SOUTHWEST WASHINGTON REGIONAL HEALTH ALLIANCE: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- SOUTHWEST WASHINGTON REGIONAL HEALTH ALLIANCE (EIN 46-2164971)
- Tax period
- 2017-07-01 to 2018-06-30
- Filed
- 2019-05-20
- IRS object ID
- 201901409349300445
- Schema version
- 2017v2.3
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule I
- Schedule J
- Schedule O
- Reasonable Cause Explanation
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2019-05-20T12:38:09-05:00 | ReturnTs |
| Tax Period End | 2018-06-30 | 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 | 2017-07-01 | 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 | AddressLine1Txt |
| City | VANCOUVER | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 98661 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JOHN HERSEN | PersonNm |
| Person Title | PRESIDENT | PersonTitleTxt |
| Phone | 3608287319 | PhoneNum |
| Signature | 2019-05-17 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | KARIN S WANDTKE | PreparerPersonNm |
| PTIN | P00172715 | PTIN |
| Phone | 5032270581 | PhoneNum |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 50.204.228.78 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2019-05-17 | IPDt |
| IP Tm | 10:17:20 | IPTm |
| IP Timezone | PD | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 16E3360C8D28A2C498A262D79CEC4CD768A9D895 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | FA9676FDB5E3B5CC3D00C9F643EA12EB39A2C68D | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2019-02-21 02:37:17Z | 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 | JON HERSEN | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2404 E MILL PLAIN BLVD | AddressLine1Txt |
| City | VANCOUVER | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 98661 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $32,143,319 | 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 | PARTNERING TO BUILD A HEALTHIER FUTURE IN SOUTHWEST WASHINGTON - FOR EVERYONE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 14 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 14 | VotingMembersIndependentCnt |
| Total Employee | 14 | TotalEmployeeCnt |
| Total Volunteers | 70 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $3,399 | PYContributionsGrantsAmt |
| CY Contributions Grants | $32,110,068 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $1,071,769 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $18 | PYInvestmentIncomeAmt |
| CY Investment Income | $29,168 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $4,083 | CYOtherRevenueAmt |
| PY Total Revenue | $1,075,186 | PYTotalRevenueAmt |
| CY Total Revenue | $32,143,319 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $3,506,410 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $150,958 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $1,633,020 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $397,204 | PYOtherExpensesAmt |
| CY Other Expenses | $1,159,982 | CYOtherExpensesAmt |
| PY Total Expenses | $548,162 | PYTotalExpensesAmt |
| CY Total Expenses | $6,299,412 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $527,024 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $25,843,907 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $1,270,307 | TotalAssetsBOYAmt |
| Total Assets EOY | $27,853,009 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $64,954 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $681,909 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $1,205,353 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $27,171,100 | 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 A HEALTHIER FUTURE FOR EVERYONE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $1,621,215 | ExpenseAmt |
| Grant | $227,267 | GrantAmt |
| Desc | SOUTHWEST WASHINGTON REGIONAL HEALTH ALLIANCE CONFIRMED PARTNERSHIPS WITH TWENTY CLINICAL ORGANIZATIONS IN CLARK, SKAMANIA AND KLICKITAT COUNTIES, COORDINATED HEALTH INFORMATION ASSESSMENTS WITH EACH ORGANIZATION, AND DEFINED A PROCESS TO CREATE TRANSFORMATION PLANS TO IMPROVE CARE AND SERVICE FOR MEDICAID MEMBERS. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $454,231 | ExpenseAmt |
