SOUTHWEST WASHINGTON REGIONAL HEALTH ALLIANCE: Form 990, tax year 2022
View the entire original 990 at ProPublica ↗
- Organization
- SOUTHWEST WASHINGTON REGIONAL HEALTH ALLIANCE (EIN 46-2164971)
- Tax period
- 2022-01-01 to 2022-12-31
- Filed
- 2023-11-13
- IRS object ID
- 202343179349310769
- Schema version
- 2022v5.0
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2023-11-13T17:18:44-06:00 | ReturnTs |
| Tax Period End | 2022-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 930900579 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MCDONALD JACOBS PC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 520 SW YAMHILL ST STE 500 | AddressLine1Txt |
| City | PORTLAND | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97204 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2022-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 462164971 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SOUTHWEST WASHINGTON REGIONAL HEALTH | BusinessNameLine1Txt |
| Business Name Line2 | ALLIANCE | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | SOUT | BusinessNameControlTxt |
| Phone | 3608287319 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2404 E MILL PLAIN BLVD B | AddressLine1Txt |
| City | VANCOUVER | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 98661 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | NICHOLE PEPPERS | PersonNm |
| Person Title | EXECUTIVE DIRECTOR | PersonTitleTxt |
| Phone | 3608287319 | PhoneNum |
| Signature | 2023-11-10 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | NICHOLE | PersonFirstNm |
| Person Last | PEPPERS | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | XXX-XX-XXXX | SSN |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | Yes (1) | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | KARIN S WANDTKE | PreparerPersonNm |
| PTIN | P00172715 | PTIN |
| Phone | 5032270581 | PhoneNum |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2022 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SOUTHWEST WASHINGTON ACCOUNTABLE | BusinessNameLine1Txt |
| Business Name Line2 | COMMUNITY OF HEALTH | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | NICHOLE PEPPERS | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2404 E MILL PLAIN BLVD B | AddressLine1Txt |
| City | VANCOUVER | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 98661 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $10,898,359 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.SOUTHWESTACH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2013 | FormationYr |
| Legal Domicile State | WA | LegalDomicileStateCd |
| Activity Or Mission | WE BRING PARTNERS TOGETHER TO CREATE EQUITABLE, SUSTAINABLE SYSTEMS CHANGE THAT REDUCES COST AND IMPROVES WHOLE-PERSON WELLNESS FOR ALL. | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 20 | TotalEmployeeCnt |
| Total Volunteers | 20 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $9,053,852 | PYContributionsGrantsAmt |
| CY Contributions Grants | $10,829,584 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $0 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $616 | PYInvestmentIncomeAmt |
| CY Investment Income | $68,425 | CYInvestmentIncomeAmt |
| PY Other Revenue | $433 | PYOtherRevenueAmt |
| CY Other Revenue | $350 | CYOtherRevenueAmt |
| PY Total Revenue | $9,054,901 | PYTotalRevenueAmt |
| CY Total Revenue | $10,898,359 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $4,246,422 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $4,294,575 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $1,388,147 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $1,318,342 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $2,247,224 | PYOtherExpensesAmt |
| CY Other Expenses | $3,433,956 | CYOtherExpensesAmt |
| PY Total Expenses | $7,881,793 | PYTotalExpensesAmt |
| CY Total Expenses | $9,046,873 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,173,108 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,851,486 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $20,152,275 | TotalAssetsBOYAmt |
