2014-11-03T12:49:32-06:00 2014-03-31 390758449 WIPFLI LLP PO BOX 8700 MADISON WI 537088700 990 2013-04-01 391407034 WISCONSIN PRIMARY HEALTH CARE ASSOCIATION INC WISC 6082777477 5202 EASTPARK BLVD NO 109 MADISON WI 53718 STEPHANIE HARRISON CHIEF EXECUTIVE OFFICER 6082777477 2014-10-21 1 JOHN HEMMING P00856805 6082741980 2014-10-21 2013 2015-11-30 17:44:51Z STEPHANIE HARRISON 5202 EASTPARK BLVD NO 109 MADISON WI 53718 2194654 0 X WWW.WPHCA.ORG X 1982 WI TO HELP PROVIDE ACCESS TO COMPREHENSIVE, COMMUNITY-ORIENTED PRIMARY HEALTH CARE SERVICES. 23 23 49 26 0 0 1789204 1822623 399795 369361 3335 1819 0 0 2192334 2193803 45008 27023 0 0 1239277 1489248 0 0 28741 895618 652409 2179903 2168680 12431 25123 1782465 1147460 1234170 574042 548295 573418 X THE MISSION OF WISCONSIN PRIMARY HEALTH CARE ASSOCIATION, INC. IS TO IMPROVE HEALTH THROUGH THE WORK OF COMMUNITY HEALTH CENTERS AND THEIR PARTNERS.WISCONSIN PRIMARY HEALTH CARE ASSOCIATION, INC. ENVISIONS A FUTURE WHERE ALL INDIVIDUALS AND COMMUNITIES IN WISCONSIN ACHIEVE THEIR HIGHEST HEALTH POTENTIAL. 0 0 670237 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. 386824 0 0 HEALTH INFORMATION QUALITY PROGRAM: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. 348640 11959 156723 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. 184356 0 0 KRESGE/STAR PROJECT 80755 0 0 ADVOCACY 58098 0 0 HPSA DESIGNATIONS 166852 15064 212638 OTHER PROGRAMS - INCLUDES THE FOLLOWING PROGRAMS:RETENTION, DIABETES PROGRAM, CHRONIC DISEASE, CANCER PROGRAM, BIOTERRORISM HOSPITAL PREPAREDNESS, COMMUNITY HEALTH VOTE, PFIZER/PAIN MANAGEMENT, RCHN, MEMBERSHIP, FEE FOR SERVICE AND OTHER. 490061 15064 212638 1895762 1 1 0 1 0 0 0 0 1 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 11 0 1 49 1 0 0 0 0 0 0 0 0 0 0 X 23 23 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 WI X KHADIJA ELDACHACH 6082777477 5202 EASTPARK BLVD SUITE 109 MADISON WI 53718 BRIAN AHLGREN DIRECTOR 1.00 X 0 0 0 DANIEL BECKER DIRECTOR (THRU OCT 2013) 1.00 X 0 0 0 LIZ BADE 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 DAVID HUGHES DIRECTOR (THRU APR 2013) 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 115827 0 16476 KHADIJA ELDACHACH BUSINESS OPERATIONS MANAGER 45.00 X 62102 0 8156 DANIEL PETERSON HIQ DIRECTOR 45.00 X 123139 0 4523 301068 0 29155 2 0 0 0 0 1600285 222338 1822623 MEMBERSHIP DUES 900099 327413 327413 FEE FOR SERVICE INCOME 561499 28302 28302 13646 13646 369361 1970 1970 700 851 -151 -151 -151 2193803 369361 0 1819 27023 27023 210308 127132 83176 946363 926391 2779 17193 20593 20533 60 222249 211473 652 10124 89735 83372 4939 1424 7331 7331 13595 13595 200344 157609 42735 89970 67252 22718 116818 90476 26342 48675 33693 14982 77574 54632 22942 8312 6957 1355 14327 11219 3108 DUES AND SUBSCRIPTIONS 55766 44045 11721 BOARD EXPENSES 8490 6228 2262 RECRUITMENT 2096 1754 342 BAD DEBT EXPENSE 1500 1255 245 7611 3792 3819 2168680 1895762 244177 28741 177045 335646 488173 496252 205625 180876 17985 57008 24844 31057 79120 32499 18793 46621 850000 0 1782465 1147460 161928 141679 222242 432363 850000 0 1234170 574042 X 533808 565368 14487 8050 548295 573418 1782465 1147460 25123 0 X 0 1 X 1 1 1 X 1086555 1429250 1744003 1789204 1822623 7871635 1086555 1429250 1744003 1789204 1822623 7871635 212996 7658639 2808 5170 2810 3335 1970 16093 7887728 1576978 0.97100 0.99250 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 10092 72921 83013 1812749 1895762 244788 61197 0 0 237013 255878 258995 244788 996674 1495011 48216 71567 123532 83013 326328 59253 63970 64749 61197 249169 373754 32736 66120 39185 10092 148133 0 1 X 21310 2486 18824 57810 30013 27797 46621 X 2193803 0 2193803 0 2193803 2168680 0 2168680 0 2168680 PART IV, LINE 2B: WISCONSIN PRIMARY HEALTH CARE ASSOCIATION, INC. (WPHCA) ACTS AS THE FISCAL AGENT FOR THE MILWAUKEE COMMUNITY HEALTH CENTERS. RESTRICTED CASH AND DUE TO MCHC ARE FUNDS HELD BY WPHCA FOR THE OTHER NONPROFIT ORGANIZATION. 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 2011 AND BEYOND REMAIN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE. 1 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. PART II THE ORGANIZATION DID NOT GIVE ANY GRANTS OR ASSISTANCE TO ORGANIZATIONS IN THE UNITED STATES THAT EXCEEDED $5,000. PAMELA CROUSE SPOUSE OF BYRON CROUSE, BOARD MEMBER 64726 EMPLOYED BY THE ORGANIZATION - INCLUDES BASE SALARY AND BENFITS. 0 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.