2021-04-23T16:45:30-05:00 2020-06-30 390758449 WIPFLI LLP 1502 LONDON ROAD SUITE 200 DULUTH MN 55812 990 2019-07-01 237088205 UNITED INDIAN HEALTH SERVICES INC UNIT 7078255000 1600 WEEOT WAY ARCATA CA 955214734 LAWANDA GREEN CHAIRPERSON 7078255000 2021-03-25 1 MICHAEL J PETERSON CPA P01833529 2187224705 2021-03-25 2019 2022-09-23 18:48:47Z LAWANDA GREEN 1600 WEEOT WAY ARCATA CA 955214734 31018080 0 X WWW.UIHS.ORG X 1970 CA TO PROVIDE HEALTH CARE SERVICES AND EDUCATION TO NATIVE AMERICANS. 17 17 321 25 0 0 17398859 16758018 14286019 13997863 18886 95401 105750 136012 31809514 30987294 458073 455204 0 0 17001275 18631808 0 0 0 11289385 12160539 28748733 31247551 3060781 -260257 41995033 49578110 16997263 24840597 24997770 24737513 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 24800307 455204 13997863 "THE ORGANIZATION PROVIDED MEDICAL, DENTAL, VISION, MENTAL HEALTH, HOSPITAL, PHARMACY, AND OTHER HEALTH SERVICES TO NATIVE AMERICANS AND THEIR FAMILIES. TOTAL VISITS DURING FISCAL YEAR 2019 - 2020 WERE 46,430 AND TOTAL PRESCRIPTIONS FILLED WERE APPROXIMATELY 53,500. 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." 24800307 1 1 0 1 0 0 1 1 0 0 1 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 168 0 321 1 0 0 0 0 0 0 0 0 0 0 0 0 X 17 17 1 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X DAVID ROSEN 7078255000 1600 WEEOT WAY ARCATA CA 955214734 ROXANNE ALSBURY MEDICAL DOCTOR 40.00 X 199246 0 20455 MATTHEW JOHN BUTTS MEDICAL DOCTOR 40.00 X 157288 0 39711 HUGH DAVID KENT MEDICAL DOCTOR 40.00 X 190857 0 20074 ANTOINETTE MARTINEZ MEDICAL DOCTOR 40.00 X 231799 0 31479 KIRK PETERSEN DENTIST 40.00 X 166369 0 40359 JOHN REEVES III CEO 40.00 X 138538 0 24413 DAVID ROSEN CFO 40.00 X 180427 0 13559 LAWANDA GREEN CHAIRPERSON 2.00 X X 4600 0 0 TERESA BALLEW VICE-CHAIRPERSON 2.00 X X 1550 0 0 KRISTEN BOYCE TREASURER 2.00 X X 200 0 0 FAWN MURPHY SECRETARY 2.00 X X 2575 0 0 CLAUDIA BRUNDIN BOARD MEMBER 2.00 X 775 0 0 WENDY GEORGE BOARD MEMBER 2.00 X 1150 0 0 JOSEPH GIOVANNETTI BOARD MEMBER 2.00 X 8125 0 0 SHIRLEY LAOS BOARD MEMBER 2.00 X 5600 0 0 TRACY MAHONEY BOARD MEMBER 2.00 X 9175 0 0 SUSAN MASTON BOARD MEMBER 2.00 X 5325 0 0 DONALD MCCOVEY BOARD MEMBER 2.00 X 3250 0 0 RICHARD L MYERS BOARD MEMBER 2.00 X 4050 0 0 LANA MCCOVEY BOARD MEMBER 2.00 X 400 0 0 DENISE PADGETTE BOARD MEMBER 2.00 X 3225 0 0 LISA SUNDBERG BOARD MEMBER 2.00 X 6750 0 0 VELVA E ANGELL ALTERNATE 2.00 X 1750 0 0 LAURA BORDEN ALTERNATE 2.00 X 10125 0 0 MADISON FLYNN ALTERNATE 2.00 X 700 0 0 JOHN GREEN ALTERNATE 2.00 X 6500 0 0 YVONNE GUIDO ALTERNATE 2.00 X 1000 0 0 DELMER KEISNER ALTERNATE 2.00 X 75 0 0 DEBORAH MARKUSSEN ALTERNATE 2.00 X 100 0 0 