2011-05-05T10:17:56-04:00 2010-09-30 BKD LLP 910 E ST LOUIS 200/PO BOX 1190 SPRINGFIELD MO 658062523 990 2009-10-01 237156236 WEST SIDE COMMUNITY HEALTH SERVICES INC WEST 6512221816 153 CESAR CHAVEZ STREET ST PAUL MN 55107 ROBERT F STEELE 2011-04-01 4178658701 2009 2016-02-24 21:20:13Z ROBERT F STEELE CFO 153 CESAR CHAVEZ STREET ST PAUL MN 55107 26335360 false X WESTSIDECHS.ORG X 1972 MN WEST SIDE COMMUNITY HEALTH SERVICES PROVIDES INNOVATIVE AND MULTICULTURAL / MULTILINGUAL HEALTH CARE SERVICES AND EDUCATION TO IMMIGRANT AND LOW-INCOME COMMUNITIES THROUGHOUT MINNESOTA. 16 16 331 24 0 9600248 10176721 15142642 15912911 118885 84387 2554 0 24864329 26174019 167810 180693 0 0 13486272 14384683 0 0 0 9329822 9660576 22983904 24225952 1880425 1948067 16069988 17683500 7165811 6746373 8904177 10937127 WEST SIDE COMMUNITY HEALTH SERVICES PROVIDES MULTICULTURAL / MULTILINGUAL HEALTH CARE SERVICES AND EDUCATION TO IMMIGRANT AND LOW-INCOME COMMUNITIES. SEE SCHEDULE O FOR MORE INFORMATION. false false 14807130 180693 11883762 THE ORGANIZATION PROVIDES COMPREHENSIVE HEALTH CARE & SOCIAL SERVICES WITH BILINGUAL/BICULTURAL STAFF ON A SLIDING FEE SCALE. SERVICES INCLUDE PRIMARY, SPECIALTY, PREVENTIVE, URGENT CARE, COMPLEMENTARY, PHARMACY, DENTAL, OB/GYN, MENTAL HEALTH, SOCIAL & WRAP-AROUND SERVICES SUCH AS CHILD CARE, TRANSPORTATION & ASSISTANCE WITH HLTH PLAN ENROLLMENT. WE ARE PROUD TO SERVE OVER 35,000 PATIENTS EACH YR. WE SERVE THE DIVERSE ST. PAUL METRO AREA COMMUNITY -- PARTICULARLY THE LATINO & HMONG POPULATIONS, ST. PAUL PUBLIC HOUSING RESIDENTS, PEOPLE IN THE HOMELESS POPULATION, & ADOLESCENTS IN A SERVICE AREA THAT INCLUDES A SIGNIFICANT PORTION OF THE CITY OF ST. PAUL & RAMSEY COUNTY. 2294203 1771107 THE ORGANIZATION PROVIDES PREVENTIVE, RESTORATIVE, & EMERGENCY DENTAL SERVICES TO OVER 5,500 PATIENTS AT TWO CLINICS: WEST SIDE DENTAL CLINIC & HELPING HAND DENTAL CLINIC. OUR BRIGHT SMILES DENTAL PROGRAM IS A PRTNRSHP W/ THE GREATER TWIN CITIES UNITED WAY & THE KNIGHT FOUNDATION. SRVCS ARE PROVIDED FOR CHILDREN IN RAMSEY & DAKOTA COUNTIES. THE PRTNRSHP FOR IMPROVING CHILDREN'S ORAL HEALTH IN RAMSEY COUNTY STRIVES TO IMPROVE THE ORAL HLTH OF DISADVANTAGED POPULATIONS THROUGH COMMUNITY OUTREACH, EDUCATION, & DENTAL SERVICES. BRIGHT SMILES STRIVES TO ENSURE THAT LATINO CHILDREN HAVE ACCESS TO DENTAL CARE & FAMILIES ARE EDUCATED ON EFFECTIVE ORAL HLTH PRACTICES. THERE IS NO CHARGE FOR THESE SRVCS. 