2017-05-15T09:55:40-05:00 2016-06-30 910189318 MOSS ADAMS LLP 101 SECOND STREET SUITE 900 SAN FRANCISCO CA 94105 990 2015-07-01 943030866 ASIAN & PACIFIC ISLANDER AMERICAN HEALTH FORUM ASIA 4155683337 ONE KAISER PLAZA NO 850 OAKLAND CA 94612 KATHY KO CHIN PRESIDENT/CEO 4155683337 2017-05-12 1 JOUA V LO P01225144 4159561500 2017-05-11 2015 2021-01-29 14:40:06Z KATHY KO CHIN ONE KAISER PLAZA NO 850 OAKLAND CA 94612 7107548 0 X WWW.APIAHF.ORG X 1986 CA APIAHF IS A NATIONAL HEALTH JUSTICE ORGANIZATION WHICH INFLUENCES POLICY, MOBILIZES COMMUNITIES, & STRENGTHENS PROGRAMS & ORGANIZATIONS TO IMPROVE THE HEALTH OF ASIAN AMERICANS, NATIVE HAWAIIANS, & PACIFIC ISLANDERS LIVING IN THE US & ITS TERRITORIES. 14 14 35 14 0 0 6073866 6737139 184398 368031 1256 2378 4525 0 6264045 7107548 1514183 1782136 0 0 3054426 2789156 0 0 388154 2046795 2197301 6615404 6768593 -351359 338955 2065805 2774586 378567 748393 1687238 2026193 X APIAHF IS A NATIONAL HEALTH JUSTICE ORGANIZATION WHICH INFLUENCES POLICY, MOBILIZES COMMUNITIES, & STRENGTHENS PROGRAMS & ORGANIZATIONS TO IMPROVE THE HEALTH OF ASIAN AMERICANS, NATIVE HAWAIIANS, & PACIFIC ISLANDERS LIVING IN THE US & ITS TERRITORIES. 0 0 5335160 1782136 368031 THE ASIAN & PACIFIC ISLANDER AMERICAN HEALTH FORUM (APIAHF) IS A NATIONAL ADVOCACY ORGANIZATION TO PROMOTE POLICY, PROGRAM AND RESEARCH EFFORTS FOR IMPROVING THE HEALTH OF ASIAN AND PACIFIC ISLANDERS IN THE UNITED STATES AND US AFFILIATED JURISDICTIONS IN THE PACIFIC. APIAHF PROGRAMS AND PROJECTS ARE CATEGORIZED AS FOLLOWS:1. AFFORDABLE CARE ACT PROGRAM. APIAHF PROVIDES TECHNICAL ASSISTANCE AND SUPPORTS A LEARNING COMMUNITY FOR COMMUNITY BASED ORGANIZATIONS THAT ARE ENGAGED IN OUTREACH, EDUCATION AND ENROLLMENT ASSISTANCE FOR EXPANDED HEALTH INSURANCE OPTIONS PROVIDED BY THE AFFORDABLE CARE ACT. THE PROGRAM PROVIDES GRANTS, TOOLS, SKILLS, AND TRAININGS AND DISSEMINATES BEST PRACTICES AND INFORMATION FOR COMMUNITY BASED ORGANIZATIONS TO OPTIMIZE OUTREACH, EDUCATION AND ENROLLMENT ACTIVITIES FOR ASIAN AMERICAN, NATIVE HAWAIIAN AND PACIFIC ISLANDER (AA AND NHPI), LIMITED ENGLISH PROFICIENT (LEP) AND IMMIGRANT CONSUMERS. THE PROGRAM ALSO COLLABORATES WITH NATIONAL HEALTH POLICY ORGANIZATIONS TO ADVOCATE FOR IMPROVEMENTS TO HEALTH INSURANCE MARKETPLACES TO INCREASE ACCESSIBILITY FOR AA AND NHPI, LEP AND IMMIGRANT CONSUMERS. 