IDAHO PRIMARY CARE ASSOCIATION: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- IDAHO PRIMARY CARE ASSOCIATION (EIN 82-0376764)
- Tax period
- 2021-10-01 to 2022-09-30
- Filed
- 2023-07-24
- IRS object ID
- 202312059349300851
- Schema version
- 2021v4.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2023-07-24T09:18:42-05:00 | ReturnTs |
| Tax Period End | 2022-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 264022510 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HARRIS & CO PLLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1120 S RACKHAM WAY SUITE 100 | AddressLine1Txt |
| City | MERIDIAN | CityNm |
| State Abbreviation | ID | StateAbbreviationCd |
| ZIP | 83642 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 820376764 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | IDAHO PRIMARY CARE ASSOCIATION INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | IDAH | BusinessNameControlTxt |
| Phone | 2083452335 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1087 W RIVER ST 160 | AddressLine1Txt |
| City | BOISE | CityNm |
| State Abbreviation | ID | StateAbbreviationCd |
| ZIP | 83702 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DAVID GARRETT | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 2083452335 | PhoneNum |
| Signature | 2023-06-26 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | DAVID | PersonFirstNm |
| Person Last | GARRETT | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | CHERYL GUIDDY | PreparerPersonNm |
| PTIN | P00266294 | PTIN |
| Phone | 2083338965 | PhoneNum |
| Preparation | 2023-06-26 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | DAVID GARRETT | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1087 W RIVER ST 160 | AddressLine1Txt |
| City | BOISE | CityNm |
| State Abbreviation | ID | StateAbbreviationCd |
| ZIP | 83702 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $3,363,770 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.IDAHOPCA.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1982 | FormationYr |
| Legal Domicile State | ID | LegalDomicileStateCd |
| Activity Or Mission | IPCA SUPPORTS COMMUNITY HEALTH CENTERS IN PROVIDING HIGH-QUALITY PRIMARY CARE TO ALL IDAHOANS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 16 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 15 | VotingMembersIndependentCnt |
| Total Employee | 20 | TotalEmployeeCnt |
| Total Volunteers | 16 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $2,945,140 | PYContributionsGrantsAmt |
| CY Contributions Grants | $2,778,626 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $454,379 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $584,022 | CYProgramServiceRevenueAmt |
| PY Investment Income | $123 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,122 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $3,399,642 | PYTotalRevenueAmt |
| CY Total Revenue | $3,363,770 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $1,441,060 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $1,579,752 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $1,230,359 | PYOtherExpensesAmt |
| CY Other Expenses | $1,613,678 | CYOtherExpensesAmt |
| PY Total Expenses | $2,671,419 | PYTotalExpensesAmt |
| CY Total Expenses | $3,193,430 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $728,223 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $170,340 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $2,031,665 | TotalAssetsBOYAmt |
| Total Assets EOY | $2,345,739 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $135,425 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $279,159 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $1,896,240 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $2,066,580 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | IPCA SUPPORTS COMMUNITY HEALTH CENTERS IN PROVIDING HIGH-QUALITY AND AFFORDABLE PRIMARY CARE TO ALL IDAHOANS THROUGH TRAINING AND TECHNICAL SUPPORT. IPCA KEEPS HEALTH CENTERS CURRENT ON ISSUES AND TRENDS AFFECTING THE CHANGING HEALTHCARE LANDSCAPE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $1,163,094 | ExpenseAmt |
