2017-05-09T13:50:58-05:00 2016-12-31 391203191 SVA CERTIFIED PUBLIC ACCTS SC 1221 JOHN Q HAMMONS DRIVE MADISON WI 53717 990 2016-01-01 391546086 DEAN FOUNDATION FOR HEALTH RESEARCH AND EDUCATION INC DEAN 6088272312 2711 ALLEN BLVD NO 300 MIDDLETON WI 53562 M SCOTT STATZ EXECUTIVE DIRECTOR 6088272312 2017-05-08 1 KIRSTEN HOUGHTON P01273230 6088318181 69.128.11.234 2017-05-08 08:33:54 CD P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 B9D72D75531DC738802FCF7D656FA36EF6C2B14C 2016 2021-01-29 14:40:06Z M SCOTT STATZ 2711 ALLEN BLVD SUITE 300 MIDDLETON WI 53562 3361698 0 X WWW.DEAN.ORG X 1985 WI THE FOUNDATION IS ORGANIZED TO CONDUCT MEDICAL RESEARCH ON PHYSICAL AND MENTAL DISEASES AND TO PROVIDE HEALTH EDUCATION AND CARE FOR THE UNDER SERVED. 8 7 37 102 0 0 192931 193068 2367874 2092929 55703 43873 30714 2400 2647222 2332270 0 0 0 0 1801097 1860821 6500 18158 19814 743264 783474 2550861 2662453 96361 -330183 1804612 1524554 907806 927797 896806 596757 X THE FOUNDATION IS ORGANIZED TO CONDUCT MEDICAL RESEARCH ON PHYSICAL AND MENTAL DISEASES AND TO PROVIDE HEALTH EDUCATION AND CARE FOR THE UNDER SERVED. 0 1 645365 619981 ACTIVE CONDUCT OF MEDICAL RESEARCH TO INCLUDE STUDIES TO DISCOVER OR VERIFY KNOWLEDGE RELATED TO THE CAUSES, DIAGNOSIS, TREATMENT AND/OR PREVENTION OR CONTROL OF PHYSICAL OR MENTAL DISEASES. THERE WERE OVER 1,160 VISITS IN 2016. 1263495 1358248 TO PROVIDE RESEARCH, TREATMENT, INFORMATION AND EDUCATION ON A VARIETY OF PSYCHIATRIC DISEASES AND THEIR TREATMENT. THERE WERE OVER 970 VISITS IN 2016. 206872 117100 PUBLIC SERVICE/EDUCATION - TO ORGANIZE OR SPONSOR SEMINARS OR OTHER EDUCATIONAL ACTIVITIES OPEN TO THE PUBLIC. TO PROVIDE CHARITABLE SERVICES WHERE THEY ARE NEEDED IN THE COMMUNITY, SPECIFICALLY: FREE SPECIALIST CARE AND ASTHMA EDUCATION TO THE UNINSURED OR UNDER INSURED. APPROXIMATELY 1,181 PEOPLE ATTENDED AT LEAST ONE OF THESE PROGRAMS IN 2016. 2115732 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 1 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 51 0 1 37 1 0 0 0 0 0 0 0 0 0 0 X 8 7 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 WI X GREGORY PITTS 6088272312 2711 ALLEN BLVD SUITE 300 MIDDLETON WI 53562 SANDRA BRUHN SECRETARY 1.00 0.00 X X 0 0 0 VICTORIA SZEWCZYK MBA CPA DIRECTOR 1.00 0.00 X 0 0 0 JULIEANNE POFAHL RN BS INTERIM EXECUTIVE DIRECTOR/CHAIR 11.00 0.00 X X 29799 0 894 DANIEL DANAHY MD DIRECTOR 1.00 0.00 X 0 0 0 TOM OAKLEY DIRECTOR 1.00 0.00 X 0 0 0 MARSHALL HEYWORTH DIRECTOR 1.00 0.00 X 0 0 0 DAVID GORWITZ TREASURER 1.00 0.00 X X 0 0 0 SARAH JOELSON DIRECTOR 1.00 0.00 X 0 0 0 M SCOTT STATZ EXECUTIVE DIRECTOR 40.00 0.00 X 25673 0 2250 ANNE KOPLIN MD MEDICAL DIRECTOR 27.00 0.00 X 193435 0 6317 248907 0 9461 1 0 1 0 0 193068 193068 PSYCH CONTRACT REVENUE 541700 1358248 1358248 MEDICAL CONTRACT REVENUE 541700 619981 619981 OTHER PROGRAM SERVICES 900099 114700 114700 2092929 36484 36484 1036817 1029428 7389 7389 7389 READING CLINIC 900099 2400 2400 2400 2332270 2095329 0 43873 248907 193435 55472 1292733 1085217 207516 37869 32083 5786 170840 152712 18128 110472 92331 18141 14222 9140 5082 2128 2128 18708 18708 18158 18158 9705 9705 13470 13470 47257 45658 1599 33987 11620 22310 57 13480 9732 3748 168829 90623 78206 18 18 14012 10940 3072 19933 19933 12095 7537 4558 43973 15606 28367 DIRECT PROJECT EXPENSES 340801 334504 6297 OTHER EXPENSES 21249 9766 11483 BANK CHARGES 6617 6617 MEALS 2325 1270 1055 665 70 595 2662453 2115732 526907 19814 200 100 65224 10651 38400 571243 341855 83139 34490 341387 321624 25734 19763 1048421 1089946 1804612 1524554 232344 241708 640000 660000 35462 26089 907806 927797 X 294844 71686 601962 525071 896806 596757 1804612 1524554 -330183 30134 0 X 0 1 X 1 0 X ST MARY'S HOSPITAL MADISON WI RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 26311 26311 0 315076 295313 19763 19763 DEAN PSYCH DEPARTMENT PAYABLE 26089 26089 2529849 30134 177150 207284 2322565 9705 9705 2332270 2829898 177150 177150 2652748 9705 9705 2662453 X X X X X 1 THE RESULTS GROUP OF WISCONSIN LLC 1101 MENOMONIE LANE MADISON WI 53704 FUNDRAISING AND PUBLIC AWARENESS ACTIVITIES 0 12400 18158 -5758 12400 18158 -5758 WI SCHEDULE G, PART I, LINE 2B, COLUMN (V) THE FOUNDATION CONTRACTED WITH THE RESULTS GROUP OF WISCONSIN, LLC FOR SERVICES IN CONNECTION WITH GRANT REQUESTS AND GRANT MANAGEMENT FOR THE BSP FREE CLINIC AND THE WRITING AND DISTRIBUTIONS OF THE FOUNDATION'S SPRING APPEAL LETTER. X 0 0 0 0 0 0 0 0 0 ANNE KOPLIN MD MEDICAL DIRECTOR 193435 0 0 0 0 0 0 0 6317 0 199752 0 0 0 FORM 990, SCHEDULE J, PART I, QUESTION 3 THE FOUNDATION PERIODICALLY USES AN INDEPENDENT COMPENSATION CONSULTANT TO ESTABLISH THE COMPENSATION OF THE EXECUTIVE DIRECTOR. CONSULTATIONS FROM PAST YEARS SERVED AS THE BASIS FOR DETERMINING THE INTERIM EXECUTIVE DIRECTOR'S 2016 COMPENSATION, AND THE CURRENT EXECUTIVE DIRECTOR'S COMPENSATION WAS DETERMINED THROUGH NEGOTIATIONS WITH THE INTERIM EXECUTIVE DIRECTOR/BOARD CHAIR. FORM 990, PART III, LINE 3 THE ASTHMA CLINIC WAS CLOSED AND THE READING PROGRAM WAS DISCONTINUED IN 2016. FORM 990, PART VI, SECTION B, LINE 11B THE PROCESS USED BY MANAGEMENT AND/OR GOVERNING BODY TO REVIEW FORM 990: DEAN FOUNDATION FOR HEALTH, RESEARCH & EDUCATION, INC'S BUDGET & FINANCE COMMITTEE (A SUB-COMMITTEE OF THE BOARD OF DIRECTORS) AND THE BOARD OF DIRECTORS REVIEWED THE FORM 990 PRIOR TO SUBMISSION TO THE INTERNAL REVENUE SERVICE. THE FORM 990 WAS MADE AVAILABE TO THE BUDGET & FINANCE COMMITTEE SO THAT THE COMMITTEE COULD REVIEW IT IN DETAIL AND ASK QUESTIONS PRIOR TO PRESENTATION TO THE FULL BOARD. THE FULL BOARD RECEIVED IT PRIOR TO THE MEETING SO THAT THEY COULD REVIEW IT IN DETAIL TO DETERMINE IF THEY HAD QUESTIONS. FORM 990, PART VI, SECTION B, LINE 12C PROCESS USED TO MONITOR TRANSACTIONS FOR CONFILICTS OF INTEREST: THE FOUNDATION MONITORS CONFLICT OF INTEREST BY REQUIRING THE BOARD OF DIRECTORS, OFFICERS AND KEY EMPLOYEES TO COMPLETE AN ANNUAL STATEMENT ABOUT ANY POTENTIAL CONFLICT SITUATIONS. DETERMINATIONS OF CONFLICT ARE DETECTED AT THE MANAGEMENT LEVEL AND ELEVATED TO BOARD LEVEL FOR DISCUSSION AND/OR ACTION. ACTUAL CONFLICTS (OF WHICH THERE HAVE BEEN NONE) WOULD BE REVIEWED AT THE BOARD LEVEL. IF IT WAS DETERMINED A CONFLICT OF INTEREST EXISTED, THE PERSON WOULD BE PROHIBITED FROM PARTICIPATING IN DISCUSSIONS OF DECISIONS CONCERNING THE TRANSACTION. FORM 990, PART VI, SECTION C, LINE 19 ORGANIZATION'S POLICY REGARDING MAKING CERTAIN DOCUMENTS PUBLIC: THE FOUNDATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC BY PROVIDING COPIES ON REQUEST.