2935378 2258042 OUR LA CLINICA PHARMACY PROVIDES MEDICATION DISPENSING SRVCS & MEDICATION THERAPY MGMT (MTM). MTM GOES BEYOND THE STANDARD COUNSELING ASSOCIATED W/ RECEIVING A NEW PRESCRIPTION, WORKING DIRECTLY W/ DOCTORS TO ASSURE THAT ALL MEDICATION NEEDS ARE BEING MET. UNINSURED PATIENTS RECEIVE SLIDING SCALE DISCOUNTS BASED UPON INCOME & LOWER PRICED DRUGS. WHEN PRICES STILL REMAIN TOO HIGH, PHARMACISTS AID PATIENTS IN RECEIVING MEDICATION THROUGH MANUFACTURER PATIENT ASSISTANCE PROGRAMS, DISPENSE SAMPLE MEDS, OR THROUGH EXPANSION OF THE PFIZER SHARING THE CARE PROGRAM WHICH PROVIDES FREE PFIZER MEDICATIONS TO QUALIFYING UNINSURED PATIENTS. 20036711 true true false true false false false false false true true false false false false false false false false false false false true true false false false false false false false false true false false false false false false false false true 28 0 true 331 true false false false false false false false false false 16 16 false true false false false false false true true false false true true true true true true true false false MN X X ROBERT F STEELE CFO 6512221816 153 CESAR CHAVEZ ST ST PAUL MN 55107 HEIDI CONRAD 1.0 X X 0 0 0 KEVIN BOREN 1.0 X X 0 0 0 ROBERT SHEEHY 1.0 X X 0 0 0 AMANDA LOGE 1.0 X X 0 0 0 KELLY WOODS BIRKENHOLZ 1.0 X 0 0 0 KATHERINE CAIRNS 1.0 X 0 0 0 ERWIN CONCEPCION 1.0 X 0 0 0 ROSAURA DE LA TORRE 1.0 X 540 0 0 PIERRE GINGERICH-BOBERG 1.0 X 0 0 0 SUSAN MARSCHALK 1.0 X X 0 0 0 WILLIAM RILEY 1.0 X 0 0 0 BERENICE RIVERA 1.0 X 0 0 0 PETE SURDO 1.0 X 0 0 0 SHENG THAO 1.0 X 0 0 0 ROSA TOCK 1.0 X 0 0 0 DR BRYAN WARREN 1.0 X 0 0 0 BILL THOMPSON 1.0 X 0 0 0 ED SIMMONS 1.0 X 0 0 0 LUIS ORTEGA 1.0 X 600 0 0 MARIA CHAVARRIA 1.0 X 0 0 0 CRAIG MORRIS 1.0 X 0 0 0 ROBERT F STEELE 40.0 X 121641 0 4123 JAESON T FOURNIER 40.0 X 23269 0 0 DR TERRIL H HART 40.0 X 0 0 0 KATHLEEN CULHANE-PERA 32.0 X 163140 0 10544 MARY NESVIG 32.0 X 147418 0 5761 KANG XIAAJ 40.0 X 140964 0 12643 MARGARITA SEVILLA 40.0 X 132229 0 1367 BRAD MCDONNELL 34.0 X 122348 0 4211 JASON COMO 40.0 X 120029 0 8380 MAVIS BREHM 40.0 X 183861 0 1737 1156039 0 48766 13 true true false QUEST DIAGNOSTICS INC LABORATORY 321220 NEIGHBORHOOD HEALTH CARE NETWORK SOFTWARE MGMT 398745 SOLBREKK IT SERVICES 203624 NETGAIN TECHNOLOGY IT HOSTING SERVICES 157602 UNIVERSITY OF MINNESOTA PHARMACY RESIDENTS 127569 7 346461 8793069 1037191 217251 10176721 PROGRAM SERVICE REV 624100 15730009 15730009 PROGRAM INCENTIVES 624100 116009 116009 PRECEPTING 624100 66625 66625 OTHER 624100 268 268 15912911 32422 32422 0 0 213306 130460 30881 82846 -30881 51965 51965 0 0 0 0 26174019 15912911 84387 0 180693 180693 0 0 323857 174824 149033 185598 185598 10984027 9778708 1205319 111217 99171 12046 1850923 1604365 246558 929061 804878 124183 81000 81000 22830 22830 69334 69334 0 0 7723 7723 1742841 1074403 668438 4513 912 3601 677363 315829 361534 781841 540322 241519 0 805921 