2017-02-03T16:38:05-06:00 2016-06-30 410746749 CLIFTONLARSONALLEN LLP 10700 NORTHUP WAY SUITE 200 BELLEVUE WA 98004 990 2015-07-01 930605570 NORTHWEST HUMAN SERVICES INC NORT 5035885828 681 CENTER STREET NE SALEM OR 97301 PAUL LOGAN CHIEF EXECUTIVE OFFICER 5035885828 2017-02-02 1 KURT BENNION CPA P01469618 4252506100 2015 2021-01-29 14:40:06Z PAUL LOGAN 681 CENTER STREET NE SALEM OR 97301 19271902 0 X WWW.NORTHWESTHUMANSERVICES.ORG X 1970 OR MEET THE NEEDS OF THE COMMUNITY MEMBERS, REGARDLESS OF SOCIAL OR ECONOMIC STATUS. 14 14 211 34 0 0 4086733 5163316 10565964 10965463 151096 120539 797334 2779072 15601127 19028390 332767 652904 0 0 10259204 11100257 0 0 30555 3711072 3635633 14303043 15388794 1298084 3639596 16802287 21037493 2094868 2780072 14707419 18257421 X NORTHWEST HUMAN SERVICES MEETS THE NEEDS OF COMMUNITY MEMBERS, REGARDLESS OF SOCIAL OR ECONOMIC STATUS, BY PROVIDING COMPREHENSIVE MEDICAL, DENTAL, MENTAL HEALTH, AND SOCIAL SERVICES WITH RESPECT, COMPASSION, AND ACCEPTANCE OF CULTURAL AND LINGUISTIC DIVERSITY. 0 0 8801317 285033 8075447 WEST SALEM CLINIC AND TOTAL HEALTH COMMUNITY CLINIC: NORTHWEST HUMAN SERVICES, INC. (THE ORGANIZATION), IS A NONPROFIT FEDERALLY QUALIFIED HEALTH CENTER (FQHC), 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, 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 MEET THE NEEDS OF COMMUNITY MEMBERS, REGARDLESS OF SOCIAL OR ECONOMIC STATUS, BY PROVIDING COMPREHENSIVE MEDICAL, DENTAL, MENTAL HEALTH, AND SOCIAL SERVICES WITH RESPECT, COMPASSION, AND ACCEPTANCE OF CULTURAL AND LINGUISTIC DIVERSITY. THE ORGANIZATION PROVIDES COMPREHENSIVE MEDICAL, DENTAL, MENTAL HEALTH, AND SOCIAL SERVICES. THE MAJORITY OF PATIENTS ARE INSURED THROUGH THE OREGON HEALTH PLAN (MEDICAID), MEDICARE, OR ARE UNINSURED. A SLIDING FEE DISCOUNT PROGRAM IS AVAILABLE BASED ON FAMILY SIZE AND INCOME. NO ONE IS DENIED SERVICES DUE TO THEIR INABILITY TO PAY. THE ORGANIZATION IS ACCREDITED BY THE JOINT COMMISSION FOR AMBULATORY AND BEHAVIORAL HEALTHCARE, AND IS CERTIFIED BY THE STATE OF OREGON AS A TIER III PATIENT-CENTERED PRIMARY CARE HOME. THE WEST SALEM CLINIC AND TOTAL HEALTH COMMUNITY CLINIC (MONMOUTH, OR) PROVIDE FULL-SERVICE PRIMARY AND PREVENTATIVE CARE, AND SERVE AS PATIENT-CENTERED MEDICAL HOMES. PATIENT SELF-MANAGEMENT AND EDUCATION SERVICES AND ACCESS TO INTEGRATED BEHAVIORAL SERVICES IS ALSO AVAILABLE.FOR THE FISCAL YEAR ENDING JUNE 30, 2016 THE CLINICS SERVED 10,403 PATIENTS TOTALING 37,211 VISITS, AND THERE WERE 4,828 VISITS WITH OUR BEHAVIORISTS, HEALTH EDUCATORS AND CASE MANAGERS. 1928761 171439 1822878 WEST SALEM MENTAL HEALTH CLINIC: 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. FOR THE FISCAL YEAR ENDING JUNE 30, 2016 THE MENTAL HEALTH CLINIC SERVED 2,056 PATIENTS TOTALING 11,572 VISITS. 