| Grant | $411,880 | GrantAmt |
| Desc | THE HEALTHY LIVING COLLABORATIVE (HLC) SUPPORTS CROSS SECTOR WORK WITH A FOCUS ON COMMUNITY ENGAGEMENT AND HEALTH POLICY AND SYSTEMS WORK. COMMUNITY ENGAGEMENT EFFORTS PRIMARILY FOCUS ON FIVE COMMUNITY HEALTH WORKER PROGRAMS. HLC SUPPORTS POLICY AND SYSTEMS WORK AT THE ORGANIZATIONAL, LOCAL, AND STATE LEVEL. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $2,867,263 | ExpenseAmt |
| Grant | $2,867,263 | GrantAmt |
| Desc | INTERGOVERNMENTAL TRANSFER (IGT) CONTRIBUTION TO THE STATEWIDE SHARED INVESTMENT POOL TO SUPPORT SPECIFIC DOMAIN 1 SERVICES FROM DESIGNATED PROVIDERS ACROSS ALL NINE ACCOUNTABLE COMMUNITY OF HEALTH (ACH) REGIONS. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $4,942,709 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | 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 |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | 0 | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | 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 | 0 | 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 With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| 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 | 5 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 14 | 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 |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 14 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 14 | 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 | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | 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 | SUSAN CRANDALL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3608287319 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2404 E MILL PLAIN BLVD | AddressLine1Txt |
| City | VANCOUVER | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 98661 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (16 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|
| JOH HERSEN | ||||||
| PRESIDENT | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| SHARON CROWELL | ||||||
| VICE PRESIDENT | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| KAREN STRAL | ||||||
| SECRETARY | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| KEVIN WITTE | ||||||
| TREASURER | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| LAUREL LEE | ||||||
| PAST SECRETARY | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| LES BURGER | ||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| SHONA CARTER | ||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| DAVID EDWARDS | ||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| DAVID KELLY | ||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| ROBB KIMMES | ||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| STEVE KUTZ | ||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| CRAIG PRIDEMORE | ||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| KIRBY RICHARDS | ||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| ROXANNE WOLFE | ||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| DAWN BONDER THROUGH 42518 | ||||||
| CEO | 40.00 | Yes (X) | $146,731 | $0 | $8,744 | |
| JANICE FINLEY THROUGH 42518 | ||||||
| CFO | 40.00 | Yes (X) | $104,808 | $0 | $9,679 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $251,539 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $18,423 | 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 |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $31,472,198 | GovernmentGrantsAmt |
| All Other Contributions | $637,870 | AllOtherContributionsAmt |
| Total Contributions | $32,110,068 | TotalContributionsAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $29,168 | TotalRevenueColumnAmt |
| Exclusion | $29,168 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | OTHER INCOME | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $4,083 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $4,083 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $4,083 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $32,143,319 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $4,083 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $29,168 | 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 | $3,506,410 | TotalAmt |