2. CAPACITY BUILDING PROGRAMS APIAHF PROVIDES TECHNICAL ASSISTANCE, TRAINING AND TOOLS TO COMMUNITY BASED ORGANIZATIONS TO ENHANCE THEIR CAPACITY TO SERVE AND ADVOCATE FOR THEIR COMMUNITIES. IT IS DESIGNED TO ENHANCE THE ABILITY OF COMMUNITY BASED ORGANIZATIONS TO PLAN, DELIVER, MONITOR AND EVALUATE EFFECTIVE, EVIDENCE-BASED PREVENTION INTERVENTIONS AND STRATEGIES. THE PROGRAM ALSO WORKS WITH COMMUNITY LEADERS TO DEVELOP THE INTERNAL INFRASTRUCTURE (E G FINANCE, HUMAN RESOURCES, GOVERNANCE) TO SUPPORT THESE INTERVENTIONS AND TO BUILD LASTING ORGANIZATIONS. 3. COMMUNITY ENGAGEMENT SERVICES APIAHF PROVIDES OPPORTUNITIES FOR COMMUNITY MEMBERS, SERVICE PROVIDERS, RESEARCHERS AND ADVOCATES TO NETWORK AND SHARE THEIR EXPERTISE AND RECOMMENDATIONS WITH EACH OTHER AND WITH POLICY MAKERS TO PROMOTE THE HEALTH AND WELLBEING OF ASIAN AMERICANS, NATIVE HAWAIIANS AND PACIFIC ISLANDERS APIAHF DISSEMINATES PROMISING PRACTICES, ANALYSES, AND INFORMATION INCLUDING DATA AND RESEARCH THROUGH CONFERENCES, CONVENTIONS, AND ELECTRONIC MEDIA INCLUDING APIAHFS WEBSITE, SOCIAL MEDIA, AND PUBLICATIONS. THIS ALLOWS NETWORK PARTNERS TO UTILIZE THESE RESOURCES FOR THEIR OWN LOCAL AND STATE BASED WORK, WHILE CONTRIBUTING TO A BODY OF KNOWLEDGE AND ACTION THAT IS ORGANIZED BY APIAHF AT THE NATIONAL LEVEL. THESE PROGRAMS ALSO AWARD GRANTS AND PROVIDE OTHER RESOURCES TO COMMUNITY MEMBERS, SERVICE PROVIDERS, RESEARCHERS TO PROMOTE THE HEALTH AND WELLBEING OF ASIAN AMERICANS, NATIVE HAWAIIANS, AND PACIFIC ISLANDERS. 4. HEALTH POLICY DEVELOPMENT APIAHF ADVOCATES FOR HEALTH EQUITY IN HEALTH SERVICES AND ALL POLICIES, FOR GREATER ACCESS TO CARE AND INSURANCE COVERAGE FOR ALL VULNERABLE POPULATIONS, AND FOR ACCURATE REPRESENTATION OF THE HEALTH NEEDS OF DISTINCT AND DIVERSE ASIAN AMERICAN, NATIVE HAWAIIAN AND PACIFIC ISLANDER COMMUNITIES, ROBUST RESEARCH AND DATA DEVELOPMENT AND RESPONSIVE EXTERNAL RELATIONSHIP DEVELOPMENT. 5. DOMESTIC VIOLENCE PROGRAM THE ASIAN & PACIFIC ISLANDER INSTITUTE ON DOMESTIC VIOLENCE IS A NATIONAL RESOURCE CENTER ON DOMESTIC VIOLENCE, SEXUAL VIOLENCE, TRAFFICKING, AND OTHER FORMS OF GENDER-BASED VIOLENCE IN ASIAN AND PACIFIC ISLANDER COMMUNITIES. IT SERVES A NATIONAL NETWORK OF ADVOCATES, COMMUNITY BASED SERVICE PROGRAMS, NATIONAL AND STATE ORGANIZATIONS, LEGAL, HEALTH, AND MENTAL HEALTH PROFESSIONALS, RESEARCHERS, POLICY ADVOCATES, AND ACTIVISTS FROM SOCIAL JUSTICE ORGANIZATIONS. IT ANALYZES CRITICAL ISSUES, PROMOTES CULTURALLY RELEVANT INTERVENTION AND PREVENTION, PROVIDES CONSULTATION, TECHNICAL ASSISTANCE AND TRAINING, CONDUCTS AND DISSEMINATES RESEARCH, AND INFORMS PUBLIC POLICY WITH THE GOALS OF STRENGTHENING