2017-11-10T11:03:43-06:00 2016-12-31 930743240 HOFFMAN STEWART & SCHMIDT PC 4900 MEADOWS ROAD STE 200 LAKE OSWEGO OR 970353295 990 2016-01-01 201082052 PTSO OF WASHINGTON PTSO 5039432500 1881 SW NAITO PARKWAY PORTLAND OR 97201 SEAN WHITELEY-ROSS CFO 5039432500 2017-11-09 1 VICTORIA L BRYSON P01243342 5032205900 74.95.39.225 2017-11-09 09:42:44 PS P 02829331012B87804550E169542AE6F0E8F941FC 152771DFACD1F00D834901529B1F8488AF9B8A65 2016 2017-02-10 21:41:12Z X SEAN WHITELEY-ROSS 1881 SW NAITO PARKWAY PORTLAND OR 97201 5690910 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. 11 11 31 0 0 0 749372 462661 5319927 5228249 0 0 0 0 6069299 5690910 4440070 5829859 0 0 3193416 3003257 0 0 0 -1432274 -2695486 6201212 6137630 -131913 -446720 3014365 2557974 729932 720261 2284433 1837713 PTSO OF WASHINGTON WAS ESTABLISHED TO IMPROVE ACCESS AND THE LEVEL AND QUALITY OF HEALTHCARE FOR FOR THE MEDICALLY UNDERSERVED THROUGH THE IMPROVEMENT OF INFORMATION TECHNOLOGY SERVICES AVAILABLE TO COMMUNITY HEALTH CENTERS AND OTHER SAFETY NET PROVIDERS. 0 0 5043108 5829859 5228249 CUSTOMIZED AND UPGRADED NEXTGEN EHR, EPM AND EDR APPLICATIONS TO MEET THE UNIQUE NEEDS OF OUR FQHC CUSTOMERS AND HELP THEM REALIZE AIU FUNDS. PREPARED FOR MEANINGFUL USE (MU STAGE 1)THROUGH MULTIPLE SYSTEM UPGRADES AND COMMENCED WORK ON MU STAGE 2. CONTINUED FORUMS FOR BEST PRACTICES AND LESSONS LEARNED.HRSA HEALTH CENTER CONTROLLED NETWORKS - HCCN GRANT - PTSO, E NET, HCHN NETWORKS PROVIDING BEST PRACTICES, OPTIMIZATION AND TRAINING AROUND PATIENT CENTERED MEDICAL HOME, MEANINGFUL USE AND EHR IMPLEMENTATION AND ADOPTION. 5043108 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 10 0 1 31 1 0 0 0 0 0 0 0 0 X 11 11 1 0 1 0 1 1 0 1 1 0 0 1 1 1 1 1 0 1 0 0 WA X SEAN WHITELEY-ROSS CFO 5039432500 1881 SW NAITO PARKWAY PORTLAND OR 97201 ANITA MONOIAN CHAIR 1.00 X X 0 0 0 JANINE CHILDS BOARD MEMBER 1.00 X 0 0 0 LINDA MCVEIGH TREASURER 1.00 X X 0 0 0 JESUS HERNANDEZ BOARD MEMBER 1.00 X 0 0 0 THOMAS TROMPETER BOARD MEMBER 1.00 X 0 0 0 HEATHER FINDLAY BOARD MEMBER 1.00 X 0 0 0 KATIE BELL BOARD MEMBER 1.00 X 0 0 0 ABBY SEARS BOARD MEMBER 1.00 X 0 0 0 SEAN WHITELEY-ROSS BOARD MEMBER 1.00 X 0 0 0 YEDDA TRAWICK BOARD MEMBER 1.00 X 0 0 0 KIM KLUPPENGER BOARD MEMBER 1.00 X 0 0 0 JAMES MALDONADO BOARD MEMBER 1.00 X 0 0 0 KEVIN GEOFFFROY BOARD MEMBER 1.00 X 0 0 0 JULIE COLIN CEO 40.00 X 290688 0 13023 ERIC GRENDELL CHIEF TECHNOLOGY MANAGER 40.00 X 147827 0 19462 ROGER HEAD TECHNOLOGY MANAGER 40.00 X 104472 0 10067 542987 0 42552 3 0 1 0 0 462661 462661 SERVICE FEE REVENUE 518210 5228249 5228249 5228249 5690910 5228249 0 0 5829859 5829859 303710 151855 151855 2219028 1729516 489512 315958 292535 23423 164561 134357 30204 24783 24783 32582 32582 43733 43733 165157 141653 23504 819729 819729 220751 102269 118482 84174 21204 62970 9426 9426 351535 351535 28826 28826 OPERATION CONSULTANTS 421562 415264 6298 TAXES 98646 98646 MISCELLANEOUS 22837 