2019-08-06T17:24:28-05:00 2018-09-30 910189318 MOSS ADAMS LLP 2707 COLBY AVENUE SUITE 801 EVERETT WA 98201 990 2017-10-01 910869056 SEATTLE INDIAN HEALTH BOARD SEAT 2063249360 611 12TH AVE SOUTH SEATTLE WA 98144 BEN LUETY CFO 5092097757 2019-08-06 1 EMINA O CRESSWELL CPA P01217304 4252597227 2019-08-06 76.28.155.2 2019-08-06 13:53:23 PD P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 92E4E1887166A1A95AEA2354EF277E907B8DEB06 2017 2019-02-21 02:37:17Z BEN LUETY 611 12TH AVE SOUTH SEATTLE WA 98144 20085375 0 X WWW.SIHB.ORG X 1970 WA ADVOCATE FOR, PROVIDE, AND ENSURE CULTURALLY APPROPRIATE, HIGH QUALITY, AND ACCESSIBLE HEALTH AND HUMAN SERVICES TO AMERICAN INDIANS AND ALASKA NATIVES. 12 12 249 13 0 28548 10926489 13265121 6632994 6371773 12731 22950 83943 395587 17656157 20055431 0 0 0 0 12034914 13712102 0 0 0 5789828 6377094 17824742 20089196 -168585 -33765 16534731 16784809 1175275 1435630 15359456 15349179 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. 0 0 10048943 4539927 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. 3080037 2235826 OUTPATIENT AND INPATIENT CHEMICAL DEPENDENCY SERVICES TREATMENT WAS PROVIDED THROUGH 2,631 INPATIENT DAYS AND 1,954 OUTPATIENT SERVICES DURING THE FISCAL YEAR. 2031932 0 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. 15160912 1 1 0 1 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 80 0 1 249 1 1 1 0 0 0 0 0 0 0 0 0 X 12 12 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X BEN LUETY 2063249360 611 12TH AVE SOUTH SEATTLE WA 98144 CHRIS STEARNS JD PRESIDENT 5.00 X X 0 0 0 SHARYNE THORNTON PHD VICE PRESIDENT 5.00 X X 0 0 0 TOM WARREN SB ME SECRETARY 5.00 X X 0 0 0 CORNELIUS VAN NIEL MD CO-TREASURER 5.00 X X 0 0 0 J ROGER LEE CO-TREASURER 5.00 X X 0 0 0 JULEANN GANDARA MD DIRECTOR 5.00 X 0 0 0 FRED LAUTH BA DIRECTOR 5.00 X 0 0 0 JANIA GARCIA BA MA DIRECTOR 5.00 X 0 0 0 ALIX ANDERSON RN DIRECTOR 5.00 X 0 0 0 SHELLEY MEANS BA DIRECTOR 5.00 X 0 0 0 LAUREN KING JD DIRECTOR 5.00 X 0 0 0 ARMILITO PANGILINAN MBA CPA DIRECTOR 5.00 X 0 0 0 MARSHALL JEFFRIES DIRECTOR (THROUGH 2/18) 5.00 X 0 0 0 JOYCE WILLSON DIRECTOR (THROUGH 5/18) 5.00 X 0 0 0 ROSALEE WALZ MA DIRECTOR (THROUGH 5/18) 5.00 X 0 0 0 ESTHER LUCERO CHIEF EXECUTIVE OFFICER 40.00 X 160924 0 13634 BENJAMIN LUETY CHIEF FINANCIAL OFFICER 40.00 X 140102 0 9120 GREGORY MADDOX CHIEF MEDICAL OFFICER (THROUGH 9/18) 40.00 X 230103 0 12747 PETER TALBOT PHYSICAN 40.00 X 175085 0 15229 SOCIA LOVE-THURMAN PHYSICIAN/RESIDENCY SITE COORDINATOR 40.00 X 174102 0 14169 LUKE ADAMS DENTAL DIRECTOR 40.00 X 147749 0 5503 DAVID SAPIENZA PHYSICIAN 40.00 X 138285 0 15827 PATRICK HENRY PHARMACIST 40.00 X 124469 0 22987 1290819 0 109216 20 0 1 0 ALLSCRIPTS HEALTHCARE LLC 24630 NETWORK PLACE CHICAGO IL 606731246 DATA MANAGEMENT 294335 JONES & JONES ARCHITECTS & LANDSCAPE ARC 105 S MAIN ST 300 SEATTLE WA 98104 ARCHITECT FIRM 124396 ELLIOT & MORGAN PO BOX 1024 AUBURN WA 980711024 JANITORIAL SERVICES 120470 MOSS ADAMS LLP 999 3RD AVE SUITE 2800 SEATTLE WA 98104 ACCOUNTING FIRM 114001 4 30700 9972374 3262047 13265121 MEDICAL/ DENTAL PATIENT BILLING 621400 4135947 4135947 CHEMICAL DEPENDENCY GOVERNMENT FE 623990 2235826 2235826 6371773 22950 22950 21551 30700 29944 -8393 -8393 INCENTIVE REVENUE 900099 164970 164970 WA TRIBAL CLAIMS REIMBURSEMENT 900099 156451 156451 HONORARIUM INCOME 900099 16383 16383 66176 66176 403980 20055431 6775753 0 14557 X 586863 198172 388691 10161441 8480758 1680683 458349 392663 65686 1505532 1132247 373285 999917 815149 184768 55767 55767 117407 117407 2212047 1552891 659156 323857 133308 190549 393051 243686 149365 814677 304109 510568 316030 269058 46972 186953 41288 145665 196174 196174 PATIENT CARE SUPPLIES 1099139 1099139 EQUIPMENT REPAIR AND MA 257581 209001 48580 PUBLICATIONS, LICENSES 214751 185269 29482 STAFF TRAINING 92261 63074 29187 97399 41100 56299 20089196 15160912 4928284 0 3535490 1483861 2259889 2333283 1862938 4134133 1150725 1180439 226481 278997 11983842 4609746 7499208 7374096 16534731 16784809 1175275 1435630 1175275 1435630 X 15359456 15349179 15359456 15349179 16534731 16784809 -33765 23488 0 X 0 1 X 1 1 1 X 9155320 9100658 10138938 10926489 13265121 52586526 9155320 9100658 10138938 10926489 13265121 52586526 52586526 7218 2685 8205 12731 22950 53789 10643 15604 101715 403980 531942 53172257 27363804 0.98900 0.99650 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: OTHER INCOME - 2013 AMOUNT: $ 10,643. 2014 AMOUNT: $ 15,604. 2016 AMOUNT: $ 101,715. 2017 AMOUNT: $ 403,980. 1 1 0 0 0 0 1 18148 1 3939 0 22087 0 PART II-B, LINE 1: 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. 4926349 4926349 2814543 891071 1923472 2108874 1655893 452981 2134076 2062782 71294 7374096 X 20108862 23488 29943 53431 20055431 0 20055431 20119139 29943 29943 20089196 0 20089196 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. ADELINE GARCIA BANQUET 46409 26900 19509 395 9942 2447 SPIRIT WALK 5842 3800 2042 603 1000 15557 52251 30700 21551 603 395 10942 2447 15557 29944 -8393 X X 0 0 0 0 0 0 0 0 0 ESTHER LUCERO CHIEF EXECUTIVE OFFICER 160924 0 0 0 0 0 4800 0 8834 0 174558 0 0 0 GREGORY MADDOX CHIEF MEDICAL OFFICER (THROUGH 9/18) 230103 0 0 0 0 0 10902 0 1845 0 242850 0 0 0 PETER TALBOT PHYSICAN 175085 0 0 0 0 0 13274 0 1955 0 190314 0 0 0 SOCIA LOVE-THURMAN PHYSICIAN/RESIDENCY SITE COORDINATOR 174102 0 0 0 0 0 5220 0 8949 0 188271 0 0 0 LUKE ADAMS DENTAL DIRECTOR 147749 0 0 0 0 0 4596 0 907 0 153252 0 0 0 DAVID SAPIENZA PHYSICIAN 138285 0 0 0 0 0 7114 0 8713 0 154112 0 0 0 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.