ADVOCACY, CHANGING SYSTEMS, AND PREVENTING GENDER VIOLENCE THROUGH COMMUNITY TRANSFORMATION TO FULFILL ITS VISION OF GENDER DEMOCRACY. APIAHF CEASED TO BE THE FISCAL SPONSOR FOR THE PROGRAM EFFECTIVE SEPTEMBER 30, 2014, AS APIDV COMMENCED OPERATIONS UNDER THE NEW CORPORATION ON OCTOBER 1, 2014. APIAHF STILL ACTS AS THE GRANTEE OF RECORD FOR THE FEDERAL GRANT PROGRAM AND APIDV IS THE SUB-GRANTEE. 6. SPECIAL PROJECTS APIAHF DELIVERS CONVENTIONS AND CONFERENCES BRINGING TOGETHER COMMUNITY BASED PARTNERS, GOVERNMENT OFFICIALS, CONGRESSIONAL LEADERS, AND HEALTH ADVOCATES TO HIGHLIGHT THE HEALTH NEEDS AND DISPARITY AMONG THE ASIAN AMERICAN, NATIVE HAWAIIAN AND PACIFIC ISLANDER COMMUNITIES. 5335160 1 1 0 1 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 56 0 1 35 1 0 0 0 0 0 0 0 0 0 0 X 14 14 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CA DC X MARTINE PHAM 4155683320 ONE KAIZER PLAZA SUITE 850 OAKLAND CA 94612 GAIL HANNEMANN BOARD CHAIRPERSON 4.00 X X 0 0 0 WALTER TSOU BOARD VICE-CHAIR,SECRETARY 4.00 X X 0 0 0 DIANE PALOMA TREASURER 4.00 X X 0 0 0 GAYLE TANG AT-LARGE 4.00 X 0 0 0 ELIZABETH KRAUSE AT-LARGE 4.00 X 0 0 0 DEBBIE CHANG BOARD MEMBER 4.00 X 0 0 0 JACOB FITISEMANU BOARD MEMBER 4.00 X 0 0 0 OLIVER KIM BOARD MEMBER 4.00 X 0 0 0 MINH THANH NGUYEN BOARD MEMBER 4.00 X 0 0 0 PAYAL SHAH BOARD MEMBER 4.00 X 0 0 0 MATT SHIRAKI BOARD MEMBER 4.00 X 0 0 0 LORI VILLAROSA BOARD MEMBER 4.00 X 0 0 0 H SOOK WILKINSON BOARD MEMBER 4.00 X 0 0 0 DIANNE YAMASHIRO-OMI BOARD MEMBER 4.00 X 0 0 0 REA PANARES THRU 123115 BOARD CHAIRPERSON 4.00 X X 0 0 0 DEXTER LOUIE THRU 123115 SECRETARY 4.00 X X 0 0 0 KATHY KO CHIN PRESIDENT, CEO 40.00 X 184241 0 14719 ED TEPPORN EXECUTIVE VICE-PRESIDENT 40.00 X 143017 0 14767 MARTINE PHAM CHIEF ADMINISTRATIVE OFFICER 40.00 X 131100 0 5523 458358 0 35009 3 0 1 0 0 3215554 3521585 6737139 CONFERENCE REVENUE 900099 238474 238474 PROGRAM SERVICE FEES 900099 120732 120732 OTHER PROGRAM FEES 900099 8325 8325 OTHER REVENUE 900099 500 500 368031 2378 2378 7107548 368031 0 2378 X 1782136 1782136 501700 376276 97179 28245 1823301 1389648 323462 110191 91255 69332 16484 5439 193824 144554 38764 10506 179076 136054 32347 10675 36920 36920 42106 42106 687599 505714 134815 47070 12678 12575 103 142176 89900 39810 12466 314678 231795 67963 14920 641137 454334 48691 138112 8385 8385 15235 11964 2289 982 12921 6575 6038 308 DUES, SUBSCRIPTIONS, LI 76435 37015 31371 8049 EQUIPMENT & SOFTWARE AC 71140 44563 25935 642 STAFF DEVELOPMENT & TRA 46121 