| Program Services | $3,506,410 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $596,238 | TotalAmt |
| Program Services | $264,380 | ProgramServicesAmt |
| Management And General | $331,858 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $812,035 | TotalAmt |
| Program Services | $360,068 | ProgramServicesAmt |
| Management And General | $451,967 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $23,447 | TotalAmt |
| Program Services | $10,397 | ProgramServicesAmt |
| Management And General | $13,050 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $97,916 | TotalAmt |
| Program Services | $43,417 | ProgramServicesAmt |
| Management And General | $54,499 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $103,384 | TotalAmt |
| Program Services | $45,842 | ProgramServicesAmt |
| Management And General | $57,542 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $43,470 | TotalAmt |
| Program Services | $200 | ProgramServicesAmt |
| Management And General | $43,270 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,890 | TotalAmt |
| Management And General | $10,890 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $875,679 | TotalAmt |
| Program Services | $672,468 | ProgramServicesAmt |
| Management And General | $203,211 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,320 | TotalAmt |
| Program Services | $9,236 | ProgramServicesAmt |
| Management And General | $2,084 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,631 | TotalAmt |
| Program Services | $1,180 | ProgramServicesAmt |
| Management And General | $8,451 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,156 | TotalAmt |
| Program Services | $194 | ProgramServicesAmt |
| Management And General | $26,962 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $52,341 | TotalAmt |
| Program Services | $3,944 | ProgramServicesAmt |
| Management And General | $48,397 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $39,244 | TotalAmt |
| Program Services | $24,973 | ProgramServicesAmt |
| Management And General | $14,271 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,975 | TotalAmt |
| Management And General | $6,975 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,892 | TotalAmt |
| Management And General | $2,892 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (2 entries)
| DescDesc | TotalTotalAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|
| LICENSES AND FEES | $60,361 | $60,361 |
| MISCELLANEOUS | $20,023 | $20,023 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,299,412 | TotalAmt |
| Program Services | $4,942,709 | ProgramServicesAmt |
| Management And General | $1,356,703 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,264,328 | BOYAmt |
| EOY | $16,073,235 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $3,864,395 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $167,868 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $7,725,073 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,979 | BOYAmt |
| EOY | $22,438 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,270,307 | BOYAmt |
| EOY | $27,853,009 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $64,954 | BOYAmt |
| EOY | $681,909 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $64,954 | BOYAmt |
| EOY | $681,909 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,205,353 | BOYAmt |
| EOY | $27,052,418 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $118,682 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,205,353 | BOYAmt |
| EOY | $27,171,100 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,270,307 | BOYAmt |
| EOY | $27,853,009 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $25,843,907 | ReconcilationRevenueExpnssAmt |
| Prior Period Adjustments | $121,840 | PriorPeriodAdjustmentsAmt |
| 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 | 0 | FederalGrantAuditRequiredInd |
