2013-02-15T14:44:17-06:00 2012-03-31 410746749 CLIFTONLARSONALLEN LLP 610 NORTH 39TH AVENUE YAKIMA WA 98902 990 2011-04-01 911019392 YAKIMA VALLEY FARM WORKERS CLINIC YAKI 5098655898 PO BOX 190 TOPPENISH WA 98948 K PETER TOOP 5098655898 2013-02-15 1 RALPH A CONNER CPA P00185729 5098232910 2013-02-14 2011 2016-03-07 17:11:31Z JUAN CARLOS OLIVARES PO BOX 190 TOPPENISH WA 98948 168268035 0 X WWW.YVFWC.ORG X 1978 WA YVFWC PROVIDES COMPREHENSIVE HEALTH SERVICES AS WELL AS EDUCATIONAL AND SOCIAL PROGRAMS IN UNDERSERVED AND RURAL REGIONS THROUGHOUT WASHINGTON AND OREGON STATES. ALTHOUGH OUR SERVICES ARE AVALIABLE TO ALL PEOPLE, THE MAJORITY OF OUR PATIENTS QUALIFY AS LOW INCOME UNDER STATE AND FEDERAL GUIDELINES. YVFWC'S SIGNIFICANT FUNCTIONS CONSIST OF OPERATING MEDICAL AND DENTAL CLINICS. 11 11 2166 320 0 0 34634947 35349358 103908074 88971234 1566986 1444878 0 0 140110007 125765470 5960315 4308251 0 0 85086456 81201549 0 0 719296 44241127 38928779 135287898 124438579 4822109 1326891 151001790 173007141 42475191 63536785 108526599 109470356 THE MISSION OF YVFWC IS TO IMPROVE LIVES AND STRENGTHEN THE HEALTH OF HTE COMMUNITIES THAT WE SERVE BY PROVIDING QUALITY, AFFORDABLE, AND ACCESSIBLE HEALTH CARE. 0 0 88622908 1958487 85034450 MEDICAL AND DENTAL PRIMARY CARE SERVICES, CASE MANAGEMENT, WIC AND OTHER SUCH PROGRAMS PROVIDED ON A SLIDING FEE BASIS. DURING THE YEAR THERE WERE 418,400 MEDICAL, 85,600 DENTAL AND 13,200 CASE MANAGEMENT ENCOUNTERS. 7451979 2349764 -2082 LOW INCOME ENERGY ASSISTANCE, HOME WEATHERIZATION, AND EDUCATION AND COUNSELING SERVICES. DURING THE YEAR THERE WERE 23,858 INDIVIDUALS SERVED. 4614932 5383744 MENTAL HEALTH COUNSELING AND CHEMICAL DEPENDENCY COUNSELING. MENTAL HEALTH AND CHEMICAL DEPENDENCY ENCOUNTERS DURNING THE YEAR WERE 30,500. 100689819 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 363 0 1 2166 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 11 11 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 OR X X K PETER TOOP 5098655898 518 W 1ST AVE TOPPENISH WA 989480190 TOM SAK 1.00 X X 0 0 0 VIRGINIA SANTILLANES 1.00 X X 0 0 0 MIGUEL ESQUIVEL 1.00 X 0 0 0 ALFREDO ACEVES 1.00 X 0 0 0 MARTIN TORRES 1.00 X 0 0 0 MARIA GUADALUPE PEREZ 1.00 X 0 0 0 LORENZO CUEVAS 1.00 X 0 0 0 ELIZA CERNA 1.00 X X 0 0 0 JOSE ALBERTO NUNEZ 1.00 X 0 0 0 SANDRA APRIL 1.00 X 0 0 0 PATRICIA MYERS 1.00 X X 0 0 0 JUAN CARLOS OLIVARES 40.00 X 544453 0 132492 K PETER TOOP 40.00 X 239699 0 7142 GLEN W DAVIS 40.00 X 163584 0 29293 ROSS RONISH 40.00 X 290584 0 52998 NORMAN J NAIDEN 40.00 X 548730 0 11904 MICHAEL JACH 40.00 