2016-01-14T16:07:47-06:00 2015-06-30 410746749 CLIFTONLARSONALLEN LLP 3000 NORTHUP WAY SUITE 200 BELLEVUE WA 98004 990 2014-07-01 930605570 NORTHWEST HUMAN SERVICES INC NORT 5035885828 681 CENTER STREET NE SALEM OR 97301 PAUL LOGAN CHIEF EXECUTIVE OFFICER 5035885828 2016-01-12 1 KYLA DELGADO CPA P01874220 4252506100 2014 2016-04-25 22:37:26Z PAUL LOGAN 681 CENTER STREET NE SALEM OR 97301 16329006 0 X WWW.NORTHWESTHUMANSERVICES.ORG X 1970 OR MEET THE NEEDS OF THE COMMUNITY MEMBERS, REGARDLESS OF SOCIAL OR ECONOMIC STATUS. 12 12 216 53 0 0 3701316 4086733 9371629 10565964 135900 151096 339819 797334 13548664 15601127 303431 332767 0 0 9306809 10259204 0 0 31788 3351900 3711072 12962140 14303043 586524 1298084 15614129 16802287 2071143 2094868 13542986 14707419 X NORTHWEST HUMAN SERVICES MEETS THE NEEDS OF COMMUNITY MEMBERS, REGARDLESS OF SOCIAL OR ECONOMIC STATUS, BY PROVIDING COMPREHENSIVE MEDICAL, DENTAL, MENTAL HEALTH, AND SOCIAL SERVICES WITH RESPECT, COMPASSION, AND ACCEPTANCE OF CULTURAL AND LINGUISTIC DIVERSITY. 0 0 8633879 137519 8315468 WEST SALEM CLINIC AND TOTAL HEALTH COMMUNITY CLINIC: NORTHWEST HUMAN SERVICES, INC. (THE ORGANIZATION), IS A NONPROFIT FEDERALLY QUALIFIED HEALTH CENTER (FQHC), AND RECEIVES FUNDING 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, THE PRIMARY FEDERAL AGENCY DEDICATED TO IMPROVING ACCESS TO HEALTH CARE FOR PEOPLE WHO ARE GEOGRAPHICALLY ISOLATED, ECONOMICALLY, OR MEDICALLY VULNERABLE. THE ORGANIZATION'S MISSION IS TO MEET THE NEEDS OF COMMUNITY MEMBERS, REGARDLESS OF SOCIAL OR ECONOMIC STATUS, BY PROVIDING COMPREHENSIVE MEDICAL, DENTAL, MENTAL HEALTH, AND SOCIAL SERVICES WITH RESPECT, COMPASSION, AND ACCEPTANCE OF CULTURAL AND LINGUISTIC DIVERSITY. THE ORGANIZATION PROVIDES COMPREHENSIVE MEDICAL, DENTAL, MENTAL HEALTH, AND SOCIAL SERVICES. THE MAJORITY OF PATIENTS ARE INSURED THROUGH THE OREGON HEALTH PLAN (MEDICAID), MEDICARE, OR ARE UNINSURED. A SLIDING FEE DISCOUNT PROGRAM IS 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 III 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 ARE ALSO AVAILABLE.FOR THE FISCAL YEAR ENDING JUNE 30, 2015 THE CLINICS SERVED 10,908 PATIENTS THROUGH 47,261 VISITS. 1431642 60 1450224 WEST SALEM MENTAL HEALTH CLINIC: THE MENTAL HEALTH CLINIC, LOCATED ON THE WEST SALEM CLINIC CAMPUS, PROVIDES PSYCHIATRIC SERVICES, PSYCHOTHERAPY, COUNSELING, AND CASE MANAGEMENT SERVICES IN AN INTEGRATED SETTING. 793681 146970 82460 QUICKCARE CLINICTHE QUICKCARE CLINIC, LOCATED ON THE WEST SALEM CLINIC CAMPUS, PROVIDES SAME-DAY ACUTE HEALTH CARE AND SERVICES. FOR THE FISCAL YEAR ENDING JUNE 30, 2015 QUICKCARE SERVED 2,005 PATIENTS THROUGH 2,687 VISITS.HOMELESS OUTREACH AND ADVOCACY PROJECT (HOAP): THE HOAP PROGRAM OFFERS AN ARRAY OF SERVICES DESIGNED TO GET AND KEEP INDIVIDUALS WHO ARE MENTALLY ILL AND HOMELESS, OR AT RISK OF HOMELESSNESS, OFF THE STREETS AND INTO HOUSING. CASE MANAGERS, STAFF, AND VOLUNTEERS PROVIDE STREET 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 DAY CENTER THAT PROVIDES MANY SERVICES TO PEOPLE WHO ARE HOMELESS, INCLUDING FOOD, LAUNDRY AND SHOWER FACILITIES, AND A CHANCE TO