199 2017 California Exempt Organization Return Schedule B Schedule of Contributors Form 8453-EO California e-file Return Authorization for Exempt Form RRF-1 2018 Registration/Renewal Fee Report

FEE SUMMARY

Preparation Fee DRAFT

79 2017 FEDERAL EXEMPT ORGANIZATION TAX SUMMARY PAGE 1 ASSOCIATION OF ASIAN PACIFIC COMMUNITY HEALTH ORGANIZATION 94-3050247

2017 2016 DIFF REVENUE CONTRIBUTIONS AND GRANTS ...... 2,146,218 1,135,044 1,011,174 PROGRAM SERVICE REVENUE...... 279,015 480,262 -201,247 INVESTMENT INCOME...... 40 37 3 OTHER REVENUE...... 15,641 11,250 4,391

TOTAL REVENUE...... 2,440,914 1,626,593 814,321 EXPENSES GRANTS AND SIMILAR AMOUNTS PAID...... 596,080 433,324 162,756 SALARIES, OTHER COMPEN., EMP. BENEFITS. . . 1,097,240 995,239 102,001 OTHER EXPENSES ...... 840,994 390,982 450,012

TOTAL EXPENSES ...... 2,534,314 1,819,545 714,769 NET ASSETS OR FUND BALANCES REVENUE LESS EXPENSES...... -93,400 -192,952 99,552 TOTAL ASSETS AT END OF YEAR...... 873,143 1,047,913 -174,770 TOTAL LIABILITIES AT END OF YEAR...... 340,506 98,624 241,882 NET ASSETS/FUND BALANCES AT END OF YEAR. . 532,637 949,289 -416,652

DRAFT

80 2017 CALIFORNIA 199 TAX SUMMARY PAGE 1 ASSOCIATION OF ASIAN PACIFIC COMMUNITY HEALTH ORGANIZATION 94-3050247

2017 2016 DIFF REVENUE DIVIDENDS...... 40 0 40 OTHER INCOME ...... 294,656 491,549 -196,893 GROSS CONTRIBUTIONS, GIFTS, & GRANTS...... 2,146,218 1,135,044 1,011,174

TOTAL INCOME ...... 2,440,914 1,626,593 814,321 EXPENSES AND DISBURSEMENTS CONTRIBUTIONS, GIFTS, GRANTS...... 596,080 433,324 162,756 COMPENSATION OF OFFICERS, ETC...... 182,641 226,031 -43,390 OTHER SALARIES AND WAGES ...... 712,231 594,340 117,891 TAXES...... 127,859 64,437 63,422 RENTS...... 102,637 102,893 -256 OTHER DEDUCTIONS ...... 812,866 398,520 414,346

TOTAL DEDUCTIONS ...... 2,534,314 1,819,545 714,769

EXCESS OF RECEIPTS OVER DISBURSEMENTS. . . . . -93,400 -192,952 99,552 FILING FEE FILING FEE ...... 0 0 0 BALANCE DUE...... 0 0 0

DRAFT

81 2017 FEDERAL WORKSHEETS PAGE 1 ASSOCIATION OF ASIAN PACIFIC COMMUNITY HEALTH ORGANIZATION 94-3050247

FORM 990, PART III, LINE 4E PROGRAM SERVICES TOTALS

PROGRAM SERVICES TOTAL FORM 990 SOURCE

TOTAL EXPENSES 1,953,140. 1,953,140. PART IX, LINE 25, COL. B GRANTS 596,080. 596,080. PART IX, LINES 1-3, COL. B REVENUE 2,200,506. 279,015. PART VIII, LINE 2, COL. A

FORM 990, PART IX, LINE 11G OTHER FEES FOR SERVICES

(A) (B) (C) (D) PROGRAM MANAGEMENT FUND- TOTAL SERVICES & GENERAL RAISING COMMUNICATIONS 2,500. 2,500. EVENT PLANNING 6,000. 6,000. PAYROLL 5,176. 5,176. STRATEGIC PLANNING 6,375. 6,375. TOTAL $ 20,051. $ 2,500. $ 17,551. $ 0.

FORM 990, PART IX, LINE 24E OTHER EXPENSES

(A) (B) (C) (D) PROGRAM MANAGEMENT TOTAL SERVICES & GENERAL FUNDRAISING BANK CHARGES 31. 31. DUES AND MEMBERSHIP 2,960. 750. 2,210. EQUIPMENT RENTAL 5,225. 5,225. MISCELLENOUS MOVING POSTAGE AND SHIPPING 2,187. 679. 1,508. PRINTING AND PUBLICATIONS 2,942. 1,749. 1,193. DRAFTTOTAL $ 13,345. $ 3,178. $ 10,167. $ 0. EXCESS CONTRIBUTIONS SCHEDULE A, PART II, LINE 5

2013 2014 2015 2016 2017 TOTAL 2% AMT EXCESS WALLACE H. COULTER FOUNDATION 150,000 175,000 213,000 151,250 191,535 880,785 230,777 650,008

NAT'L INSTITUTES OF HEALTH 1,200,000 989,754 1,500,000 230,053 4,537 3,924,344 230,777 3693567

1,350,000 1,164,754 1,713,000 381,303 196,072 4,805,129 461,554 4343575

82 IRS e-file Signature Authorization for an Exempt Organization Form 8879-EO OMB No. 1545-1878 For calendar year 2017, or fiscal year beginning 10/01 , 2017, and ending 9/30, 20 2018 G Do not send to the IRS. Keep for your records. Department of the Treasury 2017 Internal Revenue Service G Go to www.irs.gov/Form8879EO for the latest information. Name of exempt organization Employer identification number ASSOCIATION OF ASIAN PACIFIC COMMUNITY HEALTH ORGANIZATION 94-3050247 Name and title of officer JEFFREY CABALLERO EXECUTIVE DIR. Part I Type of Return and Return Information (Whole Dollars Only) Check the box for the return for which you are using this Form 8879-EO and enter the applicable amount, if any, from the return. If you check the box on line 1a, 2a, 3a, 4a, or 5a, below, and the amount on that line for the return being filed with this form was blank, then leave line 1b, 2b, 3b, 4b, or 5b, whichever is applicable, blank (do not enter -0-). But, if you entered -0- on the return, then enter -0- on the applicable line below. Do not complete more than one line in Part I.

1 a Form 990 check here. . . . . G X b Total revenue, if any (Form 990, Part VIII, column (A), line 12)...... 1 b 2,440,914. 2 a Form 990-EZ check here . . . . . G b Total revenue, if any (Form 990-EZ, line 9)...... 2 b 3 a Form 1120-POL check here...... G b Total tax (Form 1120-POL, line 22)...... 3 b 4 a Form 990-PF check here . . . . . G b Tax based on investment income (Form 990-PF, Part VI, line 5). . . . 4 b 5 a Form 8868 check here. . . . G b Balance Due (Form 8868, line 3c ...... 5 b

Part II Declaration and Signature Authorization of Officer Under penalties of perjury, I declare that I am an officer of the above organization and that I have examined a copy of the organization's 2017 electronic return and accompanying schedules and statements and to the best of my knowledge and belief, they are true, correct, and complete. I further declare that the amount in Part I above is the amount shown on the copy of the organization's electronic return. I consent to allow my intermediate service provider, transmitter, or electronic return originator (ERO) to send the organization's return to the IRS and to receive from the IRS (a) an acknowledgement of receipt or reason for rejection of the transmission, (b) the reason for any delay in processing the return or refund, and (c) the date of any refund. If applicable, I authorize the U.S. Treasury and its designated Financial Agent to initiate an electronic funds withdrawal (direct debit) entry to the financial institution account indicated in the tax preparation software for payment of the organization's federal taxes owed on this return, and the financial institution to debit the entry to this account. To revoke a payment, I must contact the U.S. Treasury Financial Agent at 1-888-353-4537 no later than 2 business days prior to the payment (settlement) date. I also authorize the financial institutions involved in the processing of the electronic payment of taxes to receive confidential information necessary to answer inquiries and resolve issues related to the payment. I have selected a personal identification number (PIN) as my signature for the organization's electronic return and, if applicable, the organization's consent to electronic funds withdrawal.

Officer's PIN: check one box only X I authorize WUHOOVER & CO LLP to enter my PIN 11638 as my signature ERO firm name Enter five numbers, but do not enter all zeros on the organization's tax year 2017 electronically filed return. If I have indicated within this return that a copy of the return is being filed with a state agency(ies) regulating charities as part of the IRS Fed/State program, I also authorize the aforementioned ERO to enter my PIN on the return's disclosure consent screen.

As an officer of the organization, I will enter my PIN as my signature on the organization's tax year 2017 electronically filed return. If I have indicated within this return that a copy of the return is being filed with a state agency(ies) regulating charities as part of the IRS Fed/State program, I will enter my PIN on the return's disclosure consent screen.

Officer's signature G Date G Part III Certification and Authentication ERO's EFIN/PIN. Enter your six-digit electronic filing identification number (EFIN) followed by your five-digit self-selected PIN ...... 94651612257 DRAFT Do not enter all zeros I certify that the above numeric entry is my PIN, which is my signature on the 2017 electronically filed return for the organization indicated above. I confirm that I am submitting this return in accordance with the requirements of Pub. 4163, Modernized e-File (MeF) Information for Authorized IRS e-file Providers for Business Returns.

ERO's signature G SUSAN MOSTAJO Date G

ERO Must Retain This Form ' See Instructions Do Not Submit This Form to the IRS Unless Requested To Do So

BAA For Paperwork Reduction Act Notice, see instructions. Form 8879-EO (2017)

TEEA7401L 10/12/17 83 OMB No. 1545-0047 Form 990 Return of Organization Exempt From Income Tax 2017 Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations) G Do not enter social security numbers on this form as it may be made public. Open to Public Department of the Treasury Internal Revenue Service G Go to www.irs.gov/Form990 for instructions and the latest information. Inspection A For the 2017 calendar year, or tax year beginning 10/01 , 2017, and ending 9/30 , 2018 B Check if applicable: C D Employer identification number Address change ASSOCIATION OF ASIAN PACIFIC 94-3050247 Name change COMMUNITY HEALTH ORGANIZATION E Telephone number Initial return 101 CALLAN AVENUE #400 (510) 272-9536 SAN LEANDRO, CA 94577 Final return/terminated Amended return G Gross receipts $ 2,440,914. Application pending F Name and address of principal officer: H(a) Is this a group return for subordinates? Yes X No H(b) Are all subordinates included? Yes No SAME AS C ABOVE If 'No,' attach a list. (see instructions) I Tax-exempt status X 501(c)(3) 501(c) ()H (insert no.) 4947(a)(1) or 527 J Website: G WWW.AAPCHO.ORG H(c) Group exemption number G K Form of organization: X Corporation Trust Association OtherG L Year of formation: 1987 M State of legal domicile: CA Part I Summary 1 Briefly describe the organization's mission or most significant activities:AAPCHO IS A NATIONAL ASSOCIATION REPRESENTING COMMUNITY HEALTH ORGANIZATIONS DEDICATED TO PROMOTING ADVOCACY,COLLABORATION AND LEADERSHIP THAT IMPROVES THE HEALTH STATUS AND ACCESS OF AA&NHOPI PRIMARILY THROUGH OUR MEMBER COMMUNITY HEALTH CENTERS. 2 Check this box G if the organization discontinued its operations or disposed of more than 25% of its net assets. 3 Number of voting members of the governing body (Part VI, line 1a) ...... 3 14 4 Number of independent voting members of the governing body (Part VI, line 1b)...... 4 14 5 Total number of individuals employed in calendar year 2017 (Part V, line 2a) ...... 5 14 6 Total number of volunteers (estimate if necessary)...... 6 0 7a Total unrelated business revenue from Part VIII, column (C), line 12...... 7a 0. b Net unrelated business taxable income from Form 990-T, line 34...... 7b 0. Prior Year Current Year 8 Contributions and grants (Part VIII, line 1h)...... 1,135,044. 2,146,218. 9 Program service revenue (Part VIII, line 2g) ...... 480,262. 279,015. 10 Investment income (Part VIII, column (A), lines 3, 4, and 7d) ...... 37. 40. 11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)...... 11,250. 15,641. 12 Total revenue ' add lines 8 through 11 (must equal Part VIII, column (A), line 12) . . . . . 1,626,593. 2,440,914. 13 Grants and similar amounts paid (Part IX, column (A), lines 1-3)...... 433,324. 596,080. 14 Benefits paid to or for members (Part IX, column (A), line 4)...... 15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5-10) . . . . . 995,239. 1,097,240. 16 a Professional fundraising fees (Part IX, column (A), line 11e)...... b Total fundraising expenses (Part IX, column (D), line 25) G 17 Other expenses (Part IX, column (A), lines 11a-11d, 11f-24e)...... 390,982. 840,994. 18 Total expenses. Add lines 13-17 (must equal Part IX, column (A), line 25)...... 1,819,545. 2,534,314. 19 Revenue less expenses. Subtract line 18 from line 12 ...... -192,952. -93,400. Beginning of Current Year End of Year 20 Total assets (Part X, line 16)...... 1,047,913. 873,143. 21 Total liabilities (Part X, line 26) ...... 98,624. 340,506. Net assets or fund balances. SubtractDRAFT line 21 from line 20 ...... 22 949,289. 532,637. Part II Signature Block Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.

A Signature of officer Date Sign Here JEFFREY CABALLERO EXECUTIVE DIR. A Type or print name and title

Print/Type preparer's name Preparer's signature Date Check if PTIN Paid SUSAN MOSTAJO SUSAN MOSTAJO self-employed P02016957 Preparer Firm's name G WUHOOVER & CO LLP Use Only Firm's address G 1510 FASHION ISLAND BLVD Firm's EIN G 27-2481245 SAN MATEO, CA 94404 Phone no. 650-212-3888 May the IRS discuss this return with the preparer shown above? (see instructions) ...... X Yes No BAA For Paperwork Reduction Act Notice, see the separate instructions. TEEA0113L 08/08/17 Form 990 (2017) 84 Form 990 (2017) ASSOCIATION OF ASIAN PACIFIC 94-3050247 Page 2 Part III Statement of Program Service Accomplishments Check if Schedule O contains a response or note to any line in this Part III...... X 1 Briefly describe the organization's mission: SEE SCHEDULE O

2 Did the organization undertake any significant program services during the year which were not listed on the prior Form 990 or 990-EZ?...... Yes X No If 'Yes,' describe these new services on Schedule O. 3 Did the organization cease conducting, or make significant changes in how it conducts, any program services?. . . . Yes X No If 'Yes,' describe these changes on Schedule O. 4 Describe the organization's program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.

4 a (Code: ) (Expenses $ 1,747,673. including grants of $ 596,080. ) (Revenue $ 2,200,506. ) DEVELOPS HEALTH CARE EDUCATION MATERIALS AND PROVIDES TRAINING FOR COMMUNITY HEALTH CARE PROVIDER ON ON-GOING HEALTH ISSUES IN THE ASIAN AMERICANS & NATIVE HAWAIIANS AND OTHER PACIFIC ISLANDERS (AA&NHOPI) COMMUNITY.

4 b (Code: ) (Expenses $ 205,467. including grants of $ ) (Revenue $ ) PROMOTES THE ORGANIZATION AND ITS MEMBER CENTERS IN THE ASIAN AMERICANS & NATIVE HAWAIIANS AND OTHER PACIFIC ISLANDERS (AA&NHOPI) COMMUNITY.

4 c (Code: ) (Expenses $ DRAFTincluding grants of $ ) (Revenue $ )

4 d Other program services (Describe in Schedule O.) (Expenses $ including grants of $ ) (Revenue $ ) 4 e Total program service expenses G 1,953,140. BAA TEEA0102L 12/05/17 Form 990 (2017) 85 Form 990 (2017) ASSOCIATION OF ASIAN PACIFIC 94-3050247 Page 3 Part IV Checklist of Required Schedules Yes No 1 Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If 'Yes,' complete Schedule A...... 1 X 2 Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)?...... 2 X 3 Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If 'Yes,' complete Schedule C, Part I...... 3 X 4 Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If 'Yes,' complete Schedule C, Part II...... 4 X 5 Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If 'Yes,' complete Schedule C, Part III...... 5 X

6 Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If 'Yes,' complete Schedule D, Part I ...... 6 X 7 Did the organization receive or hold a conservation easement, including easements to preserve open space, the environment, historic land areas, or historic structures? If 'Yes,' complete Schedule D, Part II...... 7 X 8 Did the organization maintain collections of works of art, historical treasures, or other similar assets? If 'Yes,' complete Schedule D, Part III...... 8 X

9 Did the organization report an amount in Part X, line 21, for escrow or custodial account liability, serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If 'Yes,' complete Schedule D, Part IV ...... 9 X 10 Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments? If 'Yes,' complete Schedule D, Part V...... 10 X 11 If the organization's answer to any of the following questions is 'Yes', then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.

a Did the organization report an amount for land, buildings, and equipment in Part X, line 10? If 'Yes,' complete Schedule D, Part VI ...... 11 a X b Did the organization report an amount for investments ' other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If 'Yes,' complete Schedule D, Part VII...... 11 b X c Did the organization report an amount for investments ' program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If 'Yes,' complete Schedule D, Part VIII ...... 11 c X d Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If 'Yes,' complete Schedule D, Part IX...... 11 d X e Did the organization report an amount for other liabilities in Part X, line 25? If 'Yes,' complete Schedule D, Part X...... 11 e X f Did the organization's separate or consolidated financial statements for the tax year include a footnote that addresses the organization's liability for uncertain tax positions under FIN 48 (ASC 740)? If 'Yes,' complete Schedule D, Part X. . . . 11 f X 12 a Did the organization obtain separate, independent audited financial statements for the tax year? If 'Yes,' complete Schedule D, Parts XI and XII ...... 12a X b Was the organization included in consolidated, independent audited financial statements for the tax year? If 'Yes,' and if the organization answered 'No' to line 12a, then completing Schedule D, Parts XI and XII is optional ...... 12 b X 13 Is the organization a school described in section 170(b)(1)(A)(ii)? If 'Yes,' complete Schedule E ...... 13 X 14 a Did the organization maintain an office, employees, or agents outside of the United States?...... 14a X b Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program serviceDRAFT activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If 'Yes,' complete Schedule F, Parts I and IV ...... 14b X 15 Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If 'Yes,' complete Schedule F, Parts II and IV ...... 15 X 16 Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If 'Yes,' complete Schedule F, Parts III and IV ...... 16 X 17 Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If 'Yes,' complete Schedule G, Part I (see instructions)...... 17 X 18 Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If 'Yes,' complete Schedule G, Part II...... 18 X 19 Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If 'Yes,' complete Schedule G, Part III...... 19 X BAA TEEA0103L 08/08/17 Form 990 (2017)

86 Form 990 (2017) ASSOCIATION OF ASIAN PACIFIC 94-3050247 Page 4 Part IV Checklist of Required Schedules (continued) Yes No

20a Did the organization operate one or more hospital facilities? If 'Yes,' complete Schedule H ...... 20a X

b If 'Yes' to line 20a, did the organization attach a copy of its audited financial statements to this return? ...... 20b 21 Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government on Part IX, column (A), line 1? If 'Yes,' complete Schedule I, Parts I and II...... 21 X 22 Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on Part IX, column (A), line 2? If 'Yes,' complete Schedule I, Parts I and III ...... 22 X 23 Did the organization answer 'Yes' to Part VII, Section A, line 3, 4, or 5 about compensation of the organization's current and former officers, directors, trustees, key employees, and highest compensated employees? If 'Yes,' complete Schedule J ...... 23 X 24 a Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If 'Yes,' answer lines 24b through 24d and complete Schedule K. If 'No, 'go to line 25a ...... 24a X b Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...... 24b

c Did the organization maintain an escrow account other than a refunding escrow at any time during the year to defease any tax-exempt bonds? ...... 24c d Did the organization act as an 'on behalf of' issuer for bonds outstanding at any time during the year? ...... 24d

25 a Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If 'Yes,' complete Schedule L, Part I ...... 25a X b Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization's prior Forms 990 or 990-EZ? If 'Yes,' complete Schedule L, Part I...... 25b X 26 Did the organization report any amount on Part X, line 5, 6, or 22 for receivables from or payables to any current or former officers, directors, trustees, key employees, highest compensated employees, or disqualified persons? If 'Yes,' complete Schedule L, Part II...... 26 X 27 Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If 'Yes,' complete Schedule L, Part III...... 27 X 28 Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions): a A current or former officer, director, trustee, or key employee? If 'Yes,' complete Schedule L, Part IV ...... 28a X b A family member of a current or former officer, director, trustee, or key employee? If 'Yes,' complete Schedule L, Part IV ...... 28b X c An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or direct or indirect owner? If 'Yes,' complete Schedule L, Part IV ...... 28c X 29 Did the organization receive more than $25,000 in non-cash contributions? If 'Yes,' complete Schedule M ...... 29 X 30 Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If 'Yes,' complete Schedule M...... 30 X 31 Did the organization liquidate, terminate, or dissolve and cease operations? If 'Yes,' complete Schedule N, Part I...... 31 X 32 Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If 'Yes,' complete Schedule N, Part II...... 32 X 33 Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If 'Yes,' complete Schedule R, Part I...... 33 X 34 Was the organization related to any tax-exempt or taxable entity? If 'Yes,' complete Schedule R, Part II, III, or IV, and Part V, line 1...... DRAFT ...... 34 X 35 a Did the organization have a controlled entity within the meaning of section 512(b)(13)?...... 35a X b If 'Yes' to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If 'Yes,' complete Schedule R, Part V, line 2...... 35b

36 Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If 'Yes,' complete Schedule R, Part V, line 2 ...... 36 X 37 Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If 'Yes,' complete Schedule R, Part VI ...... 37 X 38 Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O...... 38 X BAA Form 990 (2017)

TEEA0104L 08/08/17 87 Form 990 (2017) ASSOCIATION OF ASIAN PACIFIC 94-3050247 Page 5 Part V Statements Regarding Other IRS Filings and Tax Compliance Check if Schedule O contains a response or note to any line in this Part V ...... Yes No 1 a Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable ...... 1 a 8 b Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable...... 1 b 0 c Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners?...... 1 c X 2 a Enter the number of employees reported on Form W-3, Transmittal of Wage and Tax State- ments, filed for the calendar year ending with or within the year covered by this return . . . . . 2 a 14 b If at least one is reported on line 2a, did the organization file all required federal employment tax returns? ...... 2 b X Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions) 3 a Did the organization have unrelated business gross income of $1,000 or more during the year?...... 3 a X b If 'Yes,' has it filed a Form 990-T for this year? If 'No' to line 3b, provide an explanation in Schedule O...... 3 b 4 a At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)? ...... 4 a X b If 'Yes,' enter the name of the foreign country: G See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR). 5 a Was the organization a party to a prohibited tax shelter transaction at any time during the tax year? ...... 5 a X b Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?...... 5 b X c If 'Yes,' to line 5a or 5b, did the organization file Form 8886-T?...... 5 c 6 a Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions?...... 6 a X b If 'Yes,' did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?...... 6 b 7 Organizations that may receive deductible contributions under section 170(c). a Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?...... 7 a X b If 'Yes,' did the organization notify the donor of the value of the goods or services provided? ...... 7 b c Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282? ...... 7 c X d If 'Yes,' indicate the number of Forms 8282 filed during the year...... 7 d e Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?...... 7 e X f Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?...... 7 f X g If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?...... 7 g h If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C? ...... 7 h 8 Sponsoring organizations maintaining donor advised funds. Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year?...... 8 9 Sponsoring organizations maintaining donor advised funds. a Did the sponsoring organization make any taxable distributions under section 4966? ...... 9 a b Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?...... 9 b 10 Section 501(c)(7) organizations. Enter: a Initiation fees and capital contributions included on Part VIII, line 12 ...... 10 a b Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities . . . . 10 b 11 Section 501(c)(12) organizations. Enter:DRAFT a Gross income from members or shareholders...... 11 a b Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.)...... 11 b 12 a Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?...... 12 a b If 'Yes,' enter the amount of tax-exempt interest received or accrued during the year...... 12 b 13 Section 501(c)(29) qualified nonprofit health insurance issuers. a Is the organization licensed to issue qualified health plans in more than one state? ...... 13 a Note. See the instructions for additional information the organization must report on Schedule O. b Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans...... 13 b c Enter the amount of reserves on hand...... 13 c 14 a Did the organization receive any payments for indoor tanning services during the tax year?...... 14 a X b If 'Yes,' has it filed a Form 720 to report these payments? If 'No,' provide an explanation in Schedule O...... 14 b BAA TEEA0105L 08/08/17 Form 990 (2017)