| Desc | COOPERATIVE AGREEMENT - IPCA PROVIDES ASSISTANCE AND RESOURCES TO COMMUNITY HEALTH CENTERS TO SUPPORT AND STRENGTHEN THEIR CAPACITY TO PROVIDE ACCESSIBLE, AFFORDABLE, AND HIGH-QUALITY HEALTHCARE TO IDAHOANS. IPCA ASSESSES NATIONAL TRENDS TO ASSIST HEALTH CENTERS IN ADDRESSING EMERGENT ISSUES. IPCA PROVIDES TRAINING AND TECHNICAL ASSISTANCE ON A VARIETY OF TOPICS INCLUDING QUALITY IMPROVEMENT, PATIENT-CENTERED MEDICAL HOME MODEL OF CARE, ORAL HEALTH AND BEHAVIORAL HEALTH INTEGRATION, EMERGENCY PREPAREDNESS, MANAGING SPECIAL POPULATIONS AND HEALTH CENTER ADMINISTRATION (OPERATIONS, FINANCIAL MANAGEMENT AND HEALTH INFORMATION TECHNOLOGY). IPCA PROVIDED TRAINING AND TECHNICAL ASSISTANCE TO HEALTH CENTERS TO SUPPORT HEALTH CENTERS IN MEETING FEDERAL PROGRAM EXPECTATIONS, TO ENHANCE PATIENT QUALITY OF CARE, TO PROVIDE CULTURALLY COMPETENT CARE, AND IMPROVE HEALTH CENTER OPERATIONS. IPCA PROVIDED TRAINING AS WORKSHOPS, WEBINARS, AND PHONE CALLS AND HOSTED PEER GROUP GATHERINGS THAT FOSTERED COLLABORATION AND THE SHARING OF BEST PRACTICES. IPCA COLLABORATED WITH OTHER PUBLIC HEALTH ORGANIZATIONS TO DESIGN INNOVATIVE, COST EFFECTIVE APPROACHES TO PROVIDING HIGH QUALITY, INTEGRATED HEALTHCARE TO IDAHOANS. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $731,804 | ExpenseAmt |
| Desc | HEALTH CENTER CONTROLLED NETWORK (HCCN) - IPCA WORKS WITH IDAHO'S COMMUNITY HEALTH CENTERS TO IMPROVE HEALTH OUTCOMES AND DECREASE COSTS BY LEADING AND FACILITATING COLLABORATION TO IMPROVE ACCESS TO CARE, BY PROVIDING TRAINING AND TECHNICAL ASSISTANCE TO ENHANCE QUALITY OF CARE, AND USE TECHNOLOGY TO IMPROVE PERFORMANCE MEASUREMENTS THAT ACHIEVE COST EFFICIENCIES. IPCA SUPPORTED IDAHO'S HEALTH CENTERS IN CLOSING GAPS IN CARE AND IMPROVING QUALITY MEASURES THROUGH IMPLEMENTATION AND UTILIZATION OF DATA REPORTING TOOLS AND TRAINING AND TECHNICAL ASSISTANCE IN HEALTH INFORMATION TECHNOLOGY. IDAHO HEALTH CENTERS CONTINUE TO IMPROVE HEALTH OUTCOMES FOR THEIR PATIENTS INCLUDING: ACCESS TO PRENATAL CARE, BLOOD PRESSURE CONTROL, CERVICAL CANCER SCREENING, CHILDHOOD IMMUNIZATIONS, COLORECTAL CANCER SCREENINGS, DIABETES CONTROL, DENTAL SEALANTS AND IMPROVEMENTS IN LOW BIRTH WEIGHT. IDAHO HEALTH CENTERS ARE LEADERS IN PATIENT-CENTERED MEDICAL HOME (PCMH) MODEL OF CARE. CURRENTLY 14 OF 15 ELIGIBLE CLINIC SITES HAVE EARNED ACCREDITATION FOR PCMH. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $212,868 | ExpenseAmt |
| Desc | CONNECTING KIDS TO COVERAGE - IPCA PARTNERS WITH IDAHO'S HEALTH CENTERS TO KEEP FAMILIES HEALTHY BY CONNECTING KIDS TO COVERAGE. THE GOAL OF THIS PROJECT IS TO RETAIN CHILDREN IN MEDICAID/CHIP AS WELL AS ENROLL UNINSURED CHILDREN. IPCA IS PARTNERING WITH ORGANIZATIONS THAT HAVE ESTABLISHED SCHOOL-BASED PROGRAMS AND OUTREACH PROGRAMS, INCLUDING THE IDAHO FOODBANK AND IDAHO'S HELATH INSURANCE EXCHANGE TO PROVIDE INFORMATION TO FAMILIES ABOUT MEDICAID/CHIP ENROLLMENT. THESE PARTNERSHIPS ENSURE STATEWIDE OUTREACH EFFORTS GO BEYOND IDAHO CHC CLINICS TO REACH CHILDREN AND THEIR FAMILIES IN BOTH URBBAN AND RURAL COMMUNITIES. | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $971,344 | ExpenseAmt |
| Revenue | $584,022 | RevenueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $971,344 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Revenue | $584,022 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $3,079,110 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (1) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | Yes (1) | GrantToRelatedPersonInd |
| Business Rln With Org Mem | Yes (1) | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 20 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 16 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 15 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | 0 | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | 0 | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE ORGANIZATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 2083452335 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1087 W RIVER ST 160 | AddressLine1Txt |
