2019-10-29T10:27:24-05:00 2019-03-31 390859910 BAKER TILLY VIRCHOW KRAUSE LLP 777 E WISCONSIN AVENUE 32ND FLOOR MILWAUKEE WI 53202 990 2018-04-01 391407034 WISCONSIN PRIMARY HEALTH CARE ASSOCIATION INC WISC 6082777477 5202 EASTPARK BLVD NO 109 MADISON WI 53718 STEPHANIE HARRISON CHIEF EXECUTIVE OFFICER 6082777477 2019-10-29 1 TROY E MARINE CPA P00187863 4147775500 2019-10-04 38.122.82.115 2019-10-29 07:05:40 CD P 793A1E00ACF041F16FD41A7A782950CAF62641F6 793A1E00ACF041F16FD41A7A782950CAF62641F6 2018 2019-02-21 02:37:17Z STEPHANIE HARRISON 5202 EASTPARK BLVD NO 109 MADISON WI 53718 2747061 0 X WWW.WPHCA.ORG X 1982 WI TO ADVANCE GEOGRAPHIC, FINANCIAL & CULTURAL ACCESS TO COMPREHENSIVE COMMUNITY-ORIENTED PRIMARY HEALTH CARE SERVICES FOR ALL PEOPLE IN WISCONSIN. 23 23 55 70 0 0 1840249 2124946 659608 617616 2095 4499 0 0 2501952 2747061 10500 199134 0 0 1585998 1724087 0 0 21908 771187 849194 2367685 2772415 134267 -25354 1378788 1430768 489075 566409 889713 864359 X THE MISSION OF THE WISCONSIN PRIMARY HEALTH CARE ASSOCIATION, INC. IS TO IMPROVE HEALTH THROUGH THE WORK OF COMMUNITY HEALTH CENTERS AND THEIR PARTNERS. 0 0 766230 NONFINANCIAL TECHNICAL ASSISTANCE (NFTA):UNDER THE NFTA (BASE) GRANT, WISCONSIN PRIMARY HEALTH CARE ASSOCIATION, INC. PROVIDES TRAINING AND TECHNICAL ASSISTANCE TO HEALTH CENTERS AND ENTITIES SEEKING HEALTH CARE ACCESS OPTIONS ON GOVERNANCE AND COMPLIANCE REQUIREMENTS, QUALITY IMPROVEMENT, AND PROGRAM ANALYSIS. 399304 HEALTH CENTER CONTROLLED NETWORK:UNDER THE HEALTH INFORMATION QUALITY GRANT, WISCONSIN PRIMARY HEALTH CARE ASSOCIATION, INC. PROVIDES TRAINING AND TECHNICAL ASSISTANCE TO PARTICIPATING HEALTH CENTERS FOR ACHIEVING MEANINGFUL USE, PATIENT CENTERED MEDICAL HOME RECOGNITION, AND HEALTHY PEOPLE 2020 GOALS PRIORITIZED FOR THE UNIFORM DATA SYSTEM. 418689 AMERICORPS:THE AMERICORPS PROGRAM RECRUITS, PLACES, AND SUPERVISES AMERICORPS MEMBERS IN HEALTH CENTERS AND OTHER PUBLIC HEALTH SITES IN WISCONSIN WHERE MEMBERS ARE CONDUCTING HEALTH OUTREACH AND EDUCATION IN COMMUNITIES WHERE THERE ARE HIGH NEEDS. 724673 199134 617616 ADVOCACY & OTHER PROGRAMS:ADVOCACY, HPSA DESIGNATIONS, DIABETES PROGRAM, BIOTERRORISM HOSPITAL PREPAREDNESS, MEMBERSHIP, FEE FOR SERVICE, CONFERENCES, DENTAQUEST AND WCHCN. 