SOUTHWEST WASHINGTON REGIONAL HEALTH ALLIANCE: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization
SOUTHWEST WASHINGTON REGIONAL HEALTH ALLIANCE (EIN 46-2164971)
Tax period
2015-07-01 to 2016-06-30
Filed
2017-01-09
IRS object ID
201710099349301126
Schema version
2015v3.0
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 ReturnHeader

FieldValueIRS element (for citing)
Return2017-01-09T16:20:13-06:00ReturnTs
Tax Period End2016-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN911304455PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1MICHAEL J PLYMALE INCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 268AddressLine1Txt
CityVANCOUVERCityNm
State AbbreviationWAStateAbbreviationCd
ZIP986660268ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2015-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN462164971EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1SOUTHWEST WASHINGTON REGIONALBusinessNameLine1Txt
Business Name Line2HEALTH ALLIANCEBusinessNameLine2Txt
FieldValueIRS element (for citing)
Business Name ControlSOUTBusinessNameControlTxt
Phone3603972130PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1605 MAIN STREET NO 4693AddressLine1Txt
CityVANCOUVERCityNm
State AbbreviationWAStateAbbreviationCd
ZIP986603129ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonFEDERICO CRUZ-URIBEPersonNm
Person TitlePRESIDENTPersonTitleTxt
Phone3603972130PhoneNum
Signature2017-01-09SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonMICHAEL J PLYMALE INC PSPreparerPersonNm
PTINP01229193PTIN
Phone3606950068PhoneNum
Preparation2017-01-09PreparationDt
FieldValueIRS element (for citing)
Tax2015TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerFEDERICO CRUZ-URIBEPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1605 MAIN STREET NO 4693AddressLine1Txt
CityVANCOUVERCityNm
State AbbreviationWAStateAbbreviationCd
ZIP986603129ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$526,287GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.SWHEALTH-ALLIANCE.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2013FormationYr
Legal Domicile StateWALegalDomicileStateCd
Activity Or MissionPROVIDE BETTER QUALITY HEALTH AND HUMAN SERVICES.ActivityOrMissionDesc
Voting Members Governing Body18VotingMembersGoverningBodyCnt
Voting Members Independent18VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers18TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$225,361PYContributionsGrantsAmt
CY Contributions Grants$526,287CYContributionsGrantsAmt
PY Program Service Revenue$0PYProgramServiceRevenueAmt
CY Program Service Revenue$0CYProgramServiceRevenueAmt
PY Investment Income$1PYInvestmentIncomeAmt
CY Investment Income$0CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$225,362PYTotalRevenueAmt
CY Total Revenue$526,287CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$0PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$0CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$116,913PYOtherExpensesAmt
CY Other Expenses$162,135CYOtherExpensesAmt
PY Total Expenses$116,913PYTotalExpensesAmt
CY Total Expenses$162,135CYTotalExpensesAmt
PY Revenues Less Expenses$108,449PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$364,152CYRevenuesLessExpensesAmt
Total Assets BOY$163,219TotalAssetsBOYAmt
Total Assets EOY$527,371TotalAssetsEOYAmt
Total Liabilities BOY$0TotalLiabilitiesBOYAmt
Total Liabilities EOY$0TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$163,219NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$527,371NetAssetsOrFundBalancesEOYAmt
MissionTO IMPROVE HEALTH, HEALTH EQUITY AND WHOLE PERSON HEALTH IN SOUTHWEST WASHINGTON.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$103,524ExpenseAmt
Revenue$526,287RevenueAmt
DescTHE ORGANIZATION FOCUSED ON FURTHER DEVELOPING CROSS-SECTOR PARTNERSHIPS THAT CAN EFFECTIVELY WORK TOGETHER TO IMPROVE HEALTH OUTCOMES, AND INITIATE ORGANIZING AS A REGIONAL ACCOUNTABLE COMMUNITY OF HEALTH (ACH).Desc
Total Program Service Expenses$103,524TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building Equipment0ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J Required0ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related Entity0RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document2IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee0EmployeeCnt
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members18GoverningBodyVotingMembersCnt
Independent Voting Member18IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldWAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1LAUREL LEEBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone4254241121PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1C/O MOLINA HEALTHCARE OF WA 21540AddressLine1Txt
CityBOTHELCityNm
State AbbreviationWAStateAbbreviationCd
ZIP98021ZIPCd
FieldValueIRS element (for citing)
No Listed Persons CompensatedYes (X)NoListedPersonsCompensatedInd

Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerInd
JON HERSEN
MEMBER1.00Yes (X)$0$0$0
JARED SANFORD
MEMBER1.00Yes (X)$0$0$0
LAUREL LEE
SECRETARY2.00Yes (X)$0$0$0Yes (X)
SHARON CROWELL
MEMBER1.00Yes (X)$0$0$0
DAVID KELLY
MEMBER1.00Yes (X)$0$0$0
KEVIN WITTE
TREASURER2.00Yes (X)$0$0$0Yes (X)
STEVE KUTZ
MEMBER1.00Yes (X)$0$0$0
ALAN MELNICK
MEMBER1.00Yes (X)$0$0$0
LARRY NEVILLE
MEMBER1.00Yes (X)$0$0$0
CINDY ROBERTSON
MEMBER1.00Yes (X)$0$0$0
ERIN HAFER
MEMBER1.00Yes (X)$0$0$0
BRAD BERRY
MEMBER1.00Yes (X)$0$0$0
ANDY SILVER
VICE PRESIDENT2.00Yes (X)$0$0$0Yes (X)
FEDERICO CRUZ-URIBE
PRESIDENT3.00Yes (X)$0$0$0Yes (X)
JOHN MOREN
MEMBER1.00Yes (X)$0$0$0
AMINA SUCHOSKI
MEMBER1.00Yes (X)$0$0$0
KIRBY RICHARDS
MEMBER1.00Yes (X)$0$0$0
MOLLY HAYNES
MEMBER1.00Yes (X)$0$0$0
JOEL MADSEN
MEMBER1.00Yes (X)$0$0$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$0TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K0TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
Government Grants$480,000GovernmentGrantsAmt
All Other Contributions$46,287AllOtherContributionsAmt
Noncash Contributions$20,987NoncashContributionsAmt
Total Contributions$526,287TotalContributionsAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$526,287TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$5,223TotalAmt
Management And General$5,223ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$146,729TotalAmt
Program Services$99,123ProgramServicesAmt
Management And General$47,606ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$533TotalAmt
Program Services$85ProgramServicesAmt
Management And General$448ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$2,528TotalAmt
Management And General$2,528ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (2 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
TRAVEL & MEETINGS$7,035$4,316$2,719
MISCELLANEOUS$87$87

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$162,135TotalAmt
Program Services$103,524ProgramServicesAmt
Management And General$58,611ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$163,219BOYAmt
EOY$527,371EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$163,219BOYAmt
EOY$527,371EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$163,219BOYAmt
EOY$527,371EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$163,219BOYAmt
EOY$527,371EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$163,219BOYAmt
EOY$527,371EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$364,152ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS Audited0FSAuditedInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Public Organization170Yes (X)PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years$21,446CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$104,145CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$225,361CurrentTaxYearMinus1YearAmt
Current Tax Year$526,287CurrentTaxYearAmt
Total$877,239TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years$21,446CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$104,145CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$225,361CurrentTaxYearMinus1YearAmt
Current Tax Year$526,287CurrentTaxYearAmt
Total$877,239TotalAmt
FieldValueIRS element (for citing)
Public Support Total170$877,239PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus1 Year$1CurrentTaxYearMinus1YearAmt
Total$1TotalAmt
FieldValueIRS element (for citing)
Total Support$877,240TotalSupportAmt
First5 Years170Yes (X)First5Years170Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11BOARD MEMBERS RECEIVE A COPY OF THE 990 AT A MONTHLY BOARD MEETING. THE COPY IS REVIEWED AND COMMENTS, IF ANY, ARE DOCUMENTED IN THE MINUTES.
FORM 990, PART VI, SECTION B, LINE 12CBOARD MEMBERS ARE REQUIRED TO REVIEW POLICY AND DISCLOSE ANY CONFLICTS ANNUALLY IN WRITING.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION MAKES ALL DOCUMENTS, POLICIES AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST.
FORM 990, PART IX, LINE 11GPROJECT MANAGEMENT AND PROGRAM SUBCONTRACTOR: PROGRAM SERVICE EXPENSES 99,123. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 99,123. ADMIN AND BOARD SUPPORT SUBCONTRACTOR: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 47,606. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 47,606.

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