| Total Assets EOY | $22,446,781 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $858,515 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $1,301,535 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $19,293,760 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $21,145,246 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | SOUTHWEST WASHINGTON ACCOUNTABLE COMMUNITY OF HEALTH (SWACH) IS A LOCAL NONPROFIT WORKING TO IMPROVE HEALTH IN SOUTHWEST WASHINGTON. WE BRING TOGETHER COMMUNITY MEMBERS AND OTHER EXPERTS TO ADDRESS OUR REGION'S MAJOR HEALTH CHALLENGES. THROUGH INNOVATIVE PARTNERSHIPS AND LOCAL RESOURCES, WE'RE WORKING TO CREATE LASTING CHANGES AND IMPROVE WHOLE-PERSON WELLNESS FOR ALL. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $3,734,334 | ExpenseAmt |
| Desc | THE HEALTHCONNECT HUB CONNECTS ANYONE IN SOUTHWEST WASHINGTON TO THE CARE THEY NEED THROUGH A TRUSTED, TRAINED, HIGHLY SKILLED COMMUNITY-BASED WORKFORCE THAT PROVIDES ONE-ON-ONE SUPPORT TO ACHIEVE THEIR HEALTH GOALS. THE HEALTHCONNECT HUB SUPPORTS THIS COMMUNITY-BASED WORKFORCE AND THE NETWORK OF AGENCIES THAT EMPLOY THEM. PARTNER AGENCIES AND RESOURCES ARE ALIGNED TO SUPPORT A COMMON GOAL: TO PROVIDE THE RIGHT CARE TO PEOPLE ACROSS SOUTHWEST WASHINGTON WHEN AND HOW THEY NEED IT. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $3,378,329 | ExpenseAmt |
| Grant | $3,378,329 | GrantAmt |
| Desc | SWACH PARTICIPATED IN AND LED MULTIPLE APPROACHES TO SUPPORT OUR COMMUNITY THROUGH THE PANDEMIC. CARECONNECT WASHINGTON (CCWA) PROVIDES MORTGAGE OR RENT ASSISTANCE, GROCERIES, AND ADDITIONAL FINANCIAL SUPPORT TO HOUSEHOLDS WITH POSITIVE COVID-19 CASES. AS A RESULT OF THE GRANT, SWACH PROVIDED $1.1 MILLION IN DIRECT HOUSING ASSISTANCE TO 945 HOMES, AND $375,000 WORTH OF GROCERY ASSISTANCE TO 1,300 HOMES. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $854,111 | ExpenseAmt |
| Grant | $854,111 | GrantAmt |
| Desc | SWACH PROVIDED COVID-19 VACCINE OUTREACH WORK FUNDED BY HEALTH RESOURCES AND SERVICES ADMINISTRATION (HRSA). WITH ADDITIONAL SUPPORT FROM MOLINA HEALTHCARE AND AMERIGROUP, WE CONTINUED TO REACH OUT TO BIPOC, UNHOUSED, AND OTHER MEDICALLY UNDERREPRESENTED POPULATIONS TO PROVIDE INFORMATION AND ACCESS TO CURRENT VACCINE OPTIONS. AS A RESULT OF THE GRANT, SWACH REACHED 73,000 COMMUNITY MEMBERS THROUGH VACCINE AWARENESS EFFORTS, AND HELPED FACILITATE THE ADMINISTRATION OF 1,057 VACCINE DOSES. | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $62,135 | ExpenseAmt |
| Grant | $62,135 | GrantAmt |
| Desc | THE EQUITY AND COLLABORATIVE IMPACT (ECI) TEAM CONTINUES TO CHAMPION HEALTH EQUITY THROUGH PARTNERSHIPS AND INNOVATIVE PROGRAMMING. THROUGH A PARTNERSHIP WITH BEACON HEALTH OPTIONS, THE ECI TEAM SUCCESSFULLY INSTALLED FIVE NALOXONE VENDING MACHINES ACROSS THE REGION AND SUPPORTS THE ONGOING DISTRIBUTION OF NALOXONE TO THOSE THAT NEED IT, FREE OF CHARGE. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $62,135 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Grant | $62,135 | TotalOtherProgSrvcGrantAmt |
| Total Program Service Expenses | $8,028,909 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | 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 | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | 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 | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (1) | 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 | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | 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 | 0 | 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 | 334 | 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 |
| 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 | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | 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 | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | 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 | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | WA | StatesWhereCopyOfReturnIsFldCd |
| Own Website | Yes (X) | OwnWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EDDIE GALLAGHER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3606283919 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2404 E MILL PLAIN BLVD B | AddressLine1Txt |
