2018-02-02T20:37:14-06:00 2017-06-30 410746749 CLIFTONLARSONALLEN LLP 10700 NORTHUP WAY SUITE 200 BELLEVUE WA 98004 990 2016-07-01 930605570 NORTHWEST HUMAN SERVICES INC NORT 5035885828 681 CENTER STREET NE SALEM OR 97301 PAUL LOGAN CHIEF EXECUTIVE OFFICER 5035885828 2018-02-01 1 KURT BENNION CPA P01469618 4252506100 67.137.57.251 2018-02-01 07:11:34 PS P E8F928E9D0C866B10A8A9E52340F1A707FC238CD 65D9D98F5895FA0B49312EE1EB3C28152888AA91 2016 2021-01-29 14:40:06Z PAUL LOGAN 681 CENTER STREET NE SALEM OR 97301 21528429 0 X WWW.NORTHWESTHUMANSERVICES.ORG X 1970 OR CREATING A HEALTHY COMMUNITY WITH RESPECT, COMPASSION AND ACCEPTANCE FOR ALL. 15 15 223 24 0 0 5163316 4426218 10965463 14132147 120539 166413 2779072 2803651 19028390 21528429 652904 507481 0 0 11100257 12438651 0 0 31735 3635633 3744291 15388794 16690423 3639596 4838006 21037493 25205117 2780072 1752914 18257421 23452203 X MISSION: CREATING A HEALTHY COMMUNITY WITH RESPECT, COMPASSION AND ACCEPTANCE FOR ALL. VISION: WORKING TOGETHER TO EMPOWER INDIVIDUALS TO IMPROVE THEIR HEALTH, WELL-BEING AND SAFETY. CORE VALUES: COMMUNITY - THE SAFE, CARING, AND ENCLUSIVE ENVIRONMENT WE CREATE; COMPASSION - THE INSPIRATION THAT GUIDES OUR WORK; COMMITMENT - THE TEAMWORK WE EXEMPLIFY THROUGH OUR PASSION, MOTIVATION AND DEDICATION; AND INTEGRITY - THE FOUNDATION OF OUR WORK ETHIC. 0 1 9603776 123593 10632034 NORTHWEST HUMAN SERVICES, INC. (THE ORGANIZATION), IS A NONPROFIT FEDERALLY QUALIFIED COMMUNITY HEALTH CENTER, AND RECEIVES FUNDING UNDER SECTION 330 OF THE PUBLIC HEALTH SERVICES ACT FOR SERVICES, INCLUDING SERVICES FOR THE HOMELESS POPULATION, FROM THE HEALTH RESOURCES AND SERVICES ADMINISTRATION (HRSA). HRSA IS AN AGENCY OF THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES, BUREAU OF PRIMARY HEALTH CARE, THE PRIMARY FEDERAL AGENCY DEDICATED TO IMPROVING ACCESS TO HEALTH CARE FOR PEOPLE WHO ARE GEOGRAPHICALLY ISOLATED; ECONOMICALLY, OR MEDICALLY VULNERABLE. THE ORGANIZATION PROVIDES COMPREHENSIVE CARE - MEDICAL, DENTAL, MENTAL HEALTH, AND SOCIAL SERVICES IN AN INTEGRATED SETTING. THE MAJORITY OF PATIENTS ARE INSURED THROUGH THE OREGON HEALTH PLAN (MEDICAID), MEDICARE, OR ARE UNINSURED. 50% OF OUR MEDICAL PATIENTS ARE AT OR BELOW THE FEDERAL POVERTY LEVEL. A SLIDING FEE DISCOUNT PROGRAM IS AVAILABLE BASED ON FAMILY SIZE AND INCOME. NO ONE IS DENIED SERVICES DUE TO THEIR INABILITY TO PAY. THE ORGANIZATION IS ACCREDITED BY THE JOINT COMMISSION FOR AMBULATORY AND BEHAVIORAL HEALTHCARE, AND IS CERTIFIED BY THE STATE OF OREGON AS A TIER IV PATIENT-CENTERED PRIMARY CARE HOME. THE WEST SALEM CLINIC AND TOTAL HEALTH COMMUNITY CLINIC (MONMOUTH, OR) PROVIDE FULL-SERVICE PRIMARY AND PREVENTATIVE CARE, AND SERVE AS PATIENT-CENTERED MEDICAL HOMES. PATIENT SELF-MANAGEMENT AND EDUCATION SERVICES AND ACCESS TO INTEGRATED BEHAVIORAL SERVICES IS ALSO AVAILABLE.THE QUICKCARE CLINIC, LOCATED ON THE WEST SALEM CAMPUS, PROVIDES SAME-DAY HEALTH CARE SERVICES.FOR THE FISCAL YEAR ENDING JUNE 30, 2017, THE CLINICS SERVED 11,565 PATIENTS TOTALING OVER 60,000 VISITS. 2080307 138471 2713806 THE MENTAL HEALTH CLINIC, LOCATED ON THE WEST SALEM CLINIC CAMPUS, PROVIDES PSYCHIATRIC SERVICES, PSYCHOTHERAPY, COUNSELING, AND CASE MANAGEMENT SERVICES IN AN INTEGRATED SETTING. THE CONNECTION PROGRAM, PART OF THE WEST SALEM MENTAL HEALTH CLINIC, PROVIDES COUNSELING, ADVOCACY, CASE MANAGEMENT, CRIME VICTIM'S SERVICES, INFORMATION AND REFERRAL FOR INDIVIDUALS WHO ARE DEAF AND HARD OF HEARING. 1572885 245417 87836 OUR TRANSITIONAL SERVICES PROGRAMS CONTINUE TO BECOME FURTHER INTEGRATED IN OUR HEALTHCARE MODEL. THE HOMELESS OUTREACH & ADVOCACY PROGRAM (HOAP) OFFERS AN ARRAY OF SERVICES DESIGNED TO GET AND KEEP INDIVIDUALS, MANY OF THEM MENTALLY ILL, WHO ARE HOMELESS OR AT RISK OF HOMELESSNESS, OFF THE STREETS AND INTO HOUSING. OUR HEALTH CARE FOR THE HOMELESS BUS PICKS UP HOMELESS INDIVIDUALS FROM VARIOUS POINTS IN THE COMMUNITY AND TRANSPORTS THEM TO OUR WEST SALEM CAMPUS FOR NEEDED CARE AND SERVICES. AT HOAP, CASE MANAGERS, STAFF, AND VOLUNTEERS PROVIDE OUTREACH, CRISIS INTERVENTION, EDUCATION, SKILLS TRAINING, CASE MANAGEMENT AND THERAPEUTIC SUPPORT TO INTEGRATE THESE INDIVIDUALS INTO THE COMMUNITY AND IMPROVE THEIR QUALITY OF LIFE. THE PROGRAM OPERATES A PEER-RUN DAY CENTER THAT PROVIDES MANY SERVICES TO PEOPLE WHO ARE HOMELESS, INCLUDING FOOD, LAUNDRY AND SHOWER FACILITIES, AND A CHANCE TO SOCIALIZE. DURING THE FISCAL YEAR ENDING JUNE 30, 2017, HOAP PROVIDED SERVICES TO 2,480 HOMELESS AND AT-RISK INDIVIDUALS AND SERVED 11,606 LUNCHES.THE EMERGENCY AND INFORMATION HOTLINE PROGRAM (HOTLINE) PROVIDES 24/7/365 SUICIDE PREVENTION, CRISIS COUNSELING, EMERGENCY FINANCIAL ASSISTANCE, RESOURCES AND INFORMATION, AND OTHER SERVICES TO INDIVIDUALS AND FAMILIES IN THE SERVICE AREA. THE PROGRAM IS ACCREDITED BY THE AMERICAN ASSOCIATION OF SUICIDOLOGY. HOTLINE MAKES OVER 300 MONTHLY CALLS TO OUR PATIENTS AND CLIENTS TO OFFER FOLLOW-UP CARE AND SUPPORT. IN FISCAL YEAR 2017, HOTLINE ANSWERED OR MADE 23,944 PHONE CALLS. 522 INDIVIDUALS AND FAMILIES RECEIVED EMERGENCY FINANCIAL ASSISTANCE. 