SEATTLE INDIAN HEALTH BOARD: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- SEATTLE INDIAN HEALTH BOARD (EIN 91-0869056)
- Tax period
- 2017-10-01 to 2018-09-30
- Filed
- 2019-08-06
- IRS object ID
- 201902189349301185
- Schema version
- 2017v2.3
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2019-08-06T17:24:28-05:00 | ReturnTs |
| Tax Period End | 2018-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 910189318 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MOSS ADAMS LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2707 COLBY AVENUE SUITE 801 | AddressLine1Txt |
| City | EVERETT | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 98201 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2017-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 910869056 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SEATTLE INDIAN HEALTH BOARD | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | SEAT | BusinessNameControlTxt |
| Phone | 2063249360 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 611 12TH AVE SOUTH | AddressLine1Txt |
| City | SEATTLE | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 98144 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | BEN LUETY | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 5092097757 | PhoneNum |
| Signature | 2019-08-06 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | EMINA O CRESSWELL CPA | PreparerPersonNm |
| PTIN | P01217304 | PTIN |
| Phone | 4252597227 | PhoneNum |
| Preparation | 2019-08-06 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 76.28.155.2 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2019-08-06 | IPDt |
| IP Tm | 13:53:23 | IPTm |
| IP Timezone | PD | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 92E4E1887166A1A95AEA2354EF277E907B8DEB06 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2019-02-21 02:37:17Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | BEN LUETY | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 611 12TH AVE SOUTH | AddressLine1Txt |
| City | SEATTLE | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 98144 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $20,085,375 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.SIHB.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1970 | FormationYr |
| Legal Domicile State | WA | LegalDomicileStateCd |
| Activity Or Mission | ADVOCATE FOR, PROVIDE, AND ENSURE CULTURALLY APPROPRIATE, HIGH QUALITY, AND ACCESSIBLE HEALTH AND HUMAN SERVICES TO AMERICAN INDIANS AND ALASKA NATIVES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 12 | VotingMembersIndependentCnt |
| Total Employee | 249 | TotalEmployeeCnt |
| Total Volunteers | 13 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $28,548 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $10,926,489 | PYContributionsGrantsAmt |
| CY Contributions Grants | $13,265,121 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $6,632,994 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $6,371,773 | CYProgramServiceRevenueAmt |
| PY Investment Income | $12,731 | PYInvestmentIncomeAmt |
| CY Investment Income | $22,950 | CYInvestmentIncomeAmt |
| PY Other Revenue | $83,943 | PYOtherRevenueAmt |
| CY Other Revenue | $395,587 | CYOtherRevenueAmt |
| PY Total Revenue | $17,656,157 | PYTotalRevenueAmt |
| CY Total Revenue | $20,055,431 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $12,034,914 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $13,712,102 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $5,789,828 | PYOtherExpensesAmt |
| CY Other Expenses | $6,377,094 | CYOtherExpensesAmt |
| PY Total Expenses | $17,824,742 | PYTotalExpensesAmt |
| CY Total Expenses | $20,089,196 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$168,585 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$33,765 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $16,534,731 | TotalAssetsBOYAmt |