523940 281981 67972 59703 8269 0 94050 53655 40395 183105 183105 0 386249 316952 69297 28556 18072 10484 BAD DEBT 1557053 1557053 LICENSES, DUES & SUBSCRIPTIONS 75629 69597 6032 TAXES 201709 201709 MEDICAL SUPPLIES & DRUGS 2821312 2821312 OTHER EXPENSES 51575 42322 9253 24225952 20036711 4189241 0 3290 2717 5617508 6533983 547112 1159641 935165 1005700 89902 75768 32603 34934 8795272 2295432 6826676 6499840 1947732 2030917 70000 340000 16069988 17683500 2385724 1759625 82648 533649 4697439 4453099 7165811 6746373 X 8374132 10252943 530045 684184 8904177 10937127 16069988 17683500 X false true true X true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true false false OTHER LOBBYING ACTIVITIES PART II-B, LINE 1I THE ORGANIZATION PAYS DUES TO THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS (NACHC) AND THE MINNESOTA ASSOCIATION OF COMMUNITY HEALTH CENTERS. A PORTION OF THESE DUES MAY BE USED FOR LOBBYING PURPOSES. 615140 615140 5975636 916584 5059052 845871 603098 242773 1358625 775750 582875 6499840 26174019 24225952 1948067 84883 84883 2032950 26571500 84883 289440 -7723 366600 26204900 -30881 -30881 26174019 24538550 289440 30881 320321 24218229 7723 7723 24225952 UNCERTAIN TAX POSITION SCHEDULE D, PART X, LINE 2 MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740.BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. OTHER REVENUE NOT ON FORM 990 SCHEDULE D, PART XII, LINE 2D INVESTMENT EXPENSES ( 7,723) OTHER REVENUE NOT ON FINANCIAL STATEMENTS SCHEDULE D, PART XII, LINE 4B LOSS ON SALE OF ASSETS (30,881) OTHER EXPENSE NOT ON FORM 990 LOSS ON SALE OF ASSETS 30,881 true EVICTION PREVENTION PROGRAM-RENT 43 19563 EVICTION PREVENTION PROGRAM-UTILITIES 386 156633 EVICTION PREVENTION PROGRAM-SANITATION 11 4497 EVICTION PREVENTION GRANTS SCHEDULE I, PART I, LINE 2 WEST SIDE COMMUNITY HEALTH SERVICES OFFERS EVICTION PREVENTION SERVICES TO THOSE IN NEED IN THEIR COMMUNITY. IN ORDER TO GAIN ASSISTANCE, APPLICANTS SUBMIT A REQUEST STATING THEIR NEED. REQUESTS ARE VERIFIED WITH THE APPROPRIATE AGENCIES (IE: UTILITIES COMPANY) TO DETERMINE ACCOUNT STATUS. IF THE APPROVED APPLICANT IS ELIGIBLE FOR ASSISTANCE FROM LARGER PROGRAMS BUT NEEDS ADDITIONAL FUNDS TO PAY THE BILL OR IF THEY ARE NOT ELIGIBLE FOR THOSE PROGRAMS, WEST SIDE COMMUNITY HEALTH SERVICES WILL ASSIST IN RESOLVING THE BILL. ALL PAYMENTS ARE MADE DIRECTLY TO THE LANDLORD, UTILITY COMPANY, OR SANITATION COMPANY. CHECKS ARE PROCESSED BY WSCHS WITH SPECIFIC NAMES AND ACCOUNT NUMBERS. THIS INFORMATION GOES TO THE UTILITIES AND HC STAFF TO VERIFY AND RECORD. X X X true false false false false false false true false MAVIS BREHM 32493 0 0 0 151368 0 835 0 902 0 