2022-08-30T14:02:20-05:00 2021-12-31 481026809 Wendling Noe Nelson & Johnson LLC 623 SW 10th Ave Suite 300 Topeka KS 66612 990 2021-01-01 943483497 Kansas Healthcare Collaborative Inc KANS 7852350763 623 SW 10th Avenue Topeka KS 66612 Malea Hartvickson Executive Director 7852350763 2022-08-28 1 Malea Hartvickson 999009999 Eric L Otting P00298454 7852334226 2022-08-29 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z Malea Hartvickson 623 SW 10th Avenue Topeka KS 66612 1921743 0 X www.khconline.org X 2009 KS The Kansas Healthcare Collaborative (KHC) exists to transform health care through patient-centered initiatives that improve quality, safety, and value 18 16 15 19 0 0 1807068 1814525 34864 1500 17244 27194 0 0 1859176 1843219 0 0 0 0 1437071 1754776 0 0 0 347866 541802 1784937 2296578 74239 -453359 2924829 2257795 368185 143985 2556644 2113810 Engaging and aligning providers and stakeholders to establish Kansas as a role model for health care quality and a top performer in health care outcomes. 0 0 1653719 1500 Dedicated to transforming health care through patient-centered initiatives that improve quality, safety, and value while being the trusted source for relevant and meaningful health care quality improvement education, evaluation, and measurement. 220147 Kansas Department of Health and Environment (KDHE) has entered into a Cooperative Agreement with the CDC Division of Diabetes Translation and the Division of Heart Disease and Stroke Prevention to address the prevention and management of diabetes, heart disease, and stroke in Kansas. The long-term objectives of this Cooperative Agreement include decreasing the proportion diabetic individuals with an A1c>9, increasing the number of pre-diabetic individuals enrolled in a CDC-recognized lifestyle change program in which participants achieve 5-7% weight loss, and increasing control among adults with known high blood cholesterol. KDHE has entered into a contract with the Collaborative to work with providers and clinics in selected counties to implement the program and grant strategies. 189972 The Collaborative has entered into an agreement with Health Quality Innovators (HQI) to assist with the delivery of services related to the Indefinite Delivery/Indefinite Quality (TDIQ) contract which HQI has with the Centers for Medicare and Medicaid Services to become a Network of Quality Improvement and Innovation Contractor. The Collaborative is assisting in recruiting participation in the study from Kansas communities and assisting with the conduct of the study. 2063838 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 24 0 1 15 1 0 0 0 0 0 0 0 0 0 0 0 0 X 18 16 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 X Rhonda Lassiter 7852352383 623 SW 10th Avenue Topeka KS 66612 Samer Antonios MD Director 1.00 X 0 0 0 Craig Concannon MD Director 1.00 X 0 0 0 Chad Austin Director 1.00 39.00 X 0 0 0 Deborah Bruner Director 1.00 X 0 0 0 Joe Davison MD Director 1.00 X 0 0 0 Liz Carlton Director 1.00 X 0 0 0 Rachelle Colombo Director 1.00 39.00 X 0 0 0 Niceta Farber Director 1.00 X 0 0 0 Aron Fast MD Vice Chair 1.00 X X 0 0 0 Lynn Fisher MD Past Chair 1.00 X X 0 0 0 Jerry Slaughter Secretary/Treasurer 1.00 X X 0 0 0 Margaret Grismer Director Thru Feb. 2021 1.00 X 0 0 0 George Stover Director 1.00 X X 0 0 0 Allen Greiner MD Director 1.00 X 0 0 0 AJ Thomas Director 1.00 X 0 0 0 Jeremy Ensey Director 1.00 X 0 0 0 Brian Williams Chair 1.00 X X 0 0 0 Debra Doubek MD Director 1.00 X 0 0 0 Kiley Floyd Director Beg. Feb. 2021 1.00 X 0 0 0 Allison Degroff Executive Director thru Aug. 2021 40.00 X 271783 0 16215 Michele Clark Program Director 40.00 X 114363 0 25002 Rosanne Rutkowski Program Director 40.00 X 104838 0 14790 490984 0 56007 3 0 1 0 Your Part-Time Controller LLC PO Box 1209 Mount Laurel NJ 08054 Contract accounting 129188 1 1204213 610312 1814525 Other program cost rei 900099 1500 1500 1500 14518 