| City | VANCOUVER | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 98661 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (14 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| DAWN TOLOTTI | |||||||
| PRESIDENT | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| ROBB KIMMES | |||||||
| VICE PRESIDENT | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| KEVIN WITTE | |||||||
| TREASURER | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| ANDY TUCKER | |||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| WORKU NEGUSSIE | |||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| SUSAN STEARNS | |||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| QUINTON HAROLD | |||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| ANDREA PRUIETT | |||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| MATANIA OSBORN | |||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| KARYN KAMEROFF | |||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| ADRIANA LINARES | |||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| TAMARA CISSEL | |||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| NICHOLE PEPPERS | |||||||
| EXECUTIVE DIRECTOR | 40.00 | Yes (X) | $150,000 | $0 | $10,932 | ||
| ERIC MCNAIR SCOTT | |||||||
| PROGRAM DIRECTOR | 40.00 | $119,714 | $0 | $13,550 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $269,714 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $24,482 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 2 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (2 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| PROVIDENCE HEALTH & SERVICES (CORE) | |||||
| PO BOX 5977 | PORTLAND | OR | 97228 | PROGRAM EVALUATION | $1,035,933 |
| ASP | |||||
| 3150 RICHARDS RD SUITE 150 | BELLEVUE | WA | 98005 | FINANCE AND ACCOUNT SUPPORT | $114,208 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 2 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $10,801,584 | GovernmentGrantsAmt |
| All Other Contributions | $28,000 | AllOtherContributionsAmt |
| Total Contributions | $10,829,584 | TotalContributionsAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $68,425 | TotalRevenueColumnAmt |
| Exclusion | $68,425 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | OTHER INCOME | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $350 | TotalRevenueColumnAmt |
| Exclusion | $350 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $350 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $10,898,359 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $68,775 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,800,626 | TotalAmt |
| Program Services | $2,800,626 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,493,949 | TotalAmt |
| Program Services | $1,493,949 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $160,932 | TotalAmt |
| Program Services | $111,152 | ProgramServicesAmt |
| Management And General | $49,780 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $935,995 | TotalAmt |
| Program Services | $646,470 | ProgramServicesAmt |
| Management And General | $289,525 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $31,486 | TotalAmt |
| Program Services | $21,747 | ProgramServicesAmt |
| Management And General | $9,739 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $106,281 | TotalAmt |
| Program Services | $73,406 | ProgramServicesAmt |
| Management And General | $32,875 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $83,648 | TotalAmt |
| Program Services | $57,774 | ProgramServicesAmt |
| Management And General | $25,874 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,099 | TotalAmt |
| Program Services | $3,598 | ProgramServicesAmt |
| Management And General | $501 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $37,277 | TotalAmt |
| Program Services | $32,721 | ProgramServicesAmt |
| Management And General | $4,556 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,559,096 | TotalAmt |
| Program Services | $1,191,476 | ProgramServicesAmt |
| Management And General | $367,620 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $82,024 | TotalAmt |