22837 GRANTS TO SUPPORTING OR -5019227 -5019227 6137630 5043108 1094522 0 1061879 1833629 48033 21082 948912 94707 198161 160180 7539180 7090804 757380 448376 3014365 2557974 243193 454563 34871 33987 451868 231711 729932 720261 X 2284433 1837713 2284433 1837713 3014365 2557974 -446720 0 X X 0 0 0 X X 5 COUNTRY DOCTOR COMMUNITY CLINIC 237100868 7 1 446783 0 FAMILY HEALTH CENTERS IN OKANOGAN 911275011 7 1 462342 0 HEALTHPOINT 910884412 9 1 1933665 0 YAKIMA NEIGHBORHOOD HEALTH SERVICES 910928817 9 1 1124718 0 NEIGHBORCARE HEALTH 910893287 7 1 1862351 0 5 5829859 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 X 1 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. CURRENTLY PTSO HAS 5 MEMBERS. SEE SCHEDULE I FOR DETAILS ON GRANT RECIPIENTS AND INTENEDED USE OF GRANTS. PART IV, SECTION E, LINE 2B PTSO IS ORGANIZED TO SECURE AND MANGE 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. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 7539180 7090804 448376 448376 WAGES PAYABLE 227231 SALES TAX PAYABLE 4480 231711 0 HEALTHPOINT 955 POWELL AVE SE SUITE A RENTON WA 98057 910884412 501 C (3) 1933665 VARIOUS OPERATING SERVICES, DATA CENTER, SOFTWARE AND SUPPORT. SUPPORTIVE ASSISTANCE NEIGHBORCARE HEALTH 905 SPRUCE STREET SUITE 300 SEATTLE WA 98104 910893287 501 C (3) 1862351 VARIOUS OPERATING SERVICES, DATA CENTER, SOFTWARE AND SUPPORT. SUPPORTIVE ASSISTANCE YAKIMA NEIGHBORHOOD HEALTH SERVICES PO BOX 2605 YAKIMA WA 98907 910928817 501 C (3) 1124718 VARIOUS OPERATING SERVICES, DATA CENTER, SOFTWARE AND SUPPORT. SUPPORTIVE ASSISTANCE COUNTRY DOCTOR COMMUNITY CLINIC 500 19TH AVE EAST SEATTLE WA 98112 237100868 501 C (3) 446783 VARIOUS OPERATING SERVICES, DATA CENTER, SOFTWARE AND SUPPORT. SUPPORTIVE ASSISTANCE FAMILY HEALTH CENTERS IN OKANOGAN PO BOX 1340 OKANOGAN WA 98840 911275011 501 C (3) 462342 VARIOUS OPERATING SERVICES, DATA CENTER, SOFTWARE AND SUPPORT. SUPPORTIVE ASSISTANCE 5 PART I, LINE 2: THE ORGANIZATIONS RECEIVING ASSISTANCE ARE CLASS B MEMBERS AS IDENTIFIED IN PTSO'S GOVERNING DOCUMENTS. AS A SUPPORTING ORGANIZATION, PTSO MONITORS ITS SUPPORT TO ITS SUPPORTED ORGANIZATIONS. X X X 1 0 0 0 0 0 0 0 0 JULIE COLIN CEO 252355 0 38333 0 0 0 12176 0 847 0 303711 0 0 0 ERIC GRENDELL CHIEF TECHNOLOGY MANAGER 144031 0 1000 0 2796 0 8868 0 10594 0 167289 0 0 0 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 4 THE ORGANIZATION REVISED THEIR BYLAWS IN DECEMBER 2016 WITH UPDATED MEMBERSHIP CLASSES AS A RESULT OF BEING ACQUIRED BY OCHIN, INC. 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 FOR THE NEXT THREE YEARS, 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 B, LINE 15A THE BOARD OF DIRECTORS REVIEWS AND DETERMINES CEO COMPENSATION USING COMPARABILITY DATA AND AN INDEPENDENT COMPENSATION CONSULTANT. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING/ORGANIZING DOCUMENTS ARE AVAILABLE UPON REQUEST. 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