724673 199134 617616 2308896 1 1 0 1 0 0 0 0 1 0 1 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 30 0 55 1 0 0 0 0 0 0 0 0 0 0 0 0 X 23 23 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 WI X STEPHANIE HARRISON 6082777477 5202 EASTPARK BLVD SUITE 109 MADISON WI 53718 BRIAN AHLGREN DIRECTOR 1.00 X 0 0 0 LYLE IGNACE MD MPH DIRECTOR 1.00 X 0 0 0 TITO IZARD MD DIRECTOR 1.00 X 0 0 0 ALLISON KOS MD DIRECTOR 1.00 X 0 0 0 BONNIE KUHR DIRECTOR 1.00 X 0 0 0 KEN LOVING DIRECTOR 1.00 X 0 0 0 ALAN MARSHALL DIRECTOR 1.00 X 0 0 0 GREG NYCZ DIRECTOR 1.00 X 0 0 0 CONNIE PALMER DIRECTOR 1.00 X 0 0 0 DAYLE PATTERSON DIRECTOR 1.00 X 0 0 0 MARTY SCHALLER DIRECTOR 1.00 X 0 0 0 JULIE SCHULLER MD MPH FACP DIRECTOR 1.00 X 0 0 0 JENNI SEVENICH DIRECTOR 1.00 X 0 0 0 TIM SIZE DIRECTOR 1.00 X 0 0 0 JEN SMITH DIRECTOR 1.00 X 0 0 0 JULIE SPRECHER DIRECTOR 1.00 X 0 0 0 ARMAN TAHIR DIRECTOR 1.00 X 0 0 0 JOY R TAPPER DIRECTOR 1.00 X 0 0 0 LAURA WALDVOGEL DIRECTOR 1.00 X 0 0 0 SHELLY WHITE DIRECTOR 1.00 X 0 0 0 REBA RICE CHAIRPERSON 1.00 X X 0 0 0 KRISTENE STACKER VICE CHAIRPERSON 1.00 X X 0 0 0 KRISTIN STEARNS SECRETARY/TREASURER 1.00 X X 0 0 0 MARI FREIBERG PAST CHAIRPERSON 1.00 X X 0 0 0 STEPHANIE HARRISON CHIEF EXECUTIVE OFFICER 45.00 X 144761 0 16120 TODD SCHROEDER FINANCE DIRECTOR 45.00 X 81251 0 36849 LYNSEY RAY CHIEF OPERATING OFFICER 45.00 X 108163 0 23002 334175 0 75971 2 0 1 0 AZARA HEALTHCARE LLC 70 BLANCHARD ROAD SUITE 401 BURLINGTON MA 01803 DATA ANALYTICS 299849 ST JOHNS PROPERTIES INC 1020 JAMES DR SUITE G HARTLAND WI 53029 OFFICE LEASE 105402 2 2124946 2124946 MEMBERSHIP DUES 900099 497013 497013 FEE FOR SERVICE INCOME 561499 104823 104823 PROGRAM REVENUE 541900 15600 15600 180 180 617616 4499 4499 2747061 617616 0 4499 X 199134 199134 356697 260435 96262 945718 910033 19611 16074 36452 28980 6871 601 281607 239296 38302 4009 103613 83329 19060 1224 8846 7501 1345 15500 15500 336412 306381 30031 38543 12698 25845 33077 885 32192 128304 22730 105574 113512 112481 1031 59535 58384 1151 17247 17247 30739 4932 25807 DUES AND SUBSCRIPTIONS 14214 13430 784 RECRUITMENT 6211 5451 760 BOARD EXPENSES 3175 3175 43879 39641 4238 2772415 2308896 441611 21908 205739 99953 816576 983569 227029 202288 30410 85182 3000 0 45121 26110 124023 90357 50913 33666 1378788 1430768 212495 193534 90825 147134 185755 225741 489075 566409 X 889713 864359 889713 864359 1378788 1430768 -25354 0 X 0 1 X 1 1 1 X 2078776 1878965 1945804 1840249 2124946 9868740 2078776 1878965 1945804 1840249 2124946 9868740 220070 9648670 2100 3938 2224 2095 4499 14856 9883596 3004383 0.97620 0.95300 X 121381 121381 2187514 2308895 265445 66361 0 0 249206 254501 247560 265445 