42725 2847 549 89770 89770 6768593 5335160 1045279 388154 362354 847493 953184 1227736 580449 504887 11834 10355 27858 55892 114111 33449 63180 80662 66946 47561 2065805 2774586 370236 743412 8331 4981 378567 748393 X 811144 779661 876094 1246532 1687238 2026193 2065805 2774586 338955 0 X 0 1 X 1 1 1 X 3954898 8083818 7666542 6073866 6737139 32516263 3954898 8083818 7666542 6073866 6737139 32516263 11228378 21287885 4859 2499 4146 1256 2378 15138 26671 12693 19455 4525 63344 32594745 996111 0.65310 0.64760 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: OTHER INCOME - 2011 AMOUNT: $ 26,671. 2012 AMOUNT: $ 12,693. 2013 AMOUNT: $ 19,455. 2014 AMOUNT: $ 4,525. 2015 AMOUNT: $ 0. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 14508 0 14508 0 6754085 0 6768593 0 488430 0 122108 0 0 0 522219 572689 480770 488430 2064108 3096162 3636 1878 1602 14508 21624 130555 143172 120193 122108 516028 774042 44 88 132 87820 20946 66874 26291 12503 13788 80662 X 7107548 0 7107548 0 7107548 6768593 0 6768593 0 6768593 PART X, LINE 2: THE HEALTH FORUM IS A NONPROFIT CORPORATION UNDER INTERNAL REVENUE CODE SECTION 501(C)(3) AND HAS BEEN GRANTED TAX-EXEMPT STATUS BY THE INTERNAL REVENUE SERVICE AND THE CALIFORNIA REVENUE AND TAXATION CODE. AS OF JUNE 30, 2016 AND 2015, THE HEALTH FORUM HAD NO UNRECOGNIZED TAX POSITIONS OR UNCERTAIN TAX POSITIONS REQUIRING ACCRUAL. THEREFORE, NO PROVISION FOR INCOME TAXES HAS BEEN PROVIDED IN THE FINANCIAL STATEMENTS. 1 ASIAN PACIFIC INSTITUTE ON GENDER-BASED 500 12TH STREET 330 OAKLAND CA 94607 462288278 501(C)(3) 655267 HEALTH EDUCATION TIDES CENTER - API INSTITUTE ON DV 1014 TORNEY AVE SAN FRANCISCO CA 94129 943213100 501(C)(3) 332129 HEALTH EDUCATION SOUTHEAST ASIAN MUTUAL ASSIST COALITION INC 1711 S BROAD STREET PHILADELPHIA PA 19148 222541120 501(C)(3) 62500 HEALTH EDUCATION ASIAN PACIFIC COMMUNITY IN ACTION 6741 N 7TH STREET PHOENIX AZ 85014 753040117 501(C)(3) 55000 HEALTH EDUCATION NATIONAL TONGAN AMERICA SOCIETY 3007 S WEST TEMPLE UNIT H SALT LAKE CITY UT 84115 870556679 501(C)(3) 45877 HEALTH EDUCATION BOSTON CHINATOWN NEIGHBORHOOD CENTER 885 WASHINGTON STREET BOSTON MA 02111 237209691 501(C)(3) 45000 HEALTH EDUCATION ASIAN PACIFIC AMERICAN NETWORK OF OREGON PO BOX 6552 PORTLAND OR 97208 800252850 501(C)(3) 40000 HEALTH EDUCATION NEW MEXICO ASIAN FAMILY CENTER 128 QUINCY STREET NE ALBUQUERQUE NM 87108 260545877 501(C)(3) 35000 HEALTH EDUCATION STEPS COALITION 610 WATER ST BILOXI MS 39530 113790429 501(C)(3) 25000 HEALTH