2015-08-17T15:39:18-05:00 2015-03-31 390758449 WIPFLI LLP PO BOX 8700 MADISON WI 537088700 990 2014-04-01 391407034 WISCONSIN PRIMARY HEALTH CARE ASSOCIATION INC WISC 6082777477 5202 EASTPARK BLVD NO 109 MADISON WI 53718 STEPHANIE HARRISON CHIEF EXECUTIVE OFFICER 6082777477 2015-08-17 1 JOHN HEMMING P00856805 6082741980 2015-08-17 2014 2016-02-25 16:41:14Z STEPHANIE HARRISON 5202 EASTPARK BLVD NO 109 MADISON WI 53718 2768110 0 X WWW.WPHCA.ORG X 1982 WI TO HELP PROVIDE ACCESS TO COMPREHENSIVE, COMMUNITY-ORIENTED PRIMARY HEALTH CARE SERVICES. 23 23 58 188 0 0 1822623 2078776 369361 687234 1819 2100 0 0 2193803 2768110 27023 65456 0 0 1489248 1587582 0 0 3098 652409 743785 2168680 2396823 25123 371287 1147460 1558561 574042 613856 573418 944705 X THE MISSION OF WISCONSIN PRIMARY HEALTH CARE ASSOCIATION, INC. IS TO IMPROVE HEALTH THROUGH THE WORK OF COMMUNITY HEALTH CENTERS AND THEIR PARTNERS.THE ORGANIZATION'S VISION IS TO BE RECOGNIZED AS WISCONSIN'S LEADER IN PROMOTING ACCESS TO PRIMARY HEALTH CARE SERVICES BY ELIMINATING GEOGRAPHICAL, FINANCIAL AND CULTURAL BARRIERS, AND INFLUENCING RELATED HEALTH CARE POLICY. THESE ACTIONS WILL LEAD TO THE ELIMINATION OF HEALTH DISPARITIES IN UNDERSERVED POPULATIONS. 0 0 670026 0 0 NONFINANCIAL TECHNICAL ASSISTANCE (NFTA):UNDER THE NFTA (BASE) GRANT, WISCONSIN PRIMARY HEALTH CARE ASSOCIATION, INC. PROVIDES TRAINING AND TECHNICAL ASSISTANCE TO HEALTH CENTERS AND ENTITIES SEEKING HEALTH CARE ACCESS OPTIONS ON GOVERNANCE AND COMPLIANCE REQUIREMENTS, QUALITY IMPROVEMENT, AND PROGRAM ANALYSIS. 375319 5456 149544 AMERICORPS: THE AMERICORPS PROGRAM RECRUITS, PLACES, AND SUPERVISES AMERICORPS MEMBERS IN HEALTH CENTERS AND OTHER PUBLIC HEALTH SITES IN WISCONSIN, WHERE MEMBERS ARE CONDUCTING HEALTH OUTREACH AND EDUCATION IN COMMUNITIES WHERE THERE ARE HIGH NEEDS. 322783 0 0 HEALTH CENTER CONTROLLED NETWORK:UNDER THE HEALTH INFORMATION QUALITY GRANT, WISCONSIN PRIMARY HEALTH CARE ASSOCIATION, INC. PROVIDES TRAINING AND TECHNICAL ASSISTANCE TO PARTICIPATING HEALTH CENTERS FOR ACHIEVING MEANINGFUL USE, PATIENT CENTERED MEDICAL HOME RECOGNITION, AND HEALTHY PEOPLE 2020 GOALS PRIORITIZED FOR THE UNIFORM DATA SYSTEM. 183783 60000 0 PFIZER/PAIN MANAGEMENT & CHRONIC PAIN 144667 0 37000 KRESGE/STAR PROJECT 90091 0 0 ADVOCACY 260018 0 500690 OTHER PROGRAMS - INCLUDES THE FOLLOWING PROGRAMS:HPSA, DIABETES PROGRAM, WHITEC, BIOTERRORISM HOSPITAL PREPARDNESS, CANCER PROGRAM, RCHN, MEMBERSHIP, FEE FOR SERVICE, CONFERENCES, AND OTHER. 