X 453684 0 30540 JAMES U OPARA 40.00 X 423103 0 44812 CHRISTOPHER GOODWIN 40.00 X 333451 0 33786 ANITA SHOWALTER 40.00 X 340393 0 7228 3337681 0 350195 122 0 1 0 PATHOLOGY ASSOCIATES PO BOX 2687 SPOKANE WA 99220 LAB SERVICE 1655383 MCKESSON INFORMATION PO BOX 98347 CHICAGO IL 60693 COMPUTER SERVICES 683510 ABM JANITORIAL SERVICES PO BOX 60000 SAN FRANCISCO CA 94107 CLEANING SERVICES 683366 CHERVENELL CONSTRUCTION PO BOX 6935 KENNEWICK WA 99336 CONSTRUCTION 634157 TRI PLY CONSTRUCTION PO BOX 2872 YAKIMA WA 98907 CONSTRUCTION 614439 20 35064508 284850 35349358 MEDICAL, DENTAL, PHARM 621400 83597999 83597999 MENTAL HEALTH & SUBSTA 621400 5375317 5375317 COMMUNITY ACTION CENTE 621400 -2082 -2082 88971234 1547746 1547746 42373697 26000 42481351 21214 -107654 4786 -102868 -102868 125765470 88971234 0 1444878 1958487 1958487 2349764 2349764 1304719 1304719 64758430 53915678 10516008 326744 1456103 1159961 289523 6619 7983133 6667125 1282818 33190 5699164 4750350 917939 30875 176581 5750 170831 70925 70925 140633 140633 9294929 7435262 1615433 244234 771014 298051 472963 4162665 3254212 899526 8927 2526458 641967 1880313 4178 2610311 1968014 621113 21184 1278514 843042 426313 9159 328666 328666 5272421 3708183 1564238 1251353 1250263 1090 MEDICAL SUPPLIES 6883811 6883811 BAD DEBTS 1241551 1241551 OTHER EXPENSES 1116038 770752 341478 3808 RECRUITMENT 954277 497340 427131 29806 848632 761590 86470 572 124438579 100689819 23029464 719296 1760820 4260377 16844391 12167273 2968239 2699376 5577195 6992440 5040 644404 717049 758786 827914 96648138 46671143 47628473 49976995 69124293 68707497 5695189 26653180 151001790 173007141 18082619 41947349 34230 2000 14291251 12845719 10067091 8741717 42475191 63536785 X 108526599 109470356 108526599 109470356 151001790 173007141 X 1326891 -383134 X 0 1 1 X 1 1 X 24849192 28900817 30503829 34634947 35349358 154238143 24849192 28900817 30503829 34634947 35349358 154238143 154238143 4199552 3606618 2029619 1650137 1547746 13033672 167271815 481487822 0.92210 0.89800 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 5999212 5999212 60697639 28741214 31956425 12148631 3082224 9066407 17802656 14847705 2954951 49976995 PLEDGE RECEIVABLE 150 OTHER RECEIVABLES 1314031 FQHC RECEIVABLE 5277090 HRSA RECEIVABLE 20061909 26653180 PHYSICIAN'S INSURANCE RESERVE 2378630 PLEDGE PAYABLE TO NP SUB AGENA 5900000 BASIS HEALTH RESERVE 463087 8741717 125765470 124438579 1326891 -383134 -383134 943757 125382336 -383134 -383134 125765470 0 125765470 124438579 0 124438579 0 124438579 PART X FIN 48 FOOTNOTE UNDER PROVISIONS