2022-05-12T13:07:23-05:00 2021-06-30 390758449 WIPFLI LLP 1502 LONDON ROAD SUITE 200 DULUTH MN 55812 990 2020-07-01 237088205 UNITED INDIAN HEALTH SERVICES INC UNIT 7078255000 1600 WEEOT WAY ARCATA CA 955214734 LAWANDA GREEN CHAIRPERSON 7078255000 2022-04-07 1 LAWANDA GREEN 999009999 MICHAEL J PETERSON CPA P01833529 2187224705 2022-04-07 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z LAWANDA GREEN 1600 WEEOT WAY ARCATA CA 955214734 40410397 0 X WWW.UIHS.ORG X 1970 CA TO PROVIDE HEALTH CARE SERVICES AND EDUCATION TO NATIVE AMERICANS. 13 13 313 35 0 0 16758018 22383556 13997863 17800420 95401 8537 136012 217884 30987294 40410397 455204 394768 0 0 18631808 19654894 0 0 0 12160539 14373719 31247551 34423381 -260257 5987016 49578110 63804386 24840597 33079857 24737513 30724529 X TO WORK TOGETHER WITH OUR CLIENTS AND COMMUNITY TO ACHIEVE WELLNESS THROUGH HEALTH SERVICES THAT REFLECT THE TRADITIONAL VALUES OF OUR AMERICAN INDIAN COMMUNITY. 0 0 27572291 394768 17800420 THE ORGANIZATION PROVIDED MEDICAL, DENTAL, VISION, MENTAL HEALTH, HOSPITAL, PHARMACY, AND OTHER HEALTH SERVICES TO NATIVE AMERICANS AND THEIR FAMILIES. TOTAL VISITS DURING CALENDAR YEAR 2020-2021 WERE 69,682. OF THE TOTAL, 6,486 WERE FOR NON-INDIANS (9%). ADDITIONALLY, THE ORGANIZATION PROVIDED DIABETES TREATMENT, EDUCATION, AND PREVENTION HEALTH SERVICES. NUTRITION AND OTHER SOCIAL SERVICE PROGRAMS FOR LOW INCOME NATIVE AMERICANS (WIC, TITLE VI, ETC.). THEY ALSO PROVIDED TOBACCO EDUCATION TO NATIVE AMERICANS IN HUMBOLDT AND DEL NORTE COUNTY. THE PROGRAM PROVIDES MATERIALS ON THE HAZARDS OF TOBACCO USE, PEER-LED PREVENTION PRESENTATIONS, AND COUNSELING SERVICES. THE ORGANIZATION ALSO BEGAN PROVIDING SUICIDE PREVENTION AND OPIOID ADDICTION COUNSELING AND SERVICES. 27572291 1 1 0 1 0 0 1 1 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 133 0 313 1 0 0 0 0 0 0 0 0 0 0 0 0 X 13 13 1 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X CECIL WILSON 7078254065 1600 WEEOT WAY ARCATA CA 955214734 LAWANDA GREEN CHAIRPERSON 2.00 X X 8850 0 0 TERESA BALLEW VICE-CHAIRPERSON 2.00 X X 3450 0 0 KRISTEN BOYCE TREASURER 2.00 X X 1225 0 0 FAWN MURPHY SECRETARY 2.00 X X 1775 0 0 CLAUDIA BRUNDIN BOARD MEMBER 2.00 X 100 0 0 WENDY GEORGE BOARD MEMBER 2.00 X 0 0 0 JOSEPH GIOVANNETTI BOARD MEMBER 2.00 X 3475 0 0 SHIRLEY LAOS BOARD MEMBER 2.00 X 3375 0 0 TRACY MAHONEY BOARD MEMBER 2.00 X 0 0 0 SUSAN MASTON BOARD MEMBER 2.00 X 3350 0 0 RICHARD L MYERS BOARD MEMBER 2.00 X 0 0 0 LANA MCCOVEY BOARD MEMBER 2.00 X 0 0 0 LISA SUNDBERG BOARD MEMBER 2.00 X 0 0 0 VELVA E ANGELL ALTERNATE 2.00 X 0 0 0 DEBBIE BOARDMAN ALTERNATE 2.00 X 0 0 0 LAURA BORDEN ALTERNATE 2.00 X 0 0 0 RHONDA DOWD ALTERNATE 2.00 X 0 0 0 MADISON FLYNN ALTERNATE 2.00 X 3650 0 0 WENDELL FREEMAN ALTERNATE 2.00 X 0 0 0 JOHN GREEN ALTERNATE 2.00 X 3300 0 0 LEANN MCCALLUM ALTERNATE 2.00 X 0 0 0 MINDY NATT ALTERNATE (THRU 4/21) 2.00 X 0 