88 Form 990 (2017) ASSOCIATION OF ASIAN PACIFIC 94-3050247 Page 6 Part VI Governance, Management, and Disclosure For each 'Yes' response to lines 2 through 7b below, and for a 'No' response to line 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions. Check if Schedule O contains a response or note to any line in this Part VI...... X Section A. Governing Body and Management Yes No 1 a Enter the number of voting members of the governing body at the end of the tax year...... 1 a 14 If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O. b Enter the number of voting members included in line 1a, above, who are independent...... 1 b 14 2 Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? ...... 2 X 3 Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors, or trustees, or key employees to a management company or other person? ...... 3 X 4 Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? ...... SEE ...... SCH ...... O...... 4 X 5 Did the organization become aware during the year of a significant diversion of the organization's assets?...... 5 X 6 Did the organization have members or stockholders?...... SEE ...... SCHEDULE ...... O...... 6 X 7 a Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? . . SEE...... SCHEDULE...... O ...... 7 a X b Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...... SEE ...... SCH ...... O ...... 7 b X 8 Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following: a The governing body?...... 8 a X b Each committee with authority to act on behalf of the governing body?...... 8 b X 9 Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization's mailing address? If 'Yes,' provide the names and addresses in Schedule O ...... 9 X Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.) Yes No 10 a Did the organization have local chapters, branches, or affiliates?...... 10 a X b If 'Yes,' did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes? ...... 10 b 11 a Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form?...... 11 a X b Describe in Schedule O the process, if any, used by the organization to review this Form 990. SEE SCHEDULE O 12 a Did the organization have a written conflict of interest policy? If 'No,' go to line 13 ...... 12 a X b Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ...... 12 b c Did the organization regularly and consistently monitor and enforce compliance with the policy? If 'Yes,' describe in Schedule O how this was done...... 12 c 13 Did the organization have a written whistleblower policy?...... 13 X 14 Did the organization have a written document retention and destruction policy?...... 14 X 15 Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision? a The organization's CEO, Executive Director, or top management official...... 15 a X b Other officers or key employees of theDRAFT organization...... 15 b X If 'Yes' to line 15a or 15b, describe the process in Schedule O (see instructions). 16 a Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year?...... 16 a X b If 'Yes,' did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization's exempt status with respect to such arrangements?...... 16 b Section C. Disclosure 17 List the states with which a copy of this Form 990 is required to be filed G CA 18 Section 6104 requires an organization to make its Forms 1023 (or 1024 if applicable), 990, and 990-T (Section 501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply. Own website Another's website X Upon request Other (explain in Schedule O) 19 Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year. SEE SCHEDULE O 20 State the name, address, and telephone number of the person who possesses the organization's books and records: G PETER HO 101 CALLAN AVENUE, STE 400 SAN LEANDRO CA 94577 (510) 272-9536 BAA TEEA0106L 08/08/17 Form 990 (2017) 89 Form 990 (2017) ASSOCIATION OF ASIAN PACIFIC 94-3050247 Page 7 Part VII Compensation of Officers, Directors, Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors Check if Schedule O contains a response or note to any line in this Part VII ...... Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees 1 a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization's tax year. ? List all of the organization's current officers, directors, trustees (whether individuals or organizations), regardless of amount of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid. ? List all of the organization's current key employees, if any. See instructions for definition of 'key employee.' ? List the organization's five current highest compensated employees (other than an officer, director, trustee, or key employee) who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the organization and any related organizations. ? List all of the organization's former officers, key employees, and highest compensated employees who received more than $100,000 of reportable compensation from the organization and any related organizations. ? List all of the organization's former directors or trustees that received, in the capacity as a former director or trustee of the organization, more than $10,000 of reportable compensation from the organization and any related organizations. List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest compensated employees; and former such persons. Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee. (C) Position (do not check more (A) (B) than one box, unless person (D) (E) (F) Name and Title Average is both an officer and a Reportable Reportable Estimated hours director/trustee) compensation from compensation from amount of other per the organization related organizations compensation week (W-2/1099-MISC) (W-2/1099-MISC) from the (list any organization hours for and related related organizations organiza- tions below dotted line)

(1) SHERRY HIROTA 1 DIRECTOR 0 X X 0. 0. 0. (2) KAZUE SHIBATA 1 DIRECTOR 0 X 0. 0. 0. (3) EDDIE CHAN 1 SECRETARY 0 X X 0. 0. 0. (4) JANE ENG 1 VICE PRESIDENT 0 X X 0. 0. 0. (5) DARRIN SATO 1 PRESIDENT 0 X X 0. 0. 0. (6) DAVID DERAUF, MD 1 DIRECTOR 0 X 0. 0. 0. (7) EUGENE WELCH 1 DIRECTOR 0 X 0. 0. 0. (8) RICH BETTINI 1 TREASURER 0 X X 0. 0. 0. (9) TERESITA BATAYOLA 1 DIRECTOR 0 X 0. 0. 0. (10) MICHAEL BYUN DRAFT1 DIRECTOR 0 X 0. 0. 0. (11) MARY ONEHA 1 DIRECTOR 0 X 0. 0. 0. (12) GILDAS CHEUNG 1 DIRECTOR 0 X 0. 0. 0. (13) ANDREA CARACOSTIS 1 DIRECTOR 0 X 0. 0. 0. (14) NENA TOLENOA 1 DIRECTOR 0 X 0. 0. 0. BAA TEEA0107L 08/08/17 Form 990 (2017)

90 Form 990 (2017) ASSOCIATION OF ASIAN PACIFIC 94-3050247 Page 8 Part VII Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued) (B) (C) Position (A) Average (do not check more than one (D) (E) (F) hours box, unless person is both an Name and title Reportable Reportable Estimated per officer and a director/trustee) compensation from compensation from amount of other week the organization related organizations compensation (list any (W-2/1099-MISC) (W-2/1099-MISC) from the hours organization for and related related organizations organiza - tions below dotted line)

(15) JEFFREY CABALLERO 38 EXECUTIVE DIR. 0 X 159,370. 0. 0. (16) PETER HO 38 OPERATING DIR. 0 X 108,598. 0. 0. (17)

(18)

(19)

(20)

(21)

(22)

(23)

(24)

(25)

1 b Sub-total...... G 267,968. 0. 0. c Total from continuation sheets to Part VII, Section A ...... G 0. 0. 0. d Total (add lines 1b and 1c)...... G 267,968. 0. 0. 2 Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organization G 2 Yes No 3 Did the organization list any former officer, director, or trustee, key employee, or highest compensated employee on line 1a? If 'Yes,' complete Schedule J for such individual...... 3 X 4 For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If 'Yes,' complete Schedule J for such individual...... 4 X 5 Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization?DRAFT If 'Yes,' complete Schedule J for such person...... 5 X Section B. Independent Contractors 1 Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization's tax year. (A) (B) (C) Name and business address Description of services Compensation NIA AITAOTO 350 S 600 E APT. 502 SALT LAKE, UT 84102 TRAINING, SUPPORT 121,875.

2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization G 1 BAA TEEA0108L 08/08/17 Form 990 (2017)

91 Form 990 (2017) ASSOCIATION OF ASIAN PACIFIC 94-3050247 Page 9 Part VIII Statement of Revenue Check if Schedule O contains a response or note to any line in this Part VIII...... (A) (B) (C) (D) Total revenue Related or Unrelated Revenue exempt business excluded from tax function revenue under sections revenue 512-514 1 a Federated campaigns...... 1 a b Membership dues ...... 1 b 221,537. c Fundraising events...... 1 c d Related organizations ...... 1 d e Government grants (contributions). . . . . 1 e 1,729,955. f All other contributions, gifts, grants, and similar amounts not included above. . . . 1 f 194,726. g Noncash contributions included in lines 1a-1f: $ h Total. Add lines 1a-1f...... G 2,146,218. Business Code 2 a TRAINING, EDUCATION, ETC. 900099 279,015. 279,015. b c d e f All other program service revenue. . . . g Total. Add lines 2a-2f...... G 279,015. 3 Investment income (including dividends, interest and other similar amounts)...... G 40. 40. 4 Income from investment of tax-exempt bond proceeds. . G. 5 Royalties ...... G (i) Real (ii) Personal 6 a Gross rents...... b Less: rental expenses c Rental income or (loss). . . . d Net rental income or (loss)...... G (i) Securities (ii) Other 7 a Gross amount from sales of assets other than inventory

b Less: cost or other basis and sales expenses...... c Gain or (loss)...... d Net gain or (loss) ...... G 8 a Gross income from fundraising events (not including. $ of contributions reported on line 1c). See Part IV, line 18 ...... a b Less: direct expenses ...... b c Net income or (loss) from fundraising events...... G 9 a Gross income from gaming activities.DRAFT See Part IV, line 19 ...... a b Less: direct expenses ...... b c Net income or (loss) from gaming activities...... G 10 a Gross sales of inventory, less returns and allowances ...... a b Less: cost of goods sold...... b c Net income or (loss) from sales of inventory ...... G Miscellaneous Revenue Business Code 11 a OTHERS 900099 15,641. 15,641. b c d All other revenue...... e Total. Add lines 11a-11d...... G 15,641. 12 Total revenue. See instructions ...... G 2,440,914. 294,656. 0. 40. BAA TEEA0109L 08/08/17 Form 990 (2017) 92 Form 990 (2017) ASSOCIATION OF ASIAN PACIFIC 94-3050247 Page 10 Part IX Statement of Functional Expenses Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A). Check if Schedule O contains a response or note to any line in this Part IX...... (A) (B) (C) (D) Do not include amounts reported on lines Total expenses Program service Management and Fundraising 6b, 7b, 8b, 9b, and 10b of Part VIII. expenses general expenses expenses 1 Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21...... 279,980. 279,980. 2 Grants and other assistance to domestic individuals. See Part IV, line 22...... 3 Grants and other assistance to foreign organizations, foreign governments, and for- eign individuals. See Part IV, lines 15 and 16 316,100. 316,100. 4 Benefits paid to or for members...... 5 Compensation of current officers, directors, trustees, and key employees...... 182,641. 0. 182,641. 0. 6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ...... 0. 0. 0. 0. 7 Other salaries and wages...... 712,231. 675,974. 36,257. 8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ...... 9 Other employee benefits ...... 74,509. 52,658. 21,851. 10 Payroll taxes ...... 127,859. 54,916. 72,943. 11 Fees for services (non-employees): a Management ...... b Legal...... 3,498. 150. 3,348. c Accounting ...... 32,800. 32,800. d Lobbying ...... e Professional fundraising services. See Part IV, line 17. . . f Investment management fees...... g Other. (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O.). . . . . 20,051. 2,500. 17,551. 12 Advertising and promotion...... 4,676. 4,247. 429. 13 Office expenses...... 14 Information technology...... 15 Royalties...... 16 Occupancy ...... 102,637. 12,336. 90,301. 17 Travel...... 214,355. 187,837. 26,518. 18 Payments of travel or entertainment expenses for any federal, state, or local public officials ...... 19 Conferences, conventions, and meetings. . . . 35,671. 7,696. 27,975. 20 Interest...... 21 Payments to affiliates...... 22 Depreciation, depletion, and amortization. . . . 23 Insurance ...... 9,514. 9,514. 24 Other expenses. Itemize expenses notDRAFT covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)...... a CONSULTANTS 328,477. 327,743. 734. b SUPPLIES 28,171. 19,924. 8,247. c PUBLICATIONS AND SUBSCRIPTIONS 27,296. 7,714. 19,582. d TELECOMMUNICATION 20,503. 187. 20,316. e All other expenses...... 13,345. 3,178. 10,167. 25 Total functional expenses. Add lines 1 through 24e. . . . 2,534,314. 1,953,140. 581,174. 0. 26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here G if following SOP 98-2 (ASC 958-720)......

BAA TEEA0110L 08/08/17 Form 990 (2017) 93 Form 990 (2017) ASSOCIATION OF ASIAN PACIFIC 94-3050247 Page 11 Part X Balance Sheet Check if Schedule O contains a response or note to any line in this Part X ...... (A) (B) Beginning of year End of year 1 Cash ' non-interest-bearing...... 393,632. 1 192,955. 2 Savings and temporary cash investments...... 32,520. 2 171,145. 3 Pledges and grants receivable, net...... 3 4 Accounts receivable, net...... 586,199. 4 456,680. 5 Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L ...... 5 6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions). Complete Part II of Schedule L...... 6 7 Notes and loans receivable, net...... 7 8 Inventories for sale or use...... 8 9 Prepaid expenses and deferred charges...... 21,108. 9 35,096. 10 a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D...... 10 a 23,529. b Less: accumulated depreciation...... 10 b 23,529. 10 c 11 Investments ' publicly traded securities...... 11 12 Investments ' other securities. See Part IV, line 11...... 12 13 Investments ' program-related. See Part IV, line 11 ...... 13 14 Intangible assets...... 14 15 Other assets. See Part IV, line 11...... 14,454. 15 17,267. 16 Total assets. Add lines 1 through 15 (must equal line 34)...... 1,047,913. 16 873,143. 17 Accounts payable and accrued expenses ...... 98,624. 17 340,506. 18 Grants payable...... 18 19 Deferred revenue...... 19 20 Tax-exempt bond liabilities ...... 20 21 Escrow or custodial account liability. Complete Part IV of Schedule D...... 21 22 Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified persons. Complete Part II of Schedule L...... 22 23 Secured mortgages and notes payable to unrelated third parties ...... 23 24 Unsecured notes and loans payable to unrelated third parties...... 24 25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D. 25 26 Total liabilities. Add lines 17 through 25...... 98,624. 26 340,506. Organizations that follow SFAS 117 (ASC 958), check here G X and complete lines 27 through 29, and lines 33 and 34. 27 Unrestricted net assets...... 334,410. 27 186,633. 28 Temporarily restricted net assets...... 614,879. 28 346,004. 29 Permanently restricted net assets...... 29 Organizations that do not follow SFAS 117 (ASC 958), check here G and complete lines 30 through 34.DRAFT 30 Capital stock or trust principal, or current funds ...... 30 31 Paid-in or capital surplus, or land, building, or equipment fund...... 31 32 Retained earnings, endowment, accumulated income, or other funds ...... 32 33 Total net assets or fund balances ...... 949,289. 33 532,637. 34 Total liabilities and net assets/fund balances...... 1,047,913. 34 873,143. BAA Form 990 (2017)

TEEA0111L 08/08/17 94 Form 990 (2017) ASSOCIATION OF ASIAN PACIFIC 94-3050247 Page 12 Part XI Reconciliation of Net Assets Check if Schedule O contains a response or note to any line in this Part XI...... 1 Total revenue (must equal Part VIII, column (A), line 12) ...... 1 2,440,914. 2 Total expenses (must equal Part IX, column (A), line 25)...... 2 2,534,314. 3 Revenue less expenses. Subtract line 2 from line 1 ...... 3 -93,400. 4 Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A))...... 4 949,289. 5 Net unrealized gains (losses) on investments...... 5 6 Donated services and use of facilities ...... 6 7 Investment expenses...... 7 8 Prior period adjustments ...... 8 -323,252. 9 Other changes in net assets or fund balances (explain in Schedule O)...... 9 0. 10 Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B)) ...... 10 532,637. Part XII Financial Statements and Reporting

Check if Schedule O contains a response or note to any line in this Part XII ...... Yes No 1 Accounting method used to prepare the Form 990: Cash X Accrual Other If the organization changed its method of accounting from a prior year or checked 'Other,' explain in Schedule O. 2 a Were the organization's financial statements compiled or reviewed by an independent accountant? ...... 2 a X If 'Yes,' check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both: Separate basis Consolidated basis Both consolidated and separate basis

b Were the organization's financial statements audited by an independent accountant?...... 2 b X If 'Yes,' check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both: X Separate basis Consolidated basis Both consolidated and separate basis c If 'Yes' to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?...... 2 c X If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O. 3 a As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133? ...... 3 a X b If 'Yes,' did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits ...... 3 b X BAA Form 990 (2017) DRAFT

TEEA0112L 08/08/17 95 Public Charity Status and Public Support OMB No. 1545-0047 SCHEDULE A (Form 990 or 990-EZ) Complete if the organization is a section 501(c)(3) organization or a section 2017 4947(a)(1) nonexempt charitable trust. G Attach to Form 990 or Form 990-EZ. Open to Public Department of the Treasury Inspection Internal Revenue Service G Go to www.irs.gov/Form990 for instructions and the latest information. Name of the organization ASSOCIATION OF ASIAN PACIFIC Employer identification number COMMUNITY HEALTH ORGANIZATION 94-3050247 Part I Reason for Public Charity Status (All organizations must complete this part.) See instructions. The organization is not a private foundation because it is: (For lines 1 through 12, check only one box.) 1 A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i). 2 A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990 or 990-EZ).) 3 A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii). 4 A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state: 5 An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.) 6 A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v). 7 X An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.) 8 A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.) 9 An agricultural research organization described in section 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land-grant college of agriculture (see instructions). Enter the name, city, and state of the college or university: 10 An organization that normally receives: (1) more than 33-1/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions'subject to certain exceptions, and (2) no more than 33-1/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.) 11 An organization organized and operated exclusively to test for public safety. See section 509(a)(4). 12 An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box in lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g. a Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B. b Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C. c Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E. d Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V. e Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization. f Enter the number of supported organizations...... g Provide the following information about the supported organization(s). (i) Name of supported organization (ii) EIN (iii) Type of organization (iv) Is the (v) Amount of monetary (vi) Amount of other (described on lines 1-10 organization listed support (see instructions) support (see instructions) above (see instructions)) in your governing DRAFTdocument? Yes No

(A)

(B)

(C)

(D)

(E)

Total BAA For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ. Schedule A (Form 990 or 990-EZ) 2017 TEEA0401L 08/10/17 96 Schedule A (Form 990 or 990-EZ) 2017 ASSOCIATION OF ASIAN PACIFIC 94-3050247 Page 2 Part II Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi) (Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.) Section A. Public Support

Calendar year (or fiscal year (a) 2013 (b) 2014 (c) 2015 (d) 2016 (e) 2017 (f) Total beginning in) G 1 Gifts, grants, contributions, and membership fees received. (Do not include any 'unusual grants.')...... 2,848,174. 2,769,551. 2,391,374. 1,135,044. 2,143,027. 11,287,170. 2 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...... 0. 3 The value of services or facilities furnished by a governmental unit to the organization without charge. . . . 0. 4 Total. Add lines 1 through 3 . . . 2,848,174. 2,769,551. 2,391,374. 1,135,044. 2,143,027. 11,287,170. 5 The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f). . . 4,343,575. 6 Public support. Subtract line 5 from line 4 ...... 6,943,595. Section B. Total Support

Calendar year (or fiscal year (a) 2013 (b) 2014 (c) 2015 (d) 2016 (e) 2017 (f) Total beginning in) G 7 Amounts from line 4 ...... 2,848,174. 2,769,551. 2,391,374. 1,135,044. 2,143,027. 11,287,170. 8 Gross income from interest, dividends, payments received on securities loans, rents, royalties, and income from similar sources ...... 80. 51. 82. 37. 40. 290. 9 Net income from unrelated business activities, whether or not the business is regularly carried on...... 0. 10 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.). . SEE...... PART...... VI ...... 88,998. 104,154. 31,341. 11,250. 15,641. 251,384. 11 Total support. Add lines 7 through 10...... 11,538,844. 12 Gross receipts from related activities, etc. (see instructions)...... 12 2,019,507. 13 First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here ...... G Section C. Computation of Public Support Percentage 14 Public support percentage for 2017 (line 6, column (f) divided by line 11, column (f))...... 14 60.18 % 15 Public support percentage from 2016 DRAFTSchedule A, Part II, line 14 ...... 15 56.18 % 16a 33-1/3% support test'2017. If the organization did not check the box on line 13, and line 14 is 33-1/3% or more, check this box and stop here. The organization qualifies as a publicly supported organization...... G X b 33-1/3% support test'2016. If the organization did not check a box on line 13 or 16a, and line 15 is 33-1/3% or more, check this box and stop here. The organization qualifies as a publicly supported organization...... G

17a 10%-facts-and-circumstances test'2017. If the organization did not check a box on line 13, 16a, or 16b, and line 14 is 10% or more, and if the organization meets the 'facts-and-circumstances' test, check this box and stop here. Explain in Part VI how the organization meets the 'facts-and-circumstances' test. The organization qualifies as a publicly supported organization ...... G

b 10%-facts-and-circumstances test'2016. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line 15 is 10% or more, and if the organization meets the 'facts-and-circumstances' test, check this box and stop here. Explain in Part VI how the organization meets the 'facts-and-circumstances' test. The organization qualifies as a publicly supported organization...... G 18 Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see instructions . . . G BAA Schedule A (Form 990 or 990-EZ) 2017

TEEA0402L 08/10/17 97 Schedule A (Form 990 or 990-EZ) 2017 ASSOCIATION OF ASIAN PACIFIC 94-3050247 Page 3 Part III Support Schedule for Organizations Described in Section 509(a)(2) (Complete only if you checked the box on line 10 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.) Section A. Public Support Calendar year (or fiscal year beginning in) G (a) 2013 (b) 2014 (c) 2015 (d) 2016 (e) 2017 (f) Total 1 Gifts, grants, contributions, and membership fees received. (Do not include any 'unusual grants.') ...... 2 Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose...... 3 Gross receipts from activities that are not an unrelated trade or business under section 513 . 4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...... 5 The value of services or facilities furnished by a governmental unit to the organization without charge. . . . 6 Total. Add lines 1 through 5 . . . 7a Amounts included on lines 1, 2, and 3 received from disqualified persons...... b Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year...... c Add lines 7a and 7b...... 8 Public support. (Subtract line 7c from line 6.) ...... Section B. Total Support Calendar year (or fiscal year beginning in) G (a) 2013 (b) 2014 (c) 2015 (d) 2016 (e) 2017 (f) Total 9 Amounts from line 6 ...... 10a Gross income from interest, dividends, payments received on securities loans, rents, royalties, and income from similar sources ...... b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. . . c Add lines 10a and 10b...... 11 Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on ...... 12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)...... DRAFT 13 Total support. (Add Iines 9, 10c, 11, and 12.)...... 14 First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here ...... G Section C. Computation of Public Support Percentage 15 Public support percentage for 2017 (line 8, column (f) divided by line 13, column (f))...... 15 % 16 Public support percentage from 2016 Schedule A, Part III, line 15...... 16 % Section D. Computation of Investment Income Percentage 17 Investment income percentage for 2017 (line 10c, column (f) divided by line 13, column (f)) ...... 17 % 18 Investment income percentage from 2016 Schedule A, Part III, line 17 ...... 18 % 19a 33-1/3% support tests'2017. If the organization did not check the box on line 14, and line 15 is more than 33-1/3%, and line 17 is not more than 33-1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ...... G b 33-1/3% support tests'2016. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33-1/3%, and line 18 is not more than 33-1/3%, check this box and stop here. The organization qualifies as a publicly supported organization. . . . . G 20 Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions...... G BAA TEEA0403L 08/10/17 Schedule A (Form 990 or 990-EZ) 2017 98 Schedule A (Form 990 or 990-EZ) 2017 ASSOCIATION OF ASIAN PACIFIC 94-3050247 Page 4 Part IV Supporting Organizations (Complete only if you checked a box in line 12 on Part I. If you checked 12a of Part I, complete Sections A and B. If you checked 12b of Part I, complete Sections A and C. If you checked 12c of Part I, complete Sections A, D, and E. If you checked 12d of Part I, complete Sections A and D, and complete Part V.) Section A. All Supporting Organizations Yes No 1 Are all of the organization's supported organizations listed by name in the organization's governing documents? If 'No,' describe in Part VI how the supported organizations are designated. If designated by class or purpose, describe the designation. If historic and continuing relationship, explain. 1

2 Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If 'Yes,' explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2). 2

a3 Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If 'Yes,' answer (b) and (c) below. 3a

b Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If 'Yes,' describe in Part VI when and how the organization made the determination. 3b

c Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If 'Yes,' explain in Part VI what controls the organization put in place to ensure such use. c3

a4 Was any supported organization not organized in the United States ('foreign supported organization')? If 'Yes' and if you checked 12a or 12b in Part I, answer (b) and (c) below. a4

b Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If 'Yes,' describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations. 4b

c Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If 'Yes,' explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes. 4c

5a Did the organization add, substitute, or remove any supported organizations during the tax year? If 'Yes,' answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document). a5

b Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document? 5b

c Substitutions only. Was the substitution the result of an event beyond the organization's control? c5

6 Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization's supported organizations? If 'Yes,' provide detail in Part VI. 6

7 Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If 'Yes,' complete Part I of Schedule L (Form 990 or 990-EZ). 7 8 Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If 'Yes,' complete Part I of Schedule L (Form 990 or 990-EZ). 8

a9 Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other thanDRAFT foundation managers and organizations described in section 509(a)(1) or (2))? If 'Yes,' provide detail in Part VI. a9 b Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If 'Yes,' provide detail in Part VI. b9

c Did a disqualified person (as defined in line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If 'Yes,' provide detail in Part VI. c9

10a Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If 'Yes,' answer 10b below. 10a b Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings.) 10b

BAA TEEA0404L 08/10/17 Schedule A (Form 990 or 990-EZ) 2017

99 Schedule A (Form 990 or 990-EZ) 2017 ASSOCIATION OF ASIAN PACIFIC 94-3050247 Page 5 Part IV Supporting Organizations (continued) Yes No 11 Has the organization accepted a gift or contribution from any of the following persons? a A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization? 11a b A family member of a person described in (a) above? 11b c A 35% controlled entity of a person described in (a) or (b) above? If 'Yes' to a, b, or c, provide detail in Part VI. 11c Section B. Type I Supporting Organizations Yes No 1 Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization's directors or trustees at all times during the tax year? If 'No,' describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization's activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year. 1 2 Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If 'Yes,' explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised, or controlled the supporting organization. 2 Section C. Type II Supporting Organizations Yes No 1 Were a majority of the organization's directors or trustees during the tax year also a majority of the directors or trustees of each of the organization's supported organization(s)? If 'No,' describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s). 1 Section D. All Type III Supporting Organizations Yes No

1 Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization's tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization's governing documents in effect on the date of notification, to the extent not previously provided? 1

2 Were any of the organization's officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If 'No,' explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s). 2

3 By reason of the relationship described in (2), did the organization's supported organizations have a significant voice in the organization's investment policies and in directing the use of the organization's income or assets at all times during the tax year? If 'Yes,' describe in Part VI the role the organization's supported organizations played in this regard. 3 Section E. Type III Functionally Integrated Supporting Organizations

1 Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions). a The organization satisfied the Activities Test. Complete line 2 below. b The organization is the parent of each of its supported organizations. Complete line 3 below. c The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions). 2 Activities Test. Answer (a) and (b) below.DRAFT Yes No a Did substantially all of the organization's activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If 'Yes,' then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities. a2

b Did the activities described in (a) constitute activities that, but for the organization's involvement, one or more of the organization's supported organization(s) would have been engaged in? If 'Yes,' explain in Part VI the reasons for the organization's position that its supported organization(s) would have engaged in these activities but for the organization's involvement. b2