375 INDIVIDUALS RECEIVED SUICIDE INTERVENTION SUPPORT. THE HEALTH, OUTREACH, SHELTER, TRANSITIONS (HOST) PROGRAM PROVIDES STREET OUTREACH, A DROP-IN AND RESOURCE CENTER, EMERGENCY SHELTER AND CARE TO RUNAWAY AND HOMELESS YOUTH AND YOUNG ADULTS. OTHER AREAS OF SERVICE INCLUDE CRISIS INTERVENTION, CASE MANAGEMENT, SKILLS DEVELOPMENT AND INFORMATION, AND REFERRAL SERVICES. A TRANSITIONAL LIVING PROGRAM COMPONENT PROVIDES HOUSING AND SUPPORT TO YOUTH, ASSISTING THEM TO ACHIEVE INDEPENDENCE. FOR THE FISCAL YEAR ENDING JUNE 30, 2017 HOST MADE CONTACT WITH 636 AT-RISK YOUTH AND YOUNG ADULTS. 84 YOUTH FACING HOMELESSNESS ACCESSED THE DAYTIME RESOURCE CENTER AND EVENING DROP-IN CENTER FOR MEALS, SHOWERS, LAUNDRY, AND CASE MANAGEMENT SERVICES, TOTALING 9,283 VISITS. 692049 0 698471 THE DENTAL CLINIC, LOCATED ON THE WEST SALEM CLINIC CAMPUS, PROVIDES EMERGENT AND RESTORATIVE DENTAL SERVICES. 692049 0 698471 13949017 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 34 0 223 1 0 0 0 0 0 0 0 0 0 0 X 15 15 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 0 0 OR X X ROBERT T EDWARDS 5035885828 681 CENTER STREET NE SALEM OR 97301 LARRY GOODREAU CHAIR 1.00 X X 0 0 0 JAN MARGOSIAN VICE CHAIR 1.00 X X 0 0 0 SUSAN SCOTT SECRETARY 1.00 X X 0 0 0 PHIL SWOGGER TREASURER 1.00 X X 0 0 0 MICHAEL WISE PAST CHAIR 1.00 X X 0 0 0 SEAN COOPER DIRECTOR 1.00 X 0 0 0 KATRINA DELAMARTER DIRECTOR 1.00 X 0 0 0 WILLIAM DETTWYLER DIRECTOR 1.00 X 0 0 0 SAMANTHA FELDMAN DIRECTOR 1.00 X 0 0 0 BETH FUSCO DIRECTOR 1.00 X 0 0 0 ELOISA HERNANDEZ DIRECTOR 1.00 X 0 0 0 PAULINE MATHER DIRECTOR 1.00 X 0 0 0 MICHELLE PECORA DIRECTOR 1.00 X 0 0 0 ROBERT STEPHENS DIRECTOR 1.00 X 0 0 0 WILLIAM WILLIAMS DIRECTOR 1.00 X 0 0 0 PAUL LOGAN CHIEF EXECUTIVE OFFICER 40.00 X 204746 0 35440 ROBERT EDWARDS CHIEF FINANCIAL OFFICER 40.00 X 127029 0 33690 ERIC CHEN PROVIDER 40.00 X 202171 0 31779 KYLIE FONTENO PROVIDER 40.00 X 154744 0 84 ANDREA WAGNER PROVIDER 40.00 X 128719 0 28648 CYNTHIA NOCEK PROVIDER 20.00 X 142239 0 8250 TIMOTHY TRUSCHEL PROVIDER 40.00 X 225021 0 29690 1184669 0 167581 13 0 1 0 EMMETTPHAIR CONSTRUCTION 6305 SW ROSEWOOD ST LAKE OSWEGO OR 97305 GENERAL CONTRACTING 1112366 LENITY ARCHITECTURE 3150 KETTLE COURT SE SALEM OR 97301 ARCHITECTURAL SERVICES 125224 QUALITY SYSTEMS INC PO BOX 51449 LOS ANGELES CA 90051 SOFTWARE SUPPORT 120823 3 7876 4009090 409252 390076 4426218 MEDICAL CLINICS 621111 10632034 10632034 MENTAL HEALTH 621112 2713806 2713806 DENTAL CLINIC 621210 698471 698471 YOUTH SHELTER 624110 51400 51400 HOMELESS OUTREACH 624100 36436 36436 14132147 163263 163263 3150 0 3150 3150 3150 CCO INCENTIVES 900099 2664899 2664899 MISCELLANEOUS 900099 138752 138752 2803651 21528429 14132147 0 2970064 507481 507481 413261 413261 9392917 7732353 1631676 28888 1706183 1366843 339340 926290 748115 175328 2847 8775 