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 | $1,014,145 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $225,361 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $526,287 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,399 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $32,110,068 | CurrentTaxYearAmt |
| Total | $33,879,260 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,014,145 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $225,361 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $526,287 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,399 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $32,110,068 | CurrentTaxYearAmt |
| Total | $33,879,260 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $33,879,260 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus3 Years | $1 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus1 Year | $18 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $29,168 | CurrentTaxYearAmt |
| Total | $29,187 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year | $4,083 | CurrentTaxYearAmt |
| Total | $4,083 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $33,912,530 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $1,071,769 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.99900 | PublicSupportCY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
| Public Support PY509 | 0.95560 | PublicSupportPY509Pct |
| Investment Income PY | 0.00000 | InvestmentIncomePYPct |
Schedule B IRS990ScheduleB
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | Yes (1) | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $130 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $130 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | EMAIL CORRESPONDENCE | ExplanationTxt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $0 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $32,143,319 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $32,143,319 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $32,143,319 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $6,299,412 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $6,299,412 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $6,299,412 | TotalExpensesPerForm990Amt |
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 | 0 | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (41 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|
| 211 INFO | |||||||
| 7535 NE AMBASSADOR PLACE SUITE B | PORTLAND | OR | 97220 | 930784586 | 501(C)(3) | $8,937 | WA STATE DOH SUBGRANTEE CONTRACTED FOR OBESITY, DIABETES, AND HEART DISEASE AND STROKE PREVENTION ACTIVITIES |
| CASCADE PACIFIC ACTION ALLIANCE LLC | |||||||
| 1217 4TH AVENUE E SUITE 200 | OLYMPIA | WA | 98506 | 820799403 | LLC (PART OF 501C3 C | $10,000 | WA STATE DOH SUBGRANTEE CONTRACTED FOR OBESITY, DIABETES, AND HEART DISEASE AND STROKE PREVENTION ACTIVITIES |
| CLARK COUNTY PUBLIC HEALTH | |||||||
| 1300 FRANKLIN STREET | VANCOUVER | WA | 98660 | 916001299 | LOCAL GOVERNMENT | $53,932 | WA STATE DOH SUBGRANTEE CONTRACTED FOR OBESITY, DIABETES, AND HEART DISEASE AND STROKE PREVENTION ACTIVITIES |
| CONSUMER VOICES ARE BORN | |||||||
| 1601 E FOURTH PLAIN BLVD | VANCOUVER | WA | 98661 | 911727234 | 501(C)(3) | $42,181 | HEALTHY LIVING COLLABORATIVE ANCHOR ORGANIZATION FOR COMMUNITY HEALTH WORKERS. |
| COWLITZ COUNTY | |||||||
| 1952 9TH AVENUE | LONGVIEW | WA | 98632 | 916001310 | LOCAL GOVERNMENT | $9,382 | WA STATE DOH SUBGRANTEE CONTRACTED FOR OBESITY, DIABETES, AND HEART DISEASE AND STROKE PREVENTION ACTIVITIES |
| FOUNDATION FOR HEALTHY GENERATIONS | |||||||
| 419 3RD AVENUE WEST | SEATTLE | WA | 98119 | 916186093 | 501(C)(3) | $8,323 | WA STATE DOH SUBGRANTEE CONTRACTED FOR OBESITY, DIABETES, AND HEART DISEASE AND STROKE PREVENTION ACTIVITIES |
| FREE CLINIC OF SW WASHINGTON | |||||||
| 4100 PLOMONDON STREET | VANCOUVER | WA | 98661 | 911707542 | 501(C)(3) | $38,892 | HEALTHY LIVING COLLABORATIVE ANCHOR ORGANIZATION FOR COMMUNITY HEALTH WORKERS. |
| WASHINGTON STATE UNIVERSITY | |||||||