3 Parent of Supported Organizations. Answer (a) and (b) below. a Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI. a3

b Did the organization exercise a substantial degree of direction over the policies, programs, and activities of each of its supported organizations? If 'Yes,' describe in Part VI the role played by the organization in this regard. 3b

BAA TEEA0405L 08/10/17 Schedule A (Form 990 or 990-EZ) 2017 100 Schedule A (Form 990 or 990-EZ) 2017 ASSOCIATION OF ASIAN PACIFIC 94-3050247 Page 6 Part V Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations 1 Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E. (B) Current Year Section A ' Adjusted Net Income (A) Prior Year (optional) 1 Net short-term capital gain 1 2 Recoveries of prior-year distributions 2 3 Other gross income (see instructions) 3 4 Add lines 1 through 3. 4 5 Depreciation and depletion 5 6 Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) 6 7 Other expenses (see instructions) 7 8 Adjusted Net Income (subtract lines 5, 6, and 7 from line 4). 8 (B) Current Year Section B ' Minimum Asset Amount (A) Prior Year (optional)

1 Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): a Average monthly value of securities 1a b Average monthly cash balances 1b c Fair market value of other non-exempt-use assets c1 d Total (add lines 1a, 1b, and 1c) d1 e Discount claimed for blockage or other factors (explain in detail in Part VI): 2 Acquisition indebtedness applicable to non-exempt-use assets 2 3 Subtract line 2 from line 1d. 3 4 Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). 4 5 Net value of non-exempt-use assets (subtract line 4 from line 3) 5 6 Multiply line 5 by .035. 6 7 Recoveries of prior-year distributions 7 8 Minimum Asset Amount (add line 7 to line 6) 8 Section C ' Distributable Amount Current Year

1 Adjusted net income for prior year (from Section A, line 8, Column A) 1 2 Enter 85% of line 1. 2 3 Minimum asset amount for prior year (from Section B, line 8, Column A) 3 4 Enter greater of line 2 or line 3. 4 5 Income tax imposed in prior year 5 6 Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions). 6 7 Check here if the current year is theDRAFT organization's first as a non-functionally integrated Type III supporting organization (see instructions). BAA Schedule A (Form 990 or 990-EZ) 2017

TEEA0406L 08/10/17 101 Schedule A (Form 990 or 990-EZ) 2017 ASSOCIATION OF ASIAN PACIFIC 94-3050247 Page 7 Part V Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations (continued) Section D ' Distributions Current Year 1 Amounts paid to supported organizations to accomplish exempt purposes 2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity 3 Administrative expenses paid to accomplish exempt purposes of supported organizations 4 Amounts paid to acquire exempt-use assets 5 Qualified set-aside amounts (prior IRS approval required) 6 Other distributions (describe in Part VI). See instructions. 7 Total annual distributions. Add lines 1 through 6. 8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions. 9 Distributable amount for 2017 from Section C, line 6 10 Line 8 amount divided by line 9 amount (i) (ii) (iii) Section E ' Distribution Allocations (see instructions) Excess Underdistributions Distributable Distributions Pre-2017 Amount for 2017 1 Distributable amount for 2017 from Section C, line 6 2 Underdistributions, if any, for years prior to 2017 (reasonable cause required ' explain in Part VI). See instructions. 3 Excess distributions carryover, if any, to 2017 a

b From 2013...... c From 2014......

d From 2015...... e From 2016...... f Total of lines 3a through e g Applied to underdistributions of prior years h Applied to 2017 distributable amount i Carryover from 2012 not applied (see instructions) j Remainder. Subtract lines 3g, 3h, and 3i from 3f. 4 Distributions for 2017 from Section D, line 7: $ a Applied to underdistributions of prior years b Applied to 2017 distributable amount c Remainder. Subtract lines 4a and 4b from 4. 5 Remaining underdistributions for years prior to 2017, if any. Subtract lines 3g and 4a from line 2. For result greater than zero, explain in Part VI. See instructions. 6 Remaining underdistributions for 2017. Subtract lines 3h and 4b from line 1. For result greater than zero, explain in Part VI. See instructions. 7 Excess distributions carryover to 2018. Add lines 3j and 4c. 8 Breakdown of line 7: a Excess from 2013...... DRAFT b Excess from 2014...... c Excess from 2015......

d Excess from 2016......

e Excess from 2017...... BAA Schedule A (Form 990 or 990-EZ) 2017

TEEA0407L 08/22/17 102 Schedule A (Form 990 or 990-EZ) 2017 ASSOCIATION OF ASIAN PACIFIC 94-3050247 Page 8 Part VI Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b;Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a, and 3b; Part V, line 1; Part V, Section B, line 1e; Part V, Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions.)

PART II, LINE 10 - OTHER INCOME

NATURE AND SOURCE 2017 2016 2015 2014 2013

OTHER INCOME $ 15,641. $ 11,250. $ 31,341. $ 104,154. $ 88,998. TOTAL $ 15,641. $ 11,250. $ 31,341. $ 104,154. $ 88,998.

DRAFT

BAA TEEA0408L 08/10/17 Schedule A (Form 990 or 990-EZ) 2017 103 Schedule B OMB No. 1545-0047 (Form 990, 990-EZ, Schedule of Contributors or 990-PF) 2017 Department of the Treasury G Attach to Form 990, Form 990-EZ, or Form 990-PF. Internal Revenue Service G Go to www.irs.gov/Form990 for the latest information. Name of the organization ASSOCIATION OF ASIAN PACIFIC Employer identification number COMMUNITY HEALTH ORGANIZATION 94-3050247 Organization type (check one): Filers of: Section: Form 990 or 990-EZ X 501(c)( 3 ) (enter number) organization 4947(a)(1) nonexempt charitable trust not treated as a private foundation 527 political organization

Form 990-PF 501(c)(3) exempt private foundation 4947(a)(1) nonexempt charitable trust treated as a private foundation 501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.

Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions. General Rule For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules X For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33-1/3% support test of the regulations under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h; or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor, during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor, during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Don't complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ...... G $

Caution. An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990, 990-EZ, or 990-PF), but it must answer 'No' on Part IV, line 2, of its Form 990; or check the box on line H of its Form 990-EZ or on its Form 990-PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990, 990-EZ, or 990-PF). BAA For Paperwork Reduction Act Notice, see the instructionsDRAFT for Form 990, 990-EZ, or 990-PF. Schedule B (Form 990, 990-EZ, or 990-PF) (2017)

TEEA0701L 08/09/17 104 Schedule B (Form 990, 990-EZ, or 990-PF) (2017) Page 1of 1 of Part I Name of organization Employer identification number ASSOCIATION OF ASIAN PACIFIC 94-3050247

Part I Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.

(a) (b) (c) (d) Number Name, address, and ZIP + 4 Total Type of contribution contributions

Person 1 HEALTH RESOURCES & SERVICE ADM X Payroll 5600 FISHER LANE RM 11A-03 $ 355,967. Noncash

(Complete Part II for ROCKVILLE, MD 20857 noncash contributions.)

(a) (b) (c) (d) Number Name, address, and ZIP + 4 Total Type of contribution contributions

Person 2 WALLACE H. COULTER FOUNDATION X Payroll 790 NW 107TH AVENUE, SUITE 215 $ 191,535. Noncash

(Complete Part II for , FL 33172 noncash contributions.)

(a) (b) (c) (d) Number Name, address, and ZIP + 4 Total Type of contribution contributions

Person 3 CENTERS FOR DISEASE AND CONTROL PRE X Payroll 2920 BRANDYWINE ROAD $ 1,369,452. Noncash

(Complete Part II for ATLANTA, GA 30341 noncash contributions.)

(a) (b) (c) (d) Number Name, address, and ZIP + 4 Total Type of contribution contributions

Person Payroll $ Noncash

(Complete Part II for noncash contributions.)

(a) (b) (c) (d) Number Name, address, and ZIP + 4 Total Type of contribution contributions DRAFT Person Payroll $ Noncash

(Complete Part II for noncash contributions.)

(a) (b) (c) (d) Number Name, address, and ZIP + 4 Total Type of contribution contributions

Person Payroll $ Noncash

(Complete Part II for noncash contributions.)

BAA TEEA0702L 08/09/17 Schedule B (Form 990, 990-EZ, or 990-PF) (2017) 105 Schedule B (Form 990, 990-EZ, or 990-PF) (2017) Page 1to 1 of Part II Name of organization Employer identification number ASSOCIATION OF ASIAN PACIFIC 94-3050247 Part II Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.

(a) No. (b) (c) (d) from Description of noncash property given FMV (or estimate) Date received Part I (See instructions.)

N/A

$

(a) No. (b) (c) (d) from Description of noncash property given FMV (or estimate) Date received Part I (See instructions.)

$

(a) No. (b) (c) (d) from Description of noncash property given FMV (or estimate) Date received Part I (See instructions.)

$

(a) No. (b) (c) (d) from Description of noncash property given FMV (or estimate) Date received Part I (See instructions.)

$

(a) No. (b) (c) (d) from Description of noncash property given FMV (or estimate) Date received Part I (See instructions.)

DRAFT$ (a) No. (b) (c) (d) from Description of noncash property given FMV (or estimate) Date received Part I (See instructions.)

$

BAA Schedule B (Form 990, 990-EZ, or 990-PF) (2017)

TEEA0703L 08/09/17 106 Schedule B (Form 990, 990-EZ, or 990-PF) (2017) Page 1to 1 of Part III Name of organization Employer identification number ASSOCIATION OF ASIAN PACIFIC 94-3050247 Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.)...... G $ N/A Use duplicate copies of Part III if additional space is needed. (a) (b) (c) (d) No. from Purpose of gift Use of gift Description of how gift is held Part I N/A

(e) Transfer of gift Transferee's name, address, and ZIP + 4 Relationship of transferor to transferee

(a) (b) (c) (d) No. from Purpose of gift Use of gift Description of how gift is held Part I

(e) Transfer of gift Transferee's name, address, and ZIP + 4 Relationship of transferor to transferee

(a) (b) (c) (d) No. from Purpose of gift Use of gift Description of how gift is held Part I

(e) Transfer of gift Transferee's name,DRAFT address, and ZIP + 4 Relationship of transferor to transferee (a) (b) (c) (d) No. from Purpose of gift Use of gift Description of how gift is held Part I

(e) Transfer of gift Transferee's name, address, and ZIP + 4 Relationship of transferor to transferee

BAA Schedule B (Form 990, 990-EZ, or 990-PF) (2017) TEEA0704L 08/09/17 107 OMB No. 1545-0047 SCHEDULE D Supplemental Financial Statements (Form 990) G Complete if the organization answered 'Yes' on Form 990, Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b. 2017 G Attach to Form 990. Department of the Treasury Open to Public Internal Revenue Service G Go to www.irs.gov/Form990 for instructions and the latest information. Inspection Name of the organization Employer identification number ASSOCIATION OF ASIAN PACIFIC COMMUNITY HEALTH ORGANIZATION 94-3050247 Part I Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered 'Yes' on Form 990, Part IV, line 6. (a) Donor advised funds (b) Funds and other accounts 1 Total number at end of year ...... 2 Aggregate value of contributions to (during year)...... 3 Aggregate value of grants from (during year)...... 4 Aggregate value at end of year ......

5 Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization's property, subject to the organization's exclusive legal control?...... Yes No 6 Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...... Yes No Part II Conservation Easements. Complete if the organization answered 'Yes' on Form 990, Part IV, line 7. 1 Purpose(s) of conservation easements held by the organization (check all that apply). Preservation of land for public use (e.g., recreation or education) Preservation of a historically important land area Protection of natural habitat Preservation of a certified historic structure Preservation of open space 2 Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year. Held at the End of the Tax Year a Total number of conservation easements...... 2 a b Total acreage restricted by conservation easements...... 2 b c Number of conservation easements on a certified historic structure included in (a) ...... 2 c d Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register...... 2 d 3 Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the tax year G 4 Number of states where property subject to conservation easement is located G 5 Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ...... Yes No 6 Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year G 7 Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year G$ 8 Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)?...... Yes No 9 In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and balance sheet, and include, if applicable, the text of the footnote to the organization's financial statements that describes the organization's accounting for conservation easements. DRAFT Part III Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets. Complete if the organization answered 'Yes' on Form 990, Part IV, line 8. 1 a If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items. b If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items: (i) Revenue included on Form 990, Part VIII, line 1...... G$ (ii) Assets included in Form 990, Part X...... G$ 2 If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the following amounts required to be reported under SFAS 116 (ASC 958) relating to these items: a Revenue included on Form 990, Part VIII, line 1...... G$ b Assets included in Form 990, Part X ...... G$ BAA For Paperwork Reduction Act Notice, see the Instructions for Form 990. TEEA3301L 10/11/17 Schedule D (Form 990) 2017

108 Schedule D (Form 990) 2017 ASSOCIATION OF ASIAN PACIFIC 94-3050247 Page 2 Part III Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued) 3 Using the organization's acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply): a Public exhibition d Loan or exchange programs b Scholarly research e Other c Preservation for future generations 4 Provide a description of the organization's collections and explain how they further the organization's exempt purpose in Part XIII. 5 During the year, did the organization solicit or receive donations of art, historical treasures, or other similar assets to be sold to raise funds rather than to be maintained as part of the organization's collection?...... Yes No Part IV Escrow and Custodial Arrangements. Complete if the organization answered 'Yes' on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

1 a Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not included on Form 990, Part X?...... Yes No b If 'Yes,' explain the arrangement in Part XIII and complete the following table: Amount c Beginning balance ...... 1 c d Additions during the year...... 1 d e Distributions during the year...... 1 e f Ending balance...... 1 f 2 a Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability?. . . . . Yes No b If 'Yes,' explain the arrangement in Part XIII. Check here if the explanation has been provided on Part XIII......

Part V Endowment Funds. Complete if the organization answered 'Yes' on Form 990, Part IV, line 10. (a) Current year (b) Prior year (c) Two years back (d) Three years back (e) Four years back 1 a Beginning of year balance...... b Contributions ......

c Net investment earnings, gains, and losses...... d Grants or scholarships ...... e Other expenditures for facilities and programs...... f Administrative expenses...... g End of year balance...... 2 Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as: a Board designated or quasi-endowment G % b Permanent endowment G % c Temporarily restricted endowment G % The percentages on lines 2a, 2b, and 2c should equal 100%.

3 a Are there endowment funds not in the possession of the organization that are held and administered for the organization by: Yes No (i) unrelated organizations...... 3a(i) (ii) related organizations...... 3a(ii) b If 'Yes' on line 3a(ii), are the related organizations listed as required on Schedule R? ...... 3b 4 Describe in Part XIII the intended uses of the organization's endowment funds. Part VI DRAFT Land, Buildings, and Equipment. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11a. See Form 990, Part X, line 10. Description of property (a) Cost or other basis (b) Cost or other (c) Accumulated (d) Book value (investment) basis (other) depreciation 1 a Land...... b Buildings...... c Leasehold improvements...... d Equipment...... 23,529. 23,529. 0. e Other ...... Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10c.)...... G 0. BAA Schedule D (Form 990) 2017

TEEA3302L 08/10/17 109 Schedule D (Form 990) 2017 ASSOCIATION OF ASIAN PACIFIC 94-3050247 Page 3 Part VII Investments ' Other Securities. N/A Complete if the organization answered 'Yes' on Form 990, Part IV, line 11b. See Form 990, Part X, line 12. (a) Description of security or category (including name of security) (b) Book value (c) Method of valuation: Cost or end-of-year market value (1) Financial derivatives...... (2) Closely-held equity interests...... (3) Other (A) (B) (C) (D) (E) (F) (G) (H) (I) Total. (Column (b) must equal Form 990, Part X, column (B) line 12.). . . G Part VIII Investments ' Program Related. N/A Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13. (a) Description of investment (b) Book value (c) Method of valuation: Cost or end-of-year market value (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) Total. (Column (b) must equal Form 990, Part X, column (B) line 13.). . . G Part IX Other Assets. N/A Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15. (a) Description (b) Book value (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) Total. (Column (b) must equal Form 990, Part X, column (B) line 15.)...... G Part X Other Liabilities. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25 (a) Description of liabilityDRAFT(b) Book value (1) Federal income taxes (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) Total. (Column (b) must equal Form 990, Part X, column (B) line 25.)...... G 2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII......

BAA TEEA3303L 08/10/17 Schedule D (Form 990) 2017 110 Schedule D (Form 990) 2017 ASSOCIATION OF ASIAN PACIFIC 94-3050247 Page 4 Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a. 1 Total revenue, gains, and other support per audited financial statements ...... 1 2,440,914. 2 Amounts included on line 1 but not on Form 990, Part VIII, line 12: a Net unrealized gains (losses) on investments...... 2 a b Donated services and use of facilities ...... 2 b c Recoveries of prior year grants...... 2 c d Other (Describe in Part XIII.)...... 2 d e Add lines 2a through 2d...... 2 e 3 Subtract line 2e from line 1...... 3 2,440,914. 4 Amounts included on Form 990, Part VIII, line 12, but not on line 1: a Investment expenses not included on Form 990, Part VIII, line 7b...... 4 a b Other (Describe in Part XIII.)...... 4 b c Add lines 4a and 4b...... 4 c 5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.)...... 5 2,440,914. Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a. 1 Total expenses and losses per audited financial statements...... 1 2,534,314. 2 Amounts included on line 1 but not on Form 990, Part IX, line 25: a Donated services and use of facilities ...... 2 a b Prior year adjustments ...... 2 b c Other losses...... 2 c d Other (Describe in Part XIII.)...... 2 d e Add lines 2a through 2d...... 2 e 3 Subtract line 2e from line 1...... 3 2,534,314. 4 Amounts included on Form 990, Part IX, line 25, but not on line 1: a Investment expenses not included on Form 990, Part VIII, line 7b...... 4 a b Other (Describe in Part XIII.)...... 4 b c Add lines 4a and 4b...... 4 c 5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.)...... 5 2,534,314. Part XIII Supplemental Information. Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part IV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information. DRAFT

BAA Schedule D (Form 990) 2017

TEEA3304L 08/10/17 111 SCHEDULE F Statement of Activities Outside the United States OMB No. 1545-0047 (Form 990) G Complete if the organization answered 'Yes' on Form 990, Part IV, line 14b, 15, or 16. G Attach to Form 990. 2017 Department of the Treasury Open to Public Internal Revenue Service G Go to www.irs.gov/Form990 for instructions and the latest information Inspection Name of the organization Employer identification number ASSOCIATION OF ASIAN PACIFIC COMMUNITY HEALTH ORGANIZATION 94-3050247 Part I General Information on Activities Outside the United States. Complete if the organization answered 'Yes' on Form 990, Part IV, line 14b.

1 For grantmakers. Does the organization maintain records to substantiate the amount of its grants and other assistance, the grantees' eligibility for the grants or assistance, and the selection criteria used to award the grants or assistance?. . . . X Yes No

2 For grantmakers. Describe in Part V the organization's procedures for monitoring the use of its grants and other assistance outside the United States. PART V

3 Activities per Region. (The following Part I, line 3 table can be duplicated if additional space is needed.)

(a) Region (b) Number of (c) Number of (d) Activities conducted in (e) If activity listed in (f) Total offices in the employees, the region (by type) (such (d) is a program expenditures for region agents, and as, fundraising, program service, describe and investments independent services, investments, specific type of in the region contractors grants to recipients service(s) in in the region located in the region) the region PT V DIABETES (1) E ASIA, PACIFIC PROGRAM SERVICES PREVENTION 316,100.

(2)

(3)

(4)

(5)

(6)

(7)

(8)

(9)

(10)

(11)

(12) (13) DRAFT (14)

(15)

(16)

(17) 3 a Sub-total...... 316,100. b Total from continuation sheets to Part I...... c Totals (add lines 3a and 3b). . . 0 0 316,100. BAA For Paperwork Reduction Act Notice, see the Instructions for Form 990. Schedule F (Form 990) 2017

TEEA3501L 08/10/17 112 Schedule F (Form 990) 2017 ASSOCIATION OF ASIAN PACIFIC 94-3050247 Page 2 Part II Grants and Other Assistance to Organizations or Entities Outside the United States. Complete if the organization answered 'Yes' on Form 990, Part IV, line 15, for any recipient who received more than $5,000. Part II can be duplicated if additional space is needed.

1 (a) Name of organization (b) IRS code (c) Region (d) Purpose (e) Amount of (f) Manner of (g) Amount of (h) Description of (i) Method of section and EIN of grant cash grant cash noncash noncash valuation (book, (if applicable) disbursement assistance assistance FMV, appraisal, other) PART V E ASIA, DIABETES (1) PACIFIC PREVENTION 95,500. CHECK E ASIA, DIABETES (2) PACIFIC PREVENTION 104,772. CHECK E ASIA, DIABETES (3) PACIFIC PREVENTION 115,828. CHECK

(4)

(5)

(6)

(7)

(8)

(9)

(10)

(11)

(12)

(13)

(14)

(15) (16) DRAFT 2 Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exempt by the IRS, or for which the grantee or counsel has provided a section 501(c)(3) equivalency letter...... G 3 3 Enter total number of other organizations or entities...... G 0 BAA Schedule F (Form 990) 2017

TEEA3502L 08/10/17 113 Schedule F (Form 990) 2017 ASSOCIATION OF ASIAN PACIFIC 94-3050247 Page 3 Part III Grants and Other Assistance to Individuals Outside the United States. Complete if the organization answered 'Yes' on Form 990, Part IV, line 16. Part III can be duplicated if additional space is needed.

(a) Type of grant or assistance (b) Region (c) Number (d) Amount of (e) Manner of (f) Amount of (g) Description of (h) Method of of recipients cash grant cash noncash assistance noncash assistance valuation (book, disbursement FMV, appraisal, other)

(1)

(2)

(3)

(4)

(5)

(6)

(7)

(8)

(9)

(10)

(11)

(12)

(13)

(14) (15) DRAFT (16)

(17)

(18) BAA Schedule F (Form 990) 2017 TEEA3503L 08/10/17 114 Schedule F (Form 990) 2017 ASSOCIATION OF ASIAN PACIFIC 94-3050247 Page 4 Part IV Foreign Forms

1 Was the organization a U.S. transferor of property to a foreign corporation during the tax year? If 'Yes,' the organization may be required to file Form 926, Return by a U.S. Transferor of Property to a Foreign Corporation (see Instructions for Form 926)...... Yes X No

2 Did the organization have an interest in a foreign trust during the tax year? If 'Yes,' the organization may be required to separately file Form 3520, Annual Return To Report Transactions with Foreign Trusts and Receipt of Certain Foreign Gifts, and/or Form 3520-A Annual Information Return of Foreign Trust With a U.S. Owner (see Instructions for Forms 3520 and 3520-A; do not file with Form 990)...... Yes X No

3 Did the organization have an ownership interest in a foreign corporation during the tax year? If 'Yes,' the organization may be required to file Form 5471, Information Return of U.S. Persons With Respect To Certain Foreign Corporations (see Instructions for Form 5471)...... Yes X No

4 Was the organization a direct or indirect shareholder of a passive foreign investment company or a qualified electing fund during the tax year? If 'Yes,' the organization may be required to file Form 8621, Information Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund (see Instructions for Form 8621)...... Yes X No

5 Did the organization have an ownership interest in a foreign partnership during the tax year? If 'Yes,' the organization may be required to file Form 8865, Return of U.S. Persons With Respect to Certain Foreign Partnerships (see Instructions for Form 8865)...... Yes X No

6 Did the organization have any operations in or related to any boycotting countries during the tax year? If 'Yes,' the organization may be required to separately file Form 5713, International Boycott Report (see Instructions for Form 5713; do not file with Form 990)...... Yes X No

BAA TEEA3505L 08/10/17 Schedule F (Form 990) 2017

DRAFT

115 Schedule F (Form 990) 2017 ASSOCIATION OF ASIAN PACIFIC 94-3050247 Page 5 Part V Supplemental Information Provide the information required by Part I, line 2 (monitoring of funds); Part I, line 3, column (f) (accounting method; amounts of investments vs. expenditures per region); Part II, line 1 (accounting method); Part III (accounting method); and Part III, column (c) (estimated number of recipients), as applicable. Also complete this part to provide any additional information. See instructions. PART I, LINE 2 - GRANTMAKERS EXPLANATION FOR MONITORING USE OF FUNDS OUTSIDE US

GRANT AGREEMENTS REQUIRES REPORTING FROM RECEIPIENTS.

PART I, LINE 3F - METHOD OF ACCOUNTING

ACCRUAL

PART II, LINE 1 - METHOD OF ACCOUNTING

ACCRUAL ACCOUNTING

DRAFT

BAA TEEA3504L 08/10/17 Schedule F (Form 990) 2017 116 OMB No. 1545-0047 SCHEDULE I Grants and Other Assistance to Organizations, (Form 990) Governments, and Individuals in the United States 2017 Complete if the organization answered 'Yes' on Form 990, Part IV, line 21 or 22. G Attach to Form 990. Open to Public Department of the Treasury Internal Revenue Service G Go to www.irs.gov/Form990 for the latest information Inspection Name of the organization ASSOCIATION OF ASIAN PACIFIC Employer identification number COMMUNITY HEALTH ORGANIZATION 94-3050247 Part I General Information on Grants and Assistance 1 Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and the selection criteria used to award the grants or assistance?...... X Yes No 2 Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States. SEE PART IV Part II Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered 'Yes' on Form 990, Part IV, line 21, for any recipient that received more than $5,000. Part II can be duplicated if additional space is needed.

