2 0 0 6 A N N U A L R E P O R T

Chiricahua Community

Health Centers, Inc.

E X E C U T I V E S U M M A R Y

Jennifer “Ginger” Ryan, MBA/Ph.D.Chief Executive Officer

Chiricahua Community Health Centers, Inc. (CCHCI) has an overriding goal of corporatesocial responsibility. Respecting the dignity and worth of every individual is not just acompany slogan — it is our guiding light. It demands the highest possible standards in the way we treat our patients, the community and each other.

CCHCI is a brave, imaginative and ethical organization. We recognize that the moral testof this goal is how we treat our most vulnerable people. With that in mind, we providednearly 50,000 face-to-face services in 2006. Some of those encounters happened inone of our three medical facilities (Bisbee, Douglas and Elfrida); some of them occurredon the Mobile Medical Unit and the Mobile Dental Unit; at schools; at food banks; and,some of them happened in the dirt of the chile fields up and down the beautiful andremote Sulphur Springs Valley.

The essence of CCHCI is exemplified by its staff. Their strong sense of responsibility and integrity is at the heart of everything we do. It is this deep-rooted and unswerving commitment to provide quality and efficient medical care to everyone in Cochise Countyregardless of their ability to pay that makes CCHCI so special.

B E G I N N I N G S

CCHCI opened in the back of the Elfrida Community Center in August, 1996. Staffed with part-time doctors, 29 patients were seen that first month. The original fundingcame from the Arizona Department of Health Services’ Tobacco Tax Program. In 1997,CCHCI was designated as a federally qualified community health center and receivedfederal funding. The growth since, a testament to the incredible need in Cochise County,has been phenomenal.

“The Clinic With a Heart”During the clinic construction Richard Sampson (Director of Facility Operations and MIS)placed his Purple Heart, earned in Viet Nam, in the wet cement of the foundation. Thisact of sincere devotion to our cause, allowed CCHCI to be the “Clinic With a Heart” bothliterally and figuratively.

N O W

From those humble beginnings, CCHCI now operates three clinic facilities, two mobileunits (one medical and one dental), and a separate Business Office.

Statistics reveal that:

• CCHCI employs 22 medical and dental professionals

• CCHCI serves as an “economic engine” for Cochise County bringing in $26,035,746 in revenue to the area providing not only quality health and dental care but jobs thatprovide benefits and a living wage

• Last year alone, CCHCI provided nearly 50,000 face-to-face encounters

• CCHCI employs 92 individuals and a dozen contractors

• In addition to direct health care services, CCHCI sponsors community outreach projects such as the Sembrando Salud – Sowing Wellness Program provides a community garden and special interest classes

• During the past year, CCHCI has hired 7 new providers including two pediatricians —the only pediatricians in Cochise County outside of Sierra Vista

• CCHCI has a nationally recognized Diabetes Chronic Disease Management Program

S E R V I C E S I N C L U D E

• General Physicals

• Chronic Disease Management

• Women’s Health

• Prenatal Care

• Pediatric Care

• Dental Care

• Patient Assistance Prescription Medication Program

• CDL Physicals

• Family Planning Services

• Onsite Laboratory Services

• Mental Health Counseling

• On Call Twenty Four/Seven

• Transportation Services

• AHCCCS Applications and Eligibility

• HIV/AIDS Case Management Services

T I M E L I N E

1996• Opened for operations on August 26, 1996

• Named the Outstanding Rural Health Practice for the nation

1997• Received BPHC 330 funding status as a federally qualified community health center

• Received Outstanding Rural Economic Development Award from Arizona Governor Jane Hull

1998• Awarded the sole Well Woman Healthcheck Program contract for Cochise County and

received supplemental funding from Avon and Susan G. Komen for breast health to provide a full continuum of women’s services

1999• Built the first clinic facility in Elfrida

2000• Received designation as a migrant health center from HRSA

• Began Dental services in Elfrida

2001• Opened original Douglas Clinic

2002• Dr. John Haun joined CCHCI as Medical Director

• Completed conversion to CPSI Practice Management System

• Began processing AHCCCS applications at all offices

• Purchased a mobile medical unit

2003• Dedication of Elfrida Building to Cliff Whetten

• Opened Bisbee Clinic

2004• Created the Chiricahua Café, offering healthy food alternatives at the Cochise

County Fair

2005• Completed conversion to the Nextgen Electronic Patient Management System (EPM)

at all clinic locations

• Received a grant award for a program designed to prevent dementia and depression, the Sembrando Salud/Sowing Wellness Program

Top left to bottom right:

Elfrida, Bisbee, Douglas, Mobile Medical, Mobile Dental

“To provide quality efficient health care to all in

Cochise County regardless of ability to pay.”

