2021-11-10T13:28:53-06:00 2021-06-30 476097913 SEIM JOHNSON LLP 18081 BURT STREET SUITE 200 OMAHA NE 680224722 990 2020-07-01 237162972 COMBINED HEALTH AGENCIES DRIVE COMB 4026148500 212 SOUTH 74TH STREET NO 205 OMAHA NE 68114 MICHELLE GROSSMAN PRESIDENT/CEO 4026148500 2021-11-10 1 MICHELLE GROSSMAN 999009999 WENDY R COOLEY P01523804 4023302660 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z MICHELLE GROSSMAN 212 SOUTH 74TH STREET NO 205 OMAHA NE 68114 1682554 0 X WWW.CHCNE.ORG X 1971 NE IMPROVING LIVES BY RAISING FUNDS FOR NEBRASKA'S HEALTH CHARITIES THROUGH WORKPLACE GIVING. 44 44 8 150 0 0 1555897 1619933 279 923 21910 60632 0 0 1578086 1681488 1029744 1140134 0 0 448851 412515 0 0 19933 95345 88387 1573940 1641036 4146 40452 1806252 1956493 1052929 1058290 753323 898203 IMPROVING LIVES BY RAISING FUNDS FOR NEBRASKA'S HEALTH CHARITIES THROUGH WORKPLACE GIVING. 0 0 1469066 1140134 923 COMBINED HEALTH AGENCIES DRIVE (CHAD) CONNECTS EMPLOYEES AND EMPLOYERS VIA THE WORKPLACE TO CHAD'S MEMBER CHARITIES AND THEIR PROGRAMS, SERVICES AND VOLUNTEER OPPORTUNITIES. THIS RELATIONSHP ALLOWS EMPLOYEES TO GIVE TO CHARITIES THROUGH PAYROLL DEDUCTIONS AND OTHER TYPES OF GIFTS IN THEIR WORKPLACE. PARTICIPATING EMPLOYERS ARE STATEWIDE IN NEBRASKA AND IN ALL ECONOMIC SECTORS, INCLUDING BOTH PUBLIC AND PRIVATE ENTITIES. THE COMPANIES/EMPLOYERS RANGE FROM SMALL, LOCAL EMPLOYERS TO LARGE MULTINATIONAL COMPANIES. 1469066 1 1 0 0 0 0 0 0 0 1 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 8 1 0 0 0 0 0 0 0 0 0 0 0 0 X 44 44 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 X X X SHANNON CASTILLO 4026148500 212 S 74TH STREET OMAHA NE 68114 MIKE WADE BOARD CHAIR 1.00 X X 0 0 0 KATIE LOVE SECRETARY 1.00 X X 0 0 0 STEPHANIE VANICEK TREASURER 1.00 X X 0 0 0 TERESA LAYTON PAST BOARD CHAIR 1.00 X X 0 0 0 MARTIE CORDARO ALS REP 1.00 X 0 0 0 LARRY GUENTHER ALZHEIMER'S ASSN REP 1.00 X 0 0 0 KATHY NELLOR AMERICAN LUNG ASSOCIATION REP 1.00 X 0 0 0 CARLO RINALDI ARTHRITIS FOUNDATION REP 1.00 X 0 0 0 ANISA HOIE LEUKEMIA AND LYMPHOMA SOCIETY REP 1.00 X 0 0 0 SCOT ADAMS PHD BRAIN INJURY ALLIANCE NEBRASKA REP 1.00 X 0 0 0 JANEANE WHITNEY CHRON'S & COLITIS FND REP 1.00 X 0 0 0 CALE FURSTENBERG CYSTIC FIBROSIS FOUNDATION REP 1.00 X 0 0 0 KRYSTI CUNNINGHAM JDRF NE-IA CHAPTER REP 1.00 X 0 0 0 CARLA DEVELDER NEBRASKA AIDS PROJECT REP 1.00 X 0 0 0 TODD DEFREECE MARCH OF DIMES REP 1.00 X 0 0 0 ELLEN DISALVO NEBRASKA COMMUNITY BLOOD BANK REP 1.00 X 0 0 0 GARY GEORGE NE HOSPICE & PALLIATIVE CARE ASSOC REP 1.00 X 0 0 0 KERRY HEINRICH NEBRASKA KIDNEY FOUNDATION REP 1.00 X 0 0 0 DAWN GONZALES SUSAN G. KOMEN GREAT PLAINS REP 1.00 X 0 0 0 KAREN CARSON TEAM JACK FOUNDATION REP 1.00 X 0 0 0 M JOHN