| Total Assets EOY | $16,784,809 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $1,175,275 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $1,435,630 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $15,359,456 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $15,349,179 | NetAssetsOrFundBalancesEOYAmt |
| Mission | SERVICES ARE DESIGNED TO ADDRESS SEVERE HEALTH DISPARITIES AMONG URBAN AMERICAN INDIANS AND ALASKA NATIVES BY PROVIDING CULTURALLY RELEVANT PRIMARY CARE, BEHAVIORAL HEALTH, OUTREACH SERVICES AND NATIONAL RESEARCH. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $10,048,943 | ExpenseAmt |
| Revenue | $4,539,927 | RevenueAmt |
| Desc | HEALTH CARE OPERATIONS DIVISION INCLUDES MEDICAL, DENTAL, LAB, PHARMACY, NUTRITION AND DIABETES CLINIC SERVICES. FOR FISCAL YEAR 2018, SIHB PROVIDED 17,167 MEDICAL AND 4,528 DENTAL VISITS ALONG WITH 32,130 PHARMACY PRESCRIPTIONS (32,130 TOTAL, 18,769 NEW, 13,361 REFILLS) AND 18,336 LAB TESTS. THERE WERE 2,205 MENTAL HEALTH AND 697 CASE MANAGEMENT AND HEALTH EDUCATION VISITS. THE FAMILY MEDICINE RESIDENCY TRAINING PROGRAM IS THE ONLY ACGME APPROVED PHYSICIAN RESIDENCY FOCUSING ON INDIAN HEALTH. ESTABLISHED IN 1994, THE THREE-YEAR TRAINING PROGRAM HAS GRADUATED AS OF 2018, 41 PHYSICIANS WITH MOST GRADUATES NOW SERVING INDIAN TRIBES, URBAN INDIAN HEALTH ORGANIZATIONS, OR COMMUNITY HEALTH CENTERS ACROSS THE NATION. SIHB ALSO RUNS ELDERS DAY GROUPS, YOUTH AND OUTREACH ACTIVITIES. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $3,080,037 | ExpenseAmt |
| Revenue | $2,235,826 | RevenueAmt |
| Desc | OUTPATIENT AND INPATIENT CHEMICAL DEPENDENCY SERVICES TREATMENT WAS PROVIDED THROUGH 2,631 INPATIENT DAYS AND 1,954 OUTPATIENT SERVICES DURING THE FISCAL YEAR. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $2,031,932 | ExpenseAmt |
| Revenue | $0 | RevenueAmt |
| Desc | SPECIALIZED ONE TIME PROJECTS WITH THE UNIVERSITY OF WASHINGTON, CITY OF SEATTLE AND URBAN INDIAN HEALTH INSTITUTE. THE URBAN INDIAN HEALTH INSTITUTE IS ONE OF 12 INDIAN HEALTH SERVICE FUNDED TRIBAL EPIDEMIOLOGY CENTERS AND THE ONLY CENTER WITH A NATIONAL FOCUS. THE WORK SUPPORTS THE NETWORK OF 34 URBAN INDIAN HEALTH ORGANIZATIONS (UIHO) LOCATED IN 19 STATES BY DESCRIBING DISPARITIES WITNESSED AMONG URBAN INDIANS THROUGH DATA ANALYSIS AND USING FINDINGS TO INFORM THE DESIGNING AND PLANNING OF CULTURALLY APPROPRIATE INTERVENTIONS. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $15,160,912 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 80 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 249 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 12 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | BEN LUETY | PersonNm |
| Phone | 2063249360 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 611 12TH AVE SOUTH | AddressLine1Txt |
| City | SEATTLE | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 98144 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (23 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| CHRIS STEARNS JD | ||||||||
| PRESIDENT | 5.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| SHARYNE THORNTON PHD | ||||||||
| VICE PRESIDENT | 5.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| TOM WARREN SB ME | ||||||||
| SECRETARY | 5.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| CORNELIUS VAN NIEL MD | ||||||||
| CO-TREASURER | 5.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| J ROGER LEE | ||||||||
| CO-TREASURER | 5.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| JULEANN GANDARA MD | ||||||||
| DIRECTOR | 5.00 | Yes (X) | $0 | $0 | $0 | |||
| FRED LAUTH BA | ||||||||
| DIRECTOR | 5.00 | Yes (X) | $0 | $0 | $0 | |||
| JANIA GARCIA BA MA | ||||||||
| DIRECTOR | 5.00 | Yes (X) | $0 | $0 | $0 | |||
| ALIX ANDERSON RN | ||||||||
| DIRECTOR | 5.00 | Yes (X) | $0 | $0 | $0 | |||
| SHELLEY MEANS BA | ||||||||
| DIRECTOR | 5.00 | Yes (X) | $0 | $0 | $0 | |||
| LAUREN KING JD | ||||||||
| DIRECTOR | 5.00 | Yes (X) | $0 | $0 | $0 | |||
| ARMILITO PANGILINAN MBA CPA | ||||||||
| DIRECTOR | 5.00 | Yes (X) | $0 | $0 | $0 | |||
| MARSHALL JEFFRIES | ||||||||
| DIRECTOR (THROUGH 2/18) | 5.00 | Yes (X) | $0 | $0 | $0 | |||
| JOYCE WILLSON | ||||||||