M I S S I O N

2 0 0 6 H I G H L I G H T S

January• CCHCI completes remodel of the Dental Trailer in Elfrida

February• Sembrando Salud program in Elfrida begins development of 2 acres northwest of the

clinic for an organic community garden

March• Dr. Ramesh Karra, Family Practice Physician, joins CCHCI in Elfrida

• Mario Moreno, Adult Nurse Practitioner, joins CCHCI at all clinic locations

• Sembrando Salud program in Elfrida begins exercise and Spanish classes

April• Angela Rodriquez, R.N., MBA joins CCHCI as Director of Nursing

• Sembrando Salud program begins yoga classes in Elfrida

May• CCHCI receives a grant award to purchase hearing test equipment for pediatric

patients

• Sembrando Salud program in Elfrida begins planting in organic community garden and conducts workshops on adobe bricks and oven making

June• MaryBeth Webster, Registered Art Therapist, joins the CCHCI Sembrando Salud

program in Elfrida

July• Dr. Jonathan Lee-Melk, Pediatrician, joins CCHCI in Douglas

• New Mobile Dental Unit arrives in Elfrida

• CCHCI completes landscaping of Elfrida and Bisbee clinics

• CCHCI receives contract to provide case management services in Cochise County under the Ryan White Care Act

August• Dr. Stephen Lindstrom, Pediatrician and Family Practice, joins CCHCI in both

Douglas and Bisbee

• Sembrando Salud program in Elfrida begins sales of produce from the organic community garden, and conducts workshop on straw bale construction

• National Health Center Week Open Houses in Bisbee, Elfrida and Douglas

• Douglas Building Dedication

• Elfrida celebrates its 10 year anniversary

• Core Group begins training in preparation for conversion to Electronic Medical Records (EMR)

• Jane Sobel, Registered Dental Hygienist, joins CCHCI on the Mobile Dental Unit in Elfrida

September• Dr. Tammie Naranjo, Family Practice Physician, joins CCHCI in Douglas

• CCHCI receives visit from HRSA representatives (LaFayette Merchant, Federal Project Officer and Monica Turbin, Supervisor)

• Diana McGinnis, R.N. joins CCHCI as lead nurse in Douglas

• Mobile Dental Unit sees its first patients at a nearby school

• Sembrando Salud program in Elfrida begins “Good Grief” support group, Computer Tutoring and Chair Exercise classes

October• CCHCI is awarded a grant for a walking path to be built in the organic community

garden in Elfrida

• Sembrando Salud Program hosts the first monthly “High Tea” honoring those in the community over 80 years old

November• Sembrando Salud program in Elfrida hosts the Elfrida Farmer’s Market, Swap Meet

and Craft Sale

• Sembrando Salud program in Elfrida begins its “Fresh Starts” support group

• CCHCI is awarded a $1,000 grant to purchase children’s books as part of the Reach Out and Read program

December• Dr. Karen “Kasey” Crockett, Family Practice Physician, joins CCHCI in both Douglas

and Bisbee

• Conversion to EMR takes place at all three clinics

• CCHCI receives two grant awards: Government Information Technology and Susan G. Komen

• CCHCI completes development of its website: www.cchci.org

• Robert Fernandez joins the CCHCI Board of Directors

S E R V I C E S

Peggy Avina, MD

John Haun, MDMedical Director

Jack Hoffman, MD Theresa M. McEntee,MD

Ramesh Karra,MD

Deborah Moroney,MD

Stephen Lindstrom,MD

Jonathan Lee-Melk,MD

Prido Polanco, MD James Buttke, MD

Tammie Naranjo,MD

Shirley Bayham-Hicks, FNP

Elizabeth Fabry,ANP

Lanaya Turner, FNP Mario Moreno, ANP

M E D I C A L

CCHCI has experienced significantgrowth in the medical staff andservices over the past year.Significant additions include:

• Over 70% of the medical staff is bilingual in Spanish/English

• Four physicians are members of the faculty of the University of Arizona College of Medicine

• Two providers have added colposcopy to their procedure skills

• CCHCI now has two Board Certified pediatricians

• The Chronic Disease ManagementProgram has 650 patients in the Diabetes Registry

• CCHCI clinical studies have been presented at national meetings

• A Mobile Dental Unit arrived in July and now serves the school children of the Sulphur Springs Valley

CCHCI is in the process of converting to Electronic MedicalRecords. Util izing the Next Gen program, improvements are expected in all of our quality assurance measures. Togetherthese additions support our mission“To provide quality efficient healthcare to all in Cochise Countyregardless of their ability to pay.”