OF SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE, THE ORGANIZATION IS EXEMPT FROM FEDERAL INCOME TAXES, EXCEPT FOR NET INCOME FROM UNRELATED BUSINESS ACTIVITIES. AS OF MARCH 31, 2012, THE ORGANIZATION HAD NO UNRELATED BUSINESS ACTIVITIES SUBJECT TO FEDERAL INCOME TAXES MANAGEMENT EVALUATED THE ORGANIZATION'S TAX POSITIONS AND CONCLUDED THAT THE OKRGANIZATION HAD TAKEN NO UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENTS TO THE FINANCIAL STATEMENTS TO COMPLY WITH THE PROVISIONS OF THIS GUIDANCE. THE ORGANIZATION IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS BY TAX AUTHORITIES FOR YEARS BEFORE 2009. 1 AGENA PO BOX 190 TOPPENISH WA 98948 203316363 501(C)(3) 1900000 GENERAL SUPPORT 1 DIRECT PAYMENTS FOR HOUSING AND ENERGY SERVICES 23858 2349764 PART III, COLUMN (A) AND OTHER LIVING COSTS FOR PROGRAM PAYMENTS WHO ARE MANDATED BY THE STATE TO BE IN THIS ASSISTANCE PROGRAM AND DIRECT PAYMENTS FOR HOUSEHOLD ENERGY SERVICES(HEATING FUEL, GAS, OIL, ELECTRICITY, ETC.) FOR INDIVIDUALS AND FAMILIES. RECIPIENTS QUALIFY FOR ASSISTANCE BASED ON INCOME AND ALL PROGRAMS ARE NONDISCRIMINATORY. X 1 1 X X X X X 0 0 0 0 0 0 0 0 0 JUAN CARLOS OLIVARES 338377 0 139006 0 67070 0 120883 0 11609 0 676945 0 0 0 K PETER TOOP 212228 0 16373 0 11098 0 0 0 7142 0 246841 0 0 0 GLEN W DAVIS 153382 0 150 0 10052 0 11655 0 17638 0 192877 0 0 0 ROSS RONISH 279514 0 150 0 10920 0 21379 0 31619 0 343582 0 0 0 NORMAN J NAIDEN 546096 0 250 0 2384 0 0 0 11904 0 560634 0 0 0 MICHAEL JACH 219867 0 50 0 233767 0 0 0 30540 0 484224 0 208318 0 JAMES U OPARA 162459 0 150 0 260494 0 0 0 44812 0 467915 0 255913 0 CHRISTOPHER GOODWIN 164384 0 17426 0 151641 0 0 0 33786 0 367237 0 175265 0 ANITA SHOWALTER 337600 0 0 0 2793 0 0 0 7228 0 347621 0 34633 0 SUPPLEMENTAL INFORMATION PART III PART II, B, (I) BASE COMPENSATION: YVFWC USES MARKET SURVEY DATA PRODUCED BY AN INDEPENDENT COMPENSATION CONSULTING FIRM TO ASSIST IN DETERMINING SALARIES FOR PHYSICIANS AND MANAGEMENT STAFF. THE BOARD OF DIRECTORS, USING THESE DATA, SET THE COMPENSATION FOR THE EXECUTIVE DIRECTOR; THE EXECUTIVE DIRECTOR DETERMINES THE SALARIES FOR MANAGEMENT STAFF. INCREASES ARE BOTH PERFORMANCE AND MARKET BASED AND ACCOMPANIED BY A WRITTEN EVALUATION. PHYSICIAN COMPENSATION IS LINKED TO THEIR PRODUCTIVITY AS MEASURED BY WORK BASED RELATIVE VALUE UNITS. PART II, B, (II) BONUS AND INCENTIVE COMPENSATION: AS WITH BASE COMPENSATION, THESE COMPONENTS ARE ALSO BASED UPON MARKET DATA PROVIDED BY AN INDEPENDENT FIRM. PART II, B, (III) OTHER REPORTABLE COMPENSATION: IT IS YVFWC POLICY