| DIRECTOR (THROUGH 5/18) | 5.00 | Yes (X) | $0 | $0 | $0 | |||
| ROSALEE WALZ MA | ||||||||
| DIRECTOR (THROUGH 5/18) | 5.00 | Yes (X) | $0 | $0 | $0 | |||
| ESTHER LUCERO | ||||||||
| CHIEF EXECUTIVE OFFICER | 40.00 | Yes (X) | $160,924 | $0 | $13,634 | |||
| BENJAMIN LUETY | ||||||||
| CHIEF FINANCIAL OFFICER | 40.00 | Yes (X) | $140,102 | $0 | $9,120 | |||
| GREGORY MADDOX | ||||||||
| CHIEF MEDICAL OFFICER (THROUGH 9/18) | 40.00 | $230,103 | $0 | $12,747 | Yes (X) | |||
| PETER TALBOT | ||||||||
| PHYSICAN | 40.00 | $175,085 | $0 | $15,229 | Yes (X) | |||
| SOCIA LOVE-THURMAN | ||||||||
| PHYSICIAN/RESIDENCY SITE COORDINATOR | 40.00 | $174,102 | $0 | $14,169 | Yes (X) | |||
| LUKE ADAMS | ||||||||
| DENTAL DIRECTOR | 40.00 | $147,749 | $0 | $5,503 | Yes (X) | |||
| DAVID SAPIENZA | ||||||||
| PHYSICIAN | 40.00 | $138,285 | $0 | $15,827 | Yes (X) | |||
| PATRICK HENRY | ||||||||
| PHARMACIST | 40.00 | $124,469 | $0 | $22,987 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,290,819 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $109,216 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 20 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (4 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| ALLSCRIPTS HEALTHCARE LLC | |||||
| 24630 NETWORK PLACE | CHICAGO | IL | 606731246 | DATA MANAGEMENT | $294,335 |
| JONES & JONES ARCHITECTS & LANDSCAPE ARC | |||||
| 105 S MAIN ST 300 | SEATTLE | WA | 98104 | ARCHITECT FIRM | $124,396 |
| ELLIOT & MORGAN | |||||
| PO BOX 1024 | AUBURN | WA | 980711024 | JANITORIAL SERVICES | $120,470 |
| MOSS ADAMS LLP | |||||
| 999 3RD AVE SUITE 2800 | SEATTLE | WA | 98104 | ACCOUNTING FIRM | $114,001 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 4 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $30,700 | FundraisingAmt |
| Government Grants | $9,972,374 | GovernmentGrantsAmt |
| All Other Contributions | $3,262,047 | AllOtherContributionsAmt |
| Total Contributions | $13,265,121 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| MEDICAL/ DENTAL PATIENT BILLING | 621400 | $4,135,947 | $4,135,947 |
| CHEMICAL DEPENDENCY GOVERNMENT FE | 623990 | $2,235,826 | $2,235,826 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $6,371,773 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $22,950 | TotalRevenueColumnAmt |
| Exclusion | $22,950 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $21,551 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $30,700 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $29,944 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$8,393 | TotalRevenueColumnAmt |
| Exclusion | -$8,393 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| INCENTIVE REVENUE | 900099 | $164,970 | $164,970 |
| WA TRIBAL CLAIMS REIMBURSEMENT | 900099 | $156,451 | $156,451 |
| HONORARIUM INCOME | 900099 | $16,383 | $16,383 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $66,176 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $66,176 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $403,980 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $20,055,431 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $6,775,753 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $14,557 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $586,863 | TotalAmt |
| Program Services | $198,172 | ProgramServicesAmt |
| Management And General | $388,691 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,161,441 | TotalAmt |
| Program Services | $8,480,758 | ProgramServicesAmt |
| Management And General | $1,680,683 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $458,349 | TotalAmt |
| Program Services | $392,663 | ProgramServicesAmt |
| Management And General | $65,686 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,505,532 | TotalAmt |
| Program Services | $1,132,247 | ProgramServicesAmt |
| Management And General | $373,285 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $999,917 | TotalAmt |
| Program Services | $815,149 | ProgramServicesAmt |
| Management And General | $184,768 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $55,767 | TotalAmt |
