2020-03-03T19:31:01-06:00 2019-06-30 410746749 CLIFTONLARSONALLEN LLP 10700 NORTHUP WAY SUITE 200 BELLEVUE WA 98004 990 2018-07-01 930605570 NORTHWEST HUMAN SERVICES INC NORT 5035885828 681 CENTER STREET NE SALEM OR 97301 PAUL LOGAN CHIEF EXECUTIVE OFFICER 5035885828 2020-02-14 1 KURT BENNION CPA P01469618 4252506100 2020-02-14 67.137.57.251 2020-02-14 17:39:49 PS P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 0A137849BC389FB7B51D6FC2D6742665ACC5CBED 2018 2020-09-22 18:59:49Z PAUL LOGAN 681 CENTER STREET NE SALEM OR 97301 24778715 0 X WWW.NORTHWESTHUMANSERVICES.ORG X 1970 OR CREATING A HEALTHY COMMUNITY WITH RESPECT, COMPASSION AND ACCEPTANCE FOR ALL. 13 13 274 35 0 0 4823014 4664220 17994382 18183416 273260 415641 1830555 1515438 24921211 24778715 620011 371692 0 0 13881433 15757127 0 0 36317 4112449 4383647 18613893 20512466 6307318 4266249 31613192 35827161 1770668 1854147 29842524 33973014 X MISSION: CREATING A HEALTHY COMMUNITY WITH RESPECT, COMPASSION AND ACCEPTANCE FOR ALL. VISION: WORKING TOGETHER TO EMPOWER INDIVIDUALS TO IMPROVE THEIR HEALTH, WELL-BEING AND SAFETY. CORE VALUES: COMMUNITY - THE SAFE, CARING, AND ENCLUSIVE ENVIRONMENT WE CREATE; COMPASSION - THE INSPIRATION THAT GUIDES OUR WORK; COMMITMENT - THE TEAMWORK WE EXEMPLIFY THROUGH OUR PASSION, MOTIVATION AND DEDICATION; AND INTEGRITY - THE FOUNDATION OF OUR WORK ETHIC. 0 0 12022918 54862 14186079 NORTHWEST HUMAN SERVICES, INC. (THE ORGANIZATION), IS A NONPROFIT FEDERALLY QUALIFIED COMMUNITY HEALTH CENTER, AND RECEIVES FUNDING UNDER SECTION 330 OF THE PUBLIC HEALTH SERVICES ACT FOR SERVICES, INCLUDING SERVICES FOR THE HOMELESS POPULATION, FROM THE HEALTH RESOURCES AND SERVICES ADMINISTRATION (HRSA). HRSA IS AN AGENCY OF THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES, BUREAU OF PRIMARY HEALTH CARE, THE PRIMARY FEDERAL AGENCY DEDICATED TO IMPROVING ACCESS TO HEALTH CARE FOR PEOPLE WHO ARE GEOGRAPHICALLY ISOLATED; ECONOMICALLY, OR MEDICALLY VULNERABLE. THE ORGANIZATION'S MISSION IS TO CREATE A HEALTHY COMMUNITY WITH RESPECT AND ACCEPTANCE FOR ALL. THE ORGANIZATION IS ACCREDITED BY THE JOINT COMMISSIONFOR AMBULATOR AND BEHAVIORAL HEALTHCARE, AND IS CERTIFIED BY THE STATE OF OREGON AS A TIER V PATIENT-CENTERED PRIMARY CARE HOME FOR WEST SALEM CLINIC AND FOR TOTAL HEALTH CLINIC.THE ORGANIZATION PROVIDES COMPREHENSIVE CARE - MEDICAL, DENTAL, MENTAL HEALTH, AND SOCIAL SERVICES. THE MAJORITY OF PATIENTS ARE INSURED THROUGH THE OREGON HEALTH PLAN (MEDICAID), MEDICARE, OR ARE UNINSURED. THE ORGANIZATION PROVIDES A SIDING FEE DISCOUNT PROGRAM; BASED ON FAMILY SIZE AND INCOME. NO ONE IS DENIED SERVICES DUE TO THEIR INABILITY TO PAY.THE WEST SALEM CLINIC (SALEM, OREGON) AND TOTAL HEALTH COMMUNITY CLINIC (MONMOUTH, OREGON) PROVIDE FULL SERVICE PRIMARY AND PREVENTATIVE CARE, AND SERVE AS PATIENT-CENTERED MEDICAL HOMES. PATIENT SELF-MANAGEMENT, EDUCATION SERVICES, AND ACCESS TO INTEGRATED BEHAVIORAL SERVICES ARE ALSO AVAILABLE.THE QUICKCARE CLINIC, LOCATED ON THE WEST SALEM CAMPUS, PROVIDES SAME-DAY HEALTH CARE SERVICES.FOR THE FISCAL YEAR ENDING JUNE 30, 2019, THE CLINICS SERVED 12,285 PATIENTS TOTALING OVER 66,770 VISITS. 