2021-10-15T11:23:43-05:00 2021-05-20 930743240 HOFFMAN STEWART & SCHMIDT PC 3 CENTERPOINTE DRIVE SUITE 300 LAKE OSWEGO OR 970358663 990 2021-01-01 201082052 PTSO OF WASHINGTON PTSO 5039432500 1881 SW NAITO PARKWAY PORTLAND OR 97201 SEAN WHITELEY-ROSS CFO 5039432500 2021-10-07 1 SEAN WHITELEY-ROSS 999009999 ROBERT M PRILL P00236613 5032205900 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z X SEAN WHITELEY-ROSS 1881 SW NAITO PARKWAY PORTLAND OR 97201 0 0 X WWW.PTSOWA.ORG X 2004 WA PTSO OF WASHINGTON WAS ESTABLISHED TO IMPROVE ACCESS AND THE LEVEL AND QUALITY OF HEALTHCARE FOR THE MEDICALLY UNDERSERVED THROUGH THE IMPROVEMENTS OF INFORMATION TECHNOLOGY SERVICES AVAILABLE TO COMMUNITY HEALTH CENTERS AND OTHER SAFETY NET PROVIDERS. X 8 5 0 0 0 0 154521 0 1826657 0 -679174 0 79034 0 1381038 0 1825577 0 0 0 471574 0 0 0 0 -818336 0 1478815 0 -97777 0 9915610 0 73555 0 9842055 0 X PTSO OF WASHINGTON WAS ESTABLISHED TO IMPROVE ACCESS AND THE LEVEL AND QUALITY OF HEALTHCARE FOR THE MEDICALLY UNDERSERVED THROUGH THE IMPROVEMENT OF INFORMATION TECHNOLOGY SERVICES AVAILABLE TO COMMUNITY HEALTH CENTERS AND OTHER SAFETY NET PROVIDERS. 0 1 N/A 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 8 5 1 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 0 0 0 WA X SEAN WHITELEY-ROSS CFO 5039432500 1881 SW NAITO PARKWAY PORTLAND OR 97201 JESUS HERNANDEZ BOARD MEMBER 1.00 X 0 0 0 JANINE CHILDS BOARD MEMBER 1.00 X 0 0 0 THOMAS TROMPETER BOARD MEMBER 1.00 X 0 0 0 ABBY SEARS BOARD MEMBER 1.00 X 0 220582 15400 SEAN WHITELEY-ROSS BOARD MEMBER 1.00 X 0 168903 16917 JAMES MALDONADO BOARD MEMBER 1.00 X 0 130421 10658 ANITA MONOIAN CHAIR 1.00 X X 0 0 0 LINDA MCVEIGH TREASURER 1.00 X X 0 0 0 0 519906 42975 0 0 1 0 0 0 0 0 0 0 0 0 0 5907 0 0 0 0 0 0 0 0 22851 0 0 0 0 0 0 0 9886852 0 9915610 0 18708 0 54847 0 73555 0 X 9842055 0 9842055 0 9915610 0 X 0 -9842055 X X 0 0 0 X X 5 COUNTRY DOCTOR COMMUNITY CLINIC 237100868 7 1 0 0 FAMILY HEALTH CENTERS IN OKANOGAN 911275011 7 1 0 0 HEALTHPOINT 910884412 10 1 0 0 YAKIMA NEIGHBORHOOD HEALTH SERVICES 910928817 10 1 0 0 NEIGHBORCARE HEALTH 910893287 7 1 0 0 5 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 X 0 1 PART IV, SECTION A, LINE 1 SUPPORTING ORGANIZATIONS ARE NOTIFIED AT BOARD MEETINGS AS THEY REVIEW THE 990 AND UPDATE GOVERNING DOCUMENTS. PART IV, SECTION D, LINE 3 THE MANAGEMENT OF ALL AFFAIRS OF THE PTSO ARE VESTED IN THE BOARD OF DIRECTORS. THE BOARD OF DIRECTORS IS COMPRISED OF BOARD MEMBERS ELECTED BY OCHIN, INC. AND THE SUPPORTED ORGANIZATIONS. PART IV, SECTION E, LINE 2A PTSO IS ORGANIZED TO IMPROVE ACCESS AND THE LEVEL AND QUALITY OF HEALTH CARE FOR THE MEDICALLY UNDERSERVED THROUGH THE IMPROVEMENT OF INFORMATION TECHNOLOGY SERVICES AVAILABLE TO COMMUNITY HEALTH CENTERS. DURING THE YEAR, PTSO HAD 5 MEMBERS. PART IV, SECTION E, LINE 2B PTSO IS ORGANIZED TO SECURE AND MANAGE INFORMATION SYSTEMS WHICH ARE A NECESSARY AND INTEGRAL PART OF THE DELIVERY OF HEALTH CARE. WITHOUT PTSO'S INVOLVEMENT, EACH MEMBER WOULD BE RESPONSIBLE WITH THE PURCHASE, MAINTENANCE AND IMPLEMENTATION OF THEIR OWN INFORMATION SYSTEMS. X X X 1 0 0 0 0 