799897 136847 33139 QUICKCARE CLINIC: THE QUICKCARE CLINIC, LOCATED ON THE WEST SALEM CLINIC CAMPUS, PROVIDES SAME-DAY ACUTE HEALTH CARE AND SERVICES. FOR THE FISCAL YEAR ENDING JUNE 30, 2016 QUICKCARE SERVED 2,125 PATIENTS TOTALING 2,833 VISITS. HOMELESS OUTREACH AND ADVOCACY PROJECT (HOAP): THE HOAP PROGRAM 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. CASE MANAGERS, STAFF, AND VOLUNTEERS PROVIDE STREET 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 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, 2016, HOAP HAD 19,291 CLIENT ENCOUNTERS AND SERVED 13,349 LUNCHES TO HOMELESS INDIVIDUALS.THE 24-HOUR HOTLINE PROVIDES INFORMATION, REFERRAL, SUICIDE PREVENTION, CRISIS COUNSELING, EMERGENCY FINANCIAL ASSISTANCE, AND OTHER SERVICES TO INDIVIDUALS AND FAMILIES IN THE SERVICE AREA. VOICEMAIL TELEPHONE MESSAGE SERVICE IS ALSO PROVIDED FOR INDIVIDUALS WHO ARE PHONELESS. THE PROGRAM IS ACCREDITED BY THE AMERICAN ASSOCIATION OF SUICIDOLOGY. IN FISCAL YEAR 2016, HOTLINE SERVED 18,564 INDIVIDUALS AND THEIR FAMILIES. 626728 0 613898 WEST SALEM DENTAL CLINIC: THE DENTAL CLINIC, LOCATED ON THE WEST SALEM CLINIC CAMPUS, PROVIDES EMERGENT AND RESTORATIVE DENTAL SERVICES. FOR THE FISCAL YEAR ENDING JUNE 30, 2016 THE DENTAL CLINIC SERVED 1,285 PATIENTS TOTALING 3,572 VISITS. 539384 59585 420101 HEALTH, OUTREACH, SHELTER, TRANSITIONS PROGRAM (HOST): HOST 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. FOR THE FISCAL YEAR ENDING JUNE 30, 2016 HOST MADE OVER 7,000 CONTACTS WITH YOUTH AND YOUNG ADULTS. 1166112 59585 1033999 12696087 1 1 0 0 0 0 0 0 0 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 35 0 211 1 0 0 0 0 0 0 0 0 0 0 X 14 14 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 PHIL SWOGGER 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 SAMANTHA FELDMAN DIRECTOR 1.00 X 0 0 0 BETH FUSCO DIRECTOR 1.00 X 0 0 0 ELOISA HERNANDEZ 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 WILLIAM WILLIAMS DIRECTOR 1.00 X 0 0 0 PAUL LOGAN CHIEF EXECUTIVE OFFICER 40.00 X 186649 0 45245 ROBERT EDWARDS CHIEF FINANCIAL OFFICER 40.00 X 131265 0 40028 ERIC CHEN PROVIDER 40.00 X 179419 0 44044 KYLIE FONTENO PROVIDER 40.00 X 122565 0 24858 ADRIENNE MAYNARD PROVIDER 40.00 X 119961 0 29369 CYNTHIA NOCEK PROVIDER 20.00 X 140618 0 21414 TIMOTHY TRUSCHEL PROVIDER 40.00 X 216158 0 44296 1096635 0 249254 11 0 1 0 COMPHEALTH PO BOX 972625 DALLAS TX 753972625 LOCUM SERVICES 286873 QUALITY SYSTEMS INC PO BOX 51449 LOS ANGELES CA 90051 SOFTWARE SUPPORT 121299 2 17184 4485866 660266 634355 5163316 MEDICAL CLINICS 621111 8075447 8075447 MENTAL HEALTH 621112 1822878 1822878 DENTAL CLINIC 621210 613898 613898 YOUTH SHELTER 624110 420101 420101 HOMELESS OUTREACH 624100 33139 33139 10965463 155148 155148 208903 243512 -34609 -34609 -34609 CCO INCENTIVES 900099 2670304 2670304 MISCELLANEOUS 900099 108768 108768 2779072 19028390 10965463 0 2899611 652904 652904 427159 427159 8243682 6651053 1564817 27812 1608528 1271642 336886 820888 648464 169681 2743 8930 8930 47137 47137 489695 458969 30726 173871 133589 40282 235416 177378 58038 54569 31964 22605 300783 201333 99450 