STEIER UNITED CEREBRAL PALSY OF NE REP 1.00 X 0 0 0 CARRIE KEENE WEST CENTRAL BOARD CHAIR 1.00 X 0 0 0 MAUREEN TIERNEY MD AUTISM ACTION PARTNERSHIP REP 1.00 X 0 0 0 PETER SENIOR NE CHAPTER - NATIONAL HEMOPHILIA FNDTN REP 1.00 X 0 0 0 SHARON BRODKEY DIRECTOR AT LARGE 1.00 X 0 0 0 DAVE BUSHEY DIRECTOR AT LARGE 1.00 X 0 0 0 MICHAEL DEMMAN DIRECTOR AT LARGE 1.00 X 0 0 0 DREW FOSSUM DIRECTOR AT LARGE 1.00 X 0 0 0 DAVID GILINSKY DIRECTOR AT LARGE 1.00 X 0 0 0 BRIAN W KRUSE DIRECTOR AT LARGE 1.00 X 0 0 0 JOANN ABT DIRECTOR AT LARGE 1.00 X 0 0 0 THOMAS MACY DIRECTOR AT LARGE 1.00 X 0 0 0 BOB ORCHARD DIRECTOR AT LARGE 1.00 X 0 0 0 LINDSAY PATT DIRECTOR AT LARGE 1.00 X 0 0 0 STEVE PATTERSON DIRECTOR AT LARGE 1.00 X 0 0 0 VINCE PILLE DIRECTOR AT LARGE 1.00 X 0 0 0 GREG PORTER DIRECTOR AT LARGE 1.00 X 0 0 0 AMBER PRESTON DIRECTOR AT LARGE 1.00 X 0 0 0 MERV RIEPE DIRECTOR AT LARGE 1.00 X 0 0 0 JIM SCHELBLE DIRECTOR AT LARGE 1.00 X 0 0 0 JANE BEERMAN DIRECTOR AT LARGE 1.00 X 0 0 0 CRAIG SALL DIRECTOR AT LARGE 1.00 X 0 0 0 TIMOTHY LANGDON DIRECTOR AT LARGE 1.00 X 0 0 0 JAMIE GUTIERREZ DIRECTOR AT LARGE 1.00 X 0 0 0 MICHELLE GROSSMAN PRESIDENT/CEO 45.00 X 98383 0 22940 SHANNON CASTILLO DIRECTOR OF FINANCE 40.00 X 55767 0 2837 154150 0 25777 0 0 0 0 0 1034902 89600 495431 1619933 LEADERSHIP 25 INCOME 900099 923 923 923 16375 16375 45323 1066 44257 44257 44257 1681488 923 0 60632 1140134 1140134 174118 81866 83546 8706 195625 166674 27581 1370 5654 5390 221 43 11735 10326 1409 25383 17302 7418 663 19962 1996 15970 1996 6111 6111 2860 2002 572 286 3345 2843 167 335 15212 11732 1959 1521 26478 21182 2648 2648 2142 1821 214 107 614 552 62 2929 2343 293 293 5060 2024 2530 506 BAD DEBT EXPENSE 1900 1900 MEMBERSHIP DUES 992 496 446 50 MISCELLANEOUS 468 85 383 CAMPAIGN EXPENSE 314 298 16 1641036 1469066 152037 19933 260809 207503 6651 8372 879012 931948 2080 6240 23605 11006 11028 12599 587568 726503 59104 63328 1806252 1956493 28496 34989 934833 1023301 89600 0 1052929 1058290 X -379280 -432045 1132603 1330248 753323 898203 1806252 1956493 X 40452 100204 4224 X X 0 1 X 1 0 X 1901781 1610812 1787595 1555897 1619933 8476018 1901781 1610812 1787595 1555897 1619933 8476018 50136 8425882 14126 15247 18999 19807 16375 84554 8560572 20327 0.98430 0.98790 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 629562 10805 154924 24874 770417 630577 12855 10230 24100 629562 612484 9070 31623 22600 630577 577756 8775 39953 14000 612484 521034 17623 48099 9000 577756 0.00000 1.00000 0.00000 0 0 23605 11006 12599 12599 1790724 100204 10919 4224 115347 1675377 6111 6111 1681488 1645844 10919 10919 1634925 6111 6111 1641036 PART V, LINE 4: CHAD HOLDS ENDOWMENT FUNDS FOR SUPPORT OF ITS MEMBER CHARITIES THAT CONSIST PRIMARILY OF INVESTMENTS AND LIFE INSURANCE POLICIES. INCOME FROM THE ENDOWMENT FUNDS IS USED TO SUPPORT ONE OR MORE MEMBER CHARITIES EACH YEAR THROUGH A GRANTING PROCESS. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN CASH SURRENDER VALUE OF LIFE INSURANCE 199. CHANGE IN BENEFICIAL INTEREST 4,025. 1 ALZHEIMER'S ASSOCIATION MIDLANDS CHAPTER 11711 ARBOR ST STE 110 OMAHA NE 68144 470648438 501(C)(3) 175520 TO PROVIDE EDUCATION AND SUPPORT TO ALZHEIMER'S RELATED DISEASES AMERICAN LUNG ASSN OF THE CENTRAL STATES 11225 DAVENPORT ST STE 101 OMAHA NE 68154 430662525 501(C)(3) 44427 TO FIGHT LUNG DISEASE AND PROMOTE LUNG HEALTH THROUGH EDUCATION, ADVOCACY, RESEARCH, AND COMMUNITY PROGRAMS FOR ALL RESIDENTS ARTHRITIS FOUNDATION NEBRASKA CHAPTER 11414 WEST CENTER RD 348 OMAHA NE 68144 470483544 501(C)(3) 22570 TO IMPROVE LIVES THROUGH LEADERSHIP IN THE PREVENTION, CONTROL AND CURE OF ARTHRITIS AND RELATED DISEASES AUTISM ACTION PARTNERSHIP 10110 NICHOLAS STREET 202 OMAHA NE 68114 206892034 501(C)(3) 55875 TO IMPROVE THE QUALITY OF LIFE OF PERSONS WITH AUTISM SPECTRUM DISORDERS AND THEIR FAMILIES THROUGH EDUCATION, ADVOCACY, AND SUPPORT, THEREBY ENABLING THEM TO BE AN INTEGRAL PART OF THE COMMUNITY BRAIN INJURY ALLIANCE OF NEBRASKA 2424 RIDGE POINT CIR LINCOLN NE 68512 260851140 501(C)(3) 23326 TO SUPPORT THOSE WITH TRAUMATIC BRAIN INJURIES CROHN'S & COLITIS FOUNDATION OF NEBRASKA 3606 N 156 STE 176 OMAHA NE 68116 136193105 501(C)(3) 32909 TO CURE CROHN'S DISEASE AND ULCERATIVE COLITIS, AND TO IMPROVE THE QUALITY OF LIFE OF CHILDREN AND ADULTS AFFECTED BY THESE DISEASES CYSTIC FIBROSIS FOUNDATION NE CHAPTER 2827 S 88TH STREET OMAHA NE 68124 131930701 501(C)(3) 53505 TO SUPPORT INNOVATIVE RESEARCH TO CONTROL AND CURE CYSTIC FIBROSIS, PROVIDE SPECIALIZED MEDICAL CARE THROUGH A NATIONWIDE NETWORK OF CENTERS, AND OFFER PHARMACY AND OTHER PATIENT SERVICES HAITIAN AMERICAN FRIENDSHIP FOUNDATION PO BOX 3421 NORTH FT MEYERS FL 33918 953248186 501(C)(3) 10000 TO PARTNER WITH THE HAITIANS IN CENTRAL PLATEAU OF HAITI THROUGH ACADEMIC VOCATIONAL AND THEOLOGICAL EDUCATION TO ENRICH THEIR CULTURE SOCIALLY ACADEMICALLY AND SPIRITUALLY ALL TO THE GLORY OF GOD JUVENILE DIABETES RESEARCH FOUNDATION 9202 WEST DODGE RD STE 304 OMAHA NE 68114 231907729 501(C)(3) 121847 TO IMPROVE THE LIVES OF CHILDREN AND ADULTS LIVING WITH TYPE 1 DIABETES (T1D) THROUGH FUNDING RESEARCH TO CURE, TREAT, AND PREVENT THIS DISEASE MARCH OF DIMES NEBRASKA CHAPTER 3606 N 156 STE 101-248 OMAHA NE 68116 131846366 501(C)(3) 28695 TO IMPROVE THE LIVES OF INFANTS BY PREVENTING PREMATURE BIRTH, BIRTH DEFECTS AND INFANT MORTALITY MUSCULAR DYSTROPHY ASSOCIATION 1685 S COLORADO BLVD UNIT S DENVER CO 80222 131665552 