2022-05-19T14:51:43-05:00 2021-12-31 450250958 EIDE BAILLY LLP 200 E 10TH ST STE 500 SIOUX FALLS SD 571046375 990 2021-01-01 911776857 DELTA DENTAL OF SOUTH DAKOTA FOUNDATION DELT 6052247345 PO BOX 1157 PIERRE SD 57501 SCOTT JONES PRESIDENT 6052247345 2022-05-04 1 SCOTT JONES 999009999 LAURIE HANSON CPA P00851848 6053391999 2022-05-04 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z SCOTT JONES PO BOX 1157 PIERRE SD 57501 4623747 0 X WWW.DELTADENTALSD.COM X 1996 SD TO SUPPORT PROGRAMS THAT PROMOTE ORAL HEALTH. 10 9 0 6 0 0 4912950 2143964 601922 995837 453689 664205 0 0 5968561 3804006 1019860 1619218 0 0 0 0 0 0 43723 3486195 3687687 4506055 5306905 1462506 -1502899 12433819 12054282 550893 562271 11882926 11492011 X TO INITIATE, COLLABORATE AND/OR SUPPORT PROGRAMS THAT INCREASE ACCESS TO CARE, ENSURE AN ADEQUATE DENTAL WORK FORCE AND PREVENT DENTAL DISEASE. 0 0 2447112 859932 THE DELTA DENTAL MOBILE PROGRAM IS A STATEWIDE PROGRAM TO PROVIDE RESTORATIVE AND PREVENTIVE DENTAL CARE TO UNDERSERVED CHILDREN ACROSS SOUTH DAKOTA. FOR THE YEAR ENDED DECEMBER 31, 2021, A TOTAL OF 3,022 CHILDREN WERE PROVIDED ORAL HEALTH CARE. OF THE 3,022 CHILDREN SERVICED, 1,466 WERE MEMBERS OF MEDICAID, 1,238 HAD NO DENTAL INSURANCE, AND 318 CHILDREN HAD PRIVATE DENTAL INSURANCE. THE TWO TRUCKS PROVIDED 2,733 FLUORIDE VARNISHES, 2,382 CLEANINGS, 2,351 ORAL HEALTH INSTRUCTIONS, 13,530 SEALANTS AND ALL SERVICES PROVIDED ON THE TRUCKS HAD A VALUE OF CARE OF $2,753,267 FOR WHICH THE DELTA DENTAL FOUNDATION ONLY RECEIVED $647,809 IN COMPENSATING REVENUE FOR THE ABOVE SERVICES. 851078 135905 IN 2014 DELTA DENTAL WAS AWARDED A CMS GRANT TO PROVIDE DENTAL CARE ON SOUTH DAKOTA'S NINE INDIAN RESERVATIONS. THREE GROUPS WERE TARGETED - CHILDREN UNDER NINE YEARS OLD, PREGNANT WOMEN AND MOTHERS OF YOUNG CHILDREN, AND PEOPLE WITH DIABETES. THE PROGRAM SEEKS TO INCREASE PREVENTIVE DENTAL CARE INCLUDING CLEANINGS, DENTAL SEALANTS AND FLUORIDE VARNISHES, AND EDUCATE COMMUNITIES ABOUT ORAL HEALTH AND ITS RELATIONSHIP TO OVERALL HEALTH. THE CMS GRANT ENDED 06/30/2015, BUT THE FOUNDATION FOUND VALUE WITH THE PROGRAM AND DECIDED TO EXTEND THE SERVICES WITHOUT GRANT MONEY FOR CHILDREN THROUGH THE 8TH GRADE. THE COVID-19 PANDEMIC NEGATIVELY IMPACTED THE NUMBER OF SERVICES WE WERE ABLE TO PERFORM DURING THE YEAR. IN 2021, 1,645 PATIENTS WERE SEEN. THERE WERE 1,738 FLUORIDE VARNISHES APPLIED, 1,656 CLEANINGS PROVIDED, 1,683 PATIENTS GIVEN ORAL HEALTH INSTRUCTIONS, 4,975 SEALANTS PLACED FOR A TOTAL VALUE OF CARE OF $484,452 FOR WHICH THE DELTA DENTAL FOUNDATION ONLY RECEIVED $135,905 IN COMPENSATING REVENUE FOR THE ABOVE SERVICES. 1619218 1619218 0 $1,619,218 HAS BEEN CONTRIBUTED TO SPONSOR EDUCATIONAL PROGRAMS AND RESEARCH TO ADVANCE THE SCIENCE OF DENTISTRY AND TO EXTEND THE BENEFITS TO THOSE DENTALLY DEPRIVED. 