| PO BOX 641025 | PULLMAN | WA | 99164 | 916001108 | 501(C)(3) | $7,500 | PROVIDER ENGAGEMENT, PARTICIPATION AND IMPLEMENTATION |
| CHILDRENS HOME SOCIETY OF WASHINGTON | |||||||
| 220 EASTMONT AVE SUITE B | EAST WENATCHEE | WA | 98802 | 910575955 | 501(C)(3) | $17,500 | PROVIDER ENGAGEMENT, PARTICIPATION AND IMPLEMENTATION |
| CATHOLIC COMMUNITY SERVICES OF WESTERN WASHINGTON | |||||||
| 100 23RD AVE S | SEATTLE | WA | 98144 | 911585652 | 501(C)(3) | $17,500 | PROVIDER ENGAGEMENT, PARTICIPATION AND IMPLEMENTATION |
| LUTHERAN COMMUNITY SERVICES NORTHWEST | |||||||
| 4040 S 188TH ST SUITE 300 | SEATAC | WA | 98188 | 930386860 | 501(C)(3) | $17,500 | PROVIDER ENGAGEMENT, PARTICIPATION AND IMPLEMENTATION |
| COMPREHENSIVE HEALTHCARE | |||||||
| 402 S 4TH AVE PO BOX 959 | YAKIMA | WA | 98907 | 911043304 | 501(C)(3) | $17,500 | PROVIDER ENGAGEMENT, PARTICIPATION AND IMPLEMENTATION |
| SEA-MAR COMMUNITY HEALTH CENTERS | |||||||
| 1040 SOUTH HENDERSON ST | SEATTLE | WA | 98108 | 911020139 | 501(C)(3) | $17,500 | PROVIDER ENGAGEMENT, PARTICIPATION AND IMPLEMENTATION |
| KLICKITAT VALLEY HEALTH | |||||||
| 310 S ROOSEVELT | GOLDENDALE | WA | 98620 | 916001738 | 501(C)(3) | $17,500 | PROVIDER ENGAGEMENT, PARTICIPATION AND IMPLEMENTATION |
| PUBLIC HOSPITAL DISTRICT NO 2 OF KLICKITAT COUNTY | |||||||
| PO BOX 99 | WHITE SALMON | WA | 98672 | 916000960 | LOCAL GOVERNMENT | $17,500 | PROVIDER ENGAGEMENT, PARTICIPATION AND IMPLEMENTATION |
| CHILD AND ADOLESCENT CLINIC | |||||||
| 971 11TH AVENUE | LONGVIEW | WA | 98632 | 911139057 | 501(C)(3) | $17,500 | PROVIDER ENGAGEMENT, PARTICIPATION AND IMPLEMENTATION |
| INSTITUTE FOR FAMILY DEVELOPMENT | |||||||
| 34004 16TH AVE SOUTH SUITE 200 | FEDERAL WAY | WA | 98003 | 911158512 | 501(C)(3) | $7,500 | PROVIDER ENGAGEMENT, PARTICIPATION AND IMPLEMENTATION |
| COLUMBIA RIVER MENTAL HEALTH SERVICES | |||||||
| 6926 NE FOURTH PLAIN BLVD | VANCOUVER | WA | 98661 | 910609138 | 501(C)(3) | $17,500 | PROVIDER ENGAGEMENT, PARTICIPATION AND IMPLEMENTATION |
| COMMUNITY SERVICES NORHTWEST | |||||||
| 1601 E FOURTH PLAIN BLVD | VANCOUVER | WA | 98661 | 141848332 | 501(C)(3) | $17,500 | PROVIDER ENGAGEMENT, PARTICIPATION AND IMPLEMENTATION |
| DAYBREAK YOUTH SERVICES | |||||||
| 960 E 3RD STREET | SPOKANE | WA | 99202 | 911083936 | 501(C)(3) | $17,500 | PROVIDER ENGAGEMENT, PARTICIPATION AND IMPLEMENTATION |
| KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | |||||||
| 500 NE MULTNOMAH ST | PORTLAND | OR | 97232 | 930798039 | 501(C)(3) | $17,500 | PROVIDER ENGAGEMENT, PARTICIPATION AND IMPLEMENTATION |
| LIFELINE CONNECTIONS | |||||||
| PO BOX 1678 | VANCOUVER | WA | 98668 | 910787084 | 501(C)(3) | $17,500 | PROVIDER ENGAGEMENT, PARTICIPATION AND IMPLEMENTATION |
| NAMI SOUTHWEST WASHINGTON | |||||||
| 5411 E MILL PLAIN BLVD SUITE 4 | VANCOUVER | WA | 98661 | 911065027 | 501(C)(3) | $17,500 | PROVIDER ENGAGEMENT, PARTICIPATION AND IMPLEMENTATION |
| MID-COLUMBIA FAMILY PHYSICIANS PS | |||||||
| PO BOX 1519 | BINGEN | WA | 98672 | 911152824 | 501(C)(3) | $17,500 | PROVIDER ENGAGEMENT, PARTICIPATION AND IMPLEMENTATION |
| ONE COMMUNITY HEALTH | |||||||
| 849 PACIFIC AVE | HOOD RIVER | OR | 97031 | 930910794 | 501(C)(3) | $17,500 | PROVIDER ENGAGEMENT, PARTICIPATION AND IMPLEMENTATION |
| SKAMANIA COUNTY | |||||||
| 710 SW ROCK CREEK DR | STEVENSON | WA | 98648 | 916001363 | LOCAL GOVERNMENT | $17,500 | PROVIDER ENGAGEMENT, PARTICIPATION AND IMPLEMENTATION |
| PEACEHEALTH | |||||||
| 1115 SE 164TH AVE | VANCOUVER | WA | 98683 | 916068143 | 501(C)(3) | $17,500 | PROVIDER ENGAGEMENT, PARTICIPATION AND IMPLEMENTATION |
| PROVIDENCE HEALTH AND SERVICES-WASHINGTON | |||||||
| 1801 LIND AVE SW | RENTON | WA | 98057 | 510216586 | 501(C)(3) | $17,500 | PROVIDER ENGAGEMENT, PARTICIPATION AND IMPLEMENTATION |
| FAMILY SOLUTIONS INC | |||||||
| 1014 MAIN STREET | VANCOUVER | WA | 98660 | 912171585 | 501(C)(3) | $17,500 | PROVIDER ENGAGEMENT, PARTICIPATION AND IMPLEMENTATION |
| TELECARE CORPORATION | |||||||
| 1601 E 4TH PLAIN BLVD BLDG 17 A142 | VANCOUVER | WA | 98661 | 270342521 | 501(C)(3) | $17,500 | PROVIDER ENGAGEMENT, PARTICIPATION AND IMPLEMENTATION |