501(C)(3) 22576 TO ASSIST IN FIGHTING NEUROMUSCULAR DISEASES THROUGH WORLDWIDE RESEARCH, A NATIONWIDE NETWORK OF CLINICS OFFERING COMPREHENSIVE MEDICAL SERVICES, AND FAR-REACHING PROFESSIONAL AND PUBLIC HEALTH EDUCATION NATIONAL MULTIPLE SCLEROSIS SOCIETY NE CHAPTER 7611 STATE LINE STE 100 KANSAS CITY MO 64114 470439079 501(C)(3) 55141 TO AID IN ENDING THE DEVASTATING EFFECTS OF MS, OFFERING INFORMATION AND REFERRAL, EDUCATION AND DIRECT ASSISTANCE TO OVER 25,000 PEOPLE AFFECTED BY MS NEBRASKA AIDS PROJECT 250 S 77TH ST STE A OMAHA NE 68114 470786622 501(C)(3) 32488 TO LEAD THE COMMUNITY IN THE FIGHT TO OVERCOME HIV/AIDS AND ITS STIGMA THROUGH EDUCATION, SUPPORTIVE SERVICES AND ADVOCACY NEW YORK BLOOD CENTER INC 310 E 67TH STREET NEW YORK NY 10065 131949477 501(C)(3) 11947 TO PROVIDE COMPREHENSIVE BLOOD PRODUCTS, ADVANCED LABORATORY SERVICES, AND ENHANCED VALUE-DRIVEN SOLUTIONS FOR HOSPITALS, PHYSICIANS, AND OTHER HEALTHCARE PARTNERS NEBRASKA CHAPTER OF THE NATIONAL HEMOPHILIA FOUNDATION 8031 W CENTER RD STE 304 OMAHA NE 68124 135641857 501(C)(3) 14430 TO FIND BETTER TREATMENTS AND CURES FOR INHERITABLE BLEEDING DISORDERS AND TO PREVENT THE COMPLICATIONS OF THESE DISORDERS THROUGH EDUCATION, ADVOCACY AND RESEARCH NEBRASKA HOSPICE & PALLIATIVE CARE PARTNERSHIP 1519 M STREET COZAD NE 69130 470673727 501(C)(3) 35636 TO IMPROVE CARE AND CONDITIONS FOR CHRONICALLY AND TERMINALLY ILL NEBRASKANS THROUGH PUBLIC AND PROFESSIONAL EDUCATION, RESEARCH AND ADVOCACY NEBRASKA KIDNEY ASSOCIATION INC 11725 ARBOR ST STE 210 OMAHA NE 68144 237225449 501(C)(3) 42698 TO PROVIDE INFORMATION AND REFERRALS TO THOSE WITH KIDNEY AND UROLOGIC DISEASES AND TRANSPLANT PATIENTS, EMERGENCY FUNDING, EARLY DETECTION SCREENINGS, PROFESSIONAL EDUCATION, PUBLIC EDUCATION SUSAN G KOMEN FOR THE CURE NEBRASKA 8707 WEST CENTER RD STE 101 OMAHA NE 68124 260056671 501(C)(3) 35542 TO PROVIDE GRANTS TO LOCAL ORGANIZATIONS TO SUPPORT BREAST HEALTH EDUCATION, SCREENING AND TREATMENT PROGRAMS ACROSS THE STATE THE ALS ASSN MID AMERICA CHAPTER 6405 METCALF AVE STE 205 OVERLAND PARK KS 66202 481021611 501(C)(3) 42826 TO EMPOWER PEOPLE WITH ALS AND THEIR FAMILIES TO LIVE FULLER LIVES, PROVIDING THEM WITH SERVICES AND SUPPORT WHILE FUNDING GLOBAL RESEARCH TO FIND A CURE TEAM JACK PO BOX 607 ATKINSON NE 68713 462301134 501(C)(3) 46787 TO RAISE MONEY TO FUND IMPACTFUL PEDIATRIC BRAIN CANCER RESEARCH AND WORK TO CREATE NATIONAL AWARENESS FOR THE DISEASE THE LEUKEMIA & LYMPHOMA SOCIETY 11840 NICHOLAS ST STE 215 OMAHA NE 68154 135644916 501(C)(3) 78915 TO CURE LEUKEMIA, NON-HODGKIN'S LYMPHOMA, HODGKINS LYMPHOMA AND MYELOMA AND IMPROVE THE QUALITY OF LIFE OF PATIENTS AND FAMILIES UNITED CEREBRAL PALSY OF NEBRASKA 