0 0 0 0 ABBY SEARS BOARD MEMBER 0 200768 0 16064 0 3750 0 14761 0 639 0 235982 0 0 SEAN WHITELEY-ROSS BOARD MEMBER 0 160871 0 8032 0 0 0 15925 0 992 0 185820 0 0 CASH 2021-05-31 8361 CASH VALUE 200195556 OCHIN 1881 SW NAITO PARKWAY PORTLAND OR 972015195 501(C)(3) DUE TO/FROM RELATED CORPORATION 2021-05-31 9874260 CASH VALUE 200195556 OCHIN INC 1818 SW NAITO PARKWAY PORTLAND OR 972015195 501(C)(3) 1 1 0 0 1 1 1 1 0 PART I, LINE 2E: PERSON(S) INVOLVED: ABIGAIL SEARS, CEO, SEAN WHITELEY-ROSS, CFO AND JAMES MADONADO, CORPORATE COUNSEL PART I, LINE 2E: EXPLANATION OF INVOLVEMENT: THEY ALL HOLD THE SAME POSITION WITH THE TRANSFEREE ORGANIZATION AND ARE EMPLOYEES OF TRANSFEREE ORGANIZATION. FORM 990, PART III, LINE 3 THE ORGANIZATION CEASED CONDUCTING PROGRAM SERVICES. FORM 990, PART VI, SECTION A, LINE 2 PTSO'S BOARD CONSISTS OF REPRESENTATIVES OF ITS MEMBERS. AS SUCH BOARD MEMBERS MAY HAVE BUSINESS RELATIONSHIPS WITH EACH OTHER. FORM 990, PART VI, SECTION A, LINE 6 THE MEMBERSHIP OF PTSO CONSISTS OF TWO CLASSES OF MEMBERS. THE CLASS A MEMBER IS OCHIN, INC. CLASS B MEMBERS ARE COMMUNITY HEALTH CENTERS AND CURRENTLY CONSIST OF THE SUPPORTED ORGANIZATIONS REPORTED ON SCHEDULE A. FORM 990, PART VI, SECTION A, LINE 7A EACH CLASS MEMBER B MAY APPOINT ONE DIRECTOR AND THE CLASS MEMBER A MAY APPOINT AT LEAST SIX DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS REVIEWED BY THE FINANCE COMMITTEE AND THEN PROVIDED TO THE FULL BOARD PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICT OF INTEREST, AN INTERESTED PERSON MUST DISCLOSE THE EXISTENCE OF THE FINANCIAL INTEREST AND BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE DIRECTORS AND/OR MEMBERS OF COMMITTEES WITH GOVERNING BOARD DELEGATED POWERS CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. ALL AFFECTED PERSONS SHALL COMPLETE THE ANNUAL AFFIRMATION AND DISCLOSURE STATEMENT ON AN ANNUAL BASIS AND SUBMIT SUCH COMPLETED ANNUAL DISCLOSURE STATEMENTS TO THE SECRETARY OF THE BOARD OF DIRECTORS. THE SECRETARY SHALL BE RESPONSIBLE FOR FILING ALL COPIES OF THE ANNUAL AFFIRMATION AND DISCLOSURE STATEMENTS WITH THE OFFICIAL CORPORATE RECORDS OF THE ORGANIZATION AND SHALL BRING ANY POTENTIAL CONFLICTS OF INTEREST DISCLOSED IN THE ANNUAL AFFIRMATION AND DISCLOSURE STATEMENTS TO THE ATTENTION OF THE BOARD OF DIRECTORS AT THE NEXT MEETING OF THE BOARD DIRECTORS. AFTER DISCLOSURE OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE INTERESTED PERSON, THE INTERESTED PERSON SHALL LEAVE THE GOVERNING BOARD OR COMMITTEE MEETING WHILE THE DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON. THE REMAINING BOARD OR COMMITTEE MEMBERS SHALL DECIDE IF A CONFLICT OF INTEREST EXISTS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING/ORGANIZING DOCUMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: TRANSFER TO OCHIN -9,842,055. FORM 990, PART XII, LINE 2C THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. OCHIN INC 1881 SW NAITO PARKWAY PORTLAND OR 97201 200195556 SUPPORT AND IMPROVE INFORMATION TECHNOLOGY FOR COMMUNITY HEALTH CLINICS OR 501(C)(3) LINE 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0