| City | BOISE | CityNm |
| State Abbreviation | ID | StateAbbreviationCd |
| ZIP | 83702 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|
| DR TED EPPERLY | ||||||
| PRESIDENT | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| MARY FERGUSON | ||||||
| VICE PRESIDENT | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| LORI SESSIONS | ||||||
| SECRETARY/TREASURER | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| MIKE BAKER | ||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |
| HEIDI HART | ||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |
| KEVIN KNEPPER | ||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |
| JANICE JORDAN | ||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |
| AARON WILSON | ||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |
| ARNOLD CANTU | ||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |
| AARON HOUSTON | ||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |
| MINDY STOSICH-BENEDETTI | ||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |
| TIM HEINZE | ||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |
| STEVE REMBELSKI | ||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |
| JORGE GARCIA | ||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |
| KIM SMITH | ||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |
| HELO HANCOCK | ||||||
| DIRECTOR (ENDED FEBRUARY 2022) | 2.00 | Yes (X) | $0 | $0 | $0 | |
| YVONNE KETCHUM-WARD | ||||||
| CEO | 50.00 | Yes (X) | $170,295 | $0 | $50,318 | |
| DAVID GARRETT | ||||||
| CEO | 50.00 | Yes (X) | $29,038 | $0 | $0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $199,333 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $50,318 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 1 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp
Contractor Name ContractorName
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | AZARA HEALTHCARE | BusinessNameLine1Txt |
Contractor Address ContractorAddress
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 70 BLANCHARD RD 401 | AddressLine1Txt |
| City | BURLINGTON | CityNm |
| State Abbreviation | MA | StateAbbreviationCd |
| ZIP | 01803 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Services | PHM SYSTEM SOFTWARE SUBSCRIPTION AND FEE | ServicesDesc |
| Compensation | $418,116 | CompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 1 | CntrctRcvdGreaterThan100KCnt |
| Membership Dues | $99,569 | MembershipDuesAmt |
| Government Grants | $2,679,057 | GovernmentGrantsAmt |
| Total Contributions | $2,778,626 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| YOUR HEALTH IDAHO | 621990 | $270,264 | $270,264 |
| HEALTH NETWORK ADMINST | 621990 | $245,630 | $245,630 |
| CHCNI K1 | 561000 | $42,861 | $42,861 |
| TRAINING | 621990 | $25,267 | $25,267 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $584,022 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,122 | TotalRevenueColumnAmt |
| Exclusion | $1,122 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,363,770 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $584,022 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,122 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $331,956 | TotalAmt |
| Program Services | $322,526 | ProgramServicesAmt |
| Management And General | $9,430 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,027,191 | TotalAmt |
| Program Services | $996,411 | ProgramServicesAmt |
| Management And General | $30,780 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $47,692 | TotalAmt |
| Program Services | $47,692 | ProgramServicesAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $77,818 | TotalAmt |
| Program Services | $75,206 | ProgramServicesAmt |
| Management And General | $2,612 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $95,095 | TotalAmt |
| Program Services | $94,962 | ProgramServicesAmt |
| Management And General | $133 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $42,854 | TotalAmt |