678559 60000 537690 2046687 1 1 0 1 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 13 0 1 58 1 0 0 0 0 0 0 0 0 0 0 X 23 23 0 0 1 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 WI X STEPHANIE HARRISON 6082777477 5202 EASTPARK BLVD SUITE 109 MADISON WI 53718 BRIAN AHLGREN DIRECTOR 1.00 X 0 0 0 LIZ BADE MD DIRECTOR 1.00 X 0 0 0 KRISTIN BLANCHARD DIRECTOR 1.00 X 0 0 0 MAVIS BREHM DIRECTOR 1.00 X 0 0 0 MARY COFFEY DIRECTOR 1.00 X 0 0 0 BYRON CROUSE MD DIRECTOR 1.00 X 0 0 0 TITO IZARD MD DIRECTOR 1.00 X 0 0 0 BILL JENKINS DIRECTOR 1.00 X 0 0 0 TED KAY DIRECTOR 1.00 X 0 0 0 KEN LOVING MD DIRECTOR 1.00 X 0 0 0 GREG NYCZ DIRECTOR 1.00 X 0 0 0 MARTY SCHALLER DIRECTOR 1.00 X 0 0 0 JULIE SCHULLER MD MPH DIRECTOR 1.00 X 0 0 0 LAURA SCUDIERE DIRECTOR 1.00 X 0 0 0 JENNI SEVENICH DIRECTOR 1.00 X 0 0 0 TIM SIZE DIRECTOR 1.00 X 0 0 0 KRISTENE STACKER DIRECTOR 1.00 X 0 0 0 JOY TAPPER MPA DIRECTOR 1.00 X 0 0 0 SHELLY WHITE DIRECTOR 1.00 X 0 0 0 MARI FREIBERG PRESIDENT 1.00 X X 0 0 0 REBA RICE VICE PRESIDENT 1.00 X X 0 0 0 BONNIE KUHR SECRETARY/TREASURER 1.00 X X 0 0 0 RICHARD PERRY PAST PRESIDENT 1.00 X X 0 0 0 STEPHANIE HARRISON CHIEF EXECUTIVE OFFICER 45.00 X 127289 0 10780 KHADIJA ELDACHACH FINANCE DIRECTOR 45.00 X 69419 0 8749 LYNSEY RAY CHIEF OPERATING OFFICER 45.00 X 101678 0 16554 298386 0 36083 2 0 0 0 0 1629553 449223 2078776 MEMBERSHIP DUES 900099 316203 316203 FEE FOR SERVICE INCOME 561499 69037 69037 301994 301994 687234 2100 2100 2768110 687234 0 2100 X 65456 65456 331657 269933 61724 891080 873580 15562 1938 21260 20889 371 248300 242965 4336 999 95285 90563 4561 161 13471 13471 13750 13750 272958 186127 86831 67372 42692 24680 119897 85356 34541 73616 43878 29738 86981 40237 46744 11129 7779 3350 27518 19559 7959 DUES AND SUBSCRIPTIONS 19093 10361 8732 BAD DEBT EXPENSE 16600 9528 7072 BOARD EXPENSES 11890 4859 7031 RECRUITMENT 3020 2278 742 6490 3426 3064 2396823 2046687 347038 3098 335646 280381 496252 938102 180876 158336 57008 125818 31057 20432 79120 43628 46621 35492 1147460 1558561 141679 183807 432363 430049 574042 613856 X 565368 940496 8050 4209 573418 944705 1147460 1558561 371287 0 X 0 1 X 1 1 1 X 1429250 1744003 1789204 1822623 2078776 8863856 1429250 1744003 1789204 1822623 2078776 8863856 402815 8461041 5170 2810 3335 1970 2100 15385 8879241 2145448 0.95290 0.97100 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 5836 102097 107933 1938754 2046687 252334 63084 0 0 255878 258995 244788 252334 1011995 1517993 71567 123532 83013 107933 386045 63970 64749 61197 63084 253000 379500 66120 39185 10092 5836 121233 21310 5531 15779 57810 38097 19713 35492 X 2768110 0 2768110 0 2768110 2396823 0 2396823 0 2396823 PART X, LINE 2: WPHCA IS