1 (a) Name and address of organization (b) EIN (c) IRC section (d) Amount of cash grant (e) Amount of non-cash (f) Method of valuation (g) Description of (h) Purpose of grant or government (if applicable) assistance (book, FMV, appraisal, noncash assistance or assistance other) (1) WAIKIKI HEALTH CENTER CHARN II 277 OHUA AVENUE RESEARCH NODE , HI 96815 99-0159253 7,500. 0. HEALTH CENTE (2) CHARLES B WANG COMMT. HEALTH CIVIC 268 CANAL STREET ENGAGEMENT; NEW YORK, NY 10013 13-2739694 7,500. 0. CHARN II RES. (3) PACIFIC ARKANSAS COALITION OF MARSHAL ISLANDER 614 EAST EMMA AVE. BOX 210 DIABETES (4) SPRINGDALE, AR 72764 125,980. 0. PREVENTIO PACIFIC MALAMA I KE OLA HEALTH CENTER ISLANDER (5) 1881 NANI STREET DIABETES WAILUKU, HI 96793 137,000. 0. PREVENTIO

(6)

(7)

(8) DRAFT

2 Enter total number of section 501(c)(3) and government organizations listed in the line 1 table...... G 2 3 Enter total number of other organizations listed in the line 1 table...... G 2 BAA For Paperwork Reduction Act Notice, see the Instructions for Form 990. TEEA3901L 08/10/17 Schedule I (Form 990) (2017)

117 Schedule I (Form 990) (2017) ASSOCIATION OF ASIAN PACIFIC 94-3050247 Page 2 Part III Grants and Other Assistance to Domestic Individuals. Complete if the organization answered 'Yes' on Form 990, Part IV, line 22. Part III can be duplicated if additional space is needed.

(a) Type of grant or assistance (b) Number of (c) Amount of (d) Amount of (e) Method of valuation (book, (f) Description of noncash assistance recipients cash grant noncash assistance FMV, appraisal, other)

1

2

3

4

5

6

7 Part IV Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.

PART I, LINE 2 - PROCEDURES FOR MONITORING USE OF GRANTS FUNDS IN U.S.

GRANT AGREEMENT REQUIRES REPORTING FROM RECIPIENTS.

DRAFT

BAA Schedule I (Form 990) (2017)

TEEA3902L 11/03/16 118 SCHEDULE J Compensation Information OMB No. 1545-0047 (Form 990) For certain Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees 2017 G Complete if the organization answered 'Yes' on Form 990, Part IV, line 23. G Attach to Form 990. Department of the Treasury Open to Public Internal Revenue Service G Go to www.irs.gov/form990 for instructions and the latest information Inspection Name of the organization ASSOCIATION OF ASIAN PACIFIC Employer identification number COMMUNITY HEALTH ORGANIZATION 94-3050247 Part I Questions Regarding Compensation Yes No 1 a Check the appropriate box(es) if the organization provided any of the following to or for a person listed on Form 990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items. PART III First-class or charter travel Housing allowance or residence for personal use Travel for companions Payments for business use of personal residence Tax indemnification and gross-up payments X Health or social club dues or initiation fees Discretionary spending account Personal services (such as, maid, chauffeur, chef)

b If any of the boxes on line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If 'No,' complete Part III to explain...... 1 b X

2 Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all directors, trustees, and officers, including the CEO/Executive Director, regarding the items checked on line 1a? ...... 2

3 Indicate which, if any, of the following the filing organization used to establish the compensation of the organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III. Compensation committee X Written employment contract Independent compensation consultant Compensation survey or study Form 990 of other organizations X Approval by the board or compensation committee

4 During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization: a Receive a severance payment or change-of-control payment? ...... 4 a X b Participate in, or receive payment from, a supplemental nonqualified retirement plan? ...... 4 b X c Participate in, or receive payment from, an equity-based compensation arrangement?...... 4 c X If 'Yes' to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only section 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

5 For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any compensation contingent on the revenues of: a The organization?...... 5 a X b Any related organization? ...... 5 b X If 'Yes' on line 5a or 5b, describe in Part III.

6 For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any compensation contingent on the net earnings of: a The organization?...... 6 a X b Any related organization? ...... 6 b X If 'Yes' on line 6a or 6b, describe in PartDRAFT III. 7 For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed payments not described on lines 5 and 6? If 'Yes,' describe in Part III...... 7 X 8 Were any amounts reported on Form 990, Part VII, paid or accrued pursuant to a contract that was subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If 'Yes,' describe in Part III ...... 8 X 9 If 'Yes' on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? ...... 9 BAA For Paperwork Reduction Act Notice, see the Instructions for Form 990. Schedule J (Form 990) 2017

TEEA4101L 08/09/17 119 Schedule J (Form 990) 2017 ASSOCIATION OF ASIAN PACIFIC 94-3050247 Page 2 Part II Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.

For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the instructions, on row (ii). Do not list any individuals that aren't listed on Form 990, Part VII. Note: The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.

(B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement (D) Nontaxable (E) Total of (F) Compensation (i) (A) Name and Title Base (ii) Bonus & incentive (iii) Other and other benefits columns(B)(i)-(D) in column (B) compensation compensation reportable compensation deferred reported as compensation deferred on prior Form 990 JEFFREY CABALLERO (i) 159,370. 0. 0. 0. 0. 159,370. 0. 1 EXECUTIVE DIR. (ii) 0. 0. 0. 0. 0. 0. 0. (i) 2 (ii) (i) 3 (ii) (i) 4 (ii) (i) 5 (ii) (i) 6 (ii) (i) 7 (ii) (i) 8 (ii) (i) 9 (ii) (i) 10 (ii) (i) 11 (ii) (i) 12 (ii) (i) 13 (ii) (i) DRAFT 14 (ii) (i) 15 (ii) (i) 16 (ii) BAA TEEA4102L 08/09/17 Schedule J (Form 990) 2017

120 Schedule J (Form 990) 2017 ASSOCIATION OF ASIAN PACIFIC 94-3050247 Page 3 Part III Supplemental Information Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.

PART 1, LINE 1A - RELEVANT INFORMATION REGARDING COMPENSATION BENEFITS

AAPCHO ESTABLISHED A CORPORATE GYM ACCOUNT FOR AAPCHO STAFF LOCATED IN THE SAN

FRANCISCO BAY AREA, WITH ACTIVE SPORTS, FORMERLY CLUB ONE. AAPCHO NEGOTIATED A RATE

OF $52.08/STAFF/MONTH. AAPCHO EXTENDED THE BENEFIT TO STAFF LOCATED OUTSIDE THE

AREA/UNABLE TO USE THE FACILITY, CAPPING TO THE EQUIVALENT COST OF MONTHLY

MEMBERSHIP. AAPCHO PAYS THE LESSER OF ACTUAL COST OR AAPCHO’S COST PER STAFF THROUGH

OUR CORPORATE ACCOUNT. STAFF ARE ASKED TO PROVIDE DOCUMENTATION OF GYM OR EQUIVALENT

MEMBERSHIP.

DRAFT

BAA Schedule J (Form 990) 2017

TEEA4103L 08/09/17 121 SCHEDULE O Supplemental Information to Form 990 or 990-EZ OMB No. 1545-0047 (Form 990 or 990-EZ) Complete to provide information for responses to specific questions on Form 990 or 990-EZ or to provide any additional information. 2017 G Attach to Form 990 or 990-EZ. Open to Public Department of the Treasury G Go to www.irs.gov/Form990 for the latest information. Internal Revenue Service Inspection Name of the organization ASSOCIATION OF ASIAN PACIFIC Employer identification number COMMUNITY HEALTH ORGANIZATION 94-3050247

FORM 990, PART III, LINE 1 - ORGANIZATION MISSION

AAPCHO IS A NATIONAL ASSOCIATION REPRESENTING COMMUNITY HEALTH ORGANIZATIONS

DEDICATED TO PROMOTING ADVOCACY, COLLABORATION AND LEADERSHIP THAT IMPROVES THE

HEALTH STATUS AND ACCESS OF ASIAN AMERICANS & NATIVE HAWAIIANS AND OTHER PACIFIC

ISLANDERS (AA&NHOPI) WITHIN THE UNITED STATES, ITS TERRITORIES, AND FREELY

ASSOCIATED STATES, PRIMARILY THROUGH OUR MEMBER COMMUNITY HEALTH CENTERS.

FORM 990, PART VI, LINE 4 - SIGNIFICANT CHANGES TO ORGANIZATIONAL DOCUMENTS

AAPCHO'S BYLAWS WERE UPDATED TO CLARIFY DESIGNATOR ORGANIZATION QUALIFICATIONS,

ADJUST THE TERM OF BOARD OFFICERS TO TWO YEARS, SPECIFY SUSPENSION AND REMOVAL

CRITERIAL OF AAPCHO ASSOCIATE MEMBERS, INCREASE THE NUMBER OF MEETINGS BY THE BOARD

OF DIRECTORS, ALLOW MORE THAN ONE BOARD COMMITTEE, AND INCREASE THE NUMBER OF

CONSUMER DIRECTORS ON THE BOARD OF DIRECTORS.

FORM 990, PART VI, LINE 6 - EXPLANATION OF CLASSES OF MEMBERS OR SHAREHOLDER

MEMBERS ARE NONPROFIT HEALTH CENTERS AND ORGANIZATIONS THAT ARE INVOLVED IN

HEALTH-RELATED ISSUES OF THE AA&NHOPI COMMUNITY

FORM 990, PART VI, LINE 7A - HOW MEMBERS OR SHAREHOLDERS ELECT GOVERNING BODY

EACH FULL MEMBER HAS A REPRESENTATIVE ON THE BOARD AND THE BOARD OF DIRECTORS, BY

MAJORITY VOTE, ELECT A CONSUMER BOARD MEMBER. FORM 990, PART VI, LINE 7B - DECISIONSDRAFT OF GOVERNING BODY APPROVAL BY MEMBERS OR SHAREHOLDERS DECISIONS ARE VOTED ON AND APPROVED BY THE BOARD OF DIRECTORS. EACH FULL MEMBER HAS

A REPRESENTATIVE ON THE BOARD AND HAS ONE VOTE. THE CONSUMER BOARD MEMBER HAS ONE

VOTE.

FORM 990, PART VI, LINE 11B - FORM 990 REVIEW PROCESS

A FINAL DRAFT IS E-MAILED TO EACH MEMBER OF THE BOARD FOR THEIR REVIEW BEFORE THE

ACTUAL FILING.

BAA For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ. TEEA4901L 08/09/17 Schedule O (Form 990 or 990-EZ) (2017) 122 Schedule O (Form 990 or 990-EZ) (2017) Page 2 Name of the organization ASSOCIATION OF ASIAN PACIFIC Employer identification number COMMUNITY HEALTH ORGANIZATION 94-3050247

FORM 990, PART VI, LINE 19 - OTHER ORGANIZATION DOCUMENTS PUBLICLY AVAILABLE

THE GOVERNING DOCUMENTS, POLICIES, AND FINANCIAL STATEMENTS ARE KEPT IN THE

ADMINISTRATIVE OFFICE AND ARE AVAILABLE UPON REQUEST.

DRAFT

BAA Schedule O (Form 990 or 990-EZ) (2017) TEEA4902L 08/09/17 123 TAXABLE YEAR California Exempt Organization FORM 2017 Annual Information Return 199 Calendar Year 2017 or fiscal year beginning (mm/dd/yyyy) 10/01/2017 , and ending (mm/dd/yyyy) 9/30/2018 . Corporation/Organization name California corporation number ASSOCIATION OF ASIAN PACIFIC COMMUNITY HEALTH ORGANIZATION 1586988 Additional information. See instructions. FEIN 94-3050247 Street address (suite or room) PMB no. 101 CALLAN AVENUE #400 City State Zip code SAN LEANDRO CA 94577 Foreign country name Foreign province/state/county Foreign postal code

A First Return...... Yes X No J If exempt under R&TC Section 23701d, has the organization engaged in political activities? B Amended Return ...... @ Yes X No See instructions ...... @ Yes X No C IRC Section 4947(a)(1) trust...... Yes X No D Final Information Return? K Is the organization exempt under R&TC Section 23701g?. . . @ Yes X No @ Dissolved Surrendered (Withdrawn) Merged/Reorganized If 'Yes,' enter the gross receipts from Enter date (mm/dd/yyyy) @ nonmember sources ...... $ E Check accounting method: L If organization is exempt under R&TC Section 23701d 1 Cash 2 X Accrual 3 Other and meets the filing fee exception, check box. F Federal return filed? 1 @@990T 2 990-PF 3 @ Sch H (990) No filing fee is required...... @ X 4 Other 990 series M Is the organization a Limited Liability Company?...... @ Yes X No G Is this a group filing? See instructions ...... @ Yes X No N Did the organization file Form 100 or Form 109 to report taxable income?...... @ Yes X No H Is this organization in a group exemption?...... Yes X No O Is the organization under audit by the IRS or has the IRS If 'Yes,' what is the parent's name? audited in a prior year?...... @ Yes X No P Is federal Form 1023/1024 pending? ...... Yes No I Did the organization have any changes to its guidelines Date filed with IRS not reported to the FTB? See instructions...... @ Yes X No CACA1112L 01/02/18 Part I Complete Part I unless not required to file this form. See General Information B and C. 1 Gross sales or receipts from other sources. From Side 2, Part II, line 8...... @ 1 294,696. 2 Gross dues and assessments from members and affiliates...... @ 2 Receipts 3 Gross contributions, gifts, grants, and similar amounts received...... SEE...... SCH...... B . . @ 3 and 2,146,218. Revenues 4 Total gross receipts for filing requirement test. Add line 1 through line 3. This line must be completed. If the result is less than $50,000, see General Information B. . . @ 4 2,440,914. 5 Cost of goods sold ...... @ 5 6 Cost or other basis, and sales expenses of assets sold...... @ 6 7 Total costs. Add line 5 and line 6...... 7 8 Total gross income. Subtract line 7 from line 4...... @ 8 2,440,914. 9 Total expenses and disbursements. From Side 2, Part II, line 18 ...... @ 9 Expenses 2,534,314. 10 Excess of receipts over expenses and disbursements. Subtract line 9 from line 8...... @ 10 -93,400. 11 Total payments ...... @ 11 12 Use tax. See General Information K...... @ 12 13 Payments balance. If line 11 is more than line 12, subtract line 12 from line 11 ...... @ 13 14 Use tax balance. If line 12 is more than line 11, subtract line 11 from line 12...... 14 Filing @ Fee 15 Filing fee $10 or $25. SeeDRAFT General Information F...... 15 16 Penalties and Interest. See General Information J...... 16

17 Balance due. Add line 12, line 15, and line 16. Then subtract line 11 from the result ...... > 17 0. Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, Sign correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge. Here Title Date Signature @ Telephone of officer G EXECUTIVE DIR. (510) 272-9536 Date Check if @ PTIN Preparer's self- Paid signature G SUSAN MOSTAJO employed G P02016957 Preparer's @ FEIN Firm's name WUHOOVER & CO LLP Use Only (or yours, if self-employed) G 1510 FASHION ISLAND BLVD 27-2481245 and address SAN MATEO, CA 94404 @ Telephone 650-212-3888 May the FTB discuss this return with the preparer shown above? See instructions ...... @ X Yes No

059 3651174 Form 199 2017 Side 1 124 ASSOCIATION OF ASIAN PACIFIC 94-3050247 Part II Organizations with gross receipts of more than $50,000 and private foundations regardless of amount of gross receipts ' complete Part II or furnish substitute information. 1 Gross sales or receipts from all business activities. See instructions...... @ 1 2 Interest...... @ 2 3 Dividends...... @ 3 40. Receipts from 4 Gross rents...... @ 4 Other 5 Gross royalties...... @ 5 Sources 6 Gross amount received from sale of assets (See Instructions)...... @ 6 7 Other income. Attach schedule...... SEE ...... STATEMENT ...... 1. . @ 7 294,656. 8 Total gross sales or receipts from other sources. Add line 1 through line 7. Enter here and on Side 1, Part I, line 1 ...... 8 294,696. 9 Contributions, gifts, grants, and similar amounts paid. Attach schedule...... SEE ...... STATEMENT ...... 2. . @ 9 596,080. 10 Disbursements to or for members...... @ 10 11 Compensation of officers, directors, and trustees. Attach schedule ...... @ 11 182,641. 12 Other salaries and wages...... @ 12 712,231. Expenses Interest...... and 13 @ 13 Disburse- 14 Taxes ...... @ 14 127,859. ments 15 Rents ...... @ 15 102,637. 16 Depreciation and depletion (See instructions)...... @ 16 17 Other Expenses and Disbursements. Attach schedule...... SEE ...... STATEMENT ...... 3. . @ 17 812,866. 18 Total expenses and disbursements. Add line 9 through line 17. Enter here and on Side 1, Part I, line 9 ...... 18 2,534,314. Schedule L Balance Sheet Beginning of taxable year End of taxable year Assets (a) (b) (c) (d) 1 Cash...... 426,152. @ 364,100. 2 Net accounts receivable ...... 586,199. @ 456,680. 3 Net notes receivable...... @ 4 Inventories...... @ 5 Federal and state government obligations ...... @ 6 Investments in other bonds...... @ 7 Investments in stock ...... @ 8 Mortgage loans ...... @ 9 Other investments. Attach schedule...... @ 10 a Depreciable assets...... 23,529. 23,529. b Less accumulated depreciation...... 23,529. 23,529. 11 Land...... @ 12 Other assets. Attach schedule...... STM...... 4 35,562. @ 52,363. 13 Total assets ...... 1,047,913. 873,143. Liabilities and net worth 14 Accounts payable...... 98,624. @ 340,506. 15 Contributions, gifts, or grants payable...... @ 16 Bonds and notes payable ...... @ 17 Mortgages payable...... @ 18 Other liabilities. Attach schedule...... 19 Capital stock or principal fund ...... 949,289. @ 532,637. 20 Paid-in or capital surplus. Attach reconciliation...... @ @ 21 Retained earnings or income fund...... DRAFT . . . . . 22 Total liabilities and net worth ...... 1,047,913. 873,143. Schedule M-1 Reconciliation of income per books with income per return Do not complete this schedule if the amount on Schedule L, line 13, column (d), is less than $50,000. 1 Net income per books...... @ -93,400. 7 Income recorded on books this year not included 2 Federal income tax...... @ in this return. Attach schedule...... @ 3 Excess of capital losses over capital gains...... @ 8 Deductions in this return not charged 4 Income not recorded on books this year. against book income this year. Attach schedule...... @ Attach schedule...... @ 5 Expenses recorded on books this year not deducted 9 Total. Add line 7 and line 8...... in this return. Attach schedule ...... @ 10 Net income per return. 6 Total. Add line 1 through line 5...... -93,400. Subtract line 9 from line 6...... -93,400.

Side 2 Form 199 2017 059 3652174 CACA1112L 01/02/18 125 Schedule B CALIFORNIA COPY OMB No. 1545-0047 (Form 990, 990-EZ, Schedule of Contributors or 990-PF) 2017 Department of the Treasury G Attach to Form 990, Form 990-EZ, or Form 990-PF. Internal Revenue Service G Go to www.irs.gov/Form990 for the latest information. Name of the organization ASSOCIATION OF ASIAN PACIFIC Employer identification number COMMUNITY HEALTH ORGANIZATION 94-3050247 Organization type (check one): Filers of: Section: Form 990 or 990-EZ X 501(c)( 3 ) (enter number) organization 4947(a)(1) nonexempt charitable trust not treated as a private foundation 527 political organization

Form 990-PF 501(c)(3) exempt private foundation 4947(a)(1) nonexempt charitable trust treated as a private foundation 501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.

Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions. General Rule X For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33-1/3% support test of the regulations under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h; or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor, during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor, during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Don't complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ...... G $

Caution. An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990, 990-EZ, or 990-PF), but it must answer 'No' on Part IV, line 2, of its Form 990; or check the box on line H of its Form 990-EZ or on its Form 990-PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990, 990-EZ, or 990-PF). BAA For Paperwork Reduction Act Notice, see the instructionsDRAFT for Form 990, 990-EZ, or 990-PF. Schedule B (Form 990, 990-EZ, or 990-PF) (2017)

TEEA0701L 08/09/17 126 Schedule B (Form 990, 990-EZ, or 990-PF) (2017) Page 1of 1 of Part I Name of organization Employer identification number ASSOCIATION OF ASIAN PACIFIC 94-3050247

Part I Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.

(a) (b) (c) (d) Number Name, address, and ZIP + 4 Total Type of contribution contributions

Person 1 HEALTH RESOURCES & SERVICE ADM X Payroll 5600 FISHER LANE RM 11A-03 $ 355,967. Noncash

(Complete Part II for ROCKVILLE, MD 20857 noncash contributions.)

(a) (b) (c) (d) Number Name, address, and ZIP + 4 Total Type of contribution contributions

Person 2 WALLACE H. COULTER FOUNDATION X Payroll 790 NW 107TH AVENUE, SUITE 215 $ 191,535. Noncash

(Complete Part II for MIAMI, FL 33172 noncash contributions.)

(a) (b) (c) (d) Number Name, address, and ZIP + 4 Total Type of contribution contributions

Person 3 CENTERS FOR DISEASE AND CONTROL PRE X Payroll 2920 BRANDYWINE ROAD $ 1,369,452. Noncash

(Complete Part II for ATLANTA, GA 30341 noncash contributions.)

(a) (b) (c) (d) Number Name, address, and ZIP + 4 Total Type of contribution contributions

Person Payroll $ Noncash

(Complete Part II for noncash contributions.)

(a) (b) (c) (d) Number Name, address, and ZIP + 4 Total Type of contribution contributions DRAFT Person Payroll $ Noncash

(Complete Part II for noncash contributions.)

(a) (b) (c) (d) Number Name, address, and ZIP + 4 Total Type of contribution contributions

Person Payroll $ Noncash

(Complete Part II for noncash contributions.)

BAA TEEA0702L 08/09/17 Schedule B (Form 990, 990-EZ, or 990-PF) (2017) 127 Schedule B (Form 990, 990-EZ, or 990-PF) (2017) Page 1to 1 of Part II Name of organization Employer identification number ASSOCIATION OF ASIAN PACIFIC 94-3050247 Part II Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.

(a) No. (b) (c) (d) from Description of noncash property given FMV (or estimate) Date received Part I (See instructions.)

N/A

$

(a) No. (b) (c) (d) from Description of noncash property given FMV (or estimate) Date received Part I (See instructions.)

$

(a) No. (b) (c) (d) from Description of noncash property given FMV (or estimate) Date received Part I (See instructions.)

$

(a) No. (b) (c) (d) from Description of noncash property given FMV (or estimate) Date received Part I (See instructions.)

$

(a) No. (b) (c) (d) from Description of noncash property given FMV (or estimate) Date received Part I (See instructions.)

DRAFT$ (a) No. (b) (c) (d) from Description of noncash property given FMV (or estimate) Date received Part I (See instructions.)

$

BAA Schedule B (Form 990, 990-EZ, or 990-PF) (2017)

TEEA0703L 08/09/17 128 Schedule B (Form 990, 990-EZ, or 990-PF) (2017) Page 1to 1 of Part III Name of organization Employer identification number ASSOCIATION OF ASIAN PACIFIC 94-3050247 Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.)...... G $ N/A Use duplicate copies of Part III if additional space is needed. (a) (b) (c) (d) No. from Purpose of gift Use of gift Description of how gift is held Part I N/A

(e) Transfer of gift Transferee's name, address, and ZIP + 4 Relationship of transferor to transferee

(a) (b) (c) (d) No. from Purpose of gift Use of gift Description of how gift is held Part I

(e) Transfer of gift Transferee's name, address, and ZIP + 4 Relationship of transferor to transferee

(a) (b) (c) (d) No. from Purpose of gift Use of gift Description of how gift is held Part I

(e) Transfer of gift Transferee's name,DRAFT address, and ZIP + 4 Relationship of transferor to transferee (a) (b) (c) (d) No. from Purpose of gift Use of gift Description of how gift is held Part I

(e) Transfer of gift Transferee's name, address, and ZIP + 4 Relationship of transferor to transferee

BAA Schedule B (Form 990, 990-EZ, or 990-PF) (2017) TEEA0704L 08/09/17 129 2017 CALIFORNIA STATEMENTS PAGE 1 ASSOCIATION OF ASIAN PACIFIC COMMUNITY HEALTH ORGANIZATION 94-3050247

STATEMENT 1 FORM 199, PART II, LINE 7 OTHER INCOME

OTHERS...... $ 15,641. PROGRAM SERVICE REVENUE ...... 279,015. TOTAL $ 294,656.

STATEMENT 2 FORM 199, PART II, LINE 9 CONTRIBUTIONS, GIFTS, GRANTS, AND SIMILAR AMOUNTS PAID

DONEE'S NAME: WAIKIKI HEALTH CENTER DONEE'S STREET ADDRESS: 277 OHUA AVENUE DONEE'S CITY, STATE, ZIP: HONOLULU, HI 96815 AMOUNT GIVEN: 7,500.

DONEE'S NAME: INTERNATIONAL COMMUNITY HEALT DONEE'S STREET ADDRESS: PO BOX 3007 DONEE'S CITY, STATE, ZIP: SEATTLE, WA 98114 AMOUNT GIVEN: 2,000.

DONEE'S NAME: CHARLES B WANG COMMT. HEALTH DONEE'S STREET ADDRESS: 268 CANAL STREET DONEE'S CITY, STATE, ZIP: NEW YORK, NY 10013 AMOUNT GIVEN: 7,500.

DONEE'S NAME: ARKANSAS COALITION OF MARSHAL DONEE'S STREET ADDRESS: 614 EAST EMMA AVE. BOX 210 DONEE'S CITY, STATE, ZIP: SPRINGDALE, AR 72764 AMOUNT GIVEN: 125,980.

DONEE'S NAME: MALAMA I KE OLA HEALTH CENTER DONEE'S STREET ADDRESS: 1881 NANI STREET DONEE'S CITY, STATE, ZIP: WAILUKU, HI 96793 AMOUNT GIVEN: 137,000.

DONEE'S NAME: KWAJALEIN DIABETES COALIT AMOUNT GIVEN: 95,500.

DONEE'S NAME: KOSRAE COMMUNITY HEALTH C AMOUNT GIVEN: DRAFT 115,828. AMOUNT GIVEN: 104,772.

TOTAL $ 596,080.