| Program Services | $37,869 | ProgramServicesAmt |
| Management And General | $44,155 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $92,258 | TotalAmt |
| Program Services | $12,295 | ProgramServicesAmt |
| Management And General | $79,963 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $72,252 | TotalAmt |
| Program Services | $7,752 | ProgramServicesAmt |
| Management And General | $64,500 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $68,208 | TotalAmt |
| Program Services | $52,879 | ProgramServicesAmt |
| Management And General | $15,329 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $38,371 | TotalAmt |
| Program Services | $29,747 | ProgramServicesAmt |
| Management And General | $8,624 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,028 | TotalAmt |
| Management And General | $5,028 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PROGRAM SERVICES DIRECT | Desc |
| Total | $1,448,848 | TotalAmt |
| Program Services | $1,448,848 | ProgramServicesAmt |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,495 | TotalAmt |
| Program Services | $6,600 | ProgramServicesAmt |
| Management And General | $19,895 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,046,873 | TotalAmt |
| Program Services | $8,028,909 | ProgramServicesAmt |
| Management And General | $1,017,964 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,365,611 | BOYAmt |
| EOY | $20,635,069 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,098,669 | BOYAmt |
| EOY | $713,502 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $648,314 | BOYAmt |
| EOY | $997,508 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,467 | BOYAmt |
| EOY | $1,280 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $37,214 | BOYAmt |
| EOY | $21,956 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $27,154 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $808 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $26,346 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $51,120 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,152,275 | BOYAmt |
| EOY | $22,446,781 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $856,114 | BOYAmt |
| EOY | $1,250,006 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,401 | BOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $51,529 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $858,515 | BOYAmt |
| EOY | $1,301,535 | 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 | $19,168,169 | BOYAmt |
| EOY | $21,083,053 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $125,591 | BOYAmt |
| EOY | $62,193 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,293,760 | BOYAmt |
| EOY | $21,145,246 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,152,275 | BOYAmt |
| EOY | $22,446,781 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $1,851,486 | 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 | $438,364 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $13,347,640 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $5,772,949 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $9,053,852 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $10,829,584 | CurrentTaxYearAmt |
| Total | $39,442,389 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $438,364 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $13,347,640 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $5,772,949 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $9,053,852 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $10,829,584 | CurrentTaxYearAmt |
| Total | $39,442,389 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $8,292,294 | SubstantialContributorsTotAmt |
| Public Support Total170 | $31,150,095 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $25,827 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $109,139 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $35,650 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $616 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $68,425 | CurrentTaxYearAmt |
| Total | $239,657 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $3,069 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus1 Year | $433 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $350 | CurrentTaxYearAmt |