185598 0 KATHLEEN CULHANE-PERA 162668 0 0 0 472 0 3543 0 7001 0 173684 0 MARY NESVIG 147153 0 0 0 265 0 3730 0 2031 0 153179 0 KANG XIAAJ 134441 0 0 0 6523 0 3587 0 9056 0 153607 0 EQUITY-BASED COMPENSATION SCHEDULE J, PART I, LINE 4A THE INDIVDUAL NOTED BELOW RECEIVED A SEVERENCE PAYMENT PURSUANT TO A SEPARATION AGREEMENT AND RELEASE EXECUTED MARCH 11, 2009. MAVIS BREHM $120,858 BONUS SCHEDULE J, PART I, LINE 7 JASON COMO RECEIVED A $1,500 BONUS AFTER 6 MONTHS OF EMPLOYMENT AS SPECIFIED IN HIS CONTRACT. JAESON FOURNIER, CEO, RECEIVED A SIGNING BONUS OF $20,000 AS PART OF HIS CONTRACT. X 28 217251 FMV 0 false false false DRUGS & MEDICAL SUPPLIES PART I, LINE 20 THE ORGANIZATION RECEIVED DONATIONS OF DRUGS AND MEDICAL SUPPLIES OVER $5,000 IN VALUE FROM THREE ENTITIES. ADDITIONALLY, THE ORGANIZATION RECEIVED DONATIONS OF DRUGS AND MEDICAL SUPPLIES FROM 25 OTHER CONTRIBUTORS, WITH EACH CONTRIBUTING LESS THAN $5,000 IN VALUE. ORGANIZATION'S MISSION FORM 990, PART III, LINE 1 WEST SIDE COMMUNITY HEALTH SERVICES IS THE LARGEST COMMUNITY CLINIC ORGANIZATION IN MINNESOTA, WITH MULTIPLE LOCATIONS IN THE METRO AREA. WE PROVIDE INNOVATIVE AND MULTICULTURAL / MULTILINGUAL HEALTH CARE SERVICES AND EDUCATION TO IMMIGRANT AND LOW-INCOME COMMUNITIES. WE STRIVE TO ENSURE THAT EVERYONE HAS ACCESS TO HIGH QUALITY, AFFORDABLE HEALTH CARE, TO ACTIVELY ENGAGE PATIENTS IN THEIR OWN HEALTH CARE, AND TO RESPECT THE TRADITIONS OF THOSE WE SERVE. WE STRIVE TO IMPROVE THE HEALTH OF OUR REGION FOR THE BENEFIT OF ALL. OTHER PROGRAM SERVICES FORM 990, PART III, LINE 4D ADDITIONAL PROGRAM SERVICES THE ORGANIZATION PROVIDES AT ITS CLINICS INCLUDE: -ADOLESCENT HEALTH CARE SERVICES -DIABETES CARE -EVICTION PREVENTION -FAMILY PLANNING & PREGNANCY TESTING -FAMILY SUPPORT & MENTAL HEALTH COUNSELING -HEALTH EDUCATION -HIV CARE -NUTRITION SERVICES -PRENATAL CARE -SENIOR HEALTHCARE -WELL CHILD CARE AND IMMUNIZATIONS -WOMEN'S HEALTH, AND -WOMEN, INFANTS AND CHILDREN (WIC) PROGRAM DELEGATION OF MANAGEMENT DUTIES FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION CONTRACTED EXPERIENCED RESOURCES FOR ITS INTERIM CEO, DR. TERRIL HART. EXPERIENCED RESOURCES PAID ALL COMPENSATION AND BENEFITS FOR THE SERVICES OF THE INTERIM CEO FOR A TOTAL OF $81,000. 990 REVIEW POLICY FORM 990, PART VI, SECTION B, LINE 11A THE RETURN IS PREPARED BY AN INDEPENDENT ACCOUNTANT USING THE AUDITED FINANCIAL RECORDS OF THE ORGANIZATION. THEN, THE CEO, CFO, FINANCE COMMITTEE, AND BOARD OF DIRECTORS REVIEW AND APPROVE THE RETURN PRIOR TO BEING FILED. CONFLICT OF INTEREST FORM 990, PART VI, SECTION B, LINE 12C ALL BOARD MEMBERS ARE EXPECTED TO EXERCISE INDEPENDENT JUDGMENT IN OVERSEEING THE