1016712 1525068 160872 183432 160406 121381 626091 62302 63625 61890 66361 254178 381267 4154 937 5091 0 1 X 21310 17180 4130 102713 73177 29536 33666 X 2747061 0 2747061 0 2747061 2772415 0 2772415 0 2772415 PART IV, LINE 2B: FUNDS HELD FOR OTHERS REPRESENTS AMOUNTS RECEIVED FROM MEMBER COMMUNITY HEALTH CENTERS FOR FUTURE PHASES OF THE DATA REPORTING AND VISUALIZATION SYSTEM (DRVS) PROJECT IMPLEMENTATION. IT ALSO INCLUDES AMOUNTS RECEIVED FROM MILWAUKEE HEALTH CARE PARTNERSHIP FOR CAPACITY BUILDING PLANNING. WISCONSIN PRIMARY HEALTH CARE ASSOCIATION, INC. PROCESSES PROJECT INVOICES USING THE FUNDS HELD, NEITHER THE RECEIPT NOR THE DISBURSEMENT OF THE FUNDS IS RECOGNIZED AS AN OPERATING ACTIVITY IN THE FINANCIAL STATEMENTS. PART X, LINE 2: AS A NONPROFIT ORGANIZATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE, WPHCA IS EXEMPT FROM FEDERAL AND WISCONSIN INCOME TAXES. WCHCN IS SOLELY OWNED BY WPHCA AND THEREFORE IS TREATED AS A DISREGARDED ENTITY FOR TAX PURPOSES. THE ORGANIZATION IS REQUIRED TO ASSESS WHETHER IT IS MORE LIKELY THAN NOT THAT A TAX POSITION WILL BE SUSTAINED UPON EXAMINATION ON THE TECHNICAL MERITS OF THE POSITION ASSUMING THE TAXING AUTHORITY HAS FULL KNOWLEDGE OF ALL INFORMATION. IF THE TAX POSITION DOES NOT MEET THE MORE LIKELY THAN NOT RECOGNITION THRESHOLD, THE BENEFIT OF THAT POSITION IS NOT RECOGNIZED IN THE CONSOLIDATED FINANCIAL STATEMENTS. THE ORGANIZATION HAS DETERMINED THERE ARE NO AMOUNTS TO RECORD AS ASSETS OR LIABILITIES RELATED TO UNCERTAIN TAX POSITIONS. 0 GERALD L IGNACE INDIAN HEALTH CENTER 1711 S 11TH ST MILWAUKEE WI 53204 391958089 501C3 700 STIPEND 2018-19 CHRONIC DISEASE PROGRAM MILWAUKEE HEALTH SERVICES 2320 N LAKE DR MILWAUKEE WI 53211 391664109 501C3 1425 ACTIVE SHOOTER AND SUSPICIOUS PACKAGE & PERSONS TRAINING OUTREACH COMMUNITY HEALTH CENTERS 711 WEST CAPITOL DRIVE MILWAUKEE WI 53206 391353282 501C3 1885 EVACUATION CHAIR, PERSONAL PROTECTIVE EQUIPMENT PROGRESSIVE COMMUNITY HEALTH CENTERS 3522 WEST LISBON AVE MILWAUKEE WI 53208 391958810 501C3 2093 STIPEND 2018-19 CHRONIC DISEASE PROGRAM, WALKIE TALKIES, PHONES, WEATHER STATIONS, FLASHLIGHTS, EMERGENCY VESTS SIXTEENTH STREET COMMUNITY HEALTH CENTER 1337 S CESAR E CHAVEZ DR MILWAUKEE WI 53204 391180475 501C3 120 STIPEND 2018-19 CHRONIC DISEASE PROGRAM SCENIC BLUFFS COMMUNITY HEALTH CENTER 238 FRONT STREET CASHTON WI 54619 391760445 501C3 12387 STIPEND 2018-19 CHRONIC DISEASE PROGRAM, UPS BACKUP POWER, TELEPHONES, BACKUP SURGE