| Program Services | $42,854 | ProgramServicesAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $144,834 | TotalAmt |
| Program Services | $101,240 | ProgramServicesAmt |
| Management And General | $43,594 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $29,564 | TotalAmt |
| Program Services | $29,524 | ProgramServicesAmt |
| Management And General | $40 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,841 | TotalAmt |
| Program Services | $25,841 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $84,776 | TotalAmt |
| Program Services | $84,748 | ProgramServicesAmt |
| Management And General | $28 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $56,692 | TotalAmt |
| Program Services | $50,326 | ProgramServicesAmt |
| Management And General | $6,366 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,203 | TotalAmt |
| Program Services | $6,141 | ProgramServicesAmt |
| Management And General | $62 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,670 | TotalAmt |
| Program Services | $2,666 | ProgramServicesAmt |
| Management And General | $4 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| PROGRAM EXPENSE | $631,724 | $611,290 | $20,434 |
| TRAINING | $564,665 | $564,665 | |
| MISCELLANEOUS | $18,783 | $17,982 | $801 |
| EQUIPMENT | $5,072 | $5,036 | $36 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,193,430 | TotalAmt |
| Program Services | $3,079,110 | ProgramServicesAmt |
| Management And General | $114,320 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,083,888 | BOYAmt |
| EOY | $29,145 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $227,769 | BOYAmt |
| EOY | $1,567,915 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $197,933 | BOYAmt |
| EOY | $260,318 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $414,730 | BOYAmt |
| EOY | $347,890 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,670 | BOYAmt |
| EOY | $10,138 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $128,477 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $116,216 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,464 | BOYAmt |
| EOY | $12,261 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $75,211 | BOYAmt |
| EOY | $118,072 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,031,665 | BOYAmt |
| EOY | $2,345,739 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $130,866 | BOYAmt |
| EOY | $274,600 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,559 | BOYAmt |
| EOY | $4,559 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $135,425 | BOYAmt |
| EOY | $279,159 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,374,201 | BOYAmt |
| EOY | $1,546,857 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $522,039 | BOYAmt |
| EOY | $519,723 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,896,240 | BOYAmt |
| EOY | $2,066,580 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,031,665 | BOYAmt |
| EOY | $2,345,739 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $170,340 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,792,709 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,094,070 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,277,139 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,945,140 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,778,626 | CurrentTaxYearAmt |
| Total | $11,887,684 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,792,709 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,094,070 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,277,139 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,945,140 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,778,626 | CurrentTaxYearAmt |
| Total | $11,887,684 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $686,707 | SubstantialContributorsTotAmt |
| Public Support Total170 | $11,200,977 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,540 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,854 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,044 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $123 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,122 | CurrentTaxYearAmt |