80316 60849 19467 MEDICAL SUPPLIES 1270675 1265401 5274 REPAIRS AND MAINTENANCE 343540 188721 154819 BAD DEBTS 303559 303559 TRAINING EXPENSE 115671 53735 61936 211471 596526 -385055 15388794 12696087 2662152 30555 1563733 3160965 125244 125332 794687 603544 2957970 4955653 88491 131087 149444 122757 9464547 3802604 5104032 5661943 5457237 5967957 272728 272728 6941 6407 281780 29120 16802287 21037493 1013846 1265307 50000 1095 1031022 1513670 2094868 2780072 X 14707419 17957421 300000 14707419 18257421 16802287 21037493 3639596 -100232 10638 0 X 0 1 X 1 1 1 X 4411496 3869168 3701316 4095233 5163316 21240529 4411496 3869168 3701316 4095233 5163316 21240529 21240529 77832 91728 100725 137609 155148 563042 72091 149852 339819 788834 2779072 4129668 25933239 47950829 0.81900 0.91360 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: MISCELLANEOUS CCO INCENTIVES RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1210619 1210619 6063658 3055167 3008491 1486635 747437 739198 703635 703635 5661943 X 18548489 10638 34609 45247 18503242 525148 525148 19028390 15388794 0 15388794 0 15388794 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 2D - OTHER ADJUSTMENTS: NET REALIZED LOSS ON INVESTMENTS 34,609. PART XI, LINE 4B - OTHER ADJUSTMENTS: INVESTMENT INCOME 155,148. CONTRIBUTIONS PROVIDED FOR THE PURCHASE OF CAPITAL ASSETS 370,000. 0 RENT ASSISTANCE 124 21334 10638 FMV RENT ASSISTANCE UTILITIES ASSISTANCE 494 15741 0 PHARMACY SUPPORT 3323 22059 245701 FMV PHARMACY SAMPLES CLOTHING & OTHER PERSONAL ITEMS 16185 1150 231537 FMV DONATED CLOTHING & OTHER PERSONAL ITEMS TRANSPORTATION ASSISTANCE - PROVISION FOR BUS PASSES 3014 9361 0 FOOD ASSISTANCE 18748 2901 92283 FMV DONATED FOOD FROM LOCAL MERCHANTS MEDICAL ASSISTANCE 2 199 0 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 X X 0 0 0 0 0 0 0 0 0 PAUL LOGAN CHIEF EXECUTIVE OFFICER 150528 0 35000 0 1121 0 11537 0 33708 0 231894 0 0 0 ROBERT EDWARDS CHIEF FINANCIAL OFFICER 115895 0 15000 0 370 0 8799 0 31229 0 171293 0 0 0 ERIC CHEN PROVIDER 179271 0 0 0 148 0 9000 0 35044 0 223463 0 0 0 CYNTHIA NOCEK PROVIDER 130618 0 10000 0 0 0 8250 0 13164 0 162032 0 0 0 TIMOTHY TRUSCHEL PROVIDER 214823 0 0 0 1335 0 6557 0 37739 0 260454 0 0 0 X 70090 FAIR MARKET VALUE X 1 161447 FAIR MARKET VALUE X 454 92283 FAIR MARKET VALUE X 977 310535 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: 1. 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 2. 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 11 PRIOR TO FILING, A DRAFT OF THE FORM 990 WAS REVIEWED BY THE AUDIT COMMITTEE. THE FINANCE COMMITTEE MADE A RECOMMENDATION TO THE BOARD OF DIRECTORS TO ACCEPT THE TAX RETURN. THE TAX RETURN WAS THEN SIGNED BY THE CHIEF EXECUTIVE OFFICER AND THEN 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, EXECUTIVE DIRECTOR, AND TOP MANAGEMENT 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 2016. 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.