TO, AT THE END OF EACH CALENDAR YEAR, TO REMOVE ALL UNUSED VACATION HOURS IN EXCESS OF 480 HOURS THROUGH A PAYOUT. IN ADDITION, UPON HIRE, PHYSICIANS AND DENTISTS ARE ENROLLED INTO A DEFINED CONTRIBUTION RETIREMENT SAVINGS PROGRAM. DURING A PROVIDERS TENURE WITH THE CORPORATION, CONTRIBUTIONS ARE MADE INTO THIS SAVINGS PROGRAM; UPON THE PROVIDERS 15TH ANNIVERSARY OF CONTINUOUS EMPLOYMENT WITH THE CORPORATION, THEY FULLY VEST IN THE PROGRAM AT WHICH TIME THE FUND VALUE BECOMES TAXABLE AND IS REPORTED HERE. PART II B (C) RETIREMENT AND OTHER DEFERRED COMPENSATION: AFTER CONSULTING WITH AN INDEPENDENT FIRM TO DETERMINE APPROPRIATE MARKET COMPENSATION AND BENEFIT PACKAGE FOR THE EXECUTIVE DIRECTOR OF A CORPORATION THE SIZE AND COMPLEXITY OF YVFWC, THE BOARD OF DIRECTORS IMPLEMENTED AN EXECUTIVE RETENTION PROGRAM. AS PART OF THAT PACKAGE THE BOARD INCLUDED A REQUIREMENT THE EXECUTIVE DIRECTOR SIGN A FIVE YEAR EMPLOYMENT CONTRACT; IN EXCHANGE FOR SIGNING THE CONTRACT, REMAINING IN THE POSITION FOR FIVE YEARS, AND COMPLETING CERTAIN GOALS THE EXECUTIVE DIRECTOR WILL RECEIVE A STIPULATED BONUS AT THE END OF THE PERIOD. SHOULD THE EXECUTIVE DIRECTOR LEAVE PRIOR TO THE END OF THE FIVE YEARS, NO PAYMENT IS MADE. THE VALUE SHOWN IN COLUMN C IS 25% OF THE BONUS FOR WHICH THE EXECUTIVE DIRECTOR MAY BE ELIGIBLE. PART II, B, (D) NONTAXABLE BENEFITS: THIS COLUMN DISPLAYS THE VALUE OF THE HEALTH PLAN PROVIDED FOR ALL EMPLOYEES BY THE CORPORATION. IN ADDITION, SOME MANAGEMENT EMPLOYEES PARTICIPATE IN A SERP PLAN FUNDED BY THE CORPORATION. THE HOSPITAL FACILITY AUTHORITY OF UMATILLA COUNTY 931239006 2008-11-13 4189500 CONSTRUCT HERMISTON MEDICAL BUILDING 0 0 0 WASHINGTON HEALTH CARE FACILITIES AUTHORITY 911108929 2007-03-22 6100000 CONSTRUCT PROSSER MEDICAL BUILDING 0 0 0 WASHINGTON HEALTH CARE FACILITIES 911108929 2004-03-17 4368000 CONSTRUCT LINCOLN MEDICAL BUILDING 0 0 0 WASHINGTON HEALTH CARE FACILITIES AUTHORITY 911108929 2003-06-10 3000000 REMODEL YAKIMA MEDICAL BUILDING 0 0 0 4189500 5500 4184000 2008 0 0 1 1 6100000 6100000 2007 0 0 1 1 4368000 46082 4321918 2005 0 0 1 1 3000000 50000 2950000 2005 0 0 1 1 0 0 0 0 1 0 1 0 0 0.06800 0.06800 1 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 TOM SAK X 4218 3079 0 0 1 CARLOS OLIVARES X 1961 1961 0 1 0 5040 PART II PURPOSE OF LOANS TOM SAK, AS A MEMBER OF THE YVFWC BOARD, WAS ASKED TO PARTICIPATE ON THE ETHICS COMMITTEE OF THE COMMUNITY HEALTH PLAN OF WASHINGTON (CHPW), A MAJOR INSURER OF YVFWC PATIENTS. AS MR. SAK IS A USER OF CHPW AND YVFWC SERVICES AND QUALIFIES AS LOW INCOME UNDER THE