| Total | $7,683 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $11,895,367 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $1,761,996 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.94160 | PublicSupportCY170Pct |
| Public Support PY170 | 0.97700 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
Total Direct Lobbying TotalDirectLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Total | $3,544 | FilingOrganizationsTotalAmt |
Total Lobbying Expend TotalLobbyingExpendGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Total | $3,544 | FilingOrganizationsTotalAmt |
Other Exempt Purpose Expend OtherExemptPurposeExpendGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Total | $3,075,567 | FilingOrganizationsTotalAmt |
Total Exempt Purpose Expend TotalExemptPurposeExpendGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Total | $3,079,111 | FilingOrganizationsTotalAmt |
Lobbying Nontaxable Amount LobbyingNontaxableAmountGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Total | $303,956 | FilingOrganizationsTotalAmt |
Grassroots Nontaxable GrassrootsNontaxableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Total | $75,989 | FilingOrganizationsTotalAmt |
Tot Lbbyng Grassroot Mns Non Tx TotLbbyngGrassrootMnsNonTxGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Total | $0 | FilingOrganizationsTotalAmt |
Tot Lbby Expend Mns Lbbyng Non Tx TotLbbyExpendMnsLbbyngNonTxGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Total | $0 | FilingOrganizationsTotalAmt |
Avg Lobbying Nontaxable Amount AvgLobbyingNontaxableAmountGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year Minus3 | $269,481 | CurrentYearMinus3Amt |
| Current Year Minus2 | $281,994 | CurrentYearMinus2Amt |
| Current Year Minus1 | $283,571 | CurrentYearMinus1Amt |
| Current Year | $303,956 | CurrentYearAmt |
| Total | $1,139,002 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Lobbying Ceiling | $1,708,503 | LobbyingCeilingAmt |
Avg Total Lobbying Expend AvgTotalLobbyingExpendGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year Minus3 | $42,088 | CurrentYearMinus3Amt |
| Current Year Minus2 | $1,193 | CurrentYearMinus2Amt |
| Current Year Minus1 | $10,863 | CurrentYearMinus1Amt |
| Current Year | $3,544 | CurrentYearAmt |
| Total | $57,688 | TotalAmt |
Avg Grassroots Nontaxable AvgGrassrootsNontaxableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year Minus3 | $67,370 | CurrentYearMinus3Amt |
| Current Year Minus2 | $70,499 | CurrentYearMinus2Amt |
| Current Year Minus1 | $70,893 | CurrentYearMinus1Amt |
| Current Year | $75,989 | CurrentYearAmt |
| Total | $284,751 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grassroots Ceiling | $427,127 | GrassrootsCeilingAmt |
Schedule D IRS990ScheduleD
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $128,477 | OtherCostOrOtherBasisAmt |
| Depreciation | $116,216 | DepreciationAmt |
| Book Value | $12,261 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $12,261 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | CHCNI INVESTMENT | Desc |
| Book Value | $118,072 | BookValueAmt |
| Method Valuation | F | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $118,072 | TotalBookValueSecuritiesAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $3,320,909 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $3,320,909 | RevenueSubtotalAmt |
| Other Revenues Not Included | $42,861 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $42,861 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $3,363,770 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $3,193,430 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $3,193,430 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $3,193,430 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART X, LINE 2: | UNCERTAIN TAX POSITIONS THE ACCOUNTING STANDARD ON ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES ADDRESSES THE DETERMINATION OF WHETHER TAX BENEFITS CLAIMED OR EXPECTED TO BE CLAIMED ON A TAX RETURN SHOULD BE