| Total | $3,852 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $39,685,898 | TotalSupportAmt |
| Public Support CY170 | 0.78490 | PublicSupportCY170Pct |
| Public Support PY170 | 0.99660 | 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 D IRS990ScheduleD
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $27,154 | OtherCostOrOtherBasisAmt |
| Depreciation | $808 | DepreciationAmt |
| Book Value | $26,346 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $26,346 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | OPERATING LEASE LIABILITY | Desc |
| Amt | $51,529 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $51,529 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION FOLLOWS THE PROVISIONS OF FASB ASC TOPIC 740 ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES. MANAGEMENT HAS EVALUATED THE ORGANIZATION'S TAX POSITIONS AND CONCLUDED THAT THERE ARE NO UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENT TO THE FINANCIAL STATEMENTS TO COMPLY WITH PROVISIONS OF THIS TOPIC. | ExplanationTxt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (25 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Cash GrantCashGrantAmt | Non Cash AssistanceNonCashAssistanceAmt | Purpose Of GrantPurposeOfGrantTxt | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc |
|---|---|---|---|---|---|---|---|---|
| BRIDGEVIEW RESOURCE CENTER | ||||||||
| 505 OMAHA WAY | VANCOUVER | WA | 98661 | $57,861 | $0 | MEDICAID TRANSFORMATION PROJECT | ||
| CLARK COWLITZ FIRE AND RESCUE | ||||||||
| 911 N 65TH AVE | RIDGEFIELD | WA | 98642 | $233,000 | $0 | MEDICAID TRANSFORMATION | 911701275 | MUNICIPAL ENTITY |
| COLUMBIA RIVER MENTAL HEALTH SERVICES | ||||||||
| 6926 NE FOURTH PLAIN BLVD | VANCOUVER | WA | 98661 | $85,021 | $0 | MEDICAID TRANSFORMATION | 910609138 | 501(C)(3) |
| COMMUNITY FOUNDATION OF SW WASHINGTON | ||||||||
| 610 ESTHER ST 201 | VANCOUVER | WA | 98660 | $150,000 | $0 | MEDICAID TRANSFORMATION | 911246778 | 501(C)(3) |
| COUNCIL FOR THE HOMELESS | ||||||||
| 2500 MAIN ST | VANCOUVER | WA | 98660 | $149,387 | $0 | MEDICAID TRANSFORMATION;COVID-19 RESPONSE | 912001828 | 501(C)(3) |
| EMPLOWER FAMILY FOCUSED SERVICES | ||||||||
| 1014 MAIN STREET | VANCOUVER | WA | 98660 | $25,000 | $0 | MEDICAID TRANSFORMATION | 501(C)(3) | |
| FOUNDATION FOR VANCOUVER PUBLIC SCHOOLS | ||||||||
| 2901 FALK RD | VANCOUVER | WA | 98661 | $10,000 | $0 | MEDICAID TRANSFORMATION | 910971800 | 501(C)(3) |
| HOUSING AUTHORITY OF THE CITY OF VANCOUVER WASHINGTON | ||||||||
| 2500 MAIN ST | VANCOUVER | WA | 98660 | $191,323 | $0 | MEDICAID TRANSFORMATION | 916000981 | LOCAL GOVERNMENT |
| IDEAL OPTIONS PLLC | ||||||||
| 5615 DUNBARTON AVE | PASCO | WA | 99301 | $25,000 | $0 | MEDICAID TRANSFORMATION | 455513274 | 501(C)(3) |
| CLARK COUNTY LATINO YOUTH | ||||||||
| 14204 NE SALMON CREEK AVE | VANCOUVER | WA | 98686 | $405,000 | $0 | MEDICAID TRANSFORMATION; COVID-19 RESPONSE | ||
| LIFELINE CONNECTIONS | ||||||||
| PO BOX 1678 | VANCOUVER | WA | 98668 | $97,016 | $0 | MEDICAID TRANSFORMATOIN; COVID-19 RESPONSE | 910787084 | 501(C)(3) |
| LUTHERAN COMMUNITY SERVICES NORTHWEST | ||||||||
| 4040 S 188TH ST SUITE 300 | SEATAC | WA | 98188 | $218,289 | $0 | MEDICAID TRANSFORMATION PROJECT | 930386860 | 501(C)(3) |
| ODYSSEY WORLD INTERNATIONAL EDUCATION SERVICES | ||||||||
| PO BOX 1051 | VANCOUVER | WA | 98661 | $19,500 | $0 | MEDICAID TRANSFORMATION; COVID-19 RESPONSE | 203905057 | 501(C)(3) |
| OUTSIDERS INN | ||||||||
| 5301 NE 56TH AVE | VANCOUVER | WA | 98661 | $70,304 | $0 | COVID-19 RESPONSE; MEDICAID TRANSFORMATION | 813259312 | 501(C)(3) |
| SEA-MAR COMMUNITY HEALTH CENTERS | ||||||||
| 1040 SOUTH HENDERSON ST | SEATTLE | WA | 98108 | $97,583 | $0 | MEDICAID TRANSFORMATION; COVID-19 RESPONSE | 911020139 | 501(C)(3) |
| SHARE INC | ||||||||
| 2306 NE ANDRESEN RD | VANCOUVER | WA | 98661 | $81,169 | $0 | MEDICAID TRANSFORMATION; PATHWAYS CARE COORDINATION; COVID-19 RESPONSE | 911205119 | 501(C)(3) |
| SKAMANIA COUNTY | ||||||||
| 710 SW ROCK CREEK DR | STEVENSON | WA | 98648 | $165,348 | $0 | MEDICAID TRANSFORMATOIN; COVID-19 RESPONSE | 916001363 | LOCAL GOVERNMENT |