LEANN MCCALLUM ALTERNATE 3.00 X 6575 0 0 MINDY NATT ALTERNATE 4.00 X 0 0 0 RUBY J ROLLINGS ALTERNATE 5.00 X 8100 0 0 CHARLENE STORR ALTERNATE 6.00 X 2050 0 0 FERN BATES COMMUNITY MEMBER 7.00 X 1275 0 0 EVERETT DEWEY MEYERS COMMUNITY MEMBER 8.00 X 750 0 0 1360274 0 190050 20 0 1 0 PREMIERE MAXILLOFACIAL SURGEONS 3132 HARRISON AVENUE EUREKA CA 95503 DENTAL PROVIDER 255519 ST JOSEPH HEALTH REDWOOD MEM 3300 RENNER DRIVE FORTUNA CA 95540 MEDICAL PROVIDER 247431 RANDALL RAY HECKERT JR 2787 HARRIS STREET EUREKA CA 95503 DENTAL PROVIDER 237064 WITH OPEN ARMS REPRODUCTIVE H 2505 LUCAS STREET STE B EUREKA CA 95501 MEDICAL PROVIDER 162388 COMPHEALTH PO BOX 972651 DALLAS TX 75397 MEDICAL PROVIDER 141574 10 16735210 22808 16758018 NET PATIENT REVENUE 621110 9935535 9935535 PHARMACY REVENUE 621110 3936862 3936862 125466 125466 13997863 126187 126187 30786 -30786 -30786 -30786 136012 136012 136012 30987294 13997863 0 231413 X 431936 431936 23268 23268 503464 503464 13825639 11291670 2533969 364991 288722 76269 2871865 2356620 515245 1065849 905856 159993 62887 62887 187350 187350 4855663 4494714 360949 187900 61543 126357 564551 361984 202567 501839 13889 487950 677723 403201 274522 762595 449351 313244 197118 85471 111647 250936 165075 85861 972727 720537 252190 188146 74323 113823 CLINIC SUPPLIES 1258330 1249460 8870 PHARMACEUTICALS 1216045 1216045 EQUIPMENT PURCHASES AND 115793 115173 620 LICENSE AND FEES 68971 53080 15891 91965 38389 53576 31247551 24800307 6447244 0 5499 4000 27198835 35448079 529900 476618 1118942 1062746 142444 166760 384144 209263 27261010 15293667 12446181 11967343 169088 243301 41995033 49578110 1992127 2496592 9113421 14152672 5891715 5539543 0 2651790 16997263 24840597 X 24927225 24665054 70545 72459 24997770 24737513 41995033 49578110 -260257 0 X 0 1 X 1 1 1 X 16084192 17830540 17117002 17398859 16758018 85188611 16084192 17830540 17117002 17398859 16758018 85188611 85188611 2819 1632 1776 18886 126187 151300 85339911 65161664 0.99820 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 15764308 8916162 6848146 1322404 378053 944351 8136901 5999452 2137449 11967343 PAYROLL PROTECTION PROGRAM LOAN 2651790 2651790 30987294 0 30987294 0 30987294 31247551 0 31247551 0 31247551 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. 