STATEMENT 3 FORM 199, PART II, LINE 17 OTHER EXPENSES

ACCOUNTING FEES ...... $ 32,800. ADVERTISING AND PROMOTION ...... 4,676. BANK CHARGES...... 31. CONFERENCES, CONVENTIONS, AND MEETINGS...... 35,671. CONSULTANTS ...... 328,477.

130 2017 CALIFORNIA STATEMENTS PAGE 2 ASSOCIATION OF ASIAN PACIFIC COMMUNITY HEALTH ORGANIZATION 94-3050247

STATEMENT 3 (CONTINUED) FORM 199, PART II, LINE 17 OTHER EXPENSES

DUES AND MEMBERSHIP ...... $ 2,960. EQUIPMENT RENTAL...... 5,225. INSURANCE ...... 9,514. LEGAL FEES...... 3,498. OTHER EMPLOYEE BENEFIT...... 74,509. OTHER FEES...... 20,051. POSTAGE AND SHIPPING...... 2,187. PRINTING AND PUBLICATIONS ...... 2,942. PUBLICATIONS AND SUBSCRIPTIONS...... 27,296. SUPPLIES...... 28,171. TELECOMMUNICATION ...... 20,503. TRAVEL...... 214,355. TOTAL $ 812,866.

STATEMENT 4 FORM 199, SCHEDULE L, LINE 12 OTHER ASSETS

DEPOSITS...... 17,267. PREPAID EXPENSES AND DEFERRED CHARGES...... 35,096. TOTAL $ 52,363.

DRAFT

131 IN ANNUAL MAIL TO: Registry of Charitable Trusts REGISTRATION RENEWAL FEE REPORT P.O. Box 903447 TO ATTORNEY GENERAL OF CALIFORNIA Sacramento, CA 94203-4470 Sections 12586 and 12587, California Government Code Telephone: (916) 445-2021 11 Cal. Code Regs. sections 301-307, 311 and 312 Failure to submit this report annually no later than four months and fifteen days after the WEBSITE ADDRESS: end of the organization's accounting period may result in the loss of tax exemption and http://ag.ca.gov/charities/ the assessment of a minimum tax of $800, plus interest, and/or fines or filing penalties as defined in Government Code Section 12586.1. IRS extensions will be honored.

Check if: State Charity Registration Number 66720 Change of address ASSOCIATION OF ASIAN PACIFIC Amended report COMMUNITY HEALTH ORGANIZATION Name of Organization 101 CALLAN AVENUE #400 Corporate or Organization No. 1586988 Address (Number and Street) SAN LEANDRO, CA 94577 Federal Employer I.D. No. 94-3050247 City or Town State ZIP Code ANNUAL REGISTRATION RENEWAL FEE SCHEDULE (11 Cal. Code Regs. sections 301-307, 311 and 312) Make Check Payable to Attorney General's Registry of Charitable Trusts

Gross Annual Revenue Fee Gross Annual Revenue Fee Gross Annual Revenue Fee Less than $25,000 0 Between $100,001 and $250,000 $50 Between $1,000,001 and $10 million $150 Between $25,000 and $100,000 $25 Between $250,001 and $1 million $75 Between $10,000,001 and $50 million $225 Greater than $50 million $300 PART A ' ACTIVITIES For your most recent full accounting period (beginning 10/01/17 ending 9/30/18 ) list: Gross annual revenue $ 2,440,914. Total assets $ 873,143. PART B ' STATEMENTS REGARDING ORGANIZATION DURING THE PERIOD OF THIS REPORT

Note: If you answer 'yes' to any of the questions below, you must attach a separate sheet providing an explanation and details for each 'yes' response. Please review RRF-1 instructions for information required. Yes No 1 During this reporting period, were there any contracts, loans, leases or other financial transactions between the organization and any officer, director or trustee thereof either directly or with an entity in which any such officer, director or trustee had any financial interest? X 2 During this reporting period, was there any theft, embezzlement, diversion or misuse of the organization's charitable property or funds? X

3 During this reporting period, did non-program expenditures exceed 50% of gross revenues? X 4 During this reporting period, were any organization funds used to pay any penalty, fine or judgment? If you filed a Form 4720 with the Internal Revenue Service, attach a copy. X 5 During this reporting period, were the services of a commercial fundraiser or fundraising counsel for charitable purposes used? If 'yes,' provide an attachment listing the name, address, and telephone number of the service X provider.

6 During this reporting period, did the organization receive any governmental funding? If so, provide an attachment listing X the name of the agency, mailing address, contact person, and telephone number. SEE STATEMENT 1 7 During this reporting period, did the organizationDRAFT hold a raffle for charitable purposes? If 'yes,' provide an attachment X indicating the number of raffles and the date(s) they occurred. 8 Does the organization conduct a vehicle donation program? If 'yes,' provide an attachment indicating whether the program is operated by the charity or whether the organization contracts with a commercial fundraiser for X charitable purposes.

9 Did your organization have prepared an audited financial statement in accordance with generally accepted accounting X principles for this reporting period? Organization's area code and telephone number (510) 272-9536 Organization's e-mail address

I declare under penalty of perjury that I have examined this report, including accompanying documents, and to the best of my knowledge and belief, it is true, correct and complete.

JEFFREY CABALLERO EXECUTIVE DIR. Signature of authorized officer Printed Name Title Date

CAEA9801L 11/30/15 RRF-1 (3-05) 132 2017 CALIFORNIA STATEMENTS PAGE 1 ASSOCIATION OF ASIAN PACIFIC COMMUNITY HEALTH ORGANIZATION 94-3050247

STATEMENT 1 FORM RRF-1, PART B, LINE 6 GOVERNMENT AGENCY THAT PROVIDED FUNDING

HEALTH RESOURCES & SERVICE ADMINISTRATION 5600 FISHER LANE RM 11A-03 ROCKVILLE, MD 20857

CENTERS FOR DISEASE CONTROL AND PREVENTION 2920 BRANDYWINE ROAD, MS E-09 ATLANTA, GA 30341

DRAFT

133 OMB No. 1545-0047 Form 990 Return of Organization Exempt From Income Tax 2017 Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations) G Do not enter social security numbers on this form as it may be made public. Open to Public Department of the Treasury Internal Revenue Service G Go to www.irs.gov/Form990 for instructions and the latest information. Inspection A For the 2017 calendar year, or tax year beginning 10/01 , 2017, and ending 9/30 , 2018 B Check if applicable: C D Employer identification number Address change ASSOCIATION OF ASIAN PACIFIC 94-3050247 Name change COMMUNITY HEALTH ORGANIZATION E Telephone number Initial return 101 CALLAN AVENUE #400 (510) 272-9536 SAN LEANDRO, CA 94577 Final return/terminated Amended return G Gross receipts $ 2,440,914. Application pending F Name and address of principal officer: H(a) Is this a group return for subordinates? Yes X No H(b) Are all subordinates included? Yes No SAME AS C ABOVE If 'No,' attach a list. (see instructions) I Tax-exempt status X 501(c)(3) 501(c) ()H (insert no.) 4947(a)(1) or 527 J Website: G WWW.AAPCHO.ORG H(c) Group exemption number G K Form of organization: X Corporation Trust Association OtherG L Year of formation: 1987 M State of legal domicile: CA Part I Summary 1 Briefly describe the organization's mission or most significant activities:AAPCHO IS A NATIONAL ASSOCIATION REPRESENTING COMMUNITY HEALTH ORGANIZATIONS DEDICATED TO PROMOTING ADVOCACY,COLLABORATION AND LEADERSHIP THAT IMPROVES THE HEALTH STATUS AND ACCESS OF AA&NHOPI PRIMARILY THROUGH OUR MEMBER COMMUNITY HEALTH CENTERS. 2 Check this box G if the organization discontinued its operations or disposed of more than 25% of its net assets. 3 Number of voting members of the governing body (Part VI, line 1a) ...... 3 14 4 Number of independent voting members of the governing body (Part VI, line 1b)...... 4 14 5 Total number of individuals employed in calendar year 2017 (Part V, line 2a) ...... 5 14 6 Total number of volunteers (estimate if necessary)...... 6 0 7a Total unrelated business revenue from Part VIII, column (C), line 12...... 7a 0. b Net unrelated business taxable income from Form 990-T, line 34...... 7b 0. Prior Year Current Year 8 Contributions and grants (Part VIII, line 1h)...... 1,135,044. 2,146,218. 9 Program service revenue (Part VIII, line 2g) ...... 480,262. 279,015. 10 Investment income (Part VIII, column (A), lines 3, 4, and 7d) ...... 37. 40. 11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)...... 11,250. 15,641. 12 Total revenue ' add lines 8 through 11 (must equal Part VIII, column (A), line 12) . . . . . 1,626,593. 2,440,914. 13 Grants and similar amounts paid (Part IX, column (A), lines 1-3)...... 433,324. 596,080. 14 Benefits paid to or for members (Part IX, column (A), line 4)...... 15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5-10) . . . . . 995,239. 1,097,240. 16 a Professional fundraising fees (Part IX, column (A), line 11e)...... b Total fundraising expenses (Part IX, column (D), line 25) G 17 Other expenses (Part IX, column (A), lines 11a-11d, 11f-24e)...... 390,982. 840,994. 18 Total expenses. Add lines 13-17 (must equal Part IX, column (A), line 25)...... 1,819,545. 2,534,314. 19 Revenue less expenses. Subtract line 18 from line 12 ...... -192,952. -93,400. Beginning of Current Year End of Year 20 Total assets (Part X, line 16)...... 1,047,913. 873,143. 21 Total liabilities (Part X, line 26) ...... 98,624. 340,506. Net assets or fund balances. SubtractDRAFT line 21 from line 20 ...... 22 949,289. 532,637. Part II Signature Block Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.

A Signature of officer Date Sign Here JEFFREY CABALLERO EXECUTIVE DIR. A Type or print name and title

Print/Type preparer's name Preparer's signature Date Check if PTIN Paid SUSAN MOSTAJO SUSAN MOSTAJO self-employed P02016957 Preparer Firm's name G WUHOOVER & CO LLP Use Only Firm's address G 1510 FASHION ISLAND BLVD Firm's EIN G 27-2481245 SAN MATEO, CA 94404 Phone no. 650-212-3888 May the IRS discuss this return with the preparer shown above? (see instructions) ...... X Yes No BAA For Paperwork Reduction Act Notice, see the separate instructions. TEEA0113L 08/08/17 Form 990 (2017) 134 Form 990 (2017) ASSOCIATION OF ASIAN PACIFIC 94-3050247 Page 2 Part III Statement of Program Service Accomplishments Check if Schedule O contains a response or note to any line in this Part III...... X 1 Briefly describe the organization's mission: SEE SCHEDULE O

2 Did the organization undertake any significant program services during the year which were not listed on the prior Form 990 or 990-EZ?...... Yes X No If 'Yes,' describe these new services on Schedule O. 3 Did the organization cease conducting, or make significant changes in how it conducts, any program services?. . . . Yes X No If 'Yes,' describe these changes on Schedule O. 4 Describe the organization's program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.

4 a (Code: ) (Expenses $ 1,747,673. including grants of $ 596,080. ) (Revenue $ 2,200,506. ) DEVELOPS HEALTH CARE EDUCATION MATERIALS AND PROVIDES TRAINING FOR COMMUNITY HEALTH CARE PROVIDER ON ON-GOING HEALTH ISSUES IN THE ASIAN AMERICANS & NATIVE HAWAIIANS AND OTHER PACIFIC ISLANDERS (AA&NHOPI) COMMUNITY.

4 b (Code: ) (Expenses $ 205,467. including grants of $ ) (Revenue $ ) PROMOTES THE ORGANIZATION AND ITS MEMBER CENTERS IN THE ASIAN AMERICANS & NATIVE HAWAIIANS AND OTHER PACIFIC ISLANDERS (AA&NHOPI) COMMUNITY.

4 c (Code: ) (Expenses $ DRAFTincluding grants of $ ) (Revenue $ )

4 d Other program services (Describe in Schedule O.) (Expenses $ including grants of $ ) (Revenue $ ) 4 e Total program service expenses G 1,953,140. BAA TEEA0102L 12/05/17 Form 990 (2017) 135 Form 990 (2017) ASSOCIATION OF ASIAN PACIFIC 94-3050247 Page 3 Part IV Checklist of Required Schedules Yes No 1 Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If 'Yes,' complete Schedule A...... 1 X 2 Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)?...... 2 X 3 Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If 'Yes,' complete Schedule C, Part I...... 3 X 4 Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If 'Yes,' complete Schedule C, Part II...... 4 X 5 Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If 'Yes,' complete Schedule C, Part III...... 5 X

6 Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If 'Yes,' complete Schedule D, Part I ...... 6 X 7 Did the organization receive or hold a conservation easement, including easements to preserve open space, the environment, historic land areas, or historic structures? If 'Yes,' complete Schedule D, Part II...... 7 X 8 Did the organization maintain collections of works of art, historical treasures, or other similar assets? If 'Yes,' complete Schedule D, Part III...... 8 X

9 Did the organization report an amount in Part X, line 21, for escrow or custodial account liability, serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If 'Yes,' complete Schedule D, Part IV ...... 9 X 10 Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments? If 'Yes,' complete Schedule D, Part V...... 10 X 11 If the organization's answer to any of the following questions is 'Yes', then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.

a Did the organization report an amount for land, buildings, and equipment in Part X, line 10? If 'Yes,' complete Schedule D, Part VI ...... 11 a X b Did the organization report an amount for investments ' other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If 'Yes,' complete Schedule D, Part VII...... 11 b X c Did the organization report an amount for investments ' program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If 'Yes,' complete Schedule D, Part VIII ...... 11 c X d Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If 'Yes,' complete Schedule D, Part IX...... 11 d X e Did the organization report an amount for other liabilities in Part X, line 25? If 'Yes,' complete Schedule D, Part X...... 11 e X f Did the organization's separate or consolidated financial statements for the tax year include a footnote that addresses the organization's liability for uncertain tax positions under FIN 48 (ASC 740)? If 'Yes,' complete Schedule D, Part X. . . . 11 f X 12 a Did the organization obtain separate, independent audited financial statements for the tax year? If 'Yes,' complete Schedule D, Parts XI and XII ...... 12a X b Was the organization included in consolidated, independent audited financial statements for the tax year? If 'Yes,' and if the organization answered 'No' to line 12a, then completing Schedule D, Parts XI and XII is optional ...... 12 b X 13 Is the organization a school described in section 170(b)(1)(A)(ii)? If 'Yes,' complete Schedule E ...... 13 X 14 a Did the organization maintain an office, employees, or agents outside of the United States?...... 14a X b Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program serviceDRAFT activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If 'Yes,' complete Schedule F, Parts I and IV ...... 14b X 15 Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If 'Yes,' complete Schedule F, Parts II and IV ...... 15 X 16 Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If 'Yes,' complete Schedule F, Parts III and IV ...... 16 X 17 Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If 'Yes,' complete Schedule G, Part I (see instructions)...... 17 X 18 Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If 'Yes,' complete Schedule G, Part II...... 18 X 19 Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If 'Yes,' complete Schedule G, Part III...... 19 X BAA TEEA0103L 08/08/17 Form 990 (2017)

136 Form 990 (2017) ASSOCIATION OF ASIAN PACIFIC 94-3050247 Page 4 Part IV Checklist of Required Schedules (continued) Yes No

20a Did the organization operate one or more hospital facilities? If 'Yes,' complete Schedule H ...... 20a X

b If 'Yes' to line 20a, did the organization attach a copy of its audited financial statements to this return? ...... 20b 21 Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government on Part IX, column (A), line 1? If 'Yes,' complete Schedule I, Parts I and II...... 21 X 22 Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on Part IX, column (A), line 2? If 'Yes,' complete Schedule I, Parts I and III ...... 22 X 23 Did the organization answer 'Yes' to Part VII, Section A, line 3, 4, or 5 about compensation of the organization's current and former officers, directors, trustees, key employees, and highest compensated employees? If 'Yes,' complete Schedule J ...... 23 X 24 a Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If 'Yes,' answer lines 24b through 24d and complete Schedule K. If 'No, 'go to line 25a ...... 24a X b Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...... 24b

c Did the organization maintain an escrow account other than a refunding escrow at any time during the year to defease any tax-exempt bonds? ...... 24c d Did the organization act as an 'on behalf of' issuer for bonds outstanding at any time during the year? ...... 24d

25 a Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If 'Yes,' complete Schedule L, Part I ...... 25a X b Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization's prior Forms 990 or 990-EZ? If 'Yes,' complete Schedule L, Part I...... 25b X 26 Did the organization report any amount on Part X, line 5, 6, or 22 for receivables from or payables to any current or former officers, directors, trustees, key employees, highest compensated employees, or disqualified persons? If 'Yes,' complete Schedule L, Part II...... 26 X 27 Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If 'Yes,' complete Schedule L, Part III...... 27 X 28 Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions): a A current or former officer, director, trustee, or key employee? If 'Yes,' complete Schedule L, Part IV ...... 28a X b A family member of a current or former officer, director, trustee, or key employee? If 'Yes,' complete Schedule L, Part IV ...... 28b X c An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or direct or indirect owner? If 'Yes,' complete Schedule L, Part IV ...... 28c X 29 Did the organization receive more than $25,000 in non-cash contributions? If 'Yes,' complete Schedule M ...... 29 X 30 Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If 'Yes,' complete Schedule M...... 30 X 31 Did the organization liquidate, terminate, or dissolve and cease operations? If 'Yes,' complete Schedule N, Part I...... 31 X 32 Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If 'Yes,' complete Schedule N, Part II...... 32 X 33 Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If 'Yes,' complete Schedule R, Part I...... 33 X 34 Was the organization related to any tax-exempt or taxable entity? If 'Yes,' complete Schedule R, Part II, III, or IV, and Part V, line 1...... DRAFT ...... 34 X 35 a Did the organization have a controlled entity within the meaning of section 512(b)(13)?...... 35a X b If 'Yes' to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If 'Yes,' complete Schedule R, Part V, line 2...... 35b

36 Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If 'Yes,' complete Schedule R, Part V, line 2 ...... 36 X 37 Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If 'Yes,' complete Schedule R, Part VI ...... 37 X 38 Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O...... 38 X BAA Form 990 (2017)

TEEA0104L 08/08/17 137 Form 990 (2017) ASSOCIATION OF ASIAN PACIFIC 94-3050247 Page 5 Part V Statements Regarding Other IRS Filings and Tax Compliance Check if Schedule O contains a response or note to any line in this Part V ...... Yes No 1 a Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable ...... 1 a 8 b Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable...... 1 b 0 c Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners?...... 1 c X 2 a Enter the number of employees reported on Form W-3, Transmittal of Wage and Tax State- ments, filed for the calendar year ending with or within the year covered by this return . . . . . 2 a 14 b If at least one is reported on line 2a, did the organization file all required federal employment tax returns? ...... 2 b X Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions) 3 a Did the organization have unrelated business gross income of $1,000 or more during the year?...... 3 a X b If 'Yes,' has it filed a Form 990-T for this year? If 'No' to line 3b, provide an explanation in Schedule O...... 3 b 4 a At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)? ...... 4 a X b If 'Yes,' enter the name of the foreign country: G See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR). 5 a Was the organization a party to a prohibited tax shelter transaction at any time during the tax year? ...... 5 a X b Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?...... 5 b X c If 'Yes,' to line 5a or 5b, did the organization file Form 8886-T?...... 5 c 6 a Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions?...... 6 a X b If 'Yes,' did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?...... 6 b 7 Organizations that may receive deductible contributions under section 170(c). a Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?...... 7 a X b If 'Yes,' did the organization notify the donor of the value of the goods or services provided? ...... 7 b c Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282? ...... 7 c X d If 'Yes,' indicate the number of Forms 8282 filed during the year...... 7 d e Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?...... 7 e X f Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?...... 7 f X g If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?...... 7 g h If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C? ...... 7 h 8 Sponsoring organizations maintaining donor advised funds. Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year?...... 8 9 Sponsoring organizations maintaining donor advised funds. a Did the sponsoring organization make any taxable distributions under section 4966? ...... 9 a b Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?...... 9 b 10 Section 501(c)(7) organizations. Enter: a Initiation fees and capital contributions included on Part VIII, line 12 ...... 10 a b Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities . . . . 10 b 11 Section 501(c)(12) organizations. Enter:DRAFT a Gross income from members or shareholders...... 11 a b Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.)...... 11 b 12 a Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?...... 12 a b If 'Yes,' enter the amount of tax-exempt interest received or accrued during the year...... 12 b 13 Section 501(c)(29) qualified nonprofit health insurance issuers. a Is the organization licensed to issue qualified health plans in more than one state? ...... 13 a Note. See the instructions for additional information the organization must report on Schedule O. b Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans...... 13 b c Enter the amount of reserves on hand...... 13 c 14 a Did the organization receive any payments for indoor tanning services during the tax year?...... 14 a X b If 'Yes,' has it filed a Form 720 to report these payments? If 'No,' provide an explanation in Schedule O...... 14 b BAA TEEA0105L 08/08/17 Form 990 (2017)

138 Form 990 (2017) ASSOCIATION OF ASIAN PACIFIC 94-3050247 Page 6 Part VI Governance, Management, and Disclosure For each 'Yes' response to lines 2 through 7b below, and for a 'No' response to line 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions. Check if Schedule O contains a response or note to any line in this Part VI...... X Section A. Governing Body and Management Yes No 1 a Enter the number of voting members of the governing body at the end of the tax year...... 1 a 14 If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O. b Enter the number of voting members included in line 1a, above, who are independent...... 1 b 14 2 Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? ...... 2 X 3 Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors, or trustees, or key employees to a management company or other person? ...... 3 X 4 Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? ...... SEE ...... SCH ...... O...... 4 X 5 Did the organization become aware during the year of a significant diversion of the organization's assets?...... 5 X 6 Did the organization have members or stockholders?...... SEE ...... SCHEDULE ...... O...... 6 X 7 a Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? . . SEE...... SCHEDULE...... O ...... 7 a X b Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...... SEE ...... SCH ...... O ...... 7 b X 8 Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following: a The governing body?...... 8 a X b Each committee with authority to act on behalf of the governing body?...... 8 b X 9 Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization's mailing address? If 'Yes,' provide the names and addresses in Schedule O ...... 9 X Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.) Yes No 10 a Did the organization have local chapters, branches, or affiliates?...... 10 a X b If 'Yes,' did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes? ...... 10 b 11 a Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form?...... 11 a X b Describe in Schedule O the process, if any, used by the organization to review this Form 990. SEE SCHEDULE O 12 a Did the organization have a written conflict of interest policy? If 'No,' go to line 13 ...... 12 a X b Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ...... 12 b c Did the organization regularly and consistently monitor and enforce compliance with the policy? If 'Yes,' describe in Schedule O how this was done...... 12 c 13 Did the organization have a written whistleblower policy?...... 13 X 14 Did the organization have a written document retention and destruction policy?...... 14 X 15 Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision? a The organization's CEO, Executive Director, or top management official...... 15 a X b Other officers or key employees of theDRAFT organization...... 15 b X If 'Yes' to line 15a or 15b, describe the process in Schedule O (see instructions). 16 a Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year?...... 16 a X b If 'Yes,' did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization's exempt status with respect to such arrangements?...... 16 b Section C. Disclosure 17 List the states with which a copy of this Form 990 is required to be filed G CA 18 Section 6104 requires an organization to make its Forms 1023 (or 1024 if applicable), 990, and 990-T (Section 501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply. Own website Another's website X Upon request Other (explain in Schedule O) 19 Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year. SEE SCHEDULE O 20 State the name, address, and telephone number of the person who possesses the organization's books and records: G PETER HO 101 CALLAN AVENUE, STE 400 SAN LEANDRO CA 94577 (510) 272-9536 BAA TEEA0106L 08/08/17 Form 990 (2017) 139 Form 990 (2017) ASSOCIATION OF ASIAN PACIFIC 94-3050247 Page 7 Part VII Compensation of Officers, Directors, Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors Check if Schedule O contains a response or note to any line in this Part VII ...... Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees 1 a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization's tax year. ? List all of the organization's current officers, directors, trustees (whether individuals or organizations), regardless of amount of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid. ? List all of the organization's current key employees, if any. See instructions for definition of 'key employee.' ? List the organization's five current highest compensated employees (other than an officer, director, trustee, or key employee) who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the organization and any related organizations. ? List all of the organization's former officers, key employees, and highest compensated employees who received more than $100,000 of reportable compensation from the organization and any related organizations. ? List all of the organization's former directors or trustees that received, in the capacity as a former director or trustee of the organization, more than $10,000 of reportable compensation from the organization and any related organizations. List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest compensated employees; and former such persons. Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee. (C) Position (do not check more (A) (B) than one box, unless person (D) (E) (F) Name and Title Average is both an officer and a Reportable Reportable Estimated hours director/trustee) compensation from compensation from amount of other per the organization related organizations compensation week (W-2/1099-MISC) (W-2/1099-MISC) from the (list any organization hours for and related related organizations organiza- tions below dotted line)

(1) SHERRY HIROTA 1 DIRECTOR 0 X X 0. 0. 0. (2) KAZUE SHIBATA 1 DIRECTOR 0 X 0. 0. 0. (3) EDDIE CHAN 1 SECRETARY 0 X X 0. 0. 0. (4) JANE ENG 1 VICE PRESIDENT 0 X X 0. 0. 0. (5) DARRIN SATO 1 PRESIDENT 0 X X 0. 0. 0. (6) DAVID DERAUF, MD 1 DIRECTOR 0 X 0. 0. 0. (7) EUGENE WELCH 1 DIRECTOR 0 X 0. 0. 0. (8) RICH BETTINI 1 TREASURER 0 X X 0. 0. 0. (9) TERESITA BATAYOLA 1 DIRECTOR 0 X 0. 0. 0. (10) MICHAEL BYUN DRAFT1 DIRECTOR 0 X 0. 0. 0. (11) MARY ONEHA 1 DIRECTOR 0 X 0. 0. 0. (12) GILDAS CHEUNG 1 DIRECTOR 0 X 0. 0. 0. (13) ANDREA CARACOSTIS 1 DIRECTOR 0 X 0. 0. 0. (14) NENA TOLENOA 1 DIRECTOR 0 X 0. 0. 0. BAA TEEA0107L 08/08/17 Form 990 (2017)

140 Form 990 (2017) ASSOCIATION OF ASIAN PACIFIC 94-3050247 Page 8 Part VII Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued) (B) (C) Position (A) Average (do not check more than one (D) (E) (F) hours box, unless person is both an Name and title Reportable Reportable Estimated per officer and a director/trustee) compensation from compensation from amount of other week the organization related organizations compensation (list any (W-2/1099-MISC) (W-2/1099-MISC) from the hours organization for and related related organizations organiza - tions below dotted line)

(15) JEFFREY CABALLERO 38 EXECUTIVE DIR. 0 X 159,370. 0. 0. (16) PETER HO 38 OPERATING DIR. 0 X 108,598. 0. 0. (17)

(18)

(19)

(20)

(21)

(22)

(23)

(24)

(25)

1 b Sub-total...... G 267,968. 0. 0. c Total from continuation sheets to Part VII, Section A ...... G 0. 0. 0. d Total (add lines 1b and 1c)...... G 267,968. 0. 0. 2 Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organization G 2 Yes No 3 Did the organization list any former officer, director, or trustee, key employee, or highest compensated employee on line 1a? If 'Yes,' complete Schedule J for such individual...... 3 X 4 For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If 'Yes,' complete Schedule J for such individual...... 4 X 5 Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization?DRAFT If 'Yes,' complete Schedule J for such person...... 5 X Section B. Independent Contractors 1 Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization's tax year. (A) (B) (C) Name and business address Description of services Compensation NIA AITAOTO 350 S 600 E APT. 502 SALT LAKE, UT 84102 TRAINING, SUPPORT 121,875.