8775 58827 58827 256143 227783 28360 260321 204779 55542 225011 180612 44399 29406 21779 7627 349737 235097 114640 78078 51867 26211 MEDICAL & FACILITY SUPP 1432083 1426362 5721 REPAIRS AND MAINTENANCE 384165 231033 153132 BAD DEBTS 304705 304705 TRAINING EXPENSE 136677 79850 56827 220363 630358 -409995 16690423 13949017 2709671 31735 3160965 3553999 125332 603544 638249 4955653 5745860 131087 117312 122757 153733 10258230 4121449 5661943 6136781 5967957 8556358 272728 272728 6407 29120 30097 21037493 25205117 1265307 1126327 1095 162855 1513670 463732 2780072 1752914 X 17957421 23452203 300000 0 18257421 23452203 21037493 25205117 4838006 356776 0 X 0 1 X 1 1 1 X 3869168 3701316 4095233 5163316 4426218 21255251 3869168 3701316 4095233 5163316 4426218 21255251 21255251 91728 100725 137609 155148 163263 648473 149852 339819 788834 2779072 2803651 6861228 28764952 54603192 0.73890 0.81900 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: MISCELLANEOUS CCO INCENTIVES RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1210619 1210619 7430442 3386542 4043900 1612465 734907 877558 4704 4704 6136781 X 21377481 12315 12315 21365166 163263 163263 21528429 16702738 12315 12315 16690423 0 16690423 PART X, LINE 2: NO PROVISION FOR INCOME TAXES IS REPORTED IN THE FINANCIAL STATEMENTS BECAUSE THE ORGANIZATION IS A NONPROFIT ORGANIZATION, EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. MANAGEMENT EVALUATED THE ORGANIZATION'S TAX POSITIONS AND CONCLUDED THAT THE ORGANIZATION HAD TAKEN NO UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENTS TO THE FINANCIAL STATEMENTS TO COMPLY WITH THE PROVISIONS OF TOPIC 740 INCOME TAXES OF THE ACCOUNTING STANDARDS CODIFICATION. PART XI, LINE 4B - OTHER ADJUSTMENTS: INVESTMENT INCOME 163,263. 0 RENT ASSISTANCE 194 66964 12315 FMV RENT ASSISTANCE UTILITIES ASSISTANCE 160 18946 PHARMACY ASSISTANCE 319 2414 253821 FMV PHARMACY SAMPLES TRANSPORTATION ASSISTANCE - PROVISION FOR BUS PASSES 1107 9434 FOOD ASSISTANCE 398 99382 DONATED FOOD FROM LOCAL MERCHANTS MEDICAL ASSISTANCE 43 5286 OTHER PERSONAL ASSISTANCE 235 2046 36873 FMV DONATED CLOTHING & PERSONAL ITEMS FOR PEOPLE IN NEED AND SOFTWARE PART I, LINE 2: INDIVIDUAL ASSISTANCE IS MONITORED MONTHLY BY THE COMPLIANCE DIRECTOR AND THROUGH RECEIVABLES AND DRAW-DOWN RECONCILIATIONS. THE CFO SIGNS OFF ON DRAW-DOWNS. X X X X 0 0 0 0 0 0 0 0 0 PAUL LOGAN CHIEF EXECUTIVE OFFICER 183648 0 20000 0 1098 0 10588 0 24852 0 240186 0 0 0 ROBERT EDWARDS CHIEF FINANCIAL OFFICER 126603 0 0 0 426 0 7918 0 25772 0 160719 0 0 0 ERIC CHEN PROVIDER 201963 0 0 0 208 0 9000 0 22779 0 233950 0 0 0 KYLIE FONTENO PROVIDER 154744 