B O A R D O F D I R E C T O R S

M A N A G E M E N T T E A M

Doug Fritsche Director of Finance

Richard Sampson Director of Operations

Angela RodriguezDirector of Nursing

Melody Dugie Business Manager

Linda Noga Clinic Manager, CliffWhetten Clinic, Elfrida

Terry Nuti Clinic Manager, Bisbee

Carol Lieber Outreach Coordinator

Noemi De Castro Manager, Mobile MedicalUnit, Well WomanHealthcheck Grant

Julie Karra Prevention Coordinator,Sembrando Salud/SowingWellness

Melinda Haun, RN CQI Coordinator

Raeann BrittainDirector of HumanResources and MobileDental Unit

Gary McPherranManager, Douglas Clinicand Grant Reporting

D E N T A L

Mario Fragoso,DDS

Jane Sobel,Registered DentalHygienist

B E H A V I O R A L H E A LT H

Kenny Miller, ACSW,CISW

Marybeth Webster,Registered Art Therapist

Mr. Glenn LawPresident

Ms. Elizabeth PiperVice President

Mr. Michael Holland Secretary/Treasurer

Mr. Robert Blocher

Ms. Elisa de la Cruz

Ms. Penny Law

Mr. Philip Koop

Ms. Carrie Gustavson

Mr. Manny Alvarez

Ms. Irene Cornejo

Ms. Lourdes Fernandez

Mr. Robert Fernandez

P A T I E N T S N A P S H O TOf the 20,000 CCHCI patients served in 2006

57% were Uninsured

19% were on Medicaid

17% were under the age of 18

27% were below the federal poverty level

Insurance status of our patients

Medicaid 19%

Uninsured 54%

Private Insurance 14%

Medicare 10%

Self Pay 3%

Demographics by age

Pediatrics (0–17) 17%

Adults (18–54) 44%

Seniors (55+) 39%

Demographics by ethnicity

Hispanic 64%

Anglos 33%

Native American 1%

African American 1%

Unreported 1%

I M P R O V I N G C A R EDiabetes Management Program

Behavioral Health Program

Dental

Women’s Wellness

Sembrando Salud/Sowing Wellness

Pediatric Care

Mobile Medical Unit

Mobile Dental Unit (focusing on school age children)

2006 FISCAL YEAR REVIEW

Revenue and Public Support:Federal Grants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,715,163

Patient Generated Revenue . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,344,187

Other Grants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 349,051

Donations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 33,086

In-Kind Contributions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 120,133

Other . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 52,622

Total Revenue & Public Support – $5,614,242Expenses:Medical, Dental . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 3,342,239

Administration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,089,219

Depreciation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 194,865

Interest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 28,177

In-Kind Expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 120,133

Total Expenses – $4,774,633Unrestricted Net Assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 839,609

Excess of Revenue & Public Support over Expenses

F I N A N C I A L S

Cochise County

Elfrida

Willcox

Benson

Tombstone

SunsitesPearce

SierraVista

BisbeeDouglas

Communities serviced with mobile units

Clinic locations

Cliff Whetten Clinic10566 Highway 191

P.O. Box 263

Elfrida, Arizona 85610

520-642-2222 Phone

520-642-3591 Fax

520-384-6363 from Willcox

Jennifer “Ginger” Ryan Clinic1100 F Avenue

Douglas, Arizona 85607

520-364-3285 Phone

520-364-3378 Fax

520-384-6300 from Willcox

Bisbee Clinic108 Arizona Street

Bisbee, Arizona 85603

520-432-3309 Phone

520-432-3717 Fax

Mobile Medical Unit Office1100 F Avenue

Douglas, Arizona 85607

520-364-4984 Phone

520-805-1292 Fax

520-384-6300 from Willcox

Mobile Dental Unit Office10566 Highway 191

P.O. Box 263

Elfrida, Arizona 85610

520-642-2222 Phone

520-642-3591 Fax

CCHCI Business Office310 Arizona Street

Bisbee, Arizona 85603

520-432-1145 Phone

Chiricahua Community Health Centers, Inc.Providing quality, efficient health care to all in Cochise County regardless of ability to pay.