PROTECTORS AND LAPTOPS NORTHLAKES COMMUNITY CLINIC 11128N STATE HIGHWAY 77 HAYWARD WI 54843 352297925 501C3 7876 STIPEND 2018-19 CHRONIC DISEASE PROGRAM, SUPPLIES NEW COMMUNITY CLINIC 622 BODART ST GREEN BAY WI 54301 391200636 501C3 1165 STIPEND 2018-19 CHRONIC DISEASE PROGRAM, EMERGENCY PREPAREDNESS STOCK LAKE SUPERIOR COMMUNITY HEALTH CENTER 4325 GRAND AVENUE DULUTH MN 55807 237167576 501C3 700 STIPEND 2018-19 CHRONIC DISEASE PROGRAM LAKESHORE COMMUNITY HEALTH CLINICS 1931 N 8TH ST SHEBOYGAN WI 53081 264321839 501C3 80869 STIPEND 2018-19 CHRONIC DISEASE PROGRAM, GENERATOR KENOSHA COMMUNITY HEALTH CENTER 4536 22ND AVENUE KENOSHA WI 53140 391789874 501C3 900 STIPEND 2018-19 CHRONIC DISEASE PROGRAM FAMILY HEALTH CENTER OF MARSHFIELD 1000 NORTH OAK AVENUE MARSHFIELD WI 54449 391681547 501C3 700 STIPEND 2018-19 CHRONIC DISEASE PROGRAM FAMILY HEALTHLA CLINICA 400 SOUTH TOWN LINE RD WAUTOMA WI 54982 391181480 501C3 2698 STIPEND 2018-19 CHRONIC DISEASE PROGRAM, EMERGENCY EVACUATION STAIR CHAIR COMMUNITY HEALTH SYSTEMS 690 3RD ST BELOIT WI 53511 391918906 501C3 2359 STIPEND 2018-19 CHRONIC DISEASE PROGRAM, ALICE TRAINING BRIDGE COMMUNITY HEALTH CLINIC 1810 NORTH 2ND STREET WAUSAU WI 54403 391759404 501C3 3844 STIPEND 2018-19 CHRONIC DISEASE PROGRAM, DOOR SECURITY/ENTRANCE CODE BOX ACCESS COMMUNITY HEALTH CENTERS 3434 E WASHINGTON AVE MADISON WI 53704 391391134 501C3 79413 STIPEND 2018-19 CHRONIC DISEASE PROGRAM, GENERATOR 16 0 X X X 0 0 0 0 0 0 0 0 0 STEPHANIE HARRISON CHIEF EXECUTIVE OFFICER 144761 0 0 0 0 0 5562 0 10558 0 160881 0 0 0 FORM 990, PART VI, SECTION A, LINE 6 THERE ARE THREE CATEGORIES OF MEMBERSHIP IN WISCONSIN PRIMARY HEALTH CARE ASSOCIATION, INC. (WPHCA): HEALTH CARE MEMBERSHIP HEALTH CENTER MEMBERSHIP IN WPHCA IS AVAILABLE TO ANY INVITED ORGANIZATION WHICH SUPPORTS THE PURPOSE AND GOALS OF THE CORPORATION AND ACTIVELY ENGAGES IN THE OPERATION OF COMMUNITY-BASED PRIMARY HEALTH CARE SERVICE DELIVERY PURSUANT TO SECTION 330 OF THE PUBLIC HEALTH SERVICE ACT (42 U.S.C. 254B) AS AMENDED, AND UNDER A GRANT FROM THE FEDERAL RESOURCES AND SERVICES ADMINISTRATION. HEALTH CENTER MEMBERS, THROUGH THEIR REPRESENTATIVE DIRECTOR, HAVE ONE VOTE PER HEALTH CENTER FOR ELECTIONS AND OTHER CORPORATION BUSINESS CONDUCTED AT ANNUAL MEETINGS. STAFF EMPLOYEES OF HEALTH CENTER MEMBERS ARE ELIGIBLE TO PARTICIPATE IN CORPORATE COMMITTEES, AND ARE ELIGIBLE TO SERVE IN ONE OF THE ELECTED POSITIONS ON THE CORPORATION'S BOARD OF