2483499 79486 3237290 THE MENTAL HEALTH CLINIC, LOCATED ON THE WEST SALEM CLINIC CAMPUS, PROVIDES PSYCHIATRIC SERVICES, PSYCHOTHERAPY, COUNSELING, AND CASE MANAGEMENT SERVICES IN AN INTEGRATED SETTING. THE CONNECTION PROGRAM, PART OF THE WEST SALEM MENTAL HEALTH CLINIC, PROVIDES COUNSELING, ADVOCACY, CASE MANAGEMENT, CRIME VICTIM'S SERVICES, INFORMATION AND REFERRAL FOR INDIVIDUALS WHO ARE DEAF AND HARD OF HEARING. 2022109 237344 35638 OUR TRANSITIONAL SERVICES PROGRAMS CONTINUE TO BECOME FURTHER INTEGRATED IN OUR HEALTHCARE MODEL.THE HOMELESS OUTREACH & ADVOCACY PROGRAM (HOAP) OFFERS AN ARRAY OF SERVICES DESIGNED TO GET AND KEEP INDIVIDUALS, MANY OF THEM MENTALLY ILL, WHO ARE HOMELESS OR AT RISK OF HOMELESSNESS, OFF THE STREETS AND INTO HOUSING. OUR HEALTH CARE FOR THE HOMELESS BUS PICKS UP HOMELESS INDIVIDUALS FROM VARIOUS POINTS IN THE COMMUNITY AND TRANSPORTS THEM TO OUR WEST SALEM CAMPUS FOR NEEDED CARE AND SERVICES. AT HOAP, CASE MANAGERS, STAFF, AND VOLUNTEERS PROVIDE OUTREACH, CRISIS INTERVENTION, EDUCATION, SKILLS TRAINING, CASE MANAGEMENT AND THERAPEUTIC SUPPORT TO INTEGRATE THESE INDIVIDUALS INTO THE COMMUNITY AND IMPROVE THEIR QUALITY OF LIFE. THE PROGRAM OPERATES A PEER-RUN DAY CENTER THAT PROVIDES MANY SERVICES TO PEOPLE WHO ARE HOMELESS, INCLUDING FOOD, LAUNDRY AND SHOWER FACILITIES, AND A CHANCE TO SOCIALIZE. DURING THE FISCAL YEAR ENDING JUNE 30, 2019, HOAP PROVIDED SERVICES TO 3,691 AT-RISK INDIVIDUALS TOTALLING 23,037 VISITS. SERVICES AND GOODS INCLUDED 2,400 RIDES FROM AGENCY TRANSPORTATION AND BUS PASSES, 24,864 PERSONAL SUPPLIES (HYGIENE, CLOTHES, HOUSEHOLD), 30,173 MEALS, AND 7,260 PERSONAL VISITS.THE EMERGENCY AND INFORMATION HOTLINE PROGRAM (HOTLINE) PROVIDES 24/7/365 SUICIDE PREVENTION, CRISIS COUNSELING, EMERGENCY FINANCIAL ASSISTANCE, RESOURCES AND INFORMATION, AND OTHER SERVICES TO INDIVIDUALS AND FAMILIES IN THE SERVICE AREA. THE PROGRAM IS ACCREDITED BY THE AMERICAN ASSOCIATION OF SUICIDOLOGY. HOTLINE MAKES OVER 300 MONTHLY CALLS TO OUR PATIENTS AND CLIENTS TO OFFER FOLLOW-UP CARE AND SUPPORT. DURING THE FISCAL YEAR ENDED JUNE 30, 2019, HOTLINE ANSWERED OR MADE 19,272 CALLS. 591 INDIVIDUALS AND FAMILIES RECEIVED EMERGENCY FINANCIAL ASSISTANCE. 