BUSINESS AFFAIRS OF THE ORGANIZATION. BOARD MEMBERS ARE PROHIBITED FROM ENGAGING IN ANY SITUATION THAT IS OR APPEARS TO BE A CONFLICT OF INTEREST. THIS INCLUDES PROHIBITING BOARD MEMBERS AND MEMBERS OF THEIR IMMEDIATE FAMILY FROM BEING EMPLOYEES OR CONTRACTORS OF WEST SIDE COMMUNITY HEALTH SERVICES. ON AN ANNUAL BASIS, ALL BOARD OF DIRECTORS AND COMMITTEE MEMBERS MUST SIGN A WRITTEN DECLARATION OF THE FOLLOWING: 1. FIT OF ORGANIZATIONAL MISSION WITH PERSONAL GOALS. 2. INDIVIDUAL OR IMMEDIATE FAMILY PARTICIPATION IN OTHER BUSINESS RELATIONSHIPS OR THE ENGAGEMENT OF OTHER OUTSIDE ACTIVITIES THAT MAY IMPAIR INDEPENDENCE OF JUDGMENT CONCERNING THE OPERATIONS OF WEST SIDE COMMUNITY HEALTH SERVICES. 3. INDIVIDUAL OR IMMEDIATE FAMILY PERSONAL FINANCIAL INTERESTS THAT MAY IMPAIR INDEPENDENCE OF JUDGMENT OR INFLUENCE DECISIONS OR ACTIONS CONCERNING WEST SIDE COMMUNITY HEALTH SERVICES. 4. INDIVIDUAL OR IMMEDIATE FAMILY INVOLVEMENT, OR OTHER BOARD OR OFFICER INVOLVEMENT, IN ANY BUSINESS TRANSACTIONS INVOLVING MATERIAL INTEREST, DIRECT OR INDIRECT, PENDING OR COMPLETED, TO WHICH WEST SIDE COMMUNITY HEALTH SERVICES WAS OR IS TO BE A PARTY. 5. INDIVIDUAL OR IMMEDIATE FAMILY INVOLVEMENT OR OTHER BOARD OR OFFICER INVOLVEMENT, IN ANY BUSINESS TRANSACTION WITH A COMPANY WHICH SUBSTANTIALLY COMPETES WITH WEST SIDE COMMUNITY HEALTH SERVICES. 6. SIGNED STATEMENTS WILL BE KEPT ON FILE. ANY DECLARATION NOTING A POTENTIAL CONFLICT OF INTEREST WILL BE FURTHER REVIEWED BY THE EXECUTIVE COMMITTEE. COMPENSATION REVIEW FORM 990, PART VI, SECTION B, LINES 15A & 15B THE EXECUTIVE COMMITTEE OF THE BOARD REVIEWED THE CEO COMPENSATION. THEY USED A NUMBER OF COMPENSATION SURVEYS, INCLUDING THE 2009 NACHC AND THE 2009 VAN NORMAN & ASSOCIATES SURVEY. ADDITIONALLY, SINCE THE CEO WAS HIRED IN 2009, THE RECOMMENDATIONS OF EXECUTIVE SEARCH FIRM, WOOD EXECUTIVE SEARCH, WERE CONSIDERED. THE EXECUTIVE COMMITTEE RECOMMENDED THE COMPENSATION STRUCTURE TO THE FULL BOARD FOR APPROVAL. ALL OTHER OFFICERS AND KEY EMPLOYEE SALARIES ARE REVIEWED AND APPROVED BY THE CEO ON AN ANNUAL BASIS. DOCUMENT DISCLOSURE FORM 990, PART VI, SECTION C, LINE 19 THE AUDIT REPORT AND FORM 990 ARE CURRENTLY AVAILABLE TO THE PUBLIC FOR VIEWING ON THE ORGANIZATION'S WEBSITE. THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST, AND WILL BE MAILED TO THE REQUESTOR WHEN ANY INQUIRY IS RECEIVED BY THE ORGANIZATION. DIRECTOR COMPENSATION FORM 990, PART VII ROSAURA DE LA TORRE AND LUIS ORTEGA BOTH RECEIVED COMPENSATION FROM THE ORGANIZATION. THIS COMPENSATION WAS PROVIDED AS A COMMUNITY MEMBER PARTICIPATING IN A RESEARCH PROJECT. NO BOARD MEMBERS RECEIVE COMPENSATION FOR THEIR ROLES AS DIRECTORS.