| SKYLINE PUBLIC HOSPITAL | ||||||||
| PO BOX 1625 | WHITE SALMON | WA | 98672 | $154,425 | $0 | COVID-19 RESPONSE; MEDICAID TRANSFORMATION | 911355848 | 501(C)(3) |
| SOUTHWEST WASHINGTON RECOVERY COALITION | ||||||||
| PO BOX 869 | OMAK | WA | 98841 | $15,000 | $0 | MEDICAID TRANSFORMATION | 473302528 | 501(C)(3) |
| THE NEXT DOOR | ||||||||
| 965 TUCKER RD | HOOD RIVER | OR | 97031 | $33,057 | $0 | MEDICAID TRANSFORMATION; COVID-19 RESPONSE | 930600421 | 501(C)(3) |
| VANCOUVER HOUSING AUTHORITY | ||||||||
| 2500 MAIN ST | VANCOUVER | WA | 98660 | $33,000 | $0 | MEDICAID TRANSFORMATION | 916000981 | LOCAL GOVERNMENT |
| WASHINGTON GORGE ACTION PROGRAMS | ||||||||
| 115 W STUEBEN | BINGEN | WA | 98605 | $335,146 | $0 | MEDICAID TRANSFORMATION | 910793062 | 501(C)(3) |
| WHITE SALMON VALLEY SCHOOL DISTRICT | ||||||||
| PO BOX 157 | WHITE SALMON | WA | 98672 | $81,800 | $0 | COVID-19 RESPONSE; MEDICAID TRANSFORMATION | 911034509 | LOCAL GOVERNMENT |
| YWCA CLARK COUNTY | ||||||||
| 3609 MAIN ST | VANCOUVER | WA | 98663 | $47,605 | $0 | MEDICAID TRANSFORMATION | 910569882 | 501(C)(3) |
| CHILD AND ADOLESCENT CLINIC | ||||||||
| 971 11TH AVENUE | LONGVIEW | WA | 98632 | $19,530 | $0 | MEDICAID TRANSFORMATION | 911139057 | |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp (3 entries)
| Grant TypeGrantTypeTxt | RecipientRecipientCnt | Cash GrantCashGrantAmt |
|---|---|---|
| GROCERY ASSISTANCE | 945 | $307,811 |
| RENT/MORTGAGE ASSISTANCE | 1300 | $1,175,966 |
| UTILITY/OTHER ASSISTANCE | 20 | $10,172 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 2: | DETAILED INVOICES AND EXPENSE BACK UP REQUIRED FOR PAYMENT. PERIODIC REPORTING REQUIRED AND MONITORED BY PROGRAM DIRECTOR. WITH NEW PARTNER CONTRACTS, PARTNERS ARE REQUIRED TO COMPLETE QUARTERLY REPORTS MONITORED BY MULTIPLE SWACH STAFF. PAYMENT IS ISSUED ONCE REPORT IS REVIEWED AND PROGRESS IS CONFIRMED. |
| SCHEDULE I, PART III, COLUMN (B) | BASED ON NUMBER OF HOUSEHOLDS OR INDIVIDUALS. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | 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 | NICHOLE PEPPERS | PersonNm |
| Title | EXECUTIVE DIRECTOR | TitleTxt |
| Base Compensation Filing Org | $150,000 | 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 | $4,500 | DeferredCompensationFlngOrgAmt |
| Deferred Comp Rltd Orgs | $0 | DeferredCompRltdOrgsAmt |
| Nontaxable Benefits Filing Org | $6,432 | NontaxableBenefitsFilingOrgAmt |
| Nontaxable Benefits Rltd Orgs | $0 | NontaxableBenefitsRltdOrgsAmt |
| Total Compensation Filing Org | $160,932 | 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 4 | FormAndLineReferenceDesc |
| Explanation | BARB WEST - $135,187.46 STAFF RECEIVED SEVERANCE DUE TO INVOLENTARY SEPARATION FROM THE ORGANIZATION | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 1A | EXECUTIVE COMMITTEE IS MADE UP OF BOARD PRESIDENT, VICE PRESIDENT, TREASURER, AND SECRETARY. SAME AUTHORITY AS BOT EXCEPT MAY NOT CHANGE BYLAWS, APPOINT OR REMOVE MEMBERS OR OFFICERS, OR MAKE CHANGES TO THE STATUS OF THE CORPORATION OR ITS PROPERTY OR ASSETS. |
| FORM 990, PART VI, SECTION B, LINE 11B | A DRAFT OF THE 990 IS E-MAILED TO THE BOARD MEMBERS FOR REVIEW BEFORE BEING FINALIZED AND SUBMITTED TO THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | BOARD MEMBERS ARE REQUIRED TO REVIEW POLICY AND DISCLOSE ANY CONFLICTS ANNUALLY IN WRITING. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE BOARD APPROVES THE EXECUTIVE DIRECTOR SALARY BEFORE OFFER. THE EXECUTIVE COMMITTEE APPROVES THE FINANCE DIRECTOR SALARY BEFORE OFFER. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ALL DOCUMENTS, POLICIES, AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | CONSULTING: PROGRAM SERVICE EXPENSES 1,116,318. MANAGEMENT AND GENERAL EXPENSES 357,156. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,473,474. CONTRACT SERVICES: PROGRAM SERVICE EXPENSES 75,158. MANAGEMENT AND GENERAL EXPENSES 10,464. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 85,622. |
| PART XII LINE 2C | THE PROCESS FOR FINANCIAL STATEMENT OVERSIGHT HAS NOT CHANGED FROM THE PRIOR YEAR. |
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