SOCIALIZE. FOR THE FISCAL YEAR ENDING JUNE 30, 2015, HOAP SERVED 3,181 DISTINCT CLIENTS THROUGH 19,108 ENCOUNTERS.THE 24-HOUR HOTLINE PROVIDES INFORMATION, REFERRAL, SUICIDE PREVENTION, CRISIS COUNSELING, EMERGENCY FINANCIAL ASSISTANCE, AND OTHER SERVICES TO INDIVIDUALS AND FAMILIES IN THE SERVICE AREA. VOICEMAIL TELEPHONE MESSAGE SERVICE IS ALSO PROVIDED FOR INDIVIDUALS WHO ARE PHONELESS. THE PROGRAM IS ACCREDITED BY THE AMERICAN ASSOCIATION OF SUICIDOLOGY. IN FISCAL YEAR 2015, HOTLINE SERVED OVER 15,567 INDIVIDUALS AND THEIR FAMILIES. 525394 0 572990 WEST SALEM DENTAL CLINIC: THE DENTAL CLINIC, LOCATED ON THE WEST SALEM CLINIC CAMPUS, PROVIDES EMERGENT AND RESTORATIVE DENTAL SERVICES. FOR THE FISCAL YEAR ENDING JUNE 30, 2015 THE DENTAL CLINIC SERVED 1,357 PATIENTS THROUGH 3,907 VISITS. 495466 48218 144822 HOMES OFFERING SHELTER TO TEENS (HOST): HOST PROVIDES STREET OUTREACH, A DROP-IN 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, 2015 HOST MADE OVER 9,040 CONTACTS WITH YOUTH AND YOUNG ADULTS, WHICH INCLUDED 4,119 CONTACTS THROUGH STREET OUTREACH ACTIVITIES AND 4,921 CONTACTS AT THE DROP IN CENTER. 62401 0 0 CONNECTION PROGRAM: THE CONNECTION PROGRAM, PART OF THE WEST SALEM MENTAL HEALTH CLINIC, PROVIDES COUNSELING, ADVOCACY, CASE MANAGEMENT, VICTIM'S SERVICES, INFORMATION AND REFERRAL FOR INDIVIDUALS WHO ARE DEAF AND HARD OF HEARING AND THEIR FAMILIES. THIS PROGRAM IS HOUSED WITH THE WEST SALEM MENTAL HEALTH CLINIC. 1083261 48218 717812 11942463 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 36 0 216 1 0 0 0 0 0 0 0 0 0 0 X 12 12 0 0 1 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 CRYSTINA BLAZE DIRECTOR 1.00 X 0 0 0 SEAN COOPER 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 HEN MACH 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 NICOLE RUSSELL DIRECTOR 1.00 X 0 0 0 ROBERT STEPHENS DIRECTOR 1.00 X 0 0 0 PAUL LOGAN CHIEF EXECUTIVE OFFICER 40.00 X 166212 0 29726 ROBERT EDWARDS CHIEF FINANCIAL OFFICER 40.00 X 105454 0 20938 OLIVIA KAMAYANGI PROVIDER 40.00 X 168011 0 23331 JANE-FRANCES AKPAMGBO PROVIDER 40.00 X 161553 0 26793 ELIZABETH ANN SCOTT PROVIDER 40.00 X 144882 0 24667 CYNTHIA NOCEK PROVIDER 40.00 X 136390 0 10169 SANDRA YOUNG PROVIDER 40.00 X 113749 0 13796 996251 0 149420 9 0 1 0 COMPHEALTH PO BOX 972625 DALLAS TX 753972625 LOCUM SERVICES 437535 QUALITY SYSTEMS INC PO BOX 51449 LOS ANGELES CA 90051 SOFTWARE SUPPORT 112741 2 5237 3783541 297955 270872 4086733 MEDICAL CLINICS 621111 8315468 8315468 MENTAL HEALTH 621112 1450224 1450224 DENTAL CLINIC 621210 572990 572990 YOUTH SHELTER 624110 144822 144822 HOMELESS OUTREACH 624100 82460 82460 10565964 137609 137609 741366 727879 13487 13487 13487 CCO INCENTIVES 900099 644733 644733 MISCELLANEOUS 900099 144101 144101 MEANINGFUL USE 900099 8500 8500 797334 15601127 10565964 0 948430 332767 332767 337348 337348 7699555 6317528 1353001 29026 1469537 1185029 284508 752764 594774 155228 2762 26315 26315 61338 61338 644331 621112 23219 213208 135438 77770 243809 170588 73221 50261 24470 25791 276250 199419 76831 65598 56298 9300 MEDICAL SUPPLIES 1439260 1437834 1426 REPAIRS AND MAINTENANCE 292730 141223 151507 BAD DEBTS 107880 107880 BANK CHARGES 93883 14340 79543 196209 603763 -407554 14303043 11942463 2328792 31788 2122607 1563733 125156 125244 488217 794687 2131067 2957970 101631 88491 51163 149444 8606389 3502357 4631480 5104032 5433856 5457237 272728 272728 7475 6941 248749 281780 15614129 16802287 951526 1013846 28079 50000 1091538 1031022 2071143 2094868 X 13542986 14707419 13542986 14707419 15614129 16802287 1298084 -133651 0 X 0 1 X 1 1 1 X 4344005 4411496 3869168 3701316 4095233 20421218 4344005 4411496 3869168 3701316 4095233 20421218 20421218 79350 77832 91728 100725 137609 487244 92675 72091 149852 339819 788834 1443271 22351733 44480123 0.91360 0.94960 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: MISCELLANEOUS RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1210619 1210619 6058223 2873202 3185021 1328843 629155 699688 8704 8704 5104032 X 15450031 0 15450031 151096 151096 15601127 14303043 0 14303043 0 14303043 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: NET REALIZED GAIN ON INVESTMENTS 13,487. INTEREST INCOME 137,609. 0 RENT ASSISTANCE 97 26253 UTILITIES ASSISTANCE 692 16717 PHARMACY SUPPORT 199 4474 208237 FMV PHARMACY SAMPLES CLOTHING & OTHER PERSONAL ITEMS 1444 688 45928 FMV DONATED CLOTHING AND PERSONAL ITEMS FOR PEOPLE IN NEED TRANSPORTATION ASSISTANCE - PROVISION FOR BUS PASSES 2757 9529 FOOD 6887 3954 16707 FMV DONATED FOOD FROM LOCAL MERCHANTS MEDICAL ASSISTANCE 2 280 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 132331 0 33000 0 881 0 8564 0 21162 0 195938 0 0 0 OLIVIA KAMAYANGI PROVIDER 160306 0 7500 0 205 0 0 0 23331 0 191342 0 0 0 JANE-FRANCES AKPAMGBO PROVIDER 156574 0 4775 0 204 0 0 0 26793 0 188346 0 0 0 ELIZABETH ANN SCOTT PROVIDER 137210 0 7500 0 172 0 0 0 24667 0 169549 0 0 0 X 45928 FAIR MARKET VALUE X 1 16707 FAIR MARKET VALUE X 1 208237 FAIR MARKET VALUE 0 0 0 0 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 4 IN JANUARY 2015, THE BYLAWS WERE AMENDED. THE AMENDMENTS INCLUDED THE FOLLOWING CHANGES: A. THE ELIGIBILITY OF BOARD MEMBERS WAS MODIFIED. THE VOTING RIGHTS OF BOARD MEMBERS WHO ALSO VOLUNTEER WITH THE ORGANIZATION ARE NO LONGER LIMITED. THE DEFINITION OF A "CONSUMER" WAS EXPANDED TO INCLUDE LEGAL GUARDIANS AND LEGAL SPONSORS. THE MAJORITY OF DIRECTORS SHOULD BE COMMUNITY MEMBERS WHO LIVE OR WORK WITHIN THE ORGANIZATION'S SERVICE AREA, PRIMARILY RECEIVE THEIR HEALTH CARE FROM THE ORGANIZATION, AND HAVE USED THE ORGANIZATION'S SERVICES WITHIN THE LAST TWO YEARS. B. NO MORE THAN 50% OF NON-USER BOARD MEMBERS MAY DERIVE MORE THAN 10% OF THEIR INCOME FROM THE HEALTH CARE INDUSTRY. C. CONFLICT OF INTEREST REQUIREMENTS FOR BOARD MEMBERS WERE ADDED TO THE BYLAWS. D. BOARD APPROVAL REQUIRES A MAJORITY VOTE OF THE BOARD MEMBERS PRESENT AT A MEETING IN WHICH A QUORUM EXISTS. E. SEVERAL COMMITTEES WERE CREATED OR HAD THEIR POWERS MODIFIED, INCLUDING THE FINANCE COMMITTEE, AUDIT COMMITTEE, AND INVESTMENT COMMITTEE. 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 11 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 2015. 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.