14518 91200 78524 12676 12676 12676 1843219 1500 0 27194 X 288000 216000 72000 1084605 1065663 18942 276810 269572 7238 105361 99356 6005 8664 8664 332273 290426 41847 47582 25804 21778 75829 62416 13413 39048 39048 5433 3759 1674 32973 30842 2131 2296578 2063838 232740 0 311055 99500 1302183 1130100 736529 338083 22169 33558 552893 656554 2924829 2257795 123678 143985 244507 0 368185 143985 X 2410644 1788784 146000 325026 2556644 2113810 2924829 2257795 -453359 10525 0 X X 1 X 0 1 0 X X 2 Kansas Medical Society 480289660 10 0 1371214 0 Kansas Hospital Association Inc 480543786 10 0 692624 0 2 2063838 0 1 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 PART IV, SECTION A, LINE 2 Description of how organization determined supported organizations: The supported organizations, Kansas Hospital Association (KHA) and Kansas Medical Society (KMS), both derive over 2/3 of their revenue from program service revenue and membership dues. Less than 10% of the supported organizations' revenue is attributable to investment income. PART IV, SECTION, LINE 3B Description of when and how organization made the determinate: The organization has a close relationship with the supported organizations because 50% of its directors are appointed by the Kansas Hospital Association (KHA) and 50% of its directors are appointed by the Kansas Medical Society (KMS). The president and CEO of KHA and the Executive Director of KMS are ex-officio voting directors of the filing organization. Therefore, the filing organization has extensive knowledge of the activities of the supported organizations. PART IV, SECTION A, LINE 3C Explain what controls the organization put in place: The filing organization's expenditures are made to conduct activities and programs in conjunction with the supported organizations. These activities and programs are scientific or educational in purpose. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 X Part X, Line 2: Management is not aware of any uncertain tax positions. X X 1 0 0 0 0 0 0 0 0 Allison Degroff Executive Director thru Aug. 2021 105340 0 0 0 166443 0 5192 0 11023 0 287998 0 0 0 Part I, Line 4a Allison DeGroff received a severance payment of $166,443. Form 990, Part VI, Section B, line 11b The Form 990 is reviewed by the Board of Directors prior to filing. Form 990, Part VI, Section B, line 12c Board members are required to disclose any conflicts. Form 990, Part VI, Section B, line 15a Outside firm and survey data is used by the Executive Committee of the board to determine the compensation of the Executive Director. Data is comprised of similar positions from across the country. Form 990, Part VI, Section C, line 19 The Organization provides its governing documents, conflict of interest policy, and financial statements to the public if asked. Form 990, Part IX, line 11g Professional fee consultants: Program service expenses 290,426. Management and general expenses 41,847. Fundraising expenses 0. Total expenses 332,273. Form 990, Part XII, Line 2c The organization has made no changes to the oversight process or selection process during the tax year. Part VII, Section A. Line 1a In accordance with the instructions to the Form 990, the compensation earned by directors from member entities KHA and KMS should be reported in column (e) and column (f) of Form 990, part VII, section A, as related party compensation. In lieu of reporting this information, the 990s of member entities reporting this information are available upon request once they have been filed and available publically. No compensation is received by the board of trustees from KHC. Kansas Medical Society 623 West 10th Topeka KS 66612 480289660 Membership organization for Kansas providers KS 501 (C)(6) N/A 0 Kansas Hospital Association 215 SE 8th Ave Topeka KS 66603 480543786 Membership organization for Kansas hospitals KS 501 (C)(6) N/A 0 0 0 0 0 0 0 0 0 0 0 1 0 1 1 0 0 0 0 0