| Management And General | $55,767 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $117,407 | TotalAmt |
| Management And General | $117,407 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,212,047 | TotalAmt |
| Program Services | $1,552,891 | ProgramServicesAmt |
| Management And General | $659,156 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $323,857 | TotalAmt |
| Program Services | $133,308 | ProgramServicesAmt |
| Management And General | $190,549 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $393,051 | TotalAmt |
| Program Services | $243,686 | ProgramServicesAmt |
| Management And General | $149,365 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $814,677 | TotalAmt |
| Program Services | $304,109 | ProgramServicesAmt |
| Management And General | $510,568 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $316,030 | TotalAmt |
| Program Services | $269,058 | ProgramServicesAmt |
| Management And General | $46,972 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $186,953 | TotalAmt |
| Program Services | $41,288 | ProgramServicesAmt |
| Management And General | $145,665 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $196,174 | TotalAmt |
| Management And General | $196,174 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| PATIENT CARE SUPPLIES | $1,099,139 | $1,099,139 | |
| EQUIPMENT REPAIR AND MA | $257,581 | $209,001 | $48,580 |
| PUBLICATIONS, LICENSES | $214,751 | $185,269 | $29,482 |
| STAFF TRAINING | $92,261 | $63,074 | $29,187 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $97,399 | TotalAmt |
| Program Services | $41,100 | ProgramServicesAmt |
| Management And General | $56,299 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,089,196 | TotalAmt |
| Program Services | $15,160,912 | ProgramServicesAmt |
| Management And General | $4,928,284 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,535,490 | BOYAmt |
| EOY | $1,483,861 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,259,889 | BOYAmt |
| EOY | $2,333,283 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,862,938 | BOYAmt |
| EOY | $4,134,133 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,150,725 | BOYAmt |
| EOY | $1,180,439 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $226,481 | BOYAmt |
| EOY | $278,997 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $11,983,842 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $4,609,746 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,499,208 | BOYAmt |
| EOY | $7,374,096 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,534,731 | BOYAmt |
| EOY | $16,784,809 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,175,275 | BOYAmt |
| EOY | $1,435,630 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,175,275 | BOYAmt |
| EOY | $1,435,630 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,359,456 | BOYAmt |
| EOY | $15,349,179 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,359,456 | BOYAmt |
| EOY | $15,349,179 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,534,731 | BOYAmt |
| EOY | $16,784,809 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$33,765 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $23,488 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $9,155,320 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $9,100,658 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $10,138,938 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $10,926,489 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $13,265,121 | CurrentTaxYearAmt |
| Total | $52,586,526 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $9,155,320 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $9,100,658 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $10,138,938 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $10,926,489 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $13,265,121 | CurrentTaxYearAmt |