265 INDIVIDUALS RECEIVED SUICIDE INTERVENTION SUPPORT.THE HEALTH, OUTREACH, SHELTER, TRANSITIONS (HOST) PROGRAM PROVIDES STREET OUTREACH, A DROP-IN AND RESOURCE CENTER, EMERGENCY SHELTER AND CARE TO RUNAWAY AND HOMELESS YOUTH AND YOUNG ADULTS. OTHER AREAS OF SERVICE INCLUDE CRISIS INTERVENTION, CASE MANAGEMENT, SKILLS DEVELOPMENT AND INFORMATION, AND REFERRAL SERVICES. A TRANSITIONAL LIVING PROGRAM COMPONENT PROVIDES HOUSING AND SUPPORT TO YOUTH, ASSISTING THEM TO ACHIEVE INDEPENDENCE. DURING THE FISCAL YEAR ENDED JUNE 30, 2019, HOST MADE CONTACT WITH 341 AT-RISK YOUTH AND YOUNG ADULTS TOTALING 8,666 VISITS. SERVICES AND GOODS INCLUDED 1,611 RIDES FROM AGENCY TRANSPORTATION AND BUS PASSES, 5,742 PERSONAL SUPPLIES (HYGIENE, CLOTHES, HOUSEHOLD), 19,921 MEALS, AND 2,982 PERSONAL SERVICES. 671181 0 724409 THE DENTAL CLINIC, LOCATED ON THE WEST SALEM CLINIC CAMPUS, PROVIDES EMERGENT AND RESTORATIVE DENTAL SERVICES. 671181 0 724409 17199707 1 1 0 0 0 0 0 0 1 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 33 0 274 1 0 0 0 0 0 0 0 0 0 0 0 0 X 13 13 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 0 0 OR X X ROBERT T EDWARDS 5035885828 681 CENTER STREET NE SALEM OR 97301 LARRY GOODREAU CHAIR 1.00 X X 0 0 0 JAN MARGOSIAN VICE CHAIR 1.00 X X 0 0 0 SUSAN SCOTT SECRETARY 1.00 X X 0 0 0 WILLIAM WILLIAMS TREASURER 1.00 X X 0 0 0 MICHAEL WISE PAST CHAIR 1.00 X X 0 0 0 SEAN COOPER DIRECTOR 1.00 X 0 0 0 WILLIAM DETTWYLER DIRECTOR 1.00 X 0 0 0 BETH FUSCO DIRECTOR 1.00 X 0 0 0 PAULINE MATHER DIRECTOR 1.00 X 0 0 0 MICHELLE PECORA DIRECTOR 1.00 X 0 0 0 ROBERT STEPHENS DIRECTOR 1.00 X 0 0 0 PHIL SWOGGER DIRECTOR 1.00 X 0 0 0 ERIC TWEED DIRECTOR 1.00 X 0 0 0 PAUL LOGAN CHIEF EXECUTIVE OFFICER 50.00 X 228971 0 33543 ROBERT EDWARDS CHIEF FINANCIAL OFFICER 50.00 X 149706 0 23847 CYNTHIA NOCEK PROVIDER 13.00 X 417507 0 0 ERIC CHEN PROVIDER 40.00 X 267812 0 29114 TIMOTHY TRUSCHEL PROVIDER 40.00 X 263058 0 28062 YURIYA MANABE PROVIDER 40.00 X 158108 0 16959 JOSHUA SANDEMAN PROVIDER 40.00 X 140500 0 19437 1625662 0 150962 21 0 1 0 NEXTGEN HEALTHCARE INC PO BOX 511449 LOS ANGELES CA 90051 SOFTWARE SUPPORT 157818 COMPHEALTH PO BOX 972670 DALLAS TX 753972670 TEMPORARY STAFFING 113417 LENITY ARCHITECTURE 3150 KETTLE COURT SE SALEM OR 97301 ARCHITECTURE 108559 3 726 4440313 223181 295645 4664220 MEDICAL CLINICS 621111 14186079 14186079 MENTAL HEALTH 621112 3237290 3237290 DENTAL CLINIC 621210 724409 724409 HOMELESS OUTREACH 624100 35638 35638 18183416 415641 415641 CCO INCENTIVES 900099 1428639 1428639 MISCELLANEOUS 900099 86799 86799 1515438 24778715 18183416 0 1931079 371692 371692 477497 477497 11952880 9808938 2110493 33449 258230 221968 36027 235 2026805 1644244 382561 1041715 843034 196048 2633 6936 6936 38852 38852 320348 278877 41471 20606 16045 4561 225357 178977 46380 275124 207077 68047 5908 5908 365266 249993 115273 88669 60611 28058 MEDICAL SUPPLIES 1905470 1899638 5832 REPAIRS AND MAINTENANCE 389499 223576 165923 BAD DEBTS 