DIRECTORS. AFFILIATE MEMBERSHIP INDIAN TRIBAL CLINICS (OPERATED UNDER PUBLIC LAW 93-638 OF THE INDIAN SELF-DETERMINATION ACT), FEDERAL QUALIFIED HEALTH CENTER LOOK-ALIKES (OPERATED UNDER SECTION 1905 OF THE SOCIAL SECURITY ACT) OR ANY ENTITY WHICH SUPPORTS THE PURPOSE AND GOALS OF THE CORPORATION AND DOES NOT MEET THE REQUIREMENTS FOR HEALTH CENTER MEMBERSHIP, ARE ELIGIBLE TO BECOME AFFILIATE MEMBERS. AFFILIATE MEMBERS SHALL APPOINT A REPRESENTATIVE TO THE CORPORATION. AFFILIATE MEMBERS OR THEIR REPRESENTATIVES ARE NON-VOTING MEMBERS IN THE ANNUAL MEETING. INDIVIDUAL MEMBERSHIP INDIVIDUAL MEMBERSHIP IN THE ORGANIZATION IS OPEN TO ANY PERSON WHO SUPPORTS THE PURPOSE AND GOALS OF THE CORPORATION. INDIVIDUAL MEMBERS ARE NON-VOTING MEMBERS IN THE ANNUAL MEETING. FORM 990, PART VI, SECTION A, LINE 7A THE ORGANIZATION HAS MEMBERS WHO MAY ELECT THE GOVERNING BODY. HEALTH CENTER MEMBERS, THROUGH THEIR REPRESENTATIVE DIRECTOR, HAVE ONE VOTE PER HEALTH CENTER FOR GOVERNING BODY ELECTIONS. FORM 990, PART VI, SECTION B, LINE 11B THE 990 IS REVIEWED IN A SIMILAR MANNER AS THE ANNUAL AUDIT. A DRAFT COPY IS PROVIDED BY THE AUDIT FIRM. THE CHIEF EXECUTIVE OFFICER REVIEWS A COPY OF THE FORM 990 AND MAKES ANY NECESSARY CORRECTIONS. THE FINAL COPY IS PROVIDED TO THE WPHCA BOARD OF DIRECTORS FOR REVIEW AND APPROVAL PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C WPHCA BOARD MEMBERS AND STAFF SIGN A CONFLICT OF INTEREST DISCLOSURE FORM ON AN ANNUAL BASIS. ANY CONFLICT OF INTEREST IS BROUGHT TO THE BOARD FOR EVALUATION AND DECISION-MAKING. AN INTERESTED PERSON MAY MAKE A PRESENTATION AT THE BOARD OR COMMITTEE MEETING, BUT AFTER SUCH PRESENTATION, HE/SHE SHALL LEAVE THE MEETING DURING THE DISCUSSION OF, AND VOTE ON, THE TRANSACTION OR ARRANGEMENT THAT RESULTS IN THE CONFLICT OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15 ON AN ANNUAL BASIS, THE PERSONNEL COMMITTEE EVALUATES THE CHIEF EXECUTIVE OFFICER'S COMPENSATION PACKAGE BASED ON THE MARKET AND THE CHIEF EXECUTIVE OFFICER PERFORMANCE. RECOMMENDATIONS ARE BROUGHT TO THE BOARD FOR EVALUATION AND APPROVAL. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G OTHER FEES: PROGRAM SERVICE EXPENSES 306,381. MANAGEMENT AND GENERAL EXPENSES 30,031. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 336,412. WISCONSIN COMMUNITY HEALTH CENTER NETWORK LLC 5202 EASTPARK BLVD SUITE 109 MADISON WI 53718 CLINICALLY INTEGRATED NETWORK WI 90000 42423 WISCONSIN PRIMARY HEALTH CARE ASSOCIATION INC