| Total | $52,586,526 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $52,586,526 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $7,218 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,685 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $8,205 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $12,731 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $22,950 | CurrentTaxYearAmt |
| Total | $53,789 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $10,643 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $15,604 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus1 Year | $101,715 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $403,980 | CurrentTaxYearAmt |
| Total | $531,942 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $53,172,257 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $27,363,804 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.98900 | PublicSupportCY170Pct |
| Public Support PY170 | 0.99650 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: | FormAndLineReferenceDesc |
| Explanation | OTHER INCOME - 2013 AMOUNT: $ 10,643. 2014 AMOUNT: $ 15,604. 2016 AMOUNT: $ 101,715. 2017 AMOUNT: $ 403,980. | ExplanationTxt |
Schedule B IRS990ScheduleB
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | Yes (1) | VolunteersInd |
| Paid Staff Or Management | Yes (1) | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | Yes (1) | DirectContactLegislatorsInd |
| Direct Contact Legislators | $18,148 | DirectContactLegislatorsAmt |
| Rallies Demonstrations | Yes (1) | RalliesDemonstrationsInd |
| Rallies Demonstrations | $3,939 | RalliesDemonstrationsAmt |
| Other Activities | 0 | OtherActivitiesInd |
| Total Lobbying Expenditures | $22,087 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | TRAVEL TO OLYMPIA, WASHINGTON DC, AND TRIBAL FACILITIES FOR I/T/U CONFER AND CONSULT EVENTS, WORKGROUP PARTICIPATION, PLANNING COMMITTEES, TESTIMONY AND UIHP EDUCATION SESSIONS. FUNDS PAID TO CONSULTANT TO MONITOR FEDERAL HEALTH POLICY CONTACT KEY STAFF MEMBERS RESPONSIBLE FOR APPROPRIATION DECISIONS, COORDINATE COMMUNICATIONS TO PROTECT FUNDING AND ADVISE STRATEGIES TO EFFECTUATE POSITIVE OUTCOMES. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,926,349 | OtherCostOrOtherBasisAmt |
| Book Value | $4,926,349 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,814,543 | OtherCostOrOtherBasisAmt |
| Depreciation | $891,071 | DepreciationAmt |
| Book Value | $1,923,472 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,108,874 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,655,893 | DepreciationAmt |
| Book Value | $452,981 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,134,076 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,062,782 | DepreciationAmt |
| Book Value | $71,294 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $7,374,096 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $20,108,862 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $23,488 | NetUnrealizedGainsInvstAmt |
| Other Revenue | $29,943 | OtherRevenueAmt |
| Revenue Not Reported | $53,431 | RevenueNotReportedAmt |
| Revenue Subtotal | $20,055,431 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $20,055,431 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $20,119,139 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $29,943 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $29,943 | ExpensesNotReportedAmt |
| Expenses Subtotal | $20,089,196 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $20,089,196 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART X, LINE 2: | THE HEALTH BOARD IS NOT SUBJECT TO INCOME TAX, AS IT IS A TAX-EXEMPT ORGANIZATION UNDER INTERNAL REVENUE CODE SECTION 501(C)(3). ACCORDINGLY, NO PROVISION FOR INCOME TAX IS INCLUDED IN THESE FINANCIAL STATEMENTS. FOR THE 2018 AND 2017 FINANCIAL STATEMENTS, THE HEALTH BOARD HAS ACCOUNTED FOR UNCERTAIN TAX POSITIONS WHEREBY THE EFFECT OF THE UNCERTAINTY WOULD BE RECORDED IF THE OUTCOME WAS CONSIDERED PROBABLE AND WAS REASONABLY ESTIMABLE. AS OF SEPTEMBER 30, 2018 AND 2017, THE HEALTH BOARD HAD NOT IDENTIFIED ANY UNCERTAIN TAX POSITIONS REQUIRING ACCRUAL OR DISCLOSURE. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | FUNDRAISING EVENT EXPENSES 29,943. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | FUNDRAISING EVENT EXPENSES 29,943. |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | ADELINE GARCIA BANQUET | Event1Nm |