1 YUKON TRIBE 190 KLAMATH BLVD KLAMATH CA 95548 680178020 TRIBE 87936 TO PROMOTE GOOD HEALTH AND WELLNESS IN INDIAN COUNTRY. ELK VALLEY RANCHERIA 2332 HOWLAND HILL ROAD CRESCENT CITY CA 95531 680074968 TRIBE 45000 TO PROMOTE GOOD HEALTH AND WELLNESS IN INDIAN COUNTRY. BIG LAGOON RANCHERIA PO DRAWER 3060 TRINIDAD CA 95570 680022652 TRIBE 45000 TO PROMOTE GOOD HEALTH AND WELLNESS IN INDIAN COUNTRY. BLUE LAKE RANCHERIA PO BOX 428 BLUE LAKE CA 95525 680078113 TRIBE 45000 TO PROMOTE GOOD HEALTH AND WELLNESS IN INDIAN COUNTRY. RESIGHINI RANCHERIA PO BOX 529 KLAMATH CA 95548 942682661 TRIBE 45000 TO PROMOTE GOOD HEALTH AND WELLNESS IN INDIAN COUNTRY. BEAR RIVER BAND ROHNERVILLE 27 BEAR RIVER DRIVE LOLETA CA 95551 680085465 TRIBE 45000 TO PROMOTE GOOD HEALTH AND WELLNESS IN INDIAN COUNTRY. WIYOT TRIVE 1000 WIYOT DRIVE LOLETA CA 95551 942714533 TRIBE 15000 TO PROMOTE GOOD HEALTH AND WELLNESS IN INDIAN COUNTRY. TOLOWA DEE-NI BATION 140 ROWDY CREEK ROAD SMITH RIVER CA 95567 680087275 TRIBE 59000 TO PROMOTE GOOD HEALTH AND WELLNESS IN INDIAN COUNTRY. TRINIDAD RANCHERIA PO BOX 630 TRINIDAD CA 95570 922469967 TRIBE 45000 TO PROMOTE GOOD HEALTH AND WELLNESS IN INDIAN COUNTRY. 9 0 SCHOLARSHIPS 5 4820 DIABETES PROGRAM 261 18448 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 X 0 0 0 0 0 0 0 0 0 ROXANNE ALSBURY MEDICAL DOCTOR 199246 0 0 0 0 0 7978 0 12477 0 219701 0 0 0 MATTHEW JOHN BUTTS MEDICAL DOCTOR 157288 0 0 0 0 0 6689 0 33022 0 196999 0 0 0 HUGH DAVID KENT MEDICAL DOCTOR 190857 0 0 0 0 0 0 0 20074 0 210931 0 0 0 ANTOINETTE MARTINEZ MEDICAL DOCTOR 231799 0 0 0 0 0 9408 0 22071 0 263278 0 0 0 KIRK PETERSEN DENTIST 166369 0 0 0 0 0 7052 0 33307 0 206728 0 0 0 JOHN REEVES III CEO 138538 0 0 0 0 0 1935 0 22478 0 162951 0 0 0 DAVID ROSEN CFO 180427 0 0 0 0 0 0 0 13559 0 193986 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 DONALD MCCOVEY (BOARD MEMBER); 4. LAURA BORDEN (ALTERNATE) AND LANA MCCOVEY (VICE-CHAIRPERSON)." 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 SINGED 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 436,182. MANAGEMENT AND GENERAL EXPENSES 263,080. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 699,262. TEMPORARY CONTRACT LABOR: PROGRAM SERVICE EXPENSES 1,424,683. MANAGEMENT AND GENERAL EXPENSES 97,783. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,522,466. RESIDENTIAL SUBSTANCE ABUSE TREATMENT: PROGRAM SERVICE EXPENSES 42,249. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 42,249. MEDICAL FEES: PROGRAM SERVICE EXPENSES 1,503,459. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,503,459. DENTAL FEES: PROGRAM SERVICE EXPENSES 698,464. MANAGEMENT AND GENERAL EXPENSES 86. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 698,550. VISION FEES: PROGRAM SERVICE EXPENSES 37,312. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 37,312. PHARMACY FEES: PROGRAM SERVICE EXPENSES 143,855. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 143,855. LAB FEES: PROGRAM SERVICE EXPENSES 208,510. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 208,510.