REQUIRED TO ASSESS WHETHER IT IS MORE LIKELY THAN NOT THAT A TAX POSITION WILL BE SUSTAINED UPON EXAMINATION ON THE TECHNICAL MERITS OF THE POSITION ASSUMING THE TAXING AUTHORITY HAS FULL KNOWLEDGE OF ALL INFORMATION. IF THE TAX POSITION DOES NOT MEET THE MORE LIKELY THAN NOT RECOGNITION THRESHOLD, THE BENEFIT OF THAT POSITION IS NOT RECOGNIZED IN THE FINANCIAL STATEMENTS. WPHCA HAS DETERMINED THERE ARE NO AMOUNTS TO RECORD AS ASSETS OR LIABILITIES RELATED TO UNCERTAIN TAX POSITIONS. FEDERAL RETURNS FOR THE FISCAL YEARS ENDED 2012 AND BEYOND REMAIN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE. 1 SIXTEENTH STREET COMMUNITY HEALTH CENTERS INC 1337 S 16TH STREET 2ND FLOOR MILWAUKEE WI 53204 391180475 501(C)(3) 10785 0 COMMUNITY HEALTH CENTER PARTICIPATION SUPPORT NORTHERN HEALTH CENTERS INC PO BOX 179 LAKEWOOD WI 54138 391550213 501(C)(3) 10000 0 COMMUNITY HEALTH CENTER PARTICIPATION SUPPORT THE LAKES COMMUNITY HEALTH CENTER INC 7665 US HWY 2 IRON RIVER WI 54847 352297925 501(C)(3) 12802 0 COMMUNITY HEALTH CENTER PARTICIPATION SUPPORT LA CLINICA DE LOS CAMPESINOS INC 400 S TOWNLINE RD WAUTOMA WI 54982 391181480 501(C)(3) 10000 0 COMMUNITY HEALTH CENTER PARTICIPATION SUPPORT MADISON COMMUNITY HEALTH CENTER INC 2901 W BELTLINE HWY STE 120 MADISON WI 53713 391391134 501(C)(3) 10000 0 COMMUNITY HEALTH CENTER PARTICIPATION SUPPORT PROGRESSIVE COMMUNITY HEALTH CENTERS INC 3522 WEST LISBON AVENUE MILWAUKEE WI 53208 391958810 501(C)(3) 10095 0 COMMUNITY HEALTH CENTER PARTICIPATION SUPPORT 6 0 PART I, LINE 2: WISCONSIN PRIMARY HEALTH CARE ASSOCIATION, INC. MAINTAINS RECORDS OF WHICH ORGANIZATIONS RECEIVE GRANTS AND FINANCIAL ASSISTANCE. THE ORGANIZATION MONITORS THE USE OF GRANT FUNDS THROUGH COMPLIANCE WITH FEDERAL FUNDING SOURCE MONITORING REGULATIONS AND ONGOING ONSITE MONITORING. PAMELA CROUSE SPOUSE OF BYRON CROUSE, BOARD MEMBER 72488 EMPLOYED BY THE ORGANIZATION - INCLUDES BASE SALARY AND BENEFITS. 0 FORM 990, PART VI, SECTION A, LINE 4 NOTE FROM BOARD MINUTES: BOARD REVISED THE MISSION, VISION AND VALUES. FORM 990, PART VI, SECTION A, LINE 6 THERE ARE THREE CATEGORIES OF MEMBERSHIP IN WPHCA: HEALTH CENTER MEMBERSHIP - HEALTH CENTER MEMBERSHIP IN WPHCA IS AVAILABLE TO ANY INVITED ORGANIZATION WHICH SUPPORTS THE PURPOSE AND GOALS OF THE CORPORATION AND ACTIVELY ENGAGES IN THE OPERATION OF COMMUNITY-BASED PRIMARY HEALTH CARE SERVICE DELIVERY PURSUANT TO SECTION 330 OF THE PUBLIC HEALTH SERVICE ACT (42 U.S.C. 254B) AS AMENDED, AND UNDER A GRANT FROM THE FEDERAL HEALTH RESOURCES AND SERVICES ADMINISTRATION. HEALTH CENTER MEMBERS, THROUGH THEIR REPRESENTATIVE