| Gross Receipts Event1 | $46,409 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $26,900 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $19,509 | GrossRevenueEvent1Amt |
| Rent Facility Costs Event1 | $395 | RentFacilityCostsEvent1Amt |
| Food And Beverage Event1 | $9,942 | FoodAndBeverageEvent1Amt |
| Entertainment Event1 | $2,447 | EntertainmentEvent1Amt |
| Event2 | SPIRIT WALK | Event2Nm |
| Gross Receipts Event2 | $5,842 | GrossReceiptsEvent2Amt |
| Charitable Contri Event2 | $3,800 | CharitableContriEvent2Amt |
| Gross Revenue Event2 | $2,042 | GrossRevenueEvent2Amt |
| Non Cash Prizes Event2 | $603 | NonCashPrizesEvent2Amt |
| Food And Beverage Event2 | $1,000 | FoodAndBeverageEvent2Amt |
| Other Direct Expenses Event2 | $15,557 | OtherDirectExpensesEvent2Amt |
| Gross Receipts Total | $52,251 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $30,700 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $21,551 | GrossRevenueTotalEventsAmt |
| Non Cash Prizes Total Events | $603 | NonCashPrizesTotalEventsAmt |
| Rent Fclty Costs Total Events | $395 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $10,942 | FoodAndBeverageTotalEventsAmt |
| Entertainment Total Events | $2,447 | EntertainmentTotalEventsAmt |
| Oth Direct Expnss Total Events | $15,557 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $29,944 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | -$8,393 | NetIncomeSummaryAmt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (6 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ESTHER LUCERO | ||||||||||||||
| CHIEF EXECUTIVE OFFICER | $160,924 | $0 | $0 | $0 | $0 | $0 | $4,800 | $0 | $8,834 | $0 | $174,558 | $0 | $0 | $0 |
| GREGORY MADDOX | ||||||||||||||
| CHIEF MEDICAL OFFICER (THROUGH 9/18) | $230,103 | $0 | $0 | $0 | $0 | $0 | $10,902 | $0 | $1,845 | $0 | $242,850 | $0 | $0 | $0 |
| PETER TALBOT | ||||||||||||||
| PHYSICAN | $175,085 | $0 | $0 | $0 | $0 | $0 | $13,274 | $0 | $1,955 | $0 | $190,314 | $0 | $0 | $0 |
| SOCIA LOVE-THURMAN | ||||||||||||||
| PHYSICIAN/RESIDENCY SITE COORDINATOR | $174,102 | $0 | $0 | $0 | $0 | $0 | $5,220 | $0 | $8,949 | $0 | $188,271 | $0 | $0 | $0 |
| LUKE ADAMS | ||||||||||||||
| DENTAL DIRECTOR | $147,749 | $0 | $0 | $0 | $0 | $0 | $4,596 | $0 | $907 | $0 | $153,252 | $0 | $0 | $0 |
| DAVID SAPIENZA | ||||||||||||||
| PHYSICIAN | $138,285 | $0 | $0 | $0 | $0 | $0 | $7,114 | $0 | $8,713 | $0 | $154,112 | $0 | $0 | $0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | THE CFO REVIEWS THE 990 BEFORE IT GOES TO THE BOARD FOR REVIEW AND APPROVAL. THE 990 IS POSTED ONLINE IN A BOARD OF DIRECTORS SHARED FILE FOR REVIEW. |
| FORM 990, PART VI, SECTION B, LINE 12C | CONFLICT OF INTEREST STATEMENTS ARE COLLECTED ANNUALLY FROM THE BOARD OF DIRECTORS AND OFFICERS. DISCLOSURES WILL BE REVIEWED BY THE HUMAN RESOURCES DEPARTMENT FOR MATERIALITY AND IF DEEMED NOT MATERIAL DIRECTORS STILL MUST NOT PARTICIPATE IN VOTING OR INFLUENCE VOTING ON ANY APPLICABLE INTEREST. MAJOR CONFLICTS ARE REQUIRED TO BE TERMINATED. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE AGENCY UPDATES SALARY SURVEY INFORMATION EVERY 2 YEARS OR LESS BY POSITION BASED ON MARKET DRIVEN FACTORS. ANNUALLY THE ONLY SALARY INCREASES ARE FOR MERIT AND BASED ON AN EVALUATION PROCEDURE. MERIT RAISES RANGE FROM 2% TO 5%. THE BOARD OF DIRECTORS APPROVES THE EXECUTIVE DIRECTOR'S ANNUAL INCREASE BASED ON ESTABLISHED EVALUATION CRITERIA. |
| FORM 990, PART VI, SECTION C, LINE 19 | SIHB DOES NOT MAKE THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST NOR THE FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. THE 990 IS AVAILABLE TO THE PUBLIC BASED ON A WRITTEN REQUEST. |
| FORM 990, PART IX, LINE 11G | CONSULTANTS: PROGRAM SERVICE EXPENSES 1,552,891. MANAGEMENT AND GENERAL EXPENSES 659,156. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,212,047. |