| THE VANCOUVER CLINIC INC PS | |||||||
| 700 NE 87TH AVENUE | VANCOUVER | WA | 98664 | 910851599 | 501(C)(3) | $17,500 | PROVIDER ENGAGEMENT, PARTICIPATION AND IMPLEMENTATION |
| CHILDRENS CENTER | |||||||
| 13500 SE 7TH ST | VANCOUVER | WA | 98683 | 911459420 | 501(C)(3) | $17,500 | PROVIDER ENGAGEMENT, PARTICIPATION AND IMPLEMENTATION |
| KLICKITAT COUNTY | |||||||
| 228 W MAIN MS-CH-14 | GOLDENDALE | WA | 98620 | 916001350 | LOCAL GOVERNMENT | $7,500 | PROVIDER ENGAGEMENT, PARTICIPATION AND IMPLEMENTATION |
| LEGACY SALMON CREEK HOSPITAL | |||||||
| 1120 NW 20TH AVE SUITE 108 | PORTLAND | OR | 97209 | 331065485 | 501(C)(3) | $17,500 | PROVIDER ENGAGEMENT, PARTICIPATION AND IMPLEMENTATION |
| PLANNED PARENTHOOD OF THE COLUMBIAWILLAMETTE INC | |||||||
| 3727 NE MARTIN LUTHER KING JR BLVD | PORTLAND | OR | 97212 | 936031270 | 501(C)(3) | $17,500 | PROVIDER ENGAGEMENT, PARTICIPATION AND IMPLEMENTATION |
| ROSE MEDICAL GROUPS PC | |||||||
| 18 NW 20 AVE | BATTLE GROUND | WA | 98604 | 810799249 | 501(C)(3) | $7,500 | SHARED DOMAIN 1 INCENTIVES |
| UNIVERSITY OF WASHINGTON | |||||||
| 1959 PACIFIC STREET | SEATTLE | WA | 98195 | 916001537 | 501(C)(3) | $2,293,810 | SHARED DOMAIN 1 INCENTIVES |
| KING COUNTY PUBLIC HOSPITAL DISTRICT 2 | |||||||
| 12040 NE 128TH ST | KIRKLAND | WA | 98034 | 910844563 | LOCAL GOVERNMENT | $252,319 | SHARED DOMAIN 1 INCENTIVES |
| PUBLIC HOSPITAL DISTRICT NO 1 OF KING COUNTY | |||||||
| 400 S 43RD STREET | RENTON | WA | 98055 | 916000986 | LOCAL GOVERNMENT | $252,319 | SHARED DOMAIN 1 INCENTIVES |
| ASSOCIATION OF WA PUBLIC HOSPITAL DISTRICTS | |||||||
| 999 3RD AVE STE 1400 | SEATTLE | WA | 98104 | 911467655 | LOCAL GOVERNMENT | $21,000 | SHARED DOMAIN 1 INCENTIVES |
| PHD 1 DBA SKAGIT VALLEY HOSPITAL | |||||||
| 1415 E KINCAID STREET | MOUNT VERNON | WA | 98273 | 562392010 | LOCAL GOVERNMENT | $7,982 | SHARED DOMAIN 1 INCENTIVES |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 40 | Total501c3OrgCnt |
| Total Other Org | 1 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | DETAILED INVOICES AND EXPENSE BACK UP REQUIRED FOR PAYMENT. PERIODIC REPORTING REQUIRED AND MONITORED BY PROGRAM DIRECTOR. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Severance Payment | Yes (1) | 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 | DAWN BONDER THROUGH 42518 | PersonNm |
| Title | CEO | TitleTxt |
| Base Compensation Filing Org | $146,731 | 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 | $3,638 | DeferredCompensationFlngOrgAmt |
| Deferred Comp Rltd Orgs | $0 | DeferredCompRltdOrgsAmt |
| Nontaxable Benefits Filing Org | $5,106 | NontaxableBenefitsFilingOrgAmt |
| Nontaxable Benefits Rltd Orgs | $0 | NontaxableBenefitsRltdOrgsAmt |
| Total Compensation Filing Org | $155,475 | 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 4A | FormAndLineReferenceDesc |
| Explanation | DAWN BONDER: $200,435 PAID DURING FISCAL YEAR; SEVERANCE PAID IN SEVERAL INSTALLMENTS BETWEEN 3/1/18 AND 4/25/18. JANICE FINLEY: $128,258 PAID DURING FISCAL YEAR; SEVERANCE PAID IN SEVERAL INSTALLMENTS BETWEEN 4/16/18 AND 4/25/18. PART OF SEVERANCE IS CASH IN LIEU OF HEALTH/DENTAL INSURANCE FOR EXTENDED TIME. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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 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 467,604. MANAGEMENT AND GENERAL EXPENSES 139,542. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 607,146. OTHER PROFESSIONAL SERVICES: PROGRAM SERVICE EXPENSES 12,120. MANAGEMENT AND GENERAL EXPENSES 16,919. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 29,039. CONTRACT SERVICES: PROGRAM SERVICE EXPENSES 192,744. MANAGEMENT AND GENERAL EXPENSES 46,750. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 239,494. |
| PART XII LINE 2C | THE PROCESS FOR FINANCIAL STATEMENT OVERSIGHT HAS NOT CHANGED FROM THE PRIOR YEAR. |
Reasonable Cause Explanation ReasonableCauseExplanation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Explanation | LATE FILE RETURN DUE TO CCH SOFTWARE OUTAGE | ExplanationTxt |
Comments