2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization G 1 BAA TEEA0108L 08/08/17 Form 990 (2017)

141 Form 990 (2017) ASSOCIATION OF ASIAN PACIFIC 94-3050247 Page 9 Part VIII Statement of Revenue Check if Schedule O contains a response or note to any line in this Part VIII...... (A) (B) (C) (D) Total revenue Related or Unrelated Revenue exempt business excluded from tax function revenue under sections revenue 512-514 1 a Federated campaigns...... 1 a b Membership dues ...... 1 b 221,537. c Fundraising events...... 1 c d Related organizations ...... 1 d e Government grants (contributions). . . . . 1 e 1,729,955. f All other contributions, gifts, grants, and similar amounts not included above. . . . 1 f 194,726. g Noncash contributions included in lines 1a-1f: $ h Total. Add lines 1a-1f...... G 2,146,218. Business Code 2 a TRAINING, EDUCATION, ETC. 900099 279,015. 279,015. b c d e f All other program service revenue. . . . g Total. Add lines 2a-2f...... G 279,015. 3 Investment income (including dividends, interest and other similar amounts)...... G 40. 40. 4 Income from investment of tax-exempt bond proceeds. . G. 5 Royalties ...... G (i) Real (ii) Personal 6 a Gross rents...... b Less: rental expenses c Rental income or (loss). . . . d Net rental income or (loss)...... G (i) Securities (ii) Other 7 a Gross amount from sales of assets other than inventory

b Less: cost or other basis and sales expenses...... c Gain or (loss)...... d Net gain or (loss) ...... G 8 a Gross income from fundraising events (not including. $ of contributions reported on line 1c). See Part IV, line 18 ...... a b Less: direct expenses ...... b c Net income or (loss) from fundraising events...... G 9 a Gross income from gaming activities.DRAFT See Part IV, line 19 ...... a b Less: direct expenses ...... b c Net income or (loss) from gaming activities...... G 10 a Gross sales of inventory, less returns and allowances ...... a b Less: cost of goods sold...... b c Net income or (loss) from sales of inventory ...... G Miscellaneous Revenue Business Code 11 a OTHERS 900099 15,641. 15,641. b c d All other revenue...... e Total. Add lines 11a-11d...... G 15,641. 12 Total revenue. See instructions ...... G 2,440,914. 294,656. 0. 40. BAA TEEA0109L 08/08/17 Form 990 (2017) 142 Form 990 (2017) ASSOCIATION OF ASIAN PACIFIC 94-3050247 Page 10 Part IX Statement of Functional Expenses Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A). Check if Schedule O contains a response or note to any line in this Part IX...... (A) (B) (C) (D) Do not include amounts reported on lines Total expenses Program service Management and Fundraising 6b, 7b, 8b, 9b, and 10b of Part VIII. expenses general expenses expenses 1 Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21...... 279,980. 279,980. 2 Grants and other assistance to domestic individuals. See Part IV, line 22...... 3 Grants and other assistance to foreign organizations, foreign governments, and for- eign individuals. See Part IV, lines 15 and 16 316,100. 316,100. 4 Benefits paid to or for members...... 5 Compensation of current officers, directors, trustees, and key employees...... 182,641. 0. 182,641. 0. 6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ...... 0. 0. 0. 0. 7 Other salaries and wages...... 712,231. 675,974. 36,257. 8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ...... 9 Other employee benefits ...... 74,509. 52,658. 21,851. 10 Payroll taxes ...... 127,859. 54,916. 72,943. 11 Fees for services (non-employees): a Management ...... b Legal...... 3,498. 150. 3,348. c Accounting ...... 32,800. 32,800. d Lobbying ...... e Professional fundraising services. See Part IV, line 17. . . f Investment management fees...... g Other. (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O.). . . . . 20,051. 2,500. 17,551. 12 Advertising and promotion...... 4,676. 4,247. 429. 13 Office expenses...... 14 Information technology...... 15 Royalties...... 16 Occupancy ...... 102,637. 12,336. 90,301. 17 Travel...... 214,355. 187,837. 26,518. 18 Payments of travel or entertainment expenses for any federal, state, or local public officials ...... 19 Conferences, conventions, and meetings. . . . 35,671. 7,696. 27,975. 20 Interest...... 21 Payments to affiliates...... 22 Depreciation, depletion, and amortization. . . . 23 Insurance ...... 9,514. 9,514. 24 Other expenses. Itemize expenses notDRAFT covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)...... a CONSULTANTS 328,477. 327,743. 734. b SUPPLIES 28,171. 19,924. 8,247. c PUBLICATIONS AND SUBSCRIPTIONS 27,296. 7,714. 19,582. d TELECOMMUNICATION 20,503. 187. 20,316. e All other expenses...... 13,345. 3,178. 10,167. 25 Total functional expenses. Add lines 1 through 24e. . . . 2,534,314. 1,953,140. 581,174. 0. 26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here G if following SOP 98-2 (ASC 958-720)......

BAA TEEA0110L 08/08/17 Form 990 (2017) 143 Form 990 (2017) ASSOCIATION OF ASIAN PACIFIC 94-3050247 Page 11 Part X Balance Sheet Check if Schedule O contains a response or note to any line in this Part X ...... (A) (B) Beginning of year End of year 1 Cash ' non-interest-bearing...... 393,632. 1 192,955. 2 Savings and temporary cash investments...... 32,520. 2 171,145. 3 Pledges and grants receivable, net...... 3 4 Accounts receivable, net...... 586,199. 4 456,680. 5 Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L ...... 5 6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions). Complete Part II of Schedule L...... 6 7 Notes and loans receivable, net...... 7 8 Inventories for sale or use...... 8 9 Prepaid expenses and deferred charges...... 21,108. 9 35,096. 10 a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D...... 10 a 23,529. b Less: accumulated depreciation...... 10 b 23,529. 10 c 11 Investments ' publicly traded securities...... 11 12 Investments ' other securities. See Part IV, line 11...... 12 13 Investments ' program-related. See Part IV, line 11 ...... 13 14 Intangible assets...... 14 15 Other assets. See Part IV, line 11...... 14,454. 15 17,267. 16 Total assets. Add lines 1 through 15 (must equal line 34)...... 1,047,913. 16 873,143. 17 Accounts payable and accrued expenses ...... 98,624. 17 340,506. 18 Grants payable...... 18 19 Deferred revenue...... 19 20 Tax-exempt bond liabilities ...... 20 21 Escrow or custodial account liability. Complete Part IV of Schedule D...... 21 22 Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified persons. Complete Part II of Schedule L...... 22 23 Secured mortgages and notes payable to unrelated third parties ...... 23 24 Unsecured notes and loans payable to unrelated third parties...... 24 25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D. 25 26 Total liabilities. Add lines 17 through 25...... 98,624. 26 340,506. Organizations that follow SFAS 117 (ASC 958), check here G X and complete lines 27 through 29, and lines 33 and 34. 27 Unrestricted net assets...... 334,410. 27 186,633. 28 Temporarily restricted net assets...... 614,879. 28 346,004. 29 Permanently restricted net assets...... 29 Organizations that do not follow SFAS 117 (ASC 958), check here G and complete lines 30 through 34.DRAFT 30 Capital stock or trust principal, or current funds ...... 30 31 Paid-in or capital surplus, or land, building, or equipment fund...... 31 32 Retained earnings, endowment, accumulated income, or other funds ...... 32 33 Total net assets or fund balances ...... 949,289. 33 532,637. 34 Total liabilities and net assets/fund balances...... 1,047,913. 34 873,143. BAA Form 990 (2017)

TEEA0111L 08/08/17 144 Form 990 (2017) ASSOCIATION OF ASIAN PACIFIC 94-3050247 Page 12 Part XI Reconciliation of Net Assets Check if Schedule O contains a response or note to any line in this Part XI...... 1 Total revenue (must equal Part VIII, column (A), line 12) ...... 1 2,440,914. 2 Total expenses (must equal Part IX, column (A), line 25)...... 2 2,534,314. 3 Revenue less expenses. Subtract line 2 from line 1 ...... 3 -93,400. 4 Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A))...... 4 949,289. 5 Net unrealized gains (losses) on investments...... 5 6 Donated services and use of facilities ...... 6 7 Investment expenses...... 7 8 Prior period adjustments ...... 8 -323,252. 9 Other changes in net assets or fund balances (explain in Schedule O)...... 9 0. 10 Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B)) ...... 10 532,637. Part XII Financial Statements and Reporting

Check if Schedule O contains a response or note to any line in this Part XII ...... Yes No 1 Accounting method used to prepare the Form 990: Cash X Accrual Other If the organization changed its method of accounting from a prior year or checked 'Other,' explain in Schedule O. 2 a Were the organization's financial statements compiled or reviewed by an independent accountant? ...... 2 a X If 'Yes,' check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both: Separate basis Consolidated basis Both consolidated and separate basis

b Were the organization's financial statements audited by an independent accountant?...... 2 b X If 'Yes,' check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both: X Separate basis Consolidated basis Both consolidated and separate basis c If 'Yes' to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?...... 2 c X If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O. 3 a As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133? ...... 3 a X b If 'Yes,' did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits ...... 3 b X BAA Form 990 (2017) DRAFT

TEEA0112L 08/08/17 145 Public Charity Status and Public Support OMB No. 1545-0047 SCHEDULE A (Form 990 or 990-EZ) Complete if the organization is a section 501(c)(3) organization or a section 2017 4947(a)(1) nonexempt charitable trust. G Attach to Form 990 or Form 990-EZ. Open to Public Department of the Treasury Inspection Internal Revenue Service G Go to www.irs.gov/Form990 for instructions and the latest information. Name of the organization ASSOCIATION OF ASIAN PACIFIC Employer identification number COMMUNITY HEALTH ORGANIZATION 94-3050247 Part I Reason for Public Charity Status (All organizations must complete this part.) See instructions. The organization is not a private foundation because it is: (For lines 1 through 12, check only one box.) 1 A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i). 2 A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990 or 990-EZ).) 3 A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii). 4 A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state: 5 An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.) 6 A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v). 7 X An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.) 8 A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.) 9 An agricultural research organization described in section 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land-grant college of agriculture (see instructions). Enter the name, city, and state of the college or university: 10 An organization that normally receives: (1) more than 33-1/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions'subject to certain exceptions, and (2) no more than 33-1/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.) 11 An organization organized and operated exclusively to test for public safety. See section 509(a)(4). 12 An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box in lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g. a Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B. b Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C. c Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E. d Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V. e Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization. f Enter the number of supported organizations...... g Provide the following information about the supported organization(s). (i) Name of supported organization (ii) EIN (iii) Type of organization (iv) Is the (v) Amount of monetary (vi) Amount of other (described on lines 1-10 organization listed support (see instructions) support (see instructions) above (see instructions)) in your governing DRAFTdocument? Yes No

(A)

(B)

(C)

(D)

(E)

Total BAA For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ. Schedule A (Form 990 or 990-EZ) 2017 TEEA0401L 08/10/17 146 Schedule A (Form 990 or 990-EZ) 2017 ASSOCIATION OF ASIAN PACIFIC 94-3050247 Page 2 Part II Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi) (Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.) Section A. Public Support

Calendar year (or fiscal year (a) 2013 (b) 2014 (c) 2015 (d) 2016 (e) 2017 (f) Total beginning in) G 1 Gifts, grants, contributions, and membership fees received. (Do not include any 'unusual grants.')...... 2,848,174. 2,769,551. 2,391,374. 1,135,044. 2,143,027. 11,287,170. 2 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...... 0. 3 The value of services or facilities furnished by a governmental unit to the organization without charge. . . . 0. 4 Total. Add lines 1 through 3 . . . 2,848,174. 2,769,551. 2,391,374. 1,135,044. 2,143,027. 11,287,170. 5 The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f). . . 4,343,575. 6 Public support. Subtract line 5 from line 4 ...... 6,943,595. Section B. Total Support

Calendar year (or fiscal year (a) 2013 (b) 2014 (c) 2015 (d) 2016 (e) 2017 (f) Total beginning in) G 7 Amounts from line 4 ...... 2,848,174. 2,769,551. 2,391,374. 1,135,044. 2,143,027. 11,287,170. 8 Gross income from interest, dividends, payments received on securities loans, rents, royalties, and income from similar sources ...... 80. 51. 82. 37. 40. 290. 9 Net income from unrelated business activities, whether or not the business is regularly carried on...... 0. 10 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.). . SEE...... PART...... VI ...... 88,998. 104,154. 31,341. 11,250. 15,641. 251,384. 11 Total support. Add lines 7 through 10...... 11,538,844. 12 Gross receipts from related activities, etc. (see instructions)...... 12 2,019,507. 13 First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here ...... G Section C. Computation of Public Support Percentage 14 Public support percentage for 2017 (line 6, column (f) divided by line 11, column (f))...... 14 60.18 % 15 Public support percentage from 2016 DRAFTSchedule A, Part II, line 14 ...... 15 56.18 % 16a 33-1/3% support test'2017. If the organization did not check the box on line 13, and line 14 is 33-1/3% or more, check this box and stop here. The organization qualifies as a publicly supported organization...... G X b 33-1/3% support test'2016. If the organization did not check a box on line 13 or 16a, and line 15 is 33-1/3% or more, check this box and stop here. The organization qualifies as a publicly supported organization...... G

17a 10%-facts-and-circumstances test'2017. If the organization did not check a box on line 13, 16a, or 16b, and line 14 is 10% or more, and if the organization meets the 'facts-and-circumstances' test, check this box and stop here. Explain in Part VI how the organization meets the 'facts-and-circumstances' test. The organization qualifies as a publicly supported organization ...... G

b 10%-facts-and-circumstances test'2016. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line 15 is 10% or more, and if the organization meets the 'facts-and-circumstances' test, check this box and stop here. Explain in Part VI how the organization meets the 'facts-and-circumstances' test. The organization qualifies as a publicly supported organization...... G 18 Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see instructions . . . G BAA Schedule A (Form 990 or 990-EZ) 2017

TEEA0402L 08/10/17 147 Schedule A (Form 990 or 990-EZ) 2017 ASSOCIATION OF ASIAN PACIFIC 94-3050247 Page 3 Part III Support Schedule for Organizations Described in Section 509(a)(2) (Complete only if you checked the box on line 10 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.) Section A. Public Support Calendar year (or fiscal year beginning in) G (a) 2013 (b) 2014 (c) 2015 (d) 2016 (e) 2017 (f) Total 1 Gifts, grants, contributions, and membership fees received. (Do not include any 'unusual grants.') ...... 2 Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose...... 3 Gross receipts from activities that are not an unrelated trade or business under section 513 . 4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...... 5 The value of services or facilities furnished by a governmental unit to the organization without charge. . . . 6 Total. Add lines 1 through 5 . . . 7a Amounts included on lines 1, 2, and 3 received from disqualified persons...... b Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year...... c Add lines 7a and 7b...... 8 Public support. (Subtract line 7c from line 6.) ...... Section B. Total Support Calendar year (or fiscal year beginning in) G (a) 2013 (b) 2014 (c) 2015 (d) 2016 (e) 2017 (f) Total 9 Amounts from line 6 ...... 10a Gross income from interest, dividends, payments received on securities loans, rents, royalties, and income from similar sources ...... b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. . . c Add lines 10a and 10b...... 11 Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on ...... 12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)...... DRAFT 13 Total support. (Add Iines 9, 10c, 11, and 12.)...... 14 First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here ...... G Section C. Computation of Public Support Percentage 15 Public support percentage for 2017 (line 8, column (f) divided by line 13, column (f))...... 15 % 16 Public support percentage from 2016 Schedule A, Part III, line 15...... 16 % Section D. Computation of Investment Income Percentage 17 Investment income percentage for 2017 (line 10c, column (f) divided by line 13, column (f)) ...... 17 % 18 Investment income percentage from 2016 Schedule A, Part III, line 17 ...... 18 % 19a 33-1/3% support tests'2017. If the organization did not check the box on line 14, and line 15 is more than 33-1/3%, and line 17 is not more than 33-1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ...... G b 33-1/3% support tests'2016. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33-1/3%, and line 18 is not more than 33-1/3%, check this box and stop here. The organization qualifies as a publicly supported organization. . . . . G 20 Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions...... G BAA TEEA0403L 08/10/17 Schedule A (Form 990 or 990-EZ) 2017 148 Schedule A (Form 990 or 990-EZ) 2017 ASSOCIATION OF ASIAN PACIFIC 94-3050247 Page 4 Part IV Supporting Organizations (Complete only if you checked a box in line 12 on Part I. If you checked 12a of Part I, complete Sections A and B. If you checked 12b of Part I, complete Sections A and C. If you checked 12c of Part I, complete Sections A, D, and E. If you checked 12d of Part I, complete Sections A and D, and complete Part V.) Section A. All Supporting Organizations Yes No 1 Are all of the organization's supported organizations listed by name in the organization's governing documents? If 'No,' describe in Part VI how the supported organizations are designated. If designated by class or purpose, describe the designation. If historic and continuing relationship, explain. 1

2 Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If 'Yes,' explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2). 2

a3 Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If 'Yes,' answer (b) and (c) below. 3a

b Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If 'Yes,' describe in Part VI when and how the organization made the determination. 3b

c Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If 'Yes,' explain in Part VI what controls the organization put in place to ensure such use. c3

a4 Was any supported organization not organized in the United States ('foreign supported organization')? If 'Yes' and if you checked 12a or 12b in Part I, answer (b) and (c) below. a4

b Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If 'Yes,' describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations. 4b

c Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If 'Yes,' explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes. 4c

5a Did the organization add, substitute, or remove any supported organizations during the tax year? If 'Yes,' answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document). a5

b Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document? 5b

c Substitutions only. Was the substitution the result of an event beyond the organization's control? c5

6 Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization's supported organizations? If 'Yes,' provide detail in Part VI. 6

7 Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If 'Yes,' complete Part I of Schedule L (Form 990 or 990-EZ). 7 8 Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If 'Yes,' complete Part I of Schedule L (Form 990 or 990-EZ). 8

a9 Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other thanDRAFT foundation managers and organizations described in section 509(a)(1) or (2))? If 'Yes,' provide detail in Part VI. a9 b Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If 'Yes,' provide detail in Part VI. b9

c Did a disqualified person (as defined in line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If 'Yes,' provide detail in Part VI. c9

10a Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If 'Yes,' answer 10b below. 10a b Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings.) 10b

BAA TEEA0404L 08/10/17 Schedule A (Form 990 or 990-EZ) 2017

149 Schedule A (Form 990 or 990-EZ) 2017 ASSOCIATION OF ASIAN PACIFIC 94-3050247 Page 5 Part IV Supporting Organizations (continued) Yes No 11 Has the organization accepted a gift or contribution from any of the following persons? a A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization? 11a b A family member of a person described in (a) above? 11b c A 35% controlled entity of a person described in (a) or (b) above? If 'Yes' to a, b, or c, provide detail in Part VI. 11c Section B. Type I Supporting Organizations Yes No 1 Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization's directors or trustees at all times during the tax year? If 'No,' describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization's activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year. 1 2 Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If 'Yes,' explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised, or controlled the supporting organization. 2 Section C. Type II Supporting Organizations Yes No 1 Were a majority of the organization's directors or trustees during the tax year also a majority of the directors or trustees of each of the organization's supported organization(s)? If 'No,' describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s). 1 Section D. All Type III Supporting Organizations Yes No

1 Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization's tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization's governing documents in effect on the date of notification, to the extent not previously provided? 1

2 Were any of the organization's officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If 'No,' explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s). 2

3 By reason of the relationship described in (2), did the organization's supported organizations have a significant voice in the organization's investment policies and in directing the use of the organization's income or assets at all times during the tax year? If 'Yes,' describe in Part VI the role the organization's supported organizations played in this regard. 3 Section E. Type III Functionally Integrated Supporting Organizations

1 Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions). a The organization satisfied the Activities Test. Complete line 2 below. b The organization is the parent of each of its supported organizations. Complete line 3 below. c The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions). 2 Activities Test. Answer (a) and (b) below.DRAFT Yes No a Did substantially all of the organization's activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If 'Yes,' then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities. a2

b Did the activities described in (a) constitute activities that, but for the organization's involvement, one or more of the organization's supported organization(s) would have been engaged in? If 'Yes,' explain in Part VI the reasons for the organization's position that its supported organization(s) would have engaged in these activities but for the organization's involvement. b2

3 Parent of Supported Organizations. Answer (a) and (b) below. a Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI. a3

b Did the organization exercise a substantial degree of direction over the policies, programs, and activities of each of its supported organizations? If 'Yes,' describe in Part VI the role played by the organization in this regard. 3b

BAA TEEA0405L 08/10/17 Schedule A (Form 990 or 990-EZ) 2017 150 Schedule A (Form 990 or 990-EZ) 2017 ASSOCIATION OF ASIAN PACIFIC 94-3050247 Page 6 Part V Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations 1 Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E. (B) Current Year Section A ' Adjusted Net Income (A) Prior Year (optional) 1 Net short-term capital gain 1 2 Recoveries of prior-year distributions 2 3 Other gross income (see instructions) 3 4 Add lines 1 through 3. 4 5 Depreciation and depletion 5 6 Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) 6 7 Other expenses (see instructions) 7 8 Adjusted Net Income (subtract lines 5, 6, and 7 from line 4). 8 (B) Current Year Section B ' Minimum Asset Amount (A) Prior Year (optional)

1 Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): a Average monthly value of securities 1a b Average monthly cash balances 1b c Fair market value of other non-exempt-use assets c1 d Total (add lines 1a, 1b, and 1c) d1 e Discount claimed for blockage or other factors (explain in detail in Part VI): 2 Acquisition indebtedness applicable to non-exempt-use assets 2 3 Subtract line 2 from line 1d. 3 4 Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). 4 5 Net value of non-exempt-use assets (subtract line 4 from line 3) 5 6 Multiply line 5 by .035. 6 7 Recoveries of prior-year distributions 7 8 Minimum Asset Amount (add line 7 to line 6) 8 Section C ' Distributable Amount Current Year

1 Adjusted net income for prior year (from Section A, line 8, Column A) 1 2 Enter 85% of line 1. 2 3 Minimum asset amount for prior year (from Section B, line 8, Column A) 3 4 Enter greater of line 2 or line 3. 4 5 Income tax imposed in prior year 5 6 Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions). 6 7 Check here if the current year is theDRAFT organization's first as a non-functionally integrated Type III supporting organization (see instructions). BAA Schedule A (Form 990 or 990-EZ) 2017

TEEA0406L 08/10/17 151 Schedule A (Form 990 or 990-EZ) 2017 ASSOCIATION OF ASIAN PACIFIC 94-3050247 Page 7 Part V Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations (continued) Section D ' Distributions Current Year 1 Amounts paid to supported organizations to accomplish exempt purposes 2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity 3 Administrative expenses paid to accomplish exempt purposes of supported organizations 4 Amounts paid to acquire exempt-use assets 5 Qualified set-aside amounts (prior IRS approval required) 6 Other distributions (describe in Part VI). See instructions. 7 Total annual distributions. Add lines 1 through 6. 8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions. 9 Distributable amount for 2017 from Section C, line 6 10 Line 8 amount divided by line 9 amount (i) (ii) (iii) Section E ' Distribution Allocations (see instructions) Excess Underdistributions Distributable Distributions Pre-2017 Amount for 2017 1 Distributable amount for 2017 from Section C, line 6 2 Underdistributions, if any, for years prior to 2017 (reasonable cause required ' explain in Part VI). See instructions. 3 Excess distributions carryover, if any, to 2017 a

b From 2013...... c From 2014......

d From 2015...... e From 2016...... f Total of lines 3a through e g Applied to underdistributions of prior years h Applied to 2017 distributable amount i Carryover from 2012 not applied (see instructions) j Remainder. Subtract lines 3g, 3h, and 3i from 3f. 4 Distributions for 2017 from Section D, line 7: $ a Applied to underdistributions of prior years b Applied to 2017 distributable amount c Remainder. Subtract lines 4a and 4b from 4. 5 Remaining underdistributions for years prior to 2017, if any. Subtract lines 3g and 4a from line 2. For result greater than zero, explain in Part VI. See instructions. 6 Remaining underdistributions for 2017. Subtract lines 3h and 4b from line 1. For result greater than zero, explain in Part VI. See instructions. 7 Excess distributions carryover to 2018. Add lines 3j and 4c. 8 Breakdown of line 7: a Excess from 2013...... DRAFT b Excess from 2014...... c Excess from 2015......

d Excess from 2016......

e Excess from 2017...... BAA Schedule A (Form 990 or 990-EZ) 2017

TEEA0407L 08/22/17 152 Schedule A (Form 990 or 990-EZ) 2017 ASSOCIATION OF ASIAN PACIFIC 94-3050247 Page 8 Part VI Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b;Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a, and 3b; Part V, line 1; Part V, Section B, line 1e; Part V, Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions.)

