2022-05-09T11:28:01-05:00 2021-06-30 680037990 GILBERT CPAS 2880 GATEWAY OAKS DR STE 100 SACRAMENTO CA 95833 990 2020-07-01 942583156 CHAPA-DE INDIAN HEALTH PROGRAM INC CHAP 5308872800 11670 ATWOOD ROAD AUBURN CA 95603 SIERK HAITSMA CFO 5308872800 2022-05-06 1 SIERK HAITSMA 999009999 KEITH R GLEN P01317613 9166466464 2022-05-06 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z LISA DAVIES 11670 ATWOOD ROAD AUBURN CA 95603 58662177 0 X WWW.CHAPA-DE.ORG X 1979 CA PROVIDES COMPREHENSIVE HEALTH CARE AND ANCILLARY SERVICES TO THE NATIVE-AMERICAN POPULATION OF SIERRA, PLACER AND NEVADA COUNTIES OF CALIFORNIA. 5 5 297 0 0 0 25916727 17847918 33291642 38852079 1693657 1962180 0 0 60902026 58662177 0 0 0 0 20496253 23705459 0 0 0 12005073 11825705 32501326 35531164 28400700 23131013 132597049 171407470 14369851 19381307 118227198 152026163 PROVIDES COMPREHENSIVE HEALTH CARE AND ANCILLARY SERVICES TO THE NATIVE-AMERICAN POPULATION OF SIERRA, PLACER AND NEVADA COUNTIES OF CALIFORNIA. 0 0 23106597 38852079 PRIMARY HEALTH CARE PROGRAM- CHAPA-DE INDIAN PROGRAM, INC PROVIDED COMPREHENSIVE HEALTH SERVICES TO THE NATIVE-AMERICAN POPULATION AND OTHER RESIDENTS OF SIERRA, PLACER, AND NEVADA COUNTIES OF CALIFORNIA. COMPREHENSIVE HEALTH SERVICES INCLUDE DIRECT PATIENT CARE, IMMUNIZATIONS, HEALTH PROMOTION AND DISEASE PREVENTION, DRUG ABUSE AND EDUCATION/PREVENTION PROGRAMS, AND DENTAL CARE. 290481 DIABETES PREVENTION PROGRAM-THIS PROGRAM PROVIDES DIABETES PREVENTION, MANAGEMENT AND LIFESTYLE EDUCATION, AND TESTING SERVICES TO NATIVE- AMERICAN PATIENTS DURING THE FISCAL YEAR. THESE PATIENTS LIVE PRIMARILY IN SIERRA, PLACER, AND NEVADA COUNTIES OF CALIFORNIA. 1346164 1346164 24743242 1 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 94 0 1 297 1 0 0 0 0 0 0 0 0 0 0 0 0 X 5 5 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X SIERK HAITSMA 5308872800 11670 ATWOOD ROAD AUBURN CA 95603 BRENDA ADAMS CHAIR 2.00 X X 0 0 0 DAVID KEYSER VICE-CHAIR 2.00 X X 0 0 0 GENE WHITEHOUSE SECRETARY 2.00 X X 0 0 0 JASON CAMP BOARD MEMBER 2.00 X 0 0 0 JOHN L WILLIAMS BOARD MEMBER 2.00 X 0 0 0 DARLA CLARK COO 40.00 X 212003 0 31167 LISA DAVIES CEO 40.00 X 328706 0 38008 SIERK HAITSMA CFO 40.00 X 231577 0 22665 ALINEA STEVENS MEDICAL DIRECTOR 32.00 X 236310 0 46481 ANTHONY REYES CHIEF ADMINISTRATIVE OFFICER 40.00 X 173665 0 28365 ERIC OSBORN CHIEF INFORMATION OFFICER 40.00 X 191065 0 13365 KARINA GOOKIN LEAD PHYSICIAN 36.00 X 203911 0 42608 MICHAEL QUION LEAD PHYSICIAN 36.00 X 222425 0 39870 PAULINE KARUNAKARAN DENTAL DIRECTOR 40.00 X 223472 0 24450 ADAM BORRUSO FAMILY NURSE PRACTITIONER/CLINICAL INFORMATICS LEA 40.00 X 178530 0 26811 JASHANJOT BAJWA DENTIST 40.00 X 164608 0 17469 JULIE GARCHOW PHYSICIAN 32.00 X 171129 0 28823 RICHARD MALEK PSYCHIATRIST 40.00 X 257498 0 645 WILLIAM JORNLIN PHYSICIAN 40.00 X 231818 0 44283 3026717 0 405010 42 0 1 0 EFFORT PHARMACY SERVICES INC 3215 PENNINGTON ROAD LIVE OAK CA 95953 PHARMACY SERVICES 1904807 DESCOR BUILDERS INC 3164 GOLD CAMP DRIVE 250 RANCHO CORDOVA CA 95670 BUILDING CONTRACTOR 1816251 DEACON CONSTRUCTION LLC 7745 GREENBACK LANE 250 CITRUS HEIGHTS CA 95610 BUILDING CONTRACTOR 1810126 KEKER VAN NEST & PETERS LLP 633 BATTERY STREET SAN FRANCISCO CA 94111 PROFESSIONAL SERVICE 1084110 RCP CONSTRUCTION INC 5180 GOLDEN FOOTHILLS PKWY 110 EL DORADO HILLS CA 95762 BUILDING CONTRACTOR 905493 31 17843781 4137 17847918 HEALTH SERVICES 621400 38852079 38852079 38852079 1959516 1959516 2664 0 2664 