DIRECTOR, HAVE ONE VOTE PER HEALTH CENTER FOR ELECTIONS AND OTHER CORPORATION BUSINESS CONDUCTED AT ANNUAL MEETINGS. STAFF EMPLOYEES OF HEALTH CENTER MEMBERS ARE ELIGIBLE TO PARTICIPATE ON CORPORATE COMMITTEES, AND ARE ELIGIBLE TO SERVE IN ONE OF THE ELECTED POSITIONS ON THE CORPORATION'S BOARD OF DIRECTORS. AFFILIATE MEMBERSHIP - INDIAN TRIBAL CLINICS (OPERATED UNDER PUBLIC LAW 93-638 OF THE INDIAN SELF-DETERMINATION ACT), FEDERALLY QUALIFIED HEALTH CENTER LOOK-ALIKES (OPERATED UNDER SECTION 1905 OF THE SOCIAL SECURITY ACT) OR ANY ENTITY WHICH SUPPORTS THE PURPOSE AND GOALS OF THE CORPORATION AND DOES NOT MEET THE REQUIREMENTS FOR HEALTH CENTER MEMBERSHIP, ARE ELIGIBLE TO BECOME AFFILIATE MEMBERS. AFFILIATE MEMBERS SHALL APPOINT A REPRESENTATIVE TO THE CORPORATION. AFFILIATE MEMBERS OR THEIR REPRESENTATIVES ARE NON-VOTING MEMBERS IN THE ANNUAL MEETING. INDIVIDUAL MEMBERSHIP - INDIVIDUAL MEMBERSHIP IN THE ORGANIZATION IS OPEN TO ANY PERSON WHO SUPPORTS THE PURPOSE AND GOALS OF THE CORPORATION. INDIVIDUAL MEMBERS ARE NON-VOTING MEMBERS IN THE ANNUAL MEETING. FORM 990, PART VI, SECTION A, LINE 7A THE ORGANIZATION HAS MEMBERS WHO MAY ELECT THE GOVERNING BODY. HEALTH CENTER MEMBERS, THROUGH THEIR REPRESENTATIVE DIRECTOR, HAVE ONE VOTE PER HEALTH CENTER FOR GOVERNING BODY ELECTIONS. FORM 990, PART VI, SECTION B, LINE 11 THE 990 IS REVIEWED IN A SIMILAR MANNER AS THE ANNUAL AUDIT. A DRAFT COPY IS PROVIDED BY THE AUDIT FIRM. THE CHIEF EXECUTIVE OFFICER REVIEWS A COPY OF THE FORM 990 AND MAKES ANY NECESSARY CORRECTIONS. THE FINAL COPY IS PROVIDED TO THE WPHCA BOARD OF DIRECTORS FOR REVIEW AND APPROVAL PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C WPHCA BOARD MEMBERS AND STAFF SIGN A CONFLICT OF INTEREST DISCLOSURE FORM ON AN ANNUAL BASIS. ANY CONFLICT OF INTEREST IS BROUGHT TO THE BOARD FOR EVALUATION AND DECISION-MAKING. AN INTERESTED PERSON MAY MAKE A PRESENTATION AT THE BOARD OR COMMITTEE MEETING, BUT AFTER SUCH PRESENTATION, HE/SHE SHALL LEAVE THE MEETING DURING THE DISCUSSION OF, AND THE VOTE ON, THE TRANSACTION OR ARRANGEMENT THAT RESULTS IN THE CONFLICT OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15 ON AN ANNUAL BASIS, THE PERSONNEL COMMITTEE EVALUATES THE CHIEF EXECUTIVE OFFICER'S COMPENSATION PACKAGE BASED ON THE MARKET AND THE CHIEF EXECUTIVE OFFICER PERFORMANCE. RECOMMENDATIONS ARE BROUGHT TO THE BOARD FOR EVALUATION AND APPROVAL. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G OTHER: PROGRAM SERVICE EXPENSES 186,127. MANAGEMENT AND GENERAL EXPENSES 86,831. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 272,958.