0 0 RUBY J ROLLINGS ALTERNATE 5.00 X 3975 0 0 PHILLIP WILLIAMS ALTERNATE 2.00 X 0 0 0 JOHN REEVES III CEO 40.00 X 205519 0 24545 DAVID ROSEN CFO (THRU 5/21) 40.00 X 187255 0 14266 ROXANNE ALSBURY MEDICAL DOCTOR 40.00 X 207257 0 10603 TIMOTHY JOHN CONNELL PHARMACY DIRECTOR 40.00 X 159218 0 6987 HUGH DAVID KENT MEDICAL DOCTOR 40.00 X 211167 0 17479 ANTOINETTE MARTINEZ MEDICAL DOCTOR 40.00 X 224755 0 23005 KIRK PETERSEN DENTIST 40.00 X 190152 0 26486 1421848 0 123371 26 0 1 0 AMERICSOURCEBERGEN DRUG CORP PO BOX 100741 PASADENA CA 911890741 PHARMACY SUPPLIER 1148158 INFINITE CONSULTING SERVICES INC 2320 CENTRAL AVE SUITE A MCKINLEYVILLE CA 95519 IT CONSULTING AND MATERIAL 590062 TRIBAL EM PLLC 14818 N 74TH PLLC SCOTTSDALE AZ 952602426 MEDICAL PROVIDERS 524628 MCKESSON MEDICAL-SURGICAL PO BOX 6344404 CINCINNATI OH 452634404 MEDICAL SUPPLIES 435017 EXPRESS SERVICES INC PO BOX 844277 LOS ANGELES CA 900844277 EMPLOYMENT SERVICES 348835 20 22368490 15066 22383556 NET PATIENT REVENUE 621110 13360839 13360839 PHARMACY REVENUE 621110 4272500 4272500 167081 167081 17800420 8537 8537 217884 217884 217884 40410397 17800420 0 226421 X 390000 390000 4768 4768 520275 520275 15484585 12466437 3018148 395406 310776 84630 2166485 2166485 1088143 995004 93139 95148 7205 87943 98990 98990 6220655 5533357 687298 268978 173268 95710 691967 481219 210748 843067 66442 776625 757388 446486 310902 383213 258207 125006 202532 73042 129490 229161 155104 74057 974620 711434 263186 302330 157469 144861 CLINIC SUPPLIES 1683021 1604101 78920 PHARMACEUTICALS 1292323 1291872 451 EQUIPMENT PURCHASES AND 239174 207813 31361 LICENSE AND FEES 44281 39550 4731 46871 32252 14619 34423381 27572291 6851090 0 2655790 2655590 32796289 46618016 476618 538636 1062746 1521240 166760 170964 209263 234269 27950559 16268289 11967343 11682270 243301 383401 49578110 63804386 2496592 2971459 14152672 24934884 5539543 5173514 2651790 0 24840597 33079857 X 24665054 30648032 72459 76497 24737513 30724529 49578110 63804386 5987016 0 X 0 1 X 1 1 1 X 17830540 17117002 17398859 16758018 22383556 91487975 17830540 17117002 17398859 16758018 22383556 91487975 91487975 1632 1776 18886 126187 8537 157018 91644993 72473681 0.99830 0.99820 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 10000 10000 0 PART II-B, LINE 1: THE DARREL HOSTLER FUND PROVIDES THE RESOURCES FOR CALIFORNIA RURAL INDIAN HEALTH BOARD TO PROVIDE LEGISLATION AND ADVOCACY TO THE INDIANS OF CALIFORNIA. ACTIVITIES PERFORMED INCLUDE LOBBYING, TRAVEL TO WASHINGTON D.C. AND ATTENDING EVENTS SPECIFICALLY FOR ADVOCACY. X X X 1 20.00 0 0 1 1 200.00 8500 138235 X X 0 2037397 2037397 20085801 12484014 7601787 1322404 502662 819742 4130167 3281613 848554 374790 374790 11682270 40394920 -15477 -15477 40410397 0 40410397 34407904 0 34407904 15477 15477 34423381 PART II, LINE 9: EXPENSES RELATED TO THE CONSERVATION EASEMENT ARE REPORTED BY THE