2664 2664 58662177 38852079 0 1962180 2227442 1673629 553813 16585281 12543730 4041551 3513548 2518372 995176 1379188 988547 390641 223488 176556 46932 70211 55467 14744 136706 136706 3312595 2615356 697239 158537 6398 152139 571764 114568 457196 1007878 961 1006917 53968 47231 6737 24719 24719 1484308 183464 1300844 124084 124084 MEDICAL SUPPLIES 2770613 2748687 21926 BUILDING AND EQUIPMENT 705970 188528 517442 PATIENT RELATED COSTS 471073 449026 22047 EXPENSED EQUIPMENT 268928 239770 29158 440863 192952 247911 35531164 24743242 10787922 0 6800 6400 34761691 35279557 287067 2160222 2007769 3312912 214395 175432 48554260 18934121 24084084 29620139 71011835 100592350 223408 260458 132597049 171407470 3180254 4175320 6893197 15205987 4296400 0 14369851 19381307 X 118227198 152026163 0 0 118227198 152026163 132597049 171407470 23131013 10667952 0 X X 0 1 X 1 1 1 X 10973174 11043154 11517833 25916727 17847918 77298806 10973174 11043154 11517833 25916727 17847918 77298806 77298806 3428 245453 876819 1693657 1962180 4781537 82080343 0.94170 0.96170 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 4961827 4961827 34392575 15496150 18896425 4153087 3437971 715116 5046771 5046771 29620139 INVESTMENTS 100592350 F 100592350 69193423 10667952 10667952 58525471 136706 136706 58662177 35394458 0 35394458 136706 136706 35531164 X X 0 0 0 0 0 0 0 0 0 LISA DAVIES CEO 296706 0 32000 0 0 0 17100 0 20908 0 366714 0 0 0 ALINEA STEVENS MEDICAL DIRECTOR 210864 0 25446 0 0 0 14498 0 31983 0 282791 0 0 0 WILLIAM JORNLIN PHYSICIAN 224486 0 7332 0 0 0 12292 0 31991 0 276101 0 0 0 MICHAEL QUION LEAD PHYSICIAN 215897 0 6528 0 0 0 13621 0 26249 0 262295 0 0 0 RICHARD MALEK PSYCHIATRIST 251600 0 5898 0 0 0 0 0 645 0 258143 0 0 0 SIERK HAITSMA CFO 208217 0 23360 0 0 0 13895 0 8770 0 254242 0 0 0 PAULINE KARUNAKARAN DENTAL DIRECTOR 206027 0 17445 0 0 0 13408 0 11042 0 247922 0 0 0 KARINA GOOKIN LEAD PHYSICIAN 199795 0 4116 0 0 0 12505 0 30103 0 246519 0 0 0 DARLA CLARK COO 191103 0 20900 0 0 0 12860 0 18307 0 243170 0 0 0 ADAM BORRUSO FAMILY NURSE PRACTITIONER/CLINICAL I 171461 0 7069 0 0 0 10325 0 16486 0 205341 0 0 0 ERIC OSBORN CHIEF INFORMATION OFFICER 178565 0 12500 0 0 0 2400 0 10965 0 204430 0 0 0 ANTHONY REYES CHIEF ADMINISTRATIVE OFFICER 159289 0 14376 0 0 0 8306 0 20059 0 202030 0 0 0 JULIE GARCHOW PHYSICIAN 166436 0 4693 0 0 0 9368 0 19455 0 199952 0 0 0 JASHANJOT BAJWA DENTIST 160182 0 4426 0 0 0 6554 0 10915 0 182077 0 0 0 FORM 990, PART VI THE BOARD OF DIRECTORS HIRES ALL OFFICERS OF THE ORGANIZATION. THE COMPENSATION AMOUNT IS BASED ON PREVAILING SALARIES IN THE AREA AND THE EXPERIENCE AND QUALIFICATIONS OF THE OFFICER. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PRESENTED BY THE CFO TO THE FULL BOARD OF DIRECTORS AND IS APPROVED FOR FILING. THE CHAIRPERSON IS AUTHORIZED TO SIGN THE FORM 990 AFTER THE APPROVAL BY THE FULL BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION PERFORMS AN ANNUAL EVALUATION OF ALL POTENTIAL CONFLICT OF INTEREST SITUATIONS. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD OF DIRECTORS HIRES CEO AND TOP MANAGEMENT OF THE ORGANIZATION. THE COMPENSATION AMOUNT IS BASED ON PREVAILING SALARIES IN THE AREA AND THE EXPERIENCE AND QUALIFICATIONS OF THE EMPLOYEE. THIS PROCESS WAS LAST UNDERTAKEN IN 2020. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS ARE AVAILABLE UPON REQUEST FROM THE GENERAL PUBLIC. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED FROM THE PRIOR PERIOD.