267276 267276 TRAINING EXPENSE 196618 146844 49774 277718 775009 -497291 20512466 17199707 3276442 36317 7851188 12724203 614807 626398 5373041 4905972 89729 11068 157140 133540 11722701 4854596 6820139 6868105 10391180 10226216 272728 272728 43240 58931 31613192 35827161 1382224 1544167 13000 8400 2100 380044 294880 1770668 1854147 X 29842524 33973014 29842524 33973014 31613192 35827161 4266249 -135759 0 X 0 1 X 1 1 1 X 4095233 5163316 4426218 4823014 4664220 23172001 4095233 5163316 4426218 4823014 4664220 23172001 23172001 137609 155148 163263 273260 415641 1144921 788834 2779072 2803651 1830555 1515438 9717550 34034472 71841372 0.68080 0.70320 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: MISCELLANEOUS CCO INCENTIVES RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 1210619 1210619 7430442 3921542 3508900 1767929 933054 834875 1313711 1313711 6868105 X 24363074 0 24363074 415641 415641 24778715 20512466 0 20512466 0 20512466 PART IV, LINE 2B: THE ORGANIZATION HOLDS SECURITY DEPOSITS FOR TENANTS. THE FUNDS ARE HELD IN A NON-INTEREST BEARING CHECKING ACCOUNT. TENANTS RECEIVE REFUNDS, LESS ANY DAMAGE FEES, UPON TERMINATION OF THE LEASE. PART X, LINE 2: NO PROVISION FOR INCOME TAXES IS REPORTED IN THE FINANCIAL STATEMENTS BECAUSE THE ORGANIZATION IS A NONPROFIT ORGANIZATION, EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. MANAGEMENT EVALUATED THE ORGANIZATION'S TAX POSITIONS AND CONCLUDED THAT THE ORGANIZATION HAD TAKEN NO UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENTS TO THE FINANCIAL STATEMENTS TO COMPLY WITH THE PROVISIONS OF TOPIC 740 INCOME TAXES OF THE ACCOUNTING STANDARDS CODIFICATION. PART XI, LINE 4B - OTHER ADJUSTMENTS: INVESTMENT INCOME 415,641. 1 UTILITIES ASSISTANCE 240 13662 PHARMACY ASSISTANCE 142 124620 FMV PHARMACY SUPPLIES AND VOUCHERS TRANSPORTATION ASSISTANCE - BUS PASSES 6651 15122 FOOD ASSISTANCE 50603 65 115903 FMV DONATED FOOD FROM LOCAL MERCHANTS MEDICAL ASSISTANCE 10 1767 OTHER PERSONAL ASSISTANCE 39234 6665 55123 FMV DONATED CLOTHING AND PERSONAL ITEMS FOR PEOPLE IN NEED AND SOFTWARE RENT ASSISTANCE 130 38765 PART I, LINE 2: INDIVIDUAL ASSISTANCE IS MONITORED MONTHLY BY THE COMPLIANCE DIRECTOR AND THROUGH RECEIVABLES AND DRAW-DOWN RECONCILIATIONS. THE CFO SIGNS OFF ON DRAW-DOWNS. X X 1 1 X X X X 0 0 0 0 0 0 0 0 0 PAUL LOGAN CHIEF EXECUTIVE OFFICER 208971 0 20000 0 0 0 14106 0 19437 0 262514 0 0 0 ROBERT EDWARDS CHIEF FINANCIAL OFFICER 149706 0 0 0 0 0 9274 0 14573 0 173553 0 0 0 CYNTHIA NOCEK PROVIDER 81784 0 10000 0 325723 0 0 0 0 0 417507 0 0 0 ERIC CHEN PROVIDER 255503 0 12309 0 0 0 11095 0 18019 0 296926 0 0 0 TIMOTHY TRUSCHEL PROVIDER 253330 0 9728 0 0 0 9140 0 18922 0 291120 0 0 0 YURIYA MANABE PROVIDER 157772 0 0 0 336 0 9590 0 7369 0 175067 0 0 0 JOSHUA SANDEMAN