RECORDED IN THE FINANCIAL STATEMENTS. UNDER THAT GUIDANCE, THE ASSOCIATION MAY RECOGNIZE THE TAX BENEFIT FROM AN UNCERTAIN TAX POSITION ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITION WILL BE SUSTAINED ON EXAMINATION BY TAXING AUTHORITIES BASED ON THE TECHNICAL MERITS OF THE POSITION. THE TAX BENEFITS RECOGNIZED IN THE FINANCIAL STATEMENTS FROM SUCH A POSITION ARE MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50 PERCENT LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. THERE WERE NO UNRECOGNIZED TAX BENEFITS IDENTIFIED OR RECORDED AS LIABILITIES FOR FISCAL YEARS 2022 OR 2021. THE ASSOCIATION FILES FORM 990 IN THE U.S. FEDERAL JURISDICTION. THE ASSOCIATION IS GENERALLY NO LONGER SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE FOR YEARS BEFORE 2018. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | CHCNI K1 42,861. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | Yes (1) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | YVONNE KETCHUM-WARD | PersonNm |
| Title | CEO | TitleTxt |
| Base Compensation Filing Org | $170,295 | BaseCompensationFilingOrgAmt |
| Compensation Based On Rltd Orgs | $0 | CompensationBasedOnRltdOrgsAmt |
| Bonus Filing Organization | $0 | BonusFilingOrganizationAmount |
| Bonus Related Organizations | $0 | BonusRelatedOrganizationsAmt |
| Other Compensation Filing Org | $0 | OtherCompensationFilingOrgAmt |
| Other Compensation Rltd Orgs | $0 | OtherCompensationRltdOrgsAmt |
| Deferred Compensation Flng Org | $38,551 | DeferredCompensationFlngOrgAmt |
| Deferred Comp Rltd Orgs | $0 | DeferredCompRltdOrgsAmt |
| Nontaxable Benefits Filing Org | $11,767 | NontaxableBenefitsFilingOrgAmt |
| Nontaxable Benefits Rltd Orgs | $0 | NontaxableBenefitsRltdOrgsAmt |
| Total Compensation Filing Org | $220,613 | TotalCompensationFilingOrgAmt |
| Total Compensation Rltd Orgs | $0 | TotalCompensationRltdOrgsAmt |
| Comp Report Prior990 Filing Org | $0 | CompReportPrior990FilingOrgAmt |
| Comp Report Prior990 Rltd Orgs | $0 | CompReportPrior990RltdOrgsAmt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3 | THE BOARD APPROVES THE COMPENSATION FOR THE CEO. |
| PART I, LINE 4A | YVONNE KETCHUM-WARD RECEIVED A SEVERANCE PACKAGE OF $106,835. |
Schedule L IRS990ScheduleL
Grnt Asst Bnft Interested Prsn GrntAsstBnftInterestedPrsnGrp (15 entries)
| Relationship With OrgRelationshipWithOrgTxt | Cash GrantCashGrantAmt | Type Of AssistanceTypeOfAssistanceTxt | Assistance PurposeAssistancePurposeTxt |
|---|---|---|---|
| HEALTH WEST INC | |||
| CEO OF ENTITY IS A DIRECTOR | $208,934 | CASH GRANT | SUPPORT FOR CAMBIA GRANTS AND TRAINING & TECHNICAL SUPPORT |
| COMMUNITY HEALTH ASSOC SPOKANE | |||
| CEO OF ENTITY IS A DIRECTOR | $229,945 | CASH GRANT | SUPPORT FOR CAMBIA GRANTS AND TRAINING & TECHNICAL SUPPORT |
| HERITAGE HEALTH | |||
| CEO OF ENTITY IS A DIRECTOR | $311,295 | CASH GRANT | SUPPORT FOR CAMBIA GRANTS AND TRAINING & TECHNICAL SUPPORT |
| KANIKSU HEALTH SERVICES | |||
| CEO OF ENTITY IS A DIRECTOR | $145,284 | CASH GRANT | SUPPORT FOR CAMBIA GRANTS AND TRAINING & TECHNICAL SUPPORT |
| TERRY REILLY HEALTH SERVICES | |||
| CEO OF ENTITY IS A DIRECTOR | $214,377 | CASH GRANT | SUPPORT FOR CAMBIA GRANTS AND TRAINING & TECHNICAL SUPPORT |
| DESERT SAGE HEALTH CENTERS | |||
| CEO OF ENTITY IS A DIRECTOR | $147,790 | CASH GRANT | SUPPORT FOR CAMBIA GRANTS AND TRAINING & TECHNICAL SUPPORT |
| VALLEY FAMILY HEALTH CARE | |||
| CEO OF ENTITY IS A DIRECTOR | $144,158 | CASH GRANT | SUPPORT FOR CAMBIA GRANTS AND TRAINING & TECHNICAL SUPPORT |
| MARIMN HEALTH | |||
| CEO OF ENTITY IS A DIRECTOR | $138,362 | CASH GRANT | SUPPORT FOR CAMBIA GRANTS AND TRAINING & TECHNICAL SUPPORT |
| ADAMS COUNTY HEALTH CENTER | |||
| EXECUTIVE DIRECTOR OF ENTITY IS A DIRECTOR | $118,086 | CASH GRANT | SUPPORT FOR CAMBIA GRANTS AND TRAINING & TECHNICAL SUPPORT |
| GRAND PEAKS MEDICAL & DENTAL | |||
| CEO OF ENTITY IS A DIRECTOR | $106,508 | CASH GRANT | SUPPORT FOR CAMBIA GRANTS AND TRAINING & TECHNICAL SUPPORT |
| CHALLIS AREA HEALTH CENTER | |||