4917408 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 9 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 10 9 0 0 0 0 1 1 0 1 0 0 0 1 1 1 1 1 1 0 0 0 X X KIRBY SCOTT 6052247345 720 N EUCLID AVE PIERRE SD 57501 SCOTT JONES PRESIDENT 1.00 40.00 X X 0 957636 57013 PAUL REZICH DDS VICE PRESIDENT 1.00 2.00 X X 0 15100 0 JOHN CLAUSEN CPA TREASURER 1.00 2.00 X X 0 14150 0 ELLEN LEE SECRETARY 1.00 1.00 X X 0 6850 0 MONTY BECHTOLD DDS DIRECTOR 1.00 1.00 X 0 12125 0 DALE GIBSON DDS DIRECTOR 1.00 X 0 0 0 THANE CRUMP DDS DIRECTOR 1.00 2.00 X 0 8750 0 ANLEE ROLA DDS DIRECTOR 1.00 1.00 X 0 8850 0 ROGER WILSON DDS DIRECTOR 1.00 X 0 0 0 STEPHANIE SCHMITZ DDS DIRECTOR 1.00 X 0 0 0 0 1023461 57013 0 0 1 0 DELTA DENTAL OF SOUTH DAKOTA PO BOX 1157 PIERRE SD 57501 SHARED SERVICES 2561397 BARTON ASSOCIATES INC PO BOX 417844 BOSTON MA 02241 CONTRACT STAFF 109570 2 1443723 642690 57551 2143964 DELTA DENTAL MOBILE PROGRAM 621990 995837 995837 995837 425665 425665 1058281 819741 238540 238540 238540 3804006 995837 0 664205 X 1442179 1442179 177039 177039 11609 11609 2587852 2405776 182076 10680 10680 223451 222200 1251 30000 24600 5400 279388 275987 3401 22105 21047 1058 201198 201198 40915 40915 INDIRECT COSTS 188194 65030 123164 FUNDRAISING EXPENSES 43723 43723 MAINTENANCE AND REPAIRS 38148 38148 10424 3289 7135 5306905 4917408 345774 43723 3032126 1426739 333115 394497 24205 42830 60000 120469 25033 25231 1371108 1359974 212332 11134 8728649 10019093 18359 14289 12433819 12054282 341250 358435 79369 74170 1500 130274 128166 550893 562271 X 11882926 11492011 11882926 11492011 12433819 12054282 X -1502899 1083584 28400 X 0 1 X 1 0 X X 2 DELTA DENTAL OF SOUTH DAKOTA 460309258 10 1 0 3298190 CLASS OF SUPPORTED ORGANIZATIONS 460309258 7 1 1619218 0 2 1619218 3298190 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 PART I, LINE 11G, COLUMN (III) TYPE OF ORGANIZATION: DELTA DENTAL OF SOUTH DAKOTA: 501(C)(4) CLASS OF SUPPORTED ORGANIZATIONS: 6, 7, AND 10 PART I, LINE 11G, COLUMN (VI): THE DELTA DENTAL MOBILE PROGRAM IS A STATEWIDE PROGRAM TO PROVIDE RESTORATIVE AND PREVENTIVE DENTAL CARE TO UNDERSERVED CHILDREN ACROSS SOUTH DAKOTA. DELTA DENTAL OF SOUTH DAKOTA IS INDIRECTLY SUPPORTED BY PROVIDING THE DELTA DENTAL MOBILE PROGRAM. PART IV, SECTION A, LINE 1: DELTA DENTAL OF SOUTH DAKOTA IS SPECIFIED BY NAME IN THE ARTICLES OF INCORPORATION. OTHER ORGANIZATIONS ARE SPECIFIED BY CLASS. THE ARTICLES OF INCORPORATION STATE THAT THE FUND WILL MAKE DISTRIBUTIONS TO ORGANIZATIONS THAT QUALIFY AS EXEMPT ORGANIZATIONS UNDER SECTION 501(C)(3) AND/OR SECTION 170(C)(2) AND/OR SECTION 501(A) OF THE INTERNAL REVENUE CODE THAT ARE CLOSELY RELATED IN PURPOSE OR FUNCTION TO DELTA DENTAL OF SOUTH DAKOTA. PART IV, SECTION A, LINE 3B: DELTA DENTAL OF SOUTH DAKOTA ANNUALLY PERFORMS A PUBLIC SUPPORT TEST UNDER SECTION 509(A)(2) TO CONFIRM THAT IT QUALIFIES AS A SUPPORTED ORGANIZATION. THIS IS PERFORMED DURING PREPARATION OF THE DELTA DENTAL OF SOUTH DAKOTA FORM 990 EXEMPT ORGANIZATION INCOME TAX RETURN. PART IV, SECTION A, LINE 3C: THE FOUNDATION WORKS CLOSELY WITH DELTA DENTAL OF SOUTH DAKOTA (DDSD) THROUGH OPERATING THE DELTA DENTAL MOBILE PROGRAM EXCLUSIVELY FOR SECTION 170(C)(2)(B) PURPOSES AND BY PROVIDING GRANTS TO OTHER ORGANIZATIONS THAT ARE EXEMPT AS 501(C)(3) OR GOVERNMENTAL ENTITIES THAT FURTHER DDSD'S MISSION OF ADVANCING AND PROMOTING THE IMPROVEMENT OF ORAL HEALTH. THE CEO AND PRESIDENT OF DDSD IS A DIRECTOR OF THE FOUNDATION, ALONG WITH 6 OF THE 15 CORPORATE BOARD MEMBERS OF DDSD. GRANTS ARE NOT DIRECTLY PROVIDED TO DDSD. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1371108 1359974 11134 11134 PAYABLE TO DELTA DENTAL OF SOUTH DAKOTA 128166 128166 X 4887590 1083584 1083584 3804006 0 3804006 5278505 0 5278505 28400 28400 5306905 PART X, LINE 2: THE FOUNDATION BELIEVES THAT IT HAS APPROPRIATE SUPPORT FOR ANY TAX POSITIONS TAKEN AFFECTING ITS ANNUAL FILING REQUIREMENTS, AND AS SUCH, DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS THAT ARE MATERIAL TO THE FINANCIAL STATEMENTS. THE FOUNDATION WOULD RECOGNIZE FUTURE ACCRUED INTEREST AND PENALTIES RELATED TO UNRECOGNIZED TAX BENEFITS AND LIABILITIES IN INCOME TAX EXPENSE IF SUCH INTEREST AND PENALTIES ARE INCURRED. PART XII, LINE 4B - OTHER ADJUSTMENTS: EXPIRED CONTINUING EDUCATION CERTIFICATES 28,400. 1 SOUTH DAKOTA DENTAL FOUNDATION PO BOX 1194 PIERRE SD 57501 460363251 501(C)(3) 62500 0 GENERAL SUPPORT ST FRANCIS MISSION FOUNDATION PO BOX 499 ST FRANCIS SD 57572 261904576 501(C)(3) 25000 0 DENTAL CARE SOUTH DAKOTA COMMUNITY FOUNDATION PO BOX 296 PIERRE SD 57501 460398115 501(C)(3) 200000 0 GENERAL SUPPORT UNIVERSITY OF SOUTH DAKOTA FOUNDATION 1110 N DAKOTA ST VERMILLION SD 57069 466018891 501(C)(3) 1100000 0 SUPPORT ORAL HEALTH CENTER AND OUTREACH DENTAL CLINIC SANFORD HEALTH FOUNDATION PO BOX 5039 SIOUX FALLS SD 57117 363297853 501(C)(3) 50000 0 COMMUNITY HEALTHCARE 5 0 LOAN REPAYMENTS 4 60000 EDUCATION & PREVENTION ASSISTING NEEDY CHILDREN 10631 71239 CONTINUING EDUCATION CERTIFICATES 458 45800 PART I, LINE 2: GRANTS MADE TO ORGANIZATIONS ARE APPROVED BY THE BOARD OF DIRECTORS. GRANTS MADE TO 501(C)(3) ORGANIZATIONS, GOVERNMENTAL ENTITIES, AND OTHER ORGANIZATIONS WITH AN INTEREST IN FURTHERING DENTAL RESEARCH, EDUCATION, AND SERVICES TO DISADVANTAGED POPULATIONS ARE APPROVED BY THE BOARD. 0 0 0 0 0 0 0 0 0 SCOTT JONES PRESIDENT 0 532658 0 418089 0 6889 0 29000 0 28303 0 1014939 0 0 PART I, LINE 3 THE ORGANIZATION RELIED ON ITS PARENT, DELTA DENTAL OF SOUTH DAKOTA, TO ESTABLISH THE COMPENSATION OF THE PRESIDENT. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION HAS ONE VOTING MEMBER. IT IS DELTA DENTAL OF SOUTH DAKOTA. FORM 990, PART VI, SECTION A, LINE 7A THE MEMBER, DELTA DENTAL OF SOUTH DAKOTA, APPOINTS MEMBERS OF THE GOVERNING BODY. FORM 990, PART VI, SECTION A, LINE 8B THE ORGANIZATION DOES NOT HAVE COMMITTEES. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS AT THE MAY BOARD MEETING. A REVIEW OF THE FORM IS CONDUCTED BY THE DELTA DENTAL OF SOUTH DAKOTA CHAIRMAN OF THE AUDIT AND FINANCE COMMITTEE. THE BOARD OF DIRECTORS IS PROVIDED A COPY OF THE 990 PRIOR TO ITS FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD OF DIRECTORS COMPLETE A CONFLICT OF INTEREST FORM ANNUALLY, IN MAY, AT THE REGULARLY SCHEDULED BOARD MEETING. EACH FORM IS READ AT THE FOLLOWING MEETING, WITH ACTION TAKEN AS NEEDED. ACTION MAY INCLUDE ABSTENTION FROM DISCUSSION AND VOTING AND POSSIBLE TERMINATION AS A BOARD MEMBER. FORM 990, PART VI, SECTION C, LINE 19 ALL DOCUMENTS AND POLICIES ARE AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G CONTRACT STAFF: PROGRAM SERVICE EXPENSES 226,544. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 226,544. SHARED SERVICES: PROGRAM SERVICE EXPENSES 2,179,232. MANAGEMENT AND GENERAL EXPENSES 182,076. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,361,308. FORM 990, PART XI, LINE 9: EXPIRED CONTINUING EDUCATION CERTIFICATES 28,400. DELTA DENTAL OF SOUTH DAKOTA 2720 NORTH EUCLID AVE PIERRE SD 57501 460309258 IMPROVEMENT OF ORAL HEALTH SD 501(C)(4) 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0