0 0 0 0 0 84 0 0 0 154828 0 0 0 ANDREA WAGNER PROVIDER 128646 0 0 0 73 0 6728 0 21920 0 157367 0 0 0 CYNTHIA NOCEK PROVIDER 142239 0 0 0 0 0 8250 0 0 0 150489 0 0 0 TIMOTHY TRUSCHEL PROVIDER 222162 0 0 0 2859 0 7127 0 22563 0 254711 0 0 0 X 36873 FMV X 252 99382 FMV X 43 253821 FMV 0 0 0 0 FORM 990, PART III, LINE 3 DURING THE FISCAL YEAR, THE HOAP, HOST AND HOTLINE PROGRAMS WERE COMBINED INTO A SINGLE TRANSITIONAL SERVICES PROGRAM. FORM 990, PART VI, SECTION A, LINE 1 THE BOARD HAS AN EXECUTIVE COMMITTEE, TO ACT IN THE PLACE OF THE BOARD OF DIRECTORS DURING THE INTERIM PERIODS BETWEEN BOARD MEETINGS OR WHEN IT IS IMPRACTICABLE TO CALL A MEETING OF THE ENTIRE BOARD OF DIRECTORS IN THE EVENT OF AN EMERGENCY OR OTHER MATTER REQUIRING THE IMMEDIATE ACTION OF THE BOARD OF DIRECTORS. THE DIRECTORS WHO ARE ALSO OFFICERS SERVE AS THE EXECUTIVE COMMITTEE. THE CEO SERVES AS A NON-VOTING EX-OFFICIO MEMBER OF THE EXECUTIVE COMMITTEE. THE EXECUTIVE COMMITTEE OPERATES WITHIN THE ESTABLISHED PARAMETERS OF BOARD POLICIES AND REPORTS ALL ACTIONS TAKEN TO THE FULL BOARD FOR RATIFICATION AND RECORDING IN BOARD MINUTES. FORM 990, PART VI, SECTION A, LINE 6 MEMBERSHIP IN THE CORPORATION IS OPEN TO ANY INDIVIDUAL FROM THE COMMUNITY WHO: 1. HAS DEMONSTRATED INTEREST AND SUPPORT OF THE CORPORATION THROUGH A MONETARY CONTRIBUTION OF AT LEAST FIVE-HUNDRED DOLLARS ($500.00) IN THE 12 MONTHS PRECEDING THE ANNUAL MEETING. OR 2. IS A CURRENT MEMBER OF THE BOARD, SALARIED STAFF, PROGRAM VOLUNTEER, OR A NATIONAL HEALTH SERVICE CORPS PROVIDER ASSIGNED TO NWHS PROGRAMS. FORM 990, PART VI, SECTION A, LINE 7A THE ELECTION OF THE MEMBERS OF THE BOARD OF DIRECTORS ARE RATIFIED EACH YEAR BY A MAJORITY VOTE OF THE MEMBERS OF THE ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11B PRIOR TO FILING, A DRAFT OF THE FORM 990 WAS REVIEWED BY THE AUDIT COMMITTEE. THE FINANCE COMMITTEE MADE A RECOMMENDATION TO THE BOARD OF DIRECTORS TO ACCEPT THE TAX RETURN. THE TAX RETURN WAS THEN SIGNED BY THE CHIEF EXECUTIVE OFFICER AND THEN ELECTONICALLY FILED BY THE PREPARER. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY THROUGH ANNUAL EVALUATION AND UPDATING. OFFICERS, DIRECTORS, TRUSTEES AND KEY EMPLOYEES WOULD NOT BE ABLE TO DISCUSS OR VOTE ON AN ISSUE WHERE A CONFLICT OF INTEREST EXISTS. FORM 990, PART VI, SECTION B, LINE 15A ANNUAL EVALUATION AND COMPENSATION OF THE CEO, EXECUTIVE DIRECTOR, AND TOP MANAGEMENT IS DETERMINED BY THE BOARD. ANNUAL EVALUATION AND COMPENSATION OF OTHER OFFICERS OR KEY EMPLOYEES IS DETERMINED BY THE CEO. THESE PROCESSES WERE LAST CONDUCTED IN 2017. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.