| EDECUTIVE DIRECTOR OF ENTITY IS A DIRECTOR | $72,859 | CASH GRANT | SUPPORT FOR CAMBIA GRANTS AND TRAINING & TECHNICAL SUPPORT |
| BEAR LAKE COMMUNITY HEALTH | |||
| CEO OF ENTITY IS A DIRECTOR | $8,048 | CASH GRANT | SUPPORT FOR CAMBIA GRANTS AND TRAINING & TECHNICAL SUPPORT |
| FAMILY HEALTH SERVICES | |||
| CEO OF ENTITY IS A DIRECTOR | $202,598 | CASH GRANT | SUPPORT FOR CAMBIA GRANTS AND TRAINING & TECHNICAL SUPPORT |
| FAMILY MEDICINE RESIDENCY ID | |||
| CEO OF ENTITY IS A DIRECTOR | $149,523 | CASH GRANT | SUPPORT FOR CAMBIA GRANTS AND TRAINING & TECHNICAL SUPPORT |
| COMMUNITY FAMILY CLINIC | |||
| CEO OF ENTITY IS A DIRECTOR | $112,194 | CASH GRANT | SUPPORT FOR CAMBIA GRANTS AND TRAINING & TECHNICAL SUPPORT |
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ROD STILLER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | FORMER CFO OF ORGANIZATION | RelationshipDescriptionTxt |
| Transaction | $26,325 | TransactionAmt |
| Transaction | CONTRACT WORK | TransactionDesc |
| Sharing Of Revenues | 0 | SharingOfRevenuesInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 1A | THE GOVERNING BODY OF THE ORGANIZATION DELEGATES BROAD AUTHORITY TO THE EXECUTIVE COMMITTEE. THE EXECUTIVE COMMITTEE CONSISTS OF THE PRESIDENT, VICE-PRESIDENT, SECRETARY/TREASURER, AND ONE AT-LARGE MEMBER OF THE BOARD. EXECUTIVE COMMITTEE DECISIONS ARE SUBJECT TO RATIFICATION BY THE BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION A, LINE 6 | MEMBERS OF IDAHO PRIMARY CARE ASSOCIATION, INC. CONSIST OF COMMUNITY HEALTH CENTERS IN IDAHO. THE ORGANIZATION HAS THREE TYPES OF MEMBERSHIP, ORGANIZATIONAL MEMBERS, ASSOCIATE MEMBERS AND SUPPORTING MEMBERS. |
| FORM 990, PART VI, SECTION A, LINE 7A | DIRECTORS OF THE ORGANIZATION ARE ELECTED AT THE ANNUAL MEMBERSHIP MEETING BY A 2/3 MAJORITY VOTE OF VOTING POWER PRESENT IN QUORUM. A MAJORITY OF THE VOTING MEMBERS SHALL CONSTITUTE A QUORUM AT ANY MEETING. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE FINANCE COMMITTEE, FINANCE DIRECTOR, AND CEO CONDUCT A REVIEW OF THE FORM 990 AND APPROVE IT FOR FILING. A COPY OF THE FILED RETURN IS MAINTAINED AT THE ORGANIZATION'S PLACE OF BUSINESS FOR REVIEW BY MEMBERS OF THE BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE COMPLIANCE OFFICER CONDUCTS AN ANNUAL REVIEW TO DETERMINE THAT CONFLICT OF INTEREST POLICIES ARE CURRENT AND INQUIRES IF ANY REPORTABLE EVENTS OCCURRED DURING THE YEAR. |
| FORM 990, PART VI, SECTION B, LINE 15A | THE CEO'S SALARY AND PERFORMANCE IS REVIEWED ANNUALLY BY THE BOARD OF DIRECTORS. CHANGES IN COMPENSATION ARE APPROVED BY THE BOARD. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, FILED TAX RETURNS AND AUDITED FINANCIAL STATEMENTS ARE MAINTAINED AT THE ORGANIZATION'S PLACE OF BUSINESS AND ARE AVAILABLE FOR PUBLIC VIEWING DURING NORMAL OFFICE HOURS UPON REQUEST. |
| FORM 990, PART XII, LINE 2C: | NO CHANGE IN THE OVERSIGHT PROCESS OR SELECTION PROCESS FROM THE PRIOR YEAR. |
Schedule R IRS990ScheduleR
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY HEALTH CENTER NETWORK OF IDAHO LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1087 W RIVER STREET SUITE 160 | AddressLine1Txt |
| City | BOISE | CityNm |
| State Abbreviation | ID | StateAbbreviationCd |
| ZIP | 83702 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 460729951 | EIN |
| Primary Activities | ADMINISTRATIVE SERVICES | PrimaryActivitiesTxt |
| Legal Domicile State | ID | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Predominant Income Type | RELATED | PredominantIncomeTypeTxt |
| Share Of Total Income | $144,462 | ShareOfTotalIncomeAmt |
| Share Of EOY Assets | $118,072 | ShareOfEOYAssetsAmt |
| Disproportionate Allocations | 0 | DisproportionateAllocationsInd |
| General Or Managing Partner | 0 | GeneralOrManagingPartnerInd |
| Ownership | 0.07000 | OwnershipPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY HEALTH CENTER NETWORK OF IDAHO LLC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | L | TransactionTypeTxt |
| Involved | $245,630 | InvolvedAmt |
| Method Of Amount Determination | CONTRACT | MethodOfAmountDeterminationTxt |
Comments