EDUCATION EASTERN MICHIGAN UNIVERSITY 200 BOONE HALL YPSILANTI MI 48197 382953297 501(C)(3) 20000 HEALTHY ASIAN AMERICANS PROJECT (HAAP) KOREAN COMMUNITY SERVICES OF METROPOLITAN NY 2 WEST 32ND STREET 604 NEW YORK NY 10001 237348989 501(C)(3) 20000 HEALTH EDUCATION UNITED SIKHS 101-05 LEFFERTS BOULEVARD SUITE 207 207 NEW YORK NY 10116 113489321 501(C)(3) 20000 HEALTH EDUCATION ARKANSAS COALITION FOR MARSHALLESE 109 SPRING ST 14 SPRINGDALE AR 72764 352416698 501(C)(3) 15000 HEALTH EDUCATION ASIAN HEALTH COALITION OF ILLINOIS 180 W WASHINGTON ST 1000 CHICAGO IL 60602 311607193 501(C)(3) 15000 HEALTH EDUCATION COALITION FOR AACF 50 BROAD STREET 18TH FLOOR NEW YORK NY 10004 133682471 501(C)(3) 15000 HEALTH EDUCATION SAMOAN NATIONAL NURSES ASSOCIATION -CA 1950 E 220TH ST STE 301 LONG BEACH CA 90810 912069657 501(C)(3) 15000 HEALTH EDUCATION POLARIS PO BOX 65323 WASHINGTON DC 20035 030391561 501(C)(3) 12500 HEALTH EDUCATION LIFE FOUNDATION 677 ALA MOANA BLVD 226 HONOLULU HI 96813 990230542 501(C)(3) 11025 HEALTH EDUCATION ANGKOR RESOURCE CENTER PO BOX 962733 RIVERDALE GA 30296 455122454 501(C)(3) 10000 HEALTH EDUCATION BOAT PEOPLE SOS 9741 BOLSA AVE STE 220 WESTMINSTER CA 92683 800624033 501(C)(3) 10000 HEALTH EDUCATION BOAT PEOPLE SOS-BAYOU LA BATRE 13835 S WINTZELL AVE BAYOU LA BATRE AL 36509 541563619 501(C)(3) 10000 HEALTH EDUCATION CHINESE COMMUNITY FEDERATION OF ATLANTA 1615 ALVECOTE COURT CUMMING GA 30041 582241249 501(C)(3) 10000 HEALTH EDUCATION FRESNO INTERDENOMINATIONAL REFUGEE MINISTRIES 1940 N FRESNO ST FRESNO CA 93703 770357297 501(C)(3) 10000 HEALTH EDUCATION LIGHT & SALT ASSOCIATION 9800 TOWN PARK DR255 HOUSTON TX 77036 760604950 501(C)(3) 10000 HEALTH EDUCATION MARY QUEEN OF VIETNAM COMMUNITY DEVELOPMENT 4626 ALCEE FORTIER BLVD SUITE E NEW ORLEANS LA 70129 204929600 501(C)(3) 10000 HEALTH EDUCATION OHIO ASIAN AMERICAN HEALTH COALITION 4700 REED ROAD SUITE B COLUMBUS OH 43218 205252658 501(C)(3) 10000 HEALTH EDUCATION SPECIAL SERVICE FOR GROUPS INC 905 E 8TH STREET LOS ANGELES CA 90021 951716914 501(C)(3) 10000 ASIAN AND PACIFIC ISLANDER OBESITY PREVENTION VIETNAMESE AMERICAN COMMUNITY OF GEORGIA 6030 DAWSON BLVD SUITE B NORCROSS GA 30093 205310941 501(C)(3) 10000 HEALTH EDUCATION 28 0 PART I, LINE 2: ALL PROPOSALS FOR GRANTS OR ASSISTANCE ARE SUBJECT TO A REVIEW COMMITTEE WHICH INCLUDES THE PROJECT DIRECTOR, THE EXECUTIVE VICE-PRESIDENT, AND THE CHIEF ADMINISTRATIVE OFFICER. ALL GRANTEES ARE REQUIRED TO SUBMIT PROOF OF INCORPORATION, TAX STATUS, 