FEDERAL GUIDELINES GOVERNING YVFWC, MANAGEMENT CONSIDERED IT IMPORTANT TO HAVE MR. SAK REPRESENT THE PERSPECTIVE OF LOW INCOME USERS AT THE CHPW LEVEL. COMMITTEE MEETINGS REQUIRE TRAVEL AND LODGING, SO TO FACILITATE MR. SAKS PARTICIPATION THE ORGANIZATION PROVIDED UP FRONT MONEY IN THE FORM OF A LOAN. THE LOAN INCURS MARKET INTEREST (APPLICABLE FEDERAL RATE) AND REPAYMENT IS SECURED BY THE STIPEND MR. SAK RECEIVES FOR SERVING ON THE COMMITTEE.AS CEO JUAN CARLOS OLIVARES IS REQUIRED TO DO EXTENSIVE TRAVEL FOR WHICH THE CORPORATION PROVIDES A CREDIT CARD FOR BUSINESS EXPENSES. IN THE COURSE OF TRAVEL THERE ARE TIMES WHEN MR. OLIVARES INCURS EXPENSES NOT RELATED TO YVFWC BUSINESS WHICH HE THEN SUBSEQUENTLY REIMBURSES. FORM 990, PART VI, SECTION B, LINE 11 LINE 11A EXPLANATION - A PAPER COPY OF THE FORM 990 IS MADE AVALIABLE TO ALL BOARD MEMBERS. IN ADDITION, THE FINANCE COMMITTEE OF THE BOARD OF DIRECTORS MEETS TO REIVEW THE FORM 990 IN DETAIL WITH THE CHIEF FINANCIAL OFFICER AND CONTROLLER. FORM 990, PART VI, SECTION B, LINE 12C PERIODIC REMINDERS ARE MADE TO BOARD MEMBERS CONCERNING THE CONFLICT OF INTEREST POLICY. QUESTIONS CONCERNING CONFLICTS OF INTEREST AND DECLARATIONS OF CONFLICTS OF INTEREST ARE DULY RECORDED IN BOARD MEETING MINUTES. IN ADDITION, THE CHIEF COMPLIANCE OFFICER IS TASKED WITH INVESTIGATING ANY POTENTIAL VIOLATIONS OF THE POLICY. FORM 990, PART VI, SECTION B, LINE 15 FOR PURPOSES OF ESTABLISHING COMPENSATION THE BOARD ENGAGES THE SERVICES OF AN INDEPENDENT FIRM THAT UTILIZES MARKET SURVEYS AND REVIEWS OF COMPARABLE ORGANIZATIONS 990 FILINGS. THE BOARD THEN MEETS WITH THE OUTSIDE CONSULTANTS TO ANALYZE THE DATE. UTILIZING THIS DATA AND AN ANNUAL PERFORMANCE APPRAISAL THE BOARD THEN DETERMINES THE APPROPRIATE COMPENSATION PACKAGE FOR THE EXECUTIVE DIRECTOR. THE EXECUTIVE DIRECTOR UTILIZES MARKET DATA COMPILED BY THE INDEPENDENT FIRM AND PERFORMANCE APPRAISALS TO SET SALARIES FOR THE CORPORATE MANAGEMENT TEAM. FORM 990, PART VI, SECTION C, LINE 19 CORPORATE BYLAWS, CONFIICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AS RECORDED IN FORM 990 ARE AVALIAVLE UPON REQUEST MADE TO THE EXECUTIVE DIRECOR AT YVFWC ADMINISTRATIVE HEADQUARTERS AT P.O. BOX 190, TOPPENISH, WA 98948 CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS OR LOSSES ON INVESTMENTS -383,134. TOTAL TO FORM 990, PART XI, LINE 5: -383,134. AGENA PO BOX 190 TOPPENISH WA 98948 203316363 SUPPORT ORGANIZATION WA 501 (C)(3) 11A TYPE 1 YAKIMA VALLEY FARM WORKERS CLINIC 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 AGENA B 1900000 CASH