2024-02-05T14:51:53-06:00 2023-06-30 930743240 HOFFMAN STEWART & SCHMIDT PC 3 CENTERPOINTE DRIVE SUITE 300 LAKE OSWEGO OR 970358663 990 2022-07-01 930706892 FORA HEALTH INC FORA 5035351151 PO BOX 16040 PORTLAND OR 972920040 DEVARSHI BAJPAI CEO 5035351151 2024-01-25 1 DEVARSHI BAJPAI 999009999 0 ROBERT M PRILL P00236613 5032205900 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z DEVARSHI BAJPAI PO BOX 16040 PORTLAND OR 972920040 14781825 0 X WWW.FORAHEALTH.ORG X 1977 OR PROVIDE TREATMENT, CARE, AND ADVOCACY FOR ALL WHO ARE AFFECTED BY SUBSTANCE USE DISORDER. 12 12 208 0 0 0 4277479 1978519 9870991 12545303 394601 216258 22578 -97619 14565649 14642461 0 0 0 0 9295423 10221717 0 0 478163 3730450 4061029 13025873 14282746 1539776 359715 25496542 25090170 3998289 3893339 21498253 21196831 FORA HEALTH PROVIDES TREATMENT, CARE, AND ADVOCACY FOR ALL WHO ARE AFFECTED BY SUBSTANCE USE DISORDER. 0 0 10619367 12587048 THE ADULT AND FAMILY SERVICES PROGRAM PROVIDES UP TO 95 BEDS FOR INTENSIVE RESIDENTIAL TREATMENT AND MEDICAL DETOXIFICATION FOR MEN AND WOMEN AT ITS SOUTHEAST PORTLAND LOCATION. THE ORGANIZATION ALSO PROVIDES AN INTENSIVE OUTPATIENT STABILIZATION PROGRAM AND OUTPATIENT SERVICES FOR THOSE WHO HAVE COMPLETED OR DO NOT REQUIRE RESIDENTIAL TREATMENT AT ITS OFFICES IN WