2015-07-20T17:35:25-05:00 2014-12-31 DURBIN & COMPANY LLP 2950 50TH STREET LUBBOCK TX 79413 990 2014-01-01 752252866 HEALTH SERVICES OF NORTH TEXAS INC HEAL 9403811501 4401 NORTH I-35 SUITE 312 DENTON TX 76207 DOREEN RUE CEO 9403811501 2015-07-20 GAYLE DE HAAS P01774581 8067911591 2015-07-09 2014 2016-02-25 16:41:14Z DOREEN RUE 4401 NORTH I-35 SUITE 312 DENTON TX 76207 5825826 0 X WWW.HEALTHNTX.ORG X 1988 TX IMPROVING THE QUALITY OF LIFE FOR ALL NORTH TEXANS THROUGH MEDICAL CARE, SUPPORT SERVICES AND ADVOCACY. 15 15 98 0 0 0 4545999 5014196 366947 778686 6406 7151 -15624 -19186 4903728 5780847 0 1025656 0 0 2644807 3114889 0 0 130414 2026661 1370933 4671468 5511478 232260 269369 2153375 2350183 344309 339913 1809066 2010270 X HEALTH SERVICES OF NORTH TEXAS WAS ESTABLISHED IN 1988 IN RESPONSE TO THE FIRST DOCUMENTED CASES OF HIV/AIDS IN DENTON COUNTY. OVER ITS TWENTY-SIX YEAR HISTORY, ITS ROLE AND MISSION HAS EXPANDED TO INCLUDE PRIMARY MEDICAL CARE TARGETING THE ENTIRE COMMUNITY; CASE MANAGEMENT AND SUPPORT SERVICES FOR INDIVIDUALS LIVING WITH HIV; MENTAL HEALTH COUNSELING; AND GUARDIANSHIP SERVICES. ADDITIONALLY, THE AGENCY TODAY COVERS A FIVE-COUNTY REGION WITH OFFICES AT TWO LOCATIONS. HSNT RECEIVED A CERTIFICATE AS A FEDERALLY QUALIFIED HEALTH CENTER (FQHC), A DESIGNATION THAT WILL PROVIDE THE COMMUNITY WITH QUALITY CARE DELIVERED WITHIN A MEDICAL HOME MODEL. AS HEALTH SERVICES OF NORTH TEXAS' MISSION HAS GROWN, IT HAS BECOME INCREASINGLY CLIENT-CENTERED, GOVERNED BY A BOARD OF DIRECTORS WHO ARE REPRESENTATIVE OF THE COMMUNITIES SERVED. TODAY, THE MAJORITY OF THE MEMBERS OF THE BOARD OF DIRECTORS ARE CONSUMER MEMBERS. OUR BOARD OF DIRECTORS ACTIVELY PARTICIPATES IN ACTIVITIES THAT DIRECT OUR MISSION. 0 0 2455668 447401 784082 PRIMARY MEDICAL HEALTHCARE: HEALTHCARE IS AVAILABLE AT THE MEDICAL CENTER FOR CHILDREN AND ADULTS WITH A FOCUS ON ESTABLISHING A MEDICAL HOME FOR COMPREHENSIVE HEALTHCARE. SERVICES INCLUDE: PREVENTIVE CARE, WELL-CHILD AND WELL-ADULT EXAMS, EDUCATION AND IMMUNIZATIONS. TREATMENT IS AVAILABLE FOR A WIDE RANGE OF ACUTE AND CHRONIC PHYSICAL, MENTAL AND SOCIAL HEALTH CONDITIONS SUCH AS INFECTIOUS DISEASES, DIABETES, AND HIGH BLOOD PRESSURE. THE MEDICAL CENTER HAS A LONG HISTORY OF PROVIDING EXPERT SPECIALTY CARE FOR HIV/AIDS INCLUDING DISEASE MANAGEMENT AND TREATMENT ADHERENCE. THE CLINICAL TEAM INCLUDES PHYSICIANS, MID-LEVEL PROVIDERS, NURSES, CERTIFIED MEDICAL ASSISTANTS AND OTHER PROFESSIONALS WHO PROVIDE QUALITY, AFFORDABLE HEALTHCARE REGARDLESS OF ABILITY TO PAY. INSURANCE, MEDICAID, MEDICARE, CHIP AND SLIDING FEE PATIENTS ARE ACCEPTED. 712240 431866 HOUSING ASSISTANCE:PROVIDES ASSISTANCE TO LOW-INCOME HIV+ PERSONS WITH THE PAYMENT OF RENT AND UTILITIES (EMERGENCY AND LONG-TERM). LONG TERM PROGRAM REQUIRES ANNUAL CLIENT ELIGIBILITY RE-CERTIFICATION PROCESS OR IF THERE IS A SIGNIFICANT LIFE CHANGE THE AGENCY BECOMES AWARE OF COULD CAUSE MORE THAN ONE RE-CERTIFICATION ANNUALLY. SHORT TERM PROGRAM REQUIRES ELIGIBILITY CERTIFICATION FOR EACH EVENT. 461210 CASE MANAGEMENT:CASE MANAGEMENT PROVIDES CLIENTS ADVICE AND ASSISTANCE IN OBTAINING MEDICAL, MEDICATION, SOCIAL, COMMUNITY, LEGAL, FINANCIAL, AND OTHER NEEDED SERVICES. CASE MANAGERS ASSESS CLIENT NEEDS AND RESOURCES AND DESIGN AN INDIVIDUALIZED CLIENT-CENTERED SERVICE PLAN TO ADDRESS CRISIS SITUATIONS, MINIMIZE PROBLEMS WITH RECEIVING SERVICES, AND STABILIZE LIFE CIRCUMSTANCES. LINKING CLIENTS TO NEEDED SERVICES AND ADDRESSING BARRIERS TO RECEIVING SERVICES ENCOURAGES CLIENTS TO FOCUS ON THEIR MEDICAL CARE. 385655 PHARMACEUTICAL ASSISTANCE:ASSIST WITH ACCESS AND THE PAYMENT OF PRESCRIPTION MEDICINE. 260388 MEDICAL TRANSPORTATION:PROVIDES CLIENTS WITH DOOR-TO-DOOR VAN SERVICE TO AND FROM MEDICAL AND SOCIAL SERVICE APPOINTMENTS AND BUS TOKENS FOR LOCAL TRANSPORTATION WHERE AVAILABLE. 224703 GUARDIANSHIP SERVICES:A LOCAL GUARDIANSHIP PROGRAM SERVING INDIGENT INCAPACITATED ADULTS IN DENTON COUNTY. 204175 70772 NUTRITION CENTERS:PROVIDES WEEKLY FOOD SUPPLEMENTS, HYGIENE PRODUCTS, AND NUTRITIONAL EDUCATION. 184224 75617 INSURANCE ASSISTANCE:ASSISTS WITH THE PAYMENT OF HEALTH INSURANCE PREMIUMS, DEDUCTIBLES, AND CO-PAYS FOR CLIENTS WHO MEET ELIGIBILITY CRITERIA. 133218 COMMUNITY OUTREACH AND ENROLLMENT:A SERVICE DESIGNED TO ASSIST HEALTH CENTER PATIENTS IN ESTABLISHING ELIGIBILITY FOR AND GAINING ACCESS TO FEDERAL, STATE, AND LOCAL PROGRAM THAT PROVIDE OR FINANCIALLY SUPPORT THE PROVISION OF MEDICAL, SOCIAL, HOUSING, EDUCATIONAL, OR OTHER RELATED SERVICES. 111349 BEHAVIORAL HEALTH SERVICES:INTEGRATED BEHAVIORAL HEALTH CARE SUPPORTS BOTH MENTAL AND PHYSICAL WELL-BEING FOR OPTIMAL HEALTH AND PRODUCTIVITY. COUNSELORS USE A COLLOBARATIVE, COMPREHENSIVE TREATMENT APPROACH THAT CONSIDERS PSYCHOLOGICAL, SOCIAL, ENVIRONMENTAL AND BIOLOGICAL FACTORS FOR EMPOWERING CLIENTS TO IMPROVE THEIR ABILITY TO FUNCTION WITH LIFE CIRCUMSTANCES AND SITUATIONS. MENTAL HEALTH SCREENING, ASSESSMENTS AND THERAPY IS AVAILABLE FOR ISSUES SUCH AS DEPRESSION, ANXIETY, RELATIONSHIP PROBLEMS, LIFE-SKILLS DEVELOPMENT, SUBSTANCE ABUSE, BEHAVIORAL DIAGNOSES, POST-TRAUMATICE STRESS, GRIEF AND THE CHALLENGES OF ACUTE OR CHRONIC HEALTH CONDITIONS. TREATMENT SERVICES INCLUDE INDIVIDUAL AND GROUP THERAPY, MARRIAGE AND FAMILY THERAPY, AND CRISIS INTERVENTION SERVICES 1503712 146389 5132830 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 1 0 0 0 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 95 0 1 98 1 0 0 0 0 0 0 0 0 X 15 15 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 X PAMELA BARNES CFO 9403811501 4401 NORTH I-35 SUITE 312 DENTON TX 76207 MARTIN MAINJA PRESIDENT 2.00 X X 0 0 0 RANDY ROBINSON VICE PRESIDENT 2.00 X X 0 0 0 TODD GIBSON TREASURER 2.00 X X 0 0 0 JOE MCCARLEY SECRETARY 2.00 X X 0 0 0 JERRY GARRETT MEMBER 2.00 X 0 0 0 CORDELIA IKEGWUOHA MEMBER 2.00 X 0 0 0 GLEN MCKENZIE MEMBER 2.00 X 0 0 0 HERMAN OOSTERWIJK MEMBER 2.00 X 0 0 0 CHRISTOPHER REDDEN MEMBER 2.00 X 0 0 0 DANNY SULLIVAN MEMBER 2.00 X 0 0 0 CHRIS WATTS MEMBER 2.00 X 0 0 0 LOIUSE BALDWIN MEMBER 2.00 X 0 0 0 CLARA SANCHEZ MEMBER 2.00 X 0 0 0 GLORIA HERRON MEMBER 2.00 X 0 0 0 DR DERRELL BULLS MEMBER 2.00 X 0 0 0 DAVID DENNIS MEMBER (FORMER) 0.00 X 0 0 0 DR ROBERT SCHWAB MEMBER (FORMER) 0.00 X 0 0 0 DALE TAMPKE MEMBER (FORMER) 0.00 X 0 0 0 BELINDA PEREZ MEMBER (FORMER) 0.00 X 0 0 0 JACQUELINE JACKSON MEMBER (FORMER) 0.00 X 0 0 0 JUDGE ROBERT RAMIREZ MEMBER (FORMER) 0.00 X 0 0 0 DOREEN RUE CEO 40.00 X 128658 0 0 PAMELA BARNES CFO 40.00 X 89841 0 0 SUSAN STAMBAUGH COO 40.00 X 77439 0 0 SUKANYA AMBAVARAM PHYSICIAN 40.00 X 170863 0 0 466801 0 0 2 0 1 0 EON CONSULTING 1204 W UNIVERSITY STE 312 DENTON TX 76201 CONSULTING 172638 1 109273 4076550 828373 46178 5014196 NET PATIENT SERVICE RE 621400 778686 778686 778686 7151 7151 20397 109273 44979 -24582 -24582 MISCELLANEOUS INCOME 624200 5396 5396 5396 5780847 784082 0 -17431 1025656 1025656 378185 278182 17756 82247 2236704 2104997 117446 14261 28220 24754 2181 1285 276164 242251 21340 12573 195616 175592 10305 9719 2373 2373 231608 231608 77774 75453 1000 1321 144761 132405 9847 2509 80523 80523 319860 272825 44519 2516 30726 25908 4552 266 31343 30001 560 782 65158 53435 11510 213 58617 57481 1136 MEDICAL SUPPLIES 138561 138561 EQUIPMENT MAINTENANCE/R 136130 132481 3521 128 BAD DEBT 27526 27526 DUES 25217 22619 4 2594 756 572 184 5511478 5132830 248234 130414 512937 379515 795357 743776 460228 696724 23692 174207 12488 12307 579295 250241 336003 329054 12670 14600 2153375 2350183 344309 339913 344309 339913 X 1704427 1927619 104639 82651 1809066 2010270 2153375 2350183 X 269369 -68165 X 1 X 1 X 1 1 1 X 4307424 4003973 4031538 4545999 5014196 21903130 4307424 4003973 4031538 4545999 5014196 21903130 21903130 6361 4805 5431 6406 7151 30154 51693 106258 128512 6539 20397 313399 22246683 0.98460 0.98140 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: SPECIAL EVENT - 2010 AMOUNT: $ 51,693. 2011 AMOUNT: $ 106,258. 2012 AMOUNT: $ 128,512. 2013 AMOUNT: $ 6,539. 2014 AMOUNT: $ 20,397. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 91227 44733 46494 488068 205508 282560 329054 X 5752122 0 5752122 28725 28725 5780847 5528930 0 5528930 -17452 -17452 5511478 PART X, LINE 2: HEALTH SERVICES OF NORTH TEXAS, INC. IS A NOT-FOR-PROFIT ORGANIZATION THAT IS EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE ORGANIZATION EVALUATES AND ACCOUNTS FOR UNCERTAIN TAX POSITIONS IN ACCORDANCE WITH FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) ACCOUNTING STANDARDS CODIFICATION (ASC) 740, INCOME TAXES (FORMERLY FASB INTERPRETATION 48 (FIN 48) ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES. THIS STANDARD REQUIRES CERTAIN DISCLOSURES ABOUT UNCERTAIN INCOME TAX POSITIONS. THE ORGANIZATION EVALUATES ANY UNCERTAIN TAX POSITIONS USING THE PROVISIONS OF ASC 450, CONTINGENCIES. AS A RESULT, MANAGEMENT DOES NOT BELIEVE THAT ANY UNCERTAIN TAX POSITIONS CURRENTLY EXIST AND NO LOSS CONTINGENCY HAS BEEN RECOGNIZED IN THE ACCOMPANYING FINANCIAL STATEMENTS. THE ORGANIZATION HAS FILED ALL APPLICABLE TAX RETURNS. PART XI, LINE 4B - OTHER ADJUSTMENTS: ITEMS CONTRIBUTED FOR FUNDRAISER AUCTION 46,178. FUNDRAISING EXPENSES -44,978. BAD DEBT 27,526. ROUNDING -1. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT 27,526. FUNDRAISING EXPENSES -44,978. HEARTS & HEROES 91814 77289 14525 28165 ROCKIN' ROUND UP 25397 19525 5872 12207 2 12459 12459 4607 129670 109273 20397 44979 44979 -24582 1 MEDICAL ASSISTANCE 3063 447401 BOOK HOUSING ASSISTANCE 88 431866 BOOK INSURANCE ASSISTANCE 67 75617 BOOK FOOD PANTRY 208 70772 BOOK PART I, LINE 2: INDIVIDUALS WHO RECEIVE ASSISTANCE FROM HSNT APPLY FOR ASSISTANCE. FUNDS ARE DISTRIBUTED TO SERVICE PROVIDERS OR TO INDIVIDUALS ONLY AFTER THE INDIVIDUALS' APPLICATION FOR ASSISTANCE HAS BEEN APPROVED. 0 0 0 0 0 0 0 0 0 SUKANYA AMBAVARAM PHYSICIAN 170863 0 0 0 0 0 0 0 0 0 170863 0 0 0 X 46178 FAIR MARKET VALUE 0 0 0 FORM 990, PART VI, SECTION B, LINE 11 MANAGEMENT REVIEWS THE FORM 990. IT PRESENTS THE FORM 990 IN DETAIL TO THE BOARD OF DIRECTORS FINANCIAL COMMITTEE. THE CHAIR OF THE FINANCIAL COMMITTEE PRESENTS THE FORM 990 TO THE ENTIRE BOARD OF DIRECTORS FOR APPROVAL. AFTER BOARD APPROVAL, THE RETURN IS FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST IS INCLUDED IN HSNT'S BY-LAWS AND IN THE STANDARDS OF CONDUCT IN WHICH ALL BOARD MEMBER AND STAFF RECEIVE A COPY DURING THE ORIENTATION PROCESS. ALL BOARD MEMBERS SIGN A WRITTEN CONFLICT OF INTEREST DISCLOSING ALL CONFLICTS, IF ANY. THIS PROCESS IS RECERTIFIED ANNUALLY. FORM 990, PART VI, SECTION B, LINE 15A THE PROCESS FOR DETERMINING COMPENSATION FOR THE CEO INCLUDES REVIEW AND APPROVAL BY THE BOARD OF DIRECTORS; USING COMPARABILTY DATA OF SIMILAR ORGANIZATIONS. FORM 990, PART VI, SECTION C, LINE 19 INFORMATION ABOUT THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS REPORTED ON THE FORM 1023 AND FORM 990S IS MADE AVAILABLE TO THE PUBLIC UPON REQUEST. ANY INFORMATION ON THESE DOCUMENTS THAT IS NOT INCLUDED ON THE FORM 1023 AND FORM 990S IS NOT MADE AVAIALBE TO THE PUBLIC. FORM 990, PART XI, LINE 9: ITEMS DONATED FOR AUCTION NOT INCLUDED IN GAAP FINANCIALS -46,177. RELEASE OF TEMPORARILY RESTRICTED FUNDS -21,988.