ORGANIZATION IN THEIR NATURAL EXPENSE CATEGORIES. NO SEPARATE BALANCE SHEET AMOUNT OR FOOTNOTE DISCLOSURE HAS BEEN REPORTED. PART III, LINE 1A: THE ART COLLECTION HELD BY UNITED INDIAN HEALTH SERVICES IS COMPRISED OF SAMPLES OF ORIGINAL ARTWORKS BY PROMINENT NORTHWEST ARTISTS AND ARTWORKS OF LESSER KNOWN ARTISTS FROM OUR REGION. THE COLLECTION IS UTILIZED TO MAKE THE INDIAN COMMUNITY COME TOGETHER AS A WHOLE, TO IMPROVE THE OVERALL HEALTH AND WELLNESS OF EVERYONE INVOLVED, AND TO BRING THE INDIAN AND NON-INDIAN COMMUNITIES CLOSER TOGETHER. PART XI, LINE 2D - OTHER ADJUSTMENTS: BAD DEBT EXPENSE -15,477. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 15,477. 1 BIG LAGOON RANCHERIA PO DRAWER 3060 TRINIDAD CA 95570 680022652 TRIBE 65000 TO PROMOTE GOOD HEALTH AND WELLNESS IN INDIAN COUNTRY. BLUE LAKE RANCHERIA PO BOX 428 BLUE LAKE CA 95525 680078113 TRIBE 65000 TO PROMOTE GOOD HEALTH AND WELLNESS IN INDIAN COUNTRY. RESIGHINI RANCHERIA PO BOX 529 KLAMATH CA 95548 942682661 TRIBE 65000 TO PROMOTE GOOD HEALTH AND WELLNESS IN INDIAN COUNTRY. TOLOWA DEE-NI BATION 140 ROWDY CREEK ROAD SMITH RIVER CA 95567 680087275 TRIBE 65000 TO PROMOTE GOOD HEALTH AND WELLNESS IN INDIAN COUNTRY. TRINIDAD RANCHERIA PO BOX 630 TRINIDAD CA 95570 922469967 TRIBE 65000 TO PROMOTE GOOD HEALTH AND WELLNESS IN INDIAN COUNTRY. WIYOT TRIVE 1000 WIYOT DRIVE LOLETA CA 95551 942714533 TRIBE 65000 TO PROMOTE GOOD HEALTH AND WELLNESS IN INDIAN COUNTRY. 6 0 PART I, LINE 2: THE LISTED ORGANIZATIONS ARE SUBRECIPIENTS OF FEDERAL FUNDS AS DEFINED BY THE OMB UNIFORM GRANT GUIDANCE. FEDERAL SUBRECIPIENT MONITORING PROCEDURES ARE REQUIRED TO BE FOLLOWED. X X X X 0 0 0 0 0 0 0 0 0 ANTOINETTE MARTINEZ MEDICAL DOCTOR 224755 0 0 0 0 0 9094 0 13911 0 247760 0 0 0 JOHN REEVES III CEO 205519 0 0 0 0 0 0 0 24545 0 230064 0 0 0 HUGH DAVID KENT MEDICAL DOCTOR 211167 0 0 0 0 0 0 0 17479 0 228646 0 0 0 ROXANNE ALSBURY MEDICAL DOCTOR 207257 0 0 0 0 0 0 0 10603 0 217860 0 0 0 KIRK PETERSEN DENTIST 190152 0 0 0 0 0 7752 0 18734 0 216638 0 0 0 DAVID ROSEN CFO (THRU 5/21) 187255 0 0 0 0 0 0 0 14266 0 201521 0 0 0 TIMOTHY JOHN CONNELL PHARMACY DIRECTOR 159218 0 0 0 0 0 0 0 6987 0 166205 0 0 0 FORM 990, PART VI, SECTION A, LINE 2 BOARD MEMBER FAMILY RELATIONSHIPS: 1. LAWANDA GREEN (CHAIRPERSON) AND JOHN GREEN (ALTERNATE) 2. RUBY ROLLINGS (ALTERNATE) AND SHIRLEY LAOS (BOARD MEMBER) 3. LAURA BORDEN (ALTERNATE) AND LANA MCCOVEY (BOARD MEMBER) 4. TERESA BALLEW (VICE CHAIR) AND WENDELL FREEMAN (ALTERNATE) FORM 990, PART VI, SECTION A, LINE 6 MEMBERSHIP IN UIHS IS DEFINED IN THE ARTICLES OF INCORPORATION. ELIGIBLE INDIAN BENEFICIARIES WHO MEET CERTAIN REQUIREMENTS ARE ELIGIBLE TO BE MEMBERS. FORM 990, PART VI, SECTION A, LINE 7A THE MEMBERS HAVE THE ABILITY TO ELECT "INDIAN COMMUNITY REPRESENTATIVES" WHICH MAKE UP 5 POSITIONS ON THE BOARD. FORM 990, PART VI, SECTION B, LINE 11B THE TAX RETURN IS SUBMITTED TO