990S, AND LAST TWO FISCAL YEARS' BUDGETS. THE SELECTION CRITERIA IS DOCUMENTED AND ELECTRONICALLY FILED WITH THE CONTRACT AGREEMENTS TO THE GRANTEES. WITH THE EXCEPTION OF GENERAL SUPPORT GRANTS, ALL GRANTEES ARE REQUIRED TO REPORT DELIVERABLES AGAINST CONTRACT AGREEMENT IN THE FORM OF INTERIM AS WELL AS FINAL REPORTS. X X X 0 0 0 0 0 0 0 0 0 KATHY KO CHIN PRESIDENT, CEO 180160 0 0 0 4081 0 10632 0 4087 0 198960 0 0 0 ED TEPPORN EXECUTIVE VICE-PRESIDENT 143017 0 0 0 0 0 8519 0 6248 0 157784 0 0 0 FORM 990, PART VI, SECTION B, LINE 11 FORM 990 IS PREPARED BY OUR EXTERNAL AUDIT PARTNER WITH INPUT FROM OUR CHIEF ADMINISTRATIVE OFFICER. A DRAFT OF THE COMPLETED FORM 990 IS PROVIDED BY THE AUDIT PARTNER AND REVIEWED BY THE CHIEF ADMINISTRATIVE OFFICER AND THE PRESIDENT & CEO. INPUT/EDITS ARE INCORPORATED INTO A SECOND DRAFT, WHICH IS REVIEWED BY THE FINANCE COMMITTEE AND THE AUDIT COMMITTEE. UPON APPROVAL BY THESE COMMITTEES, THE AUDIT COMMITTEE CHAIR PROVIDES A RECOMMENDATION FOR APPROVAL TO THE BOARD. THE FINAL FORM 990 IS MADE AVAILABLE TO THE ENTIRE BOARD. FORM 990, PART VI, SECTION B, LINE 12C ALL EMPLOYEES ARE REQUIRED TO SIGN A CONFLICT OF INTEREST STATEMENT WHEN HIRED. POSSIBLE CONFLICTS ARE ADDRESSED BY MANAGERS AND SUPERVISOR AND IF NECESSARY, BROUGHT TO THE ATTENTION OF THE EXECUTIVE TEAM. ON AN ANNUAL BASIS, THE BOARD OF DIRECTORS SIGNS A CONFLICT OF INTEREST STATEMENT THAT IS REVIEWED BY THE PRESIDENT & CEO OF APIAHF. POSSIBLE CONFLICTS ARE ADDRESSED INITIALLY WITH THE BOARD CHAIR AND THEN WITH THE BOARD EXECUTIVE COMMITTEE. IF CONFLICT ARISES, THE INDIVIDUAL(S) WITH THE CONFLICT OF INTEREST IS NOT ALLOWED TO VOTE ON THE TRANSACTION. FORM 990, PART VI, SECTION B, LINE 15 HUMAN RESOURCES CONSULTS WITH A HUMAN RESOURCE MANAGEMENT AGENCY WHO ASSESSES THE COMPETITIVENESS AND REASONABLENESS OF APIAHF'S CASH COMPENSATION AND BENEFITS COMP ANALYSIS MAKES RECOMMENDATION ON ALL POSITIONS INCLUDING CEO, BASING ITS RECOMMENDATIONS ON LABOR MARKET, PAY PHILOSOPHY, BUDGET CONCERNS, AND CULTURE OF THE ORGANIZATION. RECOMMENDATION IS FORWARDED TO BOARD CHAIR WHO MAKES RECOMMENDATION TO THE FULL BOARD. APPROVAL IS REQUIRED PRIOR TO IMPLEMENTATION. THE PROCESS IS DOCUMENTED, AND WAS LAST DONE IN 2017. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, POLICIES AND FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G CONSULTANT FEES: PROGRAM SERVICE EXPENSES 505,714. MANAGEMENT AND GENERAL EXPENSES 134,815. FUNDRAISING EXPENSES 47,070. TOTAL EXPENSES 687,599.