11930 ARBOR ST STE 202 OMAHA NE 68114 470534212 501(C)(3) 20284 TO PROVIDE PROGRAMS, SERVICES, INFORMATION, REFERRAL, AND FINANCIAL SUPPORT FOR INDIVIDUALS AND FAMILIES WITH CEREBRAL PALSY AS WELL AS OTHER DISABILITIES 22 0 PART I, LINE 2: FUNDS CONTRIBUTED BY DONORS IN WORKPLACE CAMPAIGNS CONDUCTED BY OR IN PARTNERSHIP WITH CHAD ARE EITHER DESIGNATED OR UNDESIGNATED FOR SPECIFIC AGENCIES. DESIGNATED FUNDS: FULL MEMBER AGENCIES ARE CREDITED WITH ALL SPECIFICALLY DESIGNATED FUNDS. DESIGNATED FUNDS ARE DISTRIBUTED QUARTERLY (SEPTEMBER, DECEMBER, MARCH AND JUNE) THE FISCAL YEAR FOLLOWING THE FISCAL YEAR IN WHICH THEY WERE PLEDGED. UNDESIGNATED FUNDS: THE UNDESIGNATED FUNDS, LESS EXPENSES ARE CREDITED TO EACH MEMBER AGENCY BASED ON THE PERCENTAGE OF EACH AGENCY'S DESIGNATED FUNDS RELATIVE TO THE TOTAL OF ALL DESIGNATED FUNDS. THIS PERCENTAGE IS CALCULATED ANNUALLY AT THE END OF EVERY FISCAL YEAR FOR EACH AGENCY BY DIVIDING ITS DESIGNATED FUNDS BY THE TOTAL OF ALL DESIGNATED FUNDS FROM NON-NATIONAL CAMPAIGNS. UNDESIGNATED FUNDS ARE DISTRIBUTED FROM AVAILABLE COLLECTED RECEIVABLES ON THE LAST DAY OF EACH CALENDAR QUARTER (SEPTEMBER, DECEMBER, MARCH AND JUNE). FORM 990, PART VI, SECTION B, LINE 11B A COPY OF THE FORM 990 IS PROVIDED TO ALL THE MEMBERS OF THE FINANCE COMMITTEE TO BE REVIEWED AND APPROVED BEFORE IT IS FILED. A COPY IS ALSO EMAILED TO EACH BOARD MEMBER AND IS PROVIDED AT THE CLOSEST SCHEDULED BOARD MEETING. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY IS RENEWED EACH YEAR AND BOTH BOARD MEMBERS AND CHC-NE EMPLOYEES ARE ASKED TO DISCLOSE POTENTIAL CONFLICTS. THE CEO MONITORS THESE WITH THE ASSISTANCE OF THE ADMINISTRATIVE ASSISTANT. IF A CONFLICT EXISTS FOR A BOARD MEMBER IT IS ADDRESSED. FORM 990, PART VI, SECTION B, LINE 15A THE PRESIDENT & CEO POSITION IS REVIEWED ANNUALLY BY THE HUMAN RESOURCE COMMITTEE. THIS COMMITTEE CONSISTS OF THE BOARD CHAIR, IMMEDIATE PAST BOARD CHAIR AND AT LEAST THREE BUT NO MORE THAN FIVE OTHER BOARD MEMBERS. THIS COMMITTEE IS ALSO RESPONSIBLE FOR ANY OTHER HUMAN RESOURCE ISSUES THAT MAY ARISE WITH THE CEO. THE COMMITTEE USES COMPARABILITY DATA AND KEEPS MINUTES OF THE MEETING DISCUSSIONS. GOALS AND ACHIEVEMENTS ARE REVIEWED AS WELL AS ANNUAL SALARY INCREASE. 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 XI, LINE 9: CHANGE IN CASH SURRENDER VALUE OF LIFE INSURANCE 199. CHANGE IN BENEFICIAL INTEREST 4,025. FORM 990, PART XII, LINE 2C: THE TREASURER OF THE BOARD IS THE CHAIRMAN OF THE FINANCE COMMITTEE. THE TREASURER ALONG WITH THE FINANCE COMMITTEE ASSUMES RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT OF THE ORGANIZATION'S FINANCIAL STATEMENTS AND THE SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.