THE ENTIRE BOARD OF DIRECTORS FOR REVIEW PRIOR TO FILING AND SIGNED BY THE BOARD CHAIRPERSON. FORM 990, PART VI, SECTION B, LINE 12C ANY DIRECTOR WHO HAS ANY PROPRIETARY INTEREST IN, OR WHO RECEIVES OR HAS EXPECTATIONS OF RECEIVING COMPENSATION FROM OR WHO WILL HAVE ANY SIGNIFICANT MONETARY GAIN OR LOSS AS A RESULT OF THE CORPORATION'S ACTIONS OR ANY ORGANIZATIONS, PROJECT, PROGRAM, CONTRACT OR OTHER ACTION UNDER CONSIDERATION BY THE CORPORATION OR ITS BOARD, SHALL BE DEEMED TO HAVE A CONFLICT OF INTEREST. WHENEVER ANY DIRECTOR HAS OR HAS CAUSE TO BELIEVE THAT AN ACTION OR ISSUE PENDING BEFORE THE BOARD OR THE CORPORATION COULD INVOLVE A CONFLICT OF INTEREST FOR A BOARD MEMBER, HE OR SHE SHALL ANNOUNCE THE CONFLICT AND SHALL THEN ABSTAIN FROM DISCUSSION, CONSIDERATION, DECISIONS, AND VOTING ON THE MATTER. WHENEVER ANY DIRECTOR SITS ON THE GOVERNING BODY OF A TRIBE, ORGANIZATION, PROGRAM, OR OTHER PROJECT WHICH IS COMPETING FOR FUNDING WITH THE CORPORATION, HE OR SHE SHALL ANNOUNCE THE CONFLICT OF INTEREST AND SO NOTIFY THE CHAIRMAN OF THE BOARD. SUCH PERSON SHALL THEN ABSTAIN FROM DISCUSSING, CONSIDERING, DECIDING, AND VOTING ON THAT FUNDING MATTER. NO DIRECTOR MAY BE AN EMPLOYEE OF THE CORPORATION DURING THE DIRECTOR'S TERM OF SERVICE ON THE BOARD, NOR SHALL ANY EMPLOYEE OF THE CORPORATION BE ELIGIBLE TO BE A BOARD MEMBER WHILE SO EMPLOYED. FORM 990, PART VI, SECTION B, LINE 15 THE CONTRACTUAL AGREEMENT FOR THE CEO, OFFICERS, AND KEY EMPLOYEES THAT DEFINES THE TERMS, CONDITIONS, AND COMPENSATION LEVEL IS DETERMINED USING REVIEW BY OUTSIDE LEGAL COUNSEL, ANALYSIS OF COMPARABLE AGENCY DATA, AND GOVERNING BOARD REVIEW. DELIBERATION AND DECISION IS RECORDED IN THE BOARD MINUTES. FORM 990, PART VI, SECTION C, LINE 19 ALL GOVERNING DOCUMENTS, POLICIES, AND FINANCIAL REPORTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G OTHER PROFESSIONAL SERVICES: PROGRAM SERVICE EXPENSES 739,377. MANAGEMENT AND GENERAL EXPENSES 452,012. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,191,389. TEMPORARY CONTRACT LABOR: PROGRAM SERVICE EXPENSES 2,004,306. MANAGEMENT AND GENERAL EXPENSES 235,241. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,239,547. RESIDENTIAL SUBSTANCE ABUSE TREATMENT: PROGRAM SERVICE EXPENSES 4,900. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,900. MEDICAL FEES: PROGRAM SERVICE EXPENSES 1,513,515. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,513,515. DENTAL FEES: PROGRAM SERVICE EXPENSES 772,969. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 772,969. VISION FEES: PROGRAM SERVICE EXPENSES 48,126. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 48,126. PHARMACY FEES: PROGRAM SERVICE EXPENSES 91,367. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 91,367. LAB FEES: PROGRAM SERVICE EXPENSES 358,797. MANAGEMENT AND GENERAL EXPENSES 45. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 358,842.