PART II, LINE 10 - OTHER INCOME

NATURE AND SOURCE 2017 2016 2015 2014 2013

OTHER INCOME $ 15,641. $ 11,250. $ 31,341. $ 104,154. $ 88,998. TOTAL $ 15,641. $ 11,250. $ 31,341. $ 104,154. $ 88,998.

DRAFT

BAA TEEA0408L 08/10/17 Schedule A (Form 990 or 990-EZ) 2017 153 Schedule B OMB No. 1545-0047 (Form 990, 990-EZ, Schedule of Contributors or 990-PF) 2017 Department of the Treasury G Attach to Form 990, Form 990-EZ, or Form 990-PF. Internal Revenue Service G Go to www.irs.gov/Form990 for the latest information. Name of the organization ASSOCIATION OF ASIAN PACIFIC Employer identification number COMMUNITY HEALTH ORGANIZATION 94-3050247 Organization type (check one): Filers of: Section: Form 990 or 990-EZ X 501(c)( 3 ) (enter number) organization 4947(a)(1) nonexempt charitable trust not treated as a private foundation 527 political organization

Form 990-PF 501(c)(3) exempt private foundation 4947(a)(1) nonexempt charitable trust treated as a private foundation 501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.

Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions. General Rule For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules X For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33-1/3% support test of the regulations under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h; or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor, during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor, during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Don't complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ...... G $

Caution. An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990, 990-EZ, or 990-PF), but it must answer 'No' on Part IV, line 2, of its Form 990; or check the box on line H of its Form 990-EZ or on its Form 990-PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990, 990-EZ, or 990-PF). BAA For Paperwork Reduction Act Notice, see the instructionsDRAFT for Form 990, 990-EZ, or 990-PF. Schedule B (Form 990, 990-EZ, or 990-PF) (2017)

TEEA0701L 08/09/17 154 Schedule B (Form 990, 990-EZ, or 990-PF) (2017) Page 1of 1 of Part I Name of organization Employer identification number ASSOCIATION OF ASIAN PACIFIC 94-3050247

Part I Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.

(a) (b) (c) (d) Number Name, address, and ZIP + 4 Total Type of contribution contributions

Person 1 HEALTH RESOURCES & SERVICE ADM X Payroll 5600 FISHER LANE RM 11A-03 $ 355,967. Noncash

(Complete Part II for ROCKVILLE, MD 20857 noncash contributions.)

(a) (b) (c) (d) Number Name, address, and ZIP + 4 Total Type of contribution contributions

Person 2 WALLACE H. COULTER FOUNDATION X Payroll 790 NW 107TH AVENUE, SUITE 215 $ 191,535. Noncash

(Complete Part II for MIAMI, FL 33172 noncash contributions.)

(a) (b) (c) (d) Number Name, address, and ZIP + 4 Total Type of contribution contributions

Person 3 CENTERS FOR DISEASE AND CONTROL PRE X Payroll 2920 BRANDYWINE ROAD $ 1,369,452. Noncash

(Complete Part II for ATLANTA, GA 30341 noncash contributions.)

(a) (b) (c) (d) Number Name, address, and ZIP + 4 Total Type of contribution contributions

Person Payroll $ Noncash

(Complete Part II for noncash contributions.)

(a) (b) (c) (d) Number Name, address, and ZIP + 4 Total Type of contribution contributions DRAFT Person Payroll $ Noncash

(Complete Part II for noncash contributions.)

(a) (b) (c) (d) Number Name, address, and ZIP + 4 Total Type of contribution contributions

Person Payroll $ Noncash

(Complete Part II for noncash contributions.)

BAA TEEA0702L 08/09/17 Schedule B (Form 990, 990-EZ, or 990-PF) (2017) 155 Schedule B (Form 990, 990-EZ, or 990-PF) (2017) Page 1to 1 of Part II Name of organization Employer identification number ASSOCIATION OF ASIAN PACIFIC 94-3050247 Part II Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.

(a) No. (b) (c) (d) from Description of noncash property given FMV (or estimate) Date received Part I (See instructions.)

N/A

$

(a) No. (b) (c) (d) from Description of noncash property given FMV (or estimate) Date received Part I (See instructions.)

$

(a) No. (b) (c) (d) from Description of noncash property given FMV (or estimate) Date received Part I (See instructions.)

$

(a) No. (b) (c) (d) from Description of noncash property given FMV (or estimate) Date received Part I (See instructions.)

$

(a) No. (b) (c) (d) from Description of noncash property given FMV (or estimate) Date received Part I (See instructions.)

DRAFT$ (a) No. (b) (c) (d) from Description of noncash property given FMV (or estimate) Date received Part I (See instructions.)

$

BAA Schedule B (Form 990, 990-EZ, or 990-PF) (2017)

TEEA0703L 08/09/17 156 Schedule B (Form 990, 990-EZ, or 990-PF) (2017) Page 1to 1 of Part III Name of organization Employer identification number ASSOCIATION OF ASIAN PACIFIC 94-3050247 Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.)...... G $ N/A Use duplicate copies of Part III if additional space is needed. (a) (b) (c) (d) No. from Purpose of gift Use of gift Description of how gift is held Part I N/A

(e) Transfer of gift Transferee's name, address, and ZIP + 4 Relationship of transferor to transferee

(a) (b) (c) (d) No. from Purpose of gift Use of gift Description of how gift is held Part I

(e) Transfer of gift Transferee's name, address, and ZIP + 4 Relationship of transferor to transferee

(a) (b) (c) (d) No. from Purpose of gift Use of gift Description of how gift is held Part I

(e) Transfer of gift Transferee's name,DRAFT address, and ZIP + 4 Relationship of transferor to transferee (a) (b) (c) (d) No. from Purpose of gift Use of gift Description of how gift is held Part I

(e) Transfer of gift Transferee's name, address, and ZIP + 4 Relationship of transferor to transferee

BAA Schedule B (Form 990, 990-EZ, or 990-PF) (2017) TEEA0704L 08/09/17 157 OMB No. 1545-0047 SCHEDULE D Supplemental Financial Statements (Form 990) G Complete if the organization answered 'Yes' on Form 990, Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b. 2017 G Attach to Form 990. Department of the Treasury Open to Public Internal Revenue Service G Go to www.irs.gov/Form990 for instructions and the latest information. Inspection Name of the organization Employer identification number ASSOCIATION OF ASIAN PACIFIC COMMUNITY HEALTH ORGANIZATION 94-3050247 Part I Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered 'Yes' on Form 990, Part IV, line 6. (a) Donor advised funds (b) Funds and other accounts 1 Total number at end of year ...... 2 Aggregate value of contributions to (during year)...... 3 Aggregate value of grants from (during year)...... 4 Aggregate value at end of year ......

5 Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization's property, subject to the organization's exclusive legal control?...... Yes No 6 Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...... Yes No Part II Conservation Easements. Complete if the organization answered 'Yes' on Form 990, Part IV, line 7. 1 Purpose(s) of conservation easements held by the organization (check all that apply). Preservation of land for public use (e.g., recreation or education) Preservation of a historically important land area Protection of natural habitat Preservation of a certified historic structure Preservation of open space 2 Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year. Held at the End of the Tax Year a Total number of conservation easements...... 2 a b Total acreage restricted by conservation easements...... 2 b c Number of conservation easements on a certified historic structure included in (a) ...... 2 c d Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register...... 2 d 3 Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the tax year G 4 Number of states where property subject to conservation easement is located G 5 Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ...... Yes No 6 Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year G 7 Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year G$ 8 Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)?...... Yes No 9 In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and balance sheet, and include, if applicable, the text of the footnote to the organization's financial statements that describes the organization's accounting for conservation easements. DRAFT Part III Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets. Complete if the organization answered 'Yes' on Form 990, Part IV, line 8. 1 a If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items. b If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items: (i) Revenue included on Form 990, Part VIII, line 1...... G$ (ii) Assets included in Form 990, Part X...... G$ 2 If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the following amounts required to be reported under SFAS 116 (ASC 958) relating to these items: a Revenue included on Form 990, Part VIII, line 1...... G$ b Assets included in Form 990, Part X ...... G$ BAA For Paperwork Reduction Act Notice, see the Instructions for Form 990. TEEA3301L 10/11/17 Schedule D (Form 990) 2017

158 Schedule D (Form 990) 2017 ASSOCIATION OF ASIAN PACIFIC 94-3050247 Page 2 Part III Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued) 3 Using the organization's acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply): a Public exhibition d Loan or exchange programs b Scholarly research e Other c Preservation for future generations 4 Provide a description of the organization's collections and explain how they further the organization's exempt purpose in Part XIII. 5 During the year, did the organization solicit or receive donations of art, historical treasures, or other similar assets to be sold to raise funds rather than to be maintained as part of the organization's collection?...... Yes No Part IV Escrow and Custodial Arrangements. Complete if the organization answered 'Yes' on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

1 a Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not included on Form 990, Part X?...... Yes No b If 'Yes,' explain the arrangement in Part XIII and complete the following table: Amount c Beginning balance ...... 1 c d Additions during the year...... 1 d e Distributions during the year...... 1 e f Ending balance...... 1 f 2 a Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability?. . . . . Yes No b If 'Yes,' explain the arrangement in Part XIII. Check here if the explanation has been provided on Part XIII......

Part V Endowment Funds. Complete if the organization answered 'Yes' on Form 990, Part IV, line 10. (a) Current year (b) Prior year (c) Two years back (d) Three years back (e) Four years back 1 a Beginning of year balance...... b Contributions ......

c Net investment earnings, gains, and losses...... d Grants or scholarships ...... e Other expenditures for facilities and programs...... f Administrative expenses...... g End of year balance...... 2 Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as: a Board designated or quasi-endowment G % b Permanent endowment G % c Temporarily restricted endowment G % The percentages on lines 2a, 2b, and 2c should equal 100%.

3 a Are there endowment funds not in the possession of the organization that are held and administered for the organization by: Yes No (i) unrelated organizations...... 3a(i) (ii) related organizations...... 3a(ii) b If 'Yes' on line 3a(ii), are the related organizations listed as required on Schedule R? ...... 3b 4 Describe in Part XIII the intended uses of the organization's endowment funds. Part VI DRAFT Land, Buildings, and Equipment. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11a. See Form 990, Part X, line 10. Description of property (a) Cost or other basis (b) Cost or other (c) Accumulated (d) Book value (investment) basis (other) depreciation 1 a Land...... b Buildings...... c Leasehold improvements...... d Equipment...... 23,529. 23,529. 0. e Other ...... Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10c.)...... G 0. BAA Schedule D (Form 990) 2017

TEEA3302L 08/10/17 159 Schedule D (Form 990) 2017 ASSOCIATION OF ASIAN PACIFIC 94-3050247 Page 3 Part VII Investments ' Other Securities. N/A Complete if the organization answered 'Yes' on Form 990, Part IV, line 11b. See Form 990, Part X, line 12. (a) Description of security or category (including name of security) (b) Book value (c) Method of valuation: Cost or end-of-year market value (1) Financial derivatives...... (2) Closely-held equity interests...... (3) Other (A) (B) (C) (D) (E) (F) (G) (H) (I) Total. (Column (b) must equal Form 990, Part X, column (B) line 12.). . . G Part VIII Investments ' Program Related. N/A Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13. (a) Description of investment (b) Book value (c) Method of valuation: Cost or end-of-year market value (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) Total. (Column (b) must equal Form 990, Part X, column (B) line 13.). . . G Part IX Other Assets. N/A Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15. (a) Description (b) Book value (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) Total. (Column (b) must equal Form 990, Part X, column (B) line 15.)...... G Part X Other Liabilities. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25 (a) Description of liabilityDRAFT(b) Book value (1) Federal income taxes (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) Total. (Column (b) must equal Form 990, Part X, column (B) line 25.)...... G 2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII......

BAA TEEA3303L 08/10/17 Schedule D (Form 990) 2017 160 Schedule D (Form 990) 2017 ASSOCIATION OF ASIAN PACIFIC 94-3050247 Page 4 Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a. 1 Total revenue, gains, and other support per audited financial statements ...... 1 2,440,914. 2 Amounts included on line 1 but not on Form 990, Part VIII, line 12: a Net unrealized gains (losses) on investments...... 2 a b Donated services and use of facilities ...... 2 b c Recoveries of prior year grants...... 2 c d Other (Describe in Part XIII.)...... 2 d e Add lines 2a through 2d...... 2 e 3 Subtract line 2e from line 1...... 3 2,440,914. 4 Amounts included on Form 990, Part VIII, line 12, but not on line 1: a Investment expenses not included on Form 990, Part VIII, line 7b...... 4 a b Other (Describe in Part XIII.)...... 4 b c Add lines 4a and 4b...... 4 c 5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.)...... 5 2,440,914. Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a. 1 Total expenses and losses per audited financial statements...... 1 2,534,314. 2 Amounts included on line 1 but not on Form 990, Part IX, line 25: a Donated services and use of facilities ...... 2 a b Prior year adjustments ...... 2 b c Other losses...... 2 c d Other (Describe in Part XIII.)...... 2 d e Add lines 2a through 2d...... 2 e 3 Subtract line 2e from line 1...... 3 2,534,314. 4 Amounts included on Form 990, Part IX, line 25, but not on line 1: a Investment expenses not included on Form 990, Part VIII, line 7b...... 4 a b Other (Describe in Part XIII.)...... 4 b c Add lines 4a and 4b...... 4 c 5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.)...... 5 2,534,314. Part XIII Supplemental Information. Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part IV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information. DRAFT

BAA Schedule D (Form 990) 2017

TEEA3304L 08/10/17 161 SCHEDULE F Statement of Activities Outside the United States OMB No. 1545-0047 (Form 990) G Complete if the organization answered 'Yes' on Form 990, Part IV, line 14b, 15, or 16. G Attach to Form 990. 2017 Department of the Treasury Open to Public Internal Revenue Service G Go to www.irs.gov/Form990 for instructions and the latest information Inspection Name of the organization Employer identification number ASSOCIATION OF ASIAN PACIFIC COMMUNITY HEALTH ORGANIZATION 94-3050247 Part I General Information on Activities Outside the United States. Complete if the organization answered 'Yes' on Form 990, Part IV, line 14b.

1 For grantmakers. Does the organization maintain records to substantiate the amount of its grants and other assistance, the grantees' eligibility for the grants or assistance, and the selection criteria used to award the grants or assistance?. . . . X Yes No

2 For grantmakers. Describe in Part V the organization's procedures for monitoring the use of its grants and other assistance outside the United States. PART V

3 Activities per Region. (The following Part I, line 3 table can be duplicated if additional space is needed.)

(a) Region (b) Number of (c) Number of (d) Activities conducted in (e) If activity listed in (f) Total offices in the employees, the region (by type) (such (d) is a program expenditures for region agents, and as, fundraising, program service, describe and investments independent services, investments, specific type of in the region contractors grants to recipients service(s) in in the region located in the region) the region PT V DIABETES (1) E ASIA, PACIFIC PROGRAM SERVICES PREVENTION 316,100.

(2)

(3)

(4)

(5)

(6)

(7)

(8)

(9)

(10)

(11)

(12) (13) DRAFT (14)

(15)

(16)

(17) 3 a Sub-total...... 316,100. b Total from continuation sheets to Part I...... c Totals (add lines 3a and 3b). . . 0 0 316,100. BAA For Paperwork Reduction Act Notice, see the Instructions for Form 990. Schedule F (Form 990) 2017

TEEA3501L 08/10/17 162 Schedule F (Form 990) 2017 ASSOCIATION OF ASIAN PACIFIC 94-3050247 Page 2 Part II Grants and Other Assistance to Organizations or Entities Outside the United States. Complete if the organization answered 'Yes' on Form 990, Part IV, line 15, for any recipient who received more than $5,000. Part II can be duplicated if additional space is needed.

1 (a) Name of organization (b) IRS code (c) Region (d) Purpose (e) Amount of (f) Manner of (g) Amount of (h) Description of (i) Method of section and EIN of grant cash grant cash noncash noncash valuation (book, (if applicable) disbursement assistance assistance FMV, appraisal, other) PART V E ASIA, DIABETES (1) PACIFIC PREVENTION 95,500. CHECK E ASIA, DIABETES (2) PACIFIC PREVENTION 104,772. CHECK E ASIA, DIABETES (3) PACIFIC PREVENTION 115,828. CHECK

(4)

(5)

(6)

(7)

(8)

(9)

(10)

(11)

(12)

(13)

(14)

(15) (16) DRAFT 2 Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exempt by the IRS, or for which the grantee or counsel has provided a section 501(c)(3) equivalency letter...... G 3 3 Enter total number of other organizations or entities...... G 0 BAA Schedule F (Form 990) 2017

TEEA3502L 08/10/17 163 Schedule F (Form 990) 2017 ASSOCIATION OF ASIAN PACIFIC 94-3050247 Page 3 Part III Grants and Other Assistance to Individuals Outside the United States. Complete if the organization answered 'Yes' on Form 990, Part IV, line 16. Part III can be duplicated if additional space is needed.

(a) Type of grant or assistance (b) Region (c) Number (d) Amount of (e) Manner of (f) Amount of (g) Description of (h) Method of of recipients cash grant cash noncash assistance noncash assistance valuation (book, disbursement FMV, appraisal, other)

(1)

(2)

(3)

(4)

(5)

(6)

(7)

(8)

(9)

(10)

(11)

(12)

(13)

(14) (15) DRAFT (16)

(17)

(18) BAA Schedule F (Form 990) 2017 TEEA3503L 08/10/17 164 Schedule F (Form 990) 2017 ASSOCIATION OF ASIAN PACIFIC 94-3050247 Page 4 Part IV Foreign Forms

1 Was the organization a U.S. transferor of property to a foreign corporation during the tax year? If 'Yes,' the organization may be required to file Form 926, Return by a U.S. Transferor of Property to a Foreign Corporation (see Instructions for Form 926)...... Yes X No

2 Did the organization have an interest in a foreign trust during the tax year? If 'Yes,' the organization may be required to separately file Form 3520, Annual Return To Report Transactions with Foreign Trusts and Receipt of Certain Foreign Gifts, and/or Form 3520-A Annual Information Return of Foreign Trust With a U.S. Owner (see Instructions for Forms 3520 and 3520-A; do not file with Form 990)...... Yes X No

3 Did the organization have an ownership interest in a foreign corporation during the tax year? If 'Yes,' the organization may be required to file Form 5471, Information Return of U.S. Persons With Respect To Certain Foreign Corporations (see Instructions for Form 5471)...... Yes X No

4 Was the organization a direct or indirect shareholder of a passive foreign investment company or a qualified electing fund during the tax year? If 'Yes,' the organization may be required to file Form 8621, Information Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund (see Instructions for Form 8621)...... Yes X No

5 Did the organization have an ownership interest in a foreign partnership during the tax year? If 'Yes,' the organization may be required to file Form 8865, Return of U.S. Persons With Respect to Certain Foreign Partnerships (see Instructions for Form 8865)...... Yes X No

6 Did the organization have any operations in or related to any boycotting countries during the tax year? If 'Yes,' the organization may be required to separately file Form 5713, International Boycott Report (see Instructions for Form 5713; do not file with Form 990)...... Yes X No

BAA TEEA3505L 08/10/17 Schedule F (Form 990) 2017

DRAFT

165 Schedule F (Form 990) 2017 ASSOCIATION OF ASIAN PACIFIC 94-3050247 Page 5 Part V Supplemental Information Provide the information required by Part I, line 2 (monitoring of funds); Part I, line 3, column (f) (accounting method; amounts of investments vs. expenditures per region); Part II, line 1 (accounting method); Part III (accounting method); and Part III, column (c) (estimated number of recipients), as applicable. Also complete this part to provide any additional information. See instructions. PART I, LINE 2 - GRANTMAKERS EXPLANATION FOR MONITORING USE OF FUNDS OUTSIDE US

GRANT AGREEMENTS REQUIRES REPORTING FROM RECEIPIENTS.

PART I, LINE 3F - METHOD OF ACCOUNTING

ACCRUAL

PART II, LINE 1 - METHOD OF ACCOUNTING

ACCRUAL ACCOUNTING

DRAFT

BAA TEEA3504L 08/10/17 Schedule F (Form 990) 2017 166 OMB No. 1545-0047 SCHEDULE I Grants and Other Assistance to Organizations, (Form 990) Governments, and Individuals in the United States 2017 Complete if the organization answered 'Yes' on Form 990, Part IV, line 21 or 22. G Attach to Form 990. Open to Public Department of the Treasury Internal Revenue Service G Go to www.irs.gov/Form990 for the latest information Inspection Name of the organization ASSOCIATION OF ASIAN PACIFIC Employer identification number COMMUNITY HEALTH ORGANIZATION 94-3050247 Part I General Information on Grants and Assistance 1 Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and the selection criteria used to award the grants or assistance?...... X Yes No 2 Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States. SEE PART IV Part II Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered 'Yes' on Form 990, Part IV, line 21, for any recipient that received more than $5,000. Part II can be duplicated if additional space is needed.

1 (a) Name and address of organization (b) EIN (c) IRC section (d) Amount of cash grant (e) Amount of non-cash (f) Method of valuation (g) Description of (h) Purpose of grant or government (if applicable) assistance (book, FMV, appraisal, noncash assistance or assistance other) (1) WAIKIKI HEALTH CENTER CHARN II 277 OHUA AVENUE RESEARCH NODE HONOLULU, HI 96815 99-0159253 7,500. 0. HEALTH CENTE (2) CHARLES B WANG COMMT. HEALTH CIVIC 268 CANAL STREET ENGAGEMENT; NEW YORK, NY 10013 13-2739694 7,500. 0. CHARN II RES. (3) PACIFIC ARKANSAS COALITION OF MARSHAL ISLANDER 614 EAST EMMA AVE. BOX 210 DIABETES (4) SPRINGDALE, AR 72764 125,980. 0. PREVENTIO PACIFIC MALAMA I KE OLA HEALTH CENTER ISLANDER (5) 1881 NANI STREET DIABETES WAILUKU, HI 96793 137,000. 0. PREVENTIO

(6)

(7)

(8) DRAFT

2 Enter total number of section 501(c)(3) and government organizations listed in the line 1 table...... G 2 3 Enter total number of other organizations listed in the line 1 table...... G 2 BAA For Paperwork Reduction Act Notice, see the Instructions for Form 990. TEEA3901L 08/10/17 Schedule I (Form 990) (2017)

167 Schedule I (Form 990) (2017) ASSOCIATION OF ASIAN PACIFIC 94-3050247 Page 2 Part III Grants and Other Assistance to Domestic Individuals. Complete if the organization answered 'Yes' on Form 990, Part IV, line 22. Part III can be duplicated if additional space is needed.

(a) Type of grant or assistance (b) Number of (c) Amount of (d) Amount of (e) Method of valuation (book, (f) Description of noncash assistance recipients cash grant noncash assistance FMV, appraisal, other)

1

2

3

4

5

6

7 Part IV Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.

PART I, LINE 2 - PROCEDURES FOR MONITORING USE OF GRANTS FUNDS IN U.S.

GRANT AGREEMENT REQUIRES REPORTING FROM RECIPIENTS.

DRAFT

BAA Schedule I (Form 990) (2017)

TEEA3902L 11/03/16 168 SCHEDULE J Compensation Information OMB No. 1545-0047 (Form 990) For certain Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees 2017 G Complete if the organization answered 'Yes' on Form 990, Part IV, line 23. G Attach to Form 990. Department of the Treasury Open to Public Internal Revenue Service G Go to www.irs.gov/form990 for instructions and the latest information Inspection Name of the organization ASSOCIATION OF ASIAN PACIFIC Employer identification number COMMUNITY HEALTH ORGANIZATION 94-3050247 Part I Questions Regarding Compensation Yes No 1 a Check the appropriate box(es) if the organization provided any of the following to or for a person listed on Form 990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items. PART III First-class or charter travel Housing allowance or residence for personal use Travel for companions Payments for business use of personal residence Tax indemnification and gross-up payments X Health or social club dues or initiation fees Discretionary spending account Personal services (such as, maid, chauffeur, chef)

b If any of the boxes on line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If 'No,' complete Part III to explain...... 1 b X

2 Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all directors, trustees, and officers, including the CEO/Executive Director, regarding the items checked on line 1a? ...... 2

3 Indicate which, if any, of the following the filing organization used to establish the compensation of the organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III. Compensation committee X Written employment contract Independent compensation consultant Compensation survey or study Form 990 of other organizations X Approval by the board or compensation committee

4 During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization: a Receive a severance payment or change-of-control payment? ...... 4 a X b Participate in, or receive payment from, a supplemental nonqualified retirement plan? ...... 4 b X c Participate in, or receive payment from, an equity-based compensation arrangement?...... 4 c X If 'Yes' to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only section 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

5 For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any compensation contingent on the revenues of: a The organization?...... 5 a X b Any related organization? ...... 5 b X If 'Yes' on line 5a or 5b, describe in Part III.