PROVIDER 122867 0 15000 0 2633 0 0 0 19437 0 159937 0 0 0 PART I, LINE 1A THE ORGANIZATION GAVE BONUSES OF $100 PER EMPLOYEE AND THOSE ARE GROSSED UP IN THE INDIVIDUAL'S TAXABLE COMPENSATION. THIS BENEFIT IS INCLUDED IN THE EMPLOYEE'S TAXABLE COMPENSATION. THE ORGANIZATION PAYS UP TO $500 PER PERSON PER YEAR TO USE A FITNESS FACILITY. TO QUALIFY FOR THE BENEFIT, THE INDIVIDUAL MUST SHOW IMPROVEMENTS IN PHYSICAL HEALTH OR CONSISTENT USE OF THE FITNESS FACILITY. THIS BENEFIT IS INCLUDED IN THE EMPLOYEE'S TAXABLE COMPENSATION. X 55123 FAIR MARKET VALUE X 50603 115903 FAIR MARKET VALUE X 124620 FAIR MARKET VALUE 0 0 0 0 FORM 990, PART VI, SECTION A, LINE 1 THE BOARD HAS AN EXECUTIVE COMMITTEE, TO ACT IN THE PLACE OF THE BOARD OF DIRECTORS DURING THE INTERIM PERIODS BETWEEN BOARD MEETINGS OR WHEN IT IS IMPRACTICABLE TO CALL A MEETING OF THE ENTIRE BOARD OF DIRECTORS IN THE EVENT OF AN EMERGENCY OR OTHER MATTER REQUIRING THE IMMEDIATE ACTION OF THE BOARD OF DIRECTORS. THE DIRECTORS WHO ARE ALSO OFFICERS SERVE AS THE EXECUTIVE COMMITTEE. THE CEO SERVES AS A NON-VOTING EX-OFFICIO MEMBER OF THE EXECUTIVE COMMITTEE. THE EXECUTIVE COMMITTEE OPERATES WITHIN THE ESTABLISHED PARAMETERS OF BOARD POLICIES AND REPORTS ALL ACTIONS TAKEN TO THE FULL BOARD FOR RATIFICATION AND RECORDING IN BOARD MINUTES. FORM 990, PART VI, SECTION A, LINE 6 MEMBERSHIP IN THE CORPORATION IS OPEN TO ANY INDIVIDUAL FROM THE COMMUNITY WHO (A) HAS DEMONSTRATED INTEREST AND SUPPORT OF THE CORPORATION THROUGH A MONETARY CONTRIBUTION OF AT LEAST FIVE-HUNDRED DOLLARS ($500.00) IN THE 12 MONTHS PRECEDING THE ANNUAL MEETING; OR (B) IS A CURRENT MEMBER OF THE BOARD, SALARIED STAFF, PROGRAM VOLUNTEER, OR A NATIONAL HEALTH SERVICE CORPS PROVIDER ASSIGNED TO NWHS PROGRAMS. FORM 990, PART VI, SECTION A, LINE 7A THE ELECTION OF THE MEMBERS OF THE BOARD OF DIRECTORS ARE RATIFIED EACH YEAR BY A MAJORITY VOTE OF THE MEMBERS OF THE ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11B PRIOR TO FILING, A DRAFT OF THE FORM 990 WAS REVIEWED BY THE AUDIT AND FINANCE COMMITTEE'S THE FINANCE COMMITTEE MADE A RECOMMENDATION TO THE BOARD OF DIRECTORS TO ACCEPT THE FORM 990, WHICH WAS THEN SIGNED BY THE CHIEF EXECUTIVE OFFICER AND ELECTONICALLY FILED BY THE PREPARER. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY THROUGH ANNUAL EVALUATION AND UPDATING. OFFICERS, DIRECTORS, TRUSTEES AND KEY EMPLOYEES WOULD NOT BE ABLE TO DISCUSS OR VOTE ON AN ISSUE WHERE A CONFLICT OF INTEREST EXISTS. FORM 990, PART VI, SECTION B, LINE 15A ANNUAL EVALUATION AND COMPENSATION OF THE CEO IS DETERMINED BY THE BOARD. ANNUAL EVALUATION AND COMPENSATION OF OTHER OFFICERS OR KEY EMPLOYEES IS DETERMINED BY THE CEO. THESE PROCESSES WERE LAST CONDUCTED IN 2019. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.