6 For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any compensation contingent on the net earnings of: a The organization?...... 6 a X b Any related organization? ...... 6 b X If 'Yes' on line 6a or 6b, describe in PartDRAFT III. 7 For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed payments not described on lines 5 and 6? If 'Yes,' describe in Part III...... 7 X 8 Were any amounts reported on Form 990, Part VII, paid or accrued pursuant to a contract that was subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If 'Yes,' describe in Part III ...... 8 X 9 If 'Yes' on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? ...... 9 BAA For Paperwork Reduction Act Notice, see the Instructions for Form 990. Schedule J (Form 990) 2017

TEEA4101L 08/09/17 169 Schedule J (Form 990) 2017 ASSOCIATION OF ASIAN PACIFIC 94-3050247 Page 2 Part II Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.

For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the instructions, on row (ii). Do not list any individuals that aren't listed on Form 990, Part VII. Note: The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.

(B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement (D) Nontaxable (E) Total of (F) Compensation (i) (A) Name and Title Base (ii) Bonus & incentive (iii) Other and other benefits columns(B)(i)-(D) in column (B) compensation compensation reportable compensation deferred reported as compensation deferred on prior Form 990 JEFFREY CABALLERO (i) 159,370. 0. 0. 0. 0. 159,370. 0. 1 EXECUTIVE DIR. (ii) 0. 0. 0. 0. 0. 0. 0. (i) 2 (ii) (i) 3 (ii) (i) 4 (ii) (i) 5 (ii) (i) 6 (ii) (i) 7 (ii) (i) 8 (ii) (i) 9 (ii) (i) 10 (ii) (i) 11 (ii) (i) 12 (ii) (i) 13 (ii) (i) DRAFT 14 (ii) (i) 15 (ii) (i) 16 (ii) BAA TEEA4102L 08/09/17 Schedule J (Form 990) 2017

170 Schedule J (Form 990) 2017 ASSOCIATION OF ASIAN PACIFIC 94-3050247 Page 3 Part III Supplemental Information Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.

PART 1, LINE 1A - RELEVANT INFORMATION REGARDING COMPENSATION BENEFITS

AAPCHO ESTABLISHED A CORPORATE GYM ACCOUNT FOR AAPCHO STAFF LOCATED IN THE SAN

FRANCISCO BAY AREA, WITH ACTIVE SPORTS, FORMERLY CLUB ONE. AAPCHO NEGOTIATED A RATE

OF $52.08/STAFF/MONTH. AAPCHO EXTENDED THE BENEFIT TO STAFF LOCATED OUTSIDE THE

AREA/UNABLE TO USE THE FACILITY, CAPPING TO THE EQUIVALENT COST OF MONTHLY

MEMBERSHIP. AAPCHO PAYS THE LESSER OF ACTUAL COST OR AAPCHO’S COST PER STAFF THROUGH

OUR CORPORATE ACCOUNT. STAFF ARE ASKED TO PROVIDE DOCUMENTATION OF GYM OR EQUIVALENT

MEMBERSHIP.

DRAFT

BAA Schedule J (Form 990) 2017

TEEA4103L 08/09/17 171 SCHEDULE O Supplemental Information to Form 990 or 990-EZ OMB No. 1545-0047 (Form 990 or 990-EZ) Complete to provide information for responses to specific questions on Form 990 or 990-EZ or to provide any additional information. 2017 G Attach to Form 990 or 990-EZ. Open to Public Department of the Treasury G Go to www.irs.gov/Form990 for the latest information. Internal Revenue Service Inspection Name of the organization ASSOCIATION OF ASIAN PACIFIC Employer identification number COMMUNITY HEALTH ORGANIZATION 94-3050247

FORM 990, PART III, LINE 1 - ORGANIZATION MISSION

AAPCHO IS A NATIONAL ASSOCIATION REPRESENTING COMMUNITY HEALTH ORGANIZATIONS

DEDICATED TO PROMOTING ADVOCACY, COLLABORATION AND LEADERSHIP THAT IMPROVES THE

HEALTH STATUS AND ACCESS OF ASIAN AMERICANS & NATIVE HAWAIIANS AND OTHER PACIFIC

ISLANDERS (AA&NHOPI) WITHIN THE UNITED STATES, ITS TERRITORIES, AND FREELY

ASSOCIATED STATES, PRIMARILY THROUGH OUR MEMBER COMMUNITY HEALTH CENTERS.

FORM 990, PART VI, LINE 4 - SIGNIFICANT CHANGES TO ORGANIZATIONAL DOCUMENTS

AAPCHO'S BYLAWS WERE UPDATED TO CLARIFY DESIGNATOR ORGANIZATION QUALIFICATIONS,

ADJUST THE TERM OF BOARD OFFICERS TO TWO YEARS, SPECIFY SUSPENSION AND REMOVAL

CRITERIAL OF AAPCHO ASSOCIATE MEMBERS, INCREASE THE NUMBER OF MEETINGS BY THE BOARD

OF DIRECTORS, ALLOW MORE THAN ONE BOARD COMMITTEE, AND INCREASE THE NUMBER OF

CONSUMER DIRECTORS ON THE BOARD OF DIRECTORS.

FORM 990, PART VI, LINE 6 - EXPLANATION OF CLASSES OF MEMBERS OR SHAREHOLDER

MEMBERS ARE NONPROFIT HEALTH CENTERS AND ORGANIZATIONS THAT ARE INVOLVED IN

HEALTH-RELATED ISSUES OF THE AA&NHOPI COMMUNITY

FORM 990, PART VI, LINE 7A - HOW MEMBERS OR SHAREHOLDERS ELECT GOVERNING BODY

EACH FULL MEMBER HAS A REPRESENTATIVE ON THE BOARD AND THE BOARD OF DIRECTORS, BY

MAJORITY VOTE, ELECT A CONSUMER BOARD MEMBER. FORM 990, PART VI, LINE 7B - DECISIONSDRAFT OF GOVERNING BODY APPROVAL BY MEMBERS OR SHAREHOLDERS DECISIONS ARE VOTED ON AND APPROVED BY THE BOARD OF DIRECTORS. EACH FULL MEMBER HAS

A REPRESENTATIVE ON THE BOARD AND HAS ONE VOTE. THE CONSUMER BOARD MEMBER HAS ONE

VOTE.

FORM 990, PART VI, LINE 11B - FORM 990 REVIEW PROCESS

A FINAL DRAFT IS E-MAILED TO EACH MEMBER OF THE BOARD FOR THEIR REVIEW BEFORE THE

ACTUAL FILING.

BAA For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ. TEEA4901L 08/09/17 Schedule O (Form 990 or 990-EZ) (2017) 172 Schedule O (Form 990 or 990-EZ) (2017) Page 2 Name of the organization ASSOCIATION OF ASIAN PACIFIC Employer identification number COMMUNITY HEALTH ORGANIZATION 94-3050247

FORM 990, PART VI, LINE 19 - OTHER ORGANIZATION DOCUMENTS PUBLICLY AVAILABLE

THE GOVERNING DOCUMENTS, POLICIES, AND FINANCIAL STATEMENTS ARE KEPT IN THE

ADMINISTRATIVE OFFICE AND ARE AVAILABLE UPON REQUEST.

DRAFT

BAA Schedule O (Form 990 or 990-EZ) (2017) TEEA4902L 08/09/17 173 059

Date Accepted DO NOT MAIL THIS FORM TO THE FTB TAXABLE YEAR California e-file Return Authorization for FORM 2017 Exempt Organizations 8453-EO Exempt Organization name Identifying number ASSOCIATION OF ASIAN PACIFIC 94-3050247 Part I Electronic Return Information (whole dollars only) 1 Total gross receipts (Form 199, line 4) ...... 1 2,440,914. 2 Total gross income (Form 199, line 8)...... 2 2,440,914. 3 Total expenses and disbursements (Form 199, Line 9)...... 3 2,534,314. Part II Settle Your Account Electronically for Taxable Year 2017

4 Electronic funds withdrawal 4a Amount 4b Withdrawal date (mm/dd/yyyy)

Part III Banking Information (Have you verified the exempt organization's banking information?) 5 Routing number 6 Account number 7 Type of account: Checking Savings Part IV Declaration of Officer I authorize the exempt organization's account to be settled as designated in Part II. If I check Part II, Box 4, I authorize an electronic funds withdrawal for the amount listed on line 4a.

Under penalties of perjury, I declare that I am an officer of the above exempt organization and that the information I provided to my electronic return originator (ERO), transmitter, or intermediate service provider and the amounts in Part I above agree with the amounts on the corresponding lines of the exempt organization's 2017 California electronic return. To the best of my knowledge and belief, the exempt organization's return is true, correct, and complete. If the exempt organization is filing a balance due return, I understand that if the Franchise Tax Board (FTB) does not receive full and timely payment of the exempt organization's fee liability, the exempt organization will remain liable for the fee liability and all applicable interest and penalties. I authorize the exempt organization return and accompanying schedules and statements be transmitted to the FTB by the ERO, transmitter, or intermediate service provider. If the processing of the exempt organization's return or refund is delayed, I authorize the FTB to disclose to the ERO or intermediate service provider, the reason(s) for the delay.

Sign A A EXECUTIVE DIR. Here Signature of officer Date Title

Part V Declaration of Electronic Return Originator (ERO) and Paid Preparer. See instructions.

I declare that I have reviewed the above exempt organization's return and that the entries on form FTB 8453-EO are complete and correct to the best of my knowledge. (If I am only an intermediate service provider, I understand that I am not responsible for reviewing the exempt organization's return. I declare, however, that form FTB 8453-EO accurately reflects the data on the return.) I have obtained the organization officer's signature on form FTB 8453-EO before transmitting this return to the FTB; I have provided the organization officer with a copy of all forms and information that I will file with the FTB, and I have followed all other requirements described in FTB Pub. 1345, 2017 e-file Handbook for Authorized e-file Providers. I will keep form FTB 8453-EO on file for four years from the due date of the return or four years from the date the exempt organization return is filed, whichever is later, and I will make a copy available to the FTB upon request. If I am also the paid preparer, under penalties of perjury, I declare that I have examined the above exempt organization's return and accompanying schedules and statements, and to the best of my knowledge and belief, they are true, correct, and complete. I make this declaration based on all information of which I have knowledge.

Date Check if Check if ERO's PTIN ERO's also paid self- signature A SUSAN MOSTAJO preparer X employed P02016957 ERO WUHOOVER & CO LLP FEIN Firm's name (or yours DRAFT Must if self-employed) and A Sign address 1510 FASHION ISLAND BLVD 27-2481245 SAN MATEO CAZIP Code 94404 Under penalties of perjury, I declare that I have examined the above organization's return and accompanying schedules and statements, and to the best of my knowledge and belief, they are true, correct, and complete. I make this declaration based on all information of which I have knowledge. Date Paid Paid preparer's PTIN preparer's Check if self- Paid signature A employed Preparer FEIN Must Firm's name A (or yours if self- Sign employed) and address ZIP code For Privacy Notice, get FTB 1131 ENG/SP. FTB 8453-EO 2017

CAEA7001L 11/30/17 174 ASSOCIATION OF ASIAN PACIFIC COMMUNITY HEALTH ORGANIZATIONS Executive Director’s Report September 2019

The following activities reported per strategic priority areas:

Goal 1: Sustainability Strategic Priority Area

• Membership: No updates this month. ▪ We are in the process of implementing a new CDC TB project in partnership with APIAHF and Hep B Foundation. The new grant totals $350K/year with AAPCHO receiving $100K/year. ▪ A new AAPCHO & NACHC partnership proposal has been selected by RWJ Foundation for reward. The new project proposes to utilize PRAPARE tool to strengthen services and capacities of health center in partnerships with social service CBOs to respond to patient and community SDOH. The new project is anticipated to begin November 1st. ▪ SDOH Payment Learning Collaborative – With the PRAPARE Risk Stratification Learning Collaborative half-way completed, staff are developing plans for new trainings and services for health centers and health care plans. One desired outcome of the new information is to develop tools that will help health centers negotiate better payments from respective state Medicaid plans. ▪ AAPCHO Technical Assistance & Training staff are continuing to pursue fee-for-service contracts for supplementary Enabling Services trainings and PRAPARE trainings to several PCAs around the country. ▪ Recently released BPHC National Cooperative Agreement announcement provides AAPCHO an opportunity to increase annual BPHC funding by $100K for new optional services.

Goal 2: Advocacy/Policy Strategic Priority Area

• Public Charge: Senator Mazie Hirono and 26 Democratic senators introduced legislation to prevent DHS from implementing the public charge rule. The bill is similar to Rep. Judy Chu's No Federal Funds for Public Charge Act that was introduced in June. Both bills are unlikely to be enacted in the current political environment but are still important to signal Congressional opposition to public charge. Also, as a result of CHI public charge related meetings with BPHC and health center, AAPCHO is in discussions with GW and RCHN for strengthening efforts to document harm of public charge policy on health centers.

175 2019 Sept ED Report Page - 2

• Deportation rule: Office of Management and Budget continues to take meetings on the DOJ public charge deportation rule. AAPCHO, CPCA, and AHS will meet with OMB on October 4 to provide the health center perspective opposing this rule. Additionally, legislation is being prepped by Rep. Veronica Escobar’s office to mirror the No Federal Funds for Public Charge Act if/when the deportation rule is published. Please sign on to endorse the bill by September 25th using this form. You can see an unofficial version of the bill here, not for wide sharing, but only for purposes of reviewing for organizational endorsement.

• Appropriations: the House passed a continuing resolution on Thursday, September 19 extending government funding until November 21. The measure maintains level funding for most government operations and includes a temporary extension for community health center funding and other health extenders. Also included was an extension of 100 percent FMAP for the territories Medicaid programs. The Senate is expected to pass the bill next week. Congressional leaders will still need to negotiate a long-term spending agreement and extensions of health center and other health extenders for after November 21.

• Prescription drugs: Speaker Pelosi and House Democrats unveiled their prescription drug plan on Thursday, September 19. The bill would require the Secretary of Health and Human Services to negotiate drug prices for at least 25 and up to 250 medicines. The plan includes provisions supported by the Trump administration and included in the Sen Grassley's proposal. It is not intended to impact the 340B program. You can read a summary of the plan here and a title summary here.

Goal 3: Pacific Islander Initiative Strategic Priority Area

▪ Staff are still going through numerous applicants for PI Development Coordinator. This new position will be securing new resources and partnerships to implement the PI Center of Excellence plan. ▪ Staff are in discussions with Pacific Islander Health Officers Association (PIHOA) and Pacific Islander PCA (PIPCA) to explore

176 2019 Sept ED Report Page - 3 new opportunities, increase resources, and strengthen TA efforts for organizations serving PI communities.

Goal 4: Strengthening Infrastructure Strategic Priority Area • Staff Stay (satisfaction) Survey is being integrated into annual staff review schedule and development planning. The Stay Survey will have 2 parts, an anonymous portion for general organizational use and a personal portion for individual development planning with each staff’s supervisor. • Jeff and Darrin are still planning to conduct another Board survey for reporting at March 2020 Board meeting. • 2020 Board retreat and staff retreat are still being scheduled.

Travel Updates The following reflects upcoming staff leadership travel & activities:

• Jeff will be attending CDC AANHPI Communications Institute in Atlanta, on Sept. 24-26th. The Communications Institute provides an opportunity to strengthen relationships with relevant CDC career staff and learn about new CDC opportunities. • AAPCHO TA Team will be presenting at Community Healthcare Association of Dakotas’ on Oct. 1-2nd. • AAPCHO TA Team will be attending and presenting at California PCA conference on Oct. 16-17th. • AAPCHO Research Staff will be presenting PRAPARE at Root Cause Coalition Conference in San Diego on Oct. 20-22nd. • Adam and Jeff will be attending National Immigration Integration Conference in Detroit, MI on Oct. 19-22nd.

177 ASSOCIATION OF ASIAN PACIFIC COMMUNITY HEALTH ORGANIZATIONS Executive Director’s Report October 2019

The following activities reported per strategic priority areas:

Goal 1: Sustainability Strategic Priority Area

• Membership: Guam leadership just requested a membership application. ▪ New RWJ Foundation funding: Updates to last months announcement of the new RWJ Foundation funding, funding level is $198K for AAPCHO over 21 months. The new project proposes to leverage PRAPARE SDOH tool to facilitate relationships between health centers and CBO partnerships. Lastly, the start time is now scheduled to begin, Dec. 1, 2019. ▪ AAPCHO Technical Assistance & Training staff and CDC DPP staff continue to pursue fee-for-service contracts to provide CDC certified Diabetes Prevention Program trainings to PCAs and CHCs around the country, as well as CDC certified Master Trainers to teach lifestyle coaches. ▪ Staff are exploring priority areas for potential BPHC National Cooperative Agreement $100K increase for new optional services.

Goal 2: Advocacy/Policy Strategic Priority Area

PRAPARE Risk Stratification Learning Collaborative Findings: The national PRAPARE team completed a PRAPARE Risk Stratification Learning Collaborative this summer to better understand how organizations are incorporating PRAPARE social determinants of health data into risk stratification models and how they are using these models to inform care planning and population health. Interest and feasibility of developing a national standardized risk stratification model that incorporates PRAPARE social determinants data to better identify and manage high risk patients. A webinar scheduled on December 12th (noon PT) will highlight findings and lessons learned, as well as a draft of the national standardized PRAPARE risk stratification model will be presented for feedback. Register here: NACHC Dec webinar on PRAPARE RS • • • Public Charge: Senator Mazie Hirono and 26 Democratic senators introduced legislation to prevent DHS from implementing the public charge rule. The bill is similar to Rep. Judy Chu's No Federal Funds for Public Charge Act that was introduced in June. Both bills are unlikely to be enacted in the current political environment but are still

178 2019 Oct ED Report Page - 2 important to signal Congressional opposition to public charge. Also, as a result of CHI public charge related meetings with BPHC and health center, AAPCHO is in discussions with GW and RCHN for strengthening efforts to document harm of public charge policy on health centers.

• Deportation rule: Office of Management and Budget continues to take meetings on the DOJ public charge deportation rule. AAPCHO, CPCA, and AHS will meet with OMB on October 4 to provide the health center perspective opposing this rule. Additionally, legislation is being prepped by Rep. Veronica Escobar’s office to mirror the No Federal Funds for Public Charge Act if/when the deportation rule is published. Please sign on to endorse the bill by September 25th using this form. You can see an unofficial version of the bill here, not for wide sharing, but only for purposes of reviewing for organizational endorsement.

• Appropriations: the House passed a continuing resolution on Thursday, September 19 extending government funding until November 21. The measure maintains level funding for most government operations and includes a temporary extension for community health center funding and other health extenders. Also included was an extension of 100 percent FMAP for the territories Medicaid programs. The Senate is expected to pass the bill next week. Congressional leaders will still need to negotiate a long-term spending agreement and extensions of health center and other health extenders for after November 21.

• Prescription drugs: Speaker Pelosi and House Democrats unveiled their prescription drug plan on Thursday, September 19. The bill would require the Secretary of Health and Human Services to negotiate drug prices for at least 25 and up to 250 medicines. The plan includes provisions supported by the Trump administration and included in the Sen Grassley's proposal. It is not intended to impact the 340B program. You can read a summary of the plan here and a title summary here.

Goal 3: Pacific Islander Initiative Strategic Priority Area

▪ Staff are still going through numerous applicants for PI Development Coordinator. This new position will be securing new

179 2019 Oct ED Report Page - 3 resources and partnerships to implement the PI Center of Excellence plan. ▪ Staff are in discussions with Pacific Islander Health Officers Association (PIHOA) and Pacific Islander PCA (PIPCA) to explore new opportunities, increase resources, and strengthen TA efforts for organizations serving PI communities.

Goal 4: Strengthening Infrastructure Strategic Priority Area • Staff Stay (satisfaction) Survey is being integrated into annual staff review schedule and development planning. The Stay Survey will have 2 parts, an anonymous portion for general organizational use and a personal portion for individual development planning with each staff’s supervisor. • Jeff and Darrin are still planning to conduct another Board survey for reporting at March 2020 Board meeting. • 2020 Board retreat and staff retreat are still being scheduled.

Travel Updates The following reflects upcoming staff leadership travel & activities:

• Jeff will be attending CDC AANHPI Communications Institute in Atlanta, on Sept. 24-26th. The Communications Institute provides an opportunity to strengthen relationships with relevant CDC career staff and learn about new CDC opportunities. • AAPCHO TA Team will be presenting at Community Healthcare Association of Dakotas’ on Oct. 1-2nd. • AAPCHO TA Team will be attending and presenting at California PCA conference on Oct. 16-17th. • AAPCHO Research Staff will be presenting PRAPARE at Root Cause Coalition Conference in San Diego on Oct. 20-22nd. • Adam and Jeff will be attending National Immigration Integration Conference in Detroit, MI on Oct. 19-22nd.

180 AAPCHO Board of Directors Report Report Topic: Value, Impact, & Policy Research (VIPR) Board Advisory Committee Update Submitted by: Mary Oneha (Chair) and Rosy Chang Weir Board of Directors Meeting Date: November 19, 2019 Background and/or Summary: Since the last August 2019 Board of Directors meeting, the VIPR has convened one conference call (10/25/19).

AAPCHO continues to work on the national PRAPARE (Protocol for Responding to and Assessing Patients’ Assets, Risks, and Experiences) social determinants of health (SDH) program, serving as co- PI in the partnership primarily responsible for research/evaluation of PRAPARE. 1. In a recent Medicaid Managed Care annual survey report, PRAPARE was reported as the most widely used SDH tool among Medicaid Managed Care Organizations. 2. AAPCHO continues to lead the development of a PRAPARE Risk Stratification Learning Collaborative. The purpose of the Collaborative is to broaden our knowledge of PRAPARE risk stratification strategies and possible pathways towards a common national standardized method with options for localized methodologies. With two AAPCHO members as participants (WCCHC, CBWCHC), we have convened five webinars with an upcoming in-person meeting this month. We have now completed a 4th draft of the national algorithm that includes measures in five components: Clinical, Mental Health/Substance Abuse, Demographics (from UDS), SDH PRAPARE, and ED Utilization. 3. We are in the process of completing sixteen additional translated versions of PRAPARE to broaden access of the tool for the large number of underserved patients nationally. 4. We have collaborated with Regenstrief to finalize PRAPARE LOINC coding. 5. We have been working with the Gravity Project, a SDH coding collaborative, to ensure alignment of our enabling services codes with their intervention framework. Papers and Presentations 1. Our Protocol of Responding and Assessing Patient Assets, Risks, and Experiences (PRAPARE) National Paper, led by AAPCHO, was accepted with minor revisions to the Journal of Health Care for the Poor and Underserved. Minor revision of the manuscript has been completed and submitted. 2. We recently released the PRAPARE Validation fact sheet. This fact sheet describes eight “Gold Standard” Stages of Measure Development to validate PRAPARE. 3. We have completed numerous PRAPARE presentations and have been invited to present at many upcoming conferences and webinars: a. We conducted a presentation at NACHC CHI on our National Risk Stratification Learning Collaborative b. We presented our diabetes/hypertension analyses at the NIH NIDDK Center for Diabetes Translation Research webinar, highlighting how PRAPARE SDH is associated with diabetes and hypertension outcomes and the higher blood pressure and HbA1c value as the total PRAPARE SDH risk score increases (controlling for gender, age and BMI). c. We presented at the NACHC national webinar on October 28th about the identification and association of PRAPARE cluster analyses with diabetes/hypertension. d. PRAPARE was presented in November 2019 at APHA. e. We were invited by NIH to present PRAPARE on November 8th, 2019 f. On November 14th, we will present Risk Stratification at the CCALAC conference in Los Angeles. g. On November 18th, we will present PRAPARE Risk Stratification at the PCA/HCCN Conference in San Diego. h. On December 12th, 2019, we will present our national PRAPARE Risk Stratification model in the NACHC national webinar. For questions about these initiatives or to join VIPR, please contact Rosy Chang Weir, Director of Research. Issue(s): None, for update purposes only. Action Requested: Please inform AAPCHO if members are using PRAPARE data for risk stratification or if interested in related PRAPARE-enabling services analyses with other AAPCHO members.

181 Development and Fundraising Snapshot (DRAFTv.1)

Board Meeting Date: November 19.2019

Summary* By Source FY 2019 Fundraising Goal: $359,000 Goal Raised to Date Balance to % Raised Raise Amount Raised to Date: $0 New Member Acquisition $30,000 $0 $30,000 0%

Balance to Raise: $359,000 Corporate Support $86,000 $0 $86,000 0% Percentage Raised: 0% Other Fundraising $243,000 $0 $243,000 0% Strategies Total $359,000 $0 $359,000 0%

Additional Updates Existing Member Renewals Expected Renewals (P) 27 $235,466 Pending 27 $235,466 New Member Acquisition Received / Approved 0 $0 Prospecting 4 $12,000 New Government Grants/Contracts Prospecting 0 NA Submitted 0 NA Closed - Awarded 0 $0 Closed - Not Awarded 0 $0 New Foundation Grants Prospecting 2 $300,000 Submitted 2 $200,000 Closed - Awarded 0 $0 Closed - Not Awarded 0 $0 New Fee for Service Contracts Prospecting 0 NA Submitted 0 NA Closed - Awarded 0 $0 Closed - Not Awarded 0 $0 New Corporate Support Prospecting 1 $150,000 Submitted 0 $150,000 Closed - Awarded 0 $0 Closed - Not Awarded 0 $0 Other Individual Donors 9 $0

182 183 184 185 186 187

Upcoming AAPCHO Board Meetings 2019 - 2020

2019

November 19, 2019, Tuesday – Conference Call @ 11a HT/1pm PT/3pm CT/4pm ET (Nov 20th – 8a KOST).

2020

March 16th, Monday AM – Marriott Wardman, Washington, DC (updated)

June 26th, Friday , NV (Saturday, AANHPI Presidential Townhall @ Caesars)

August 29th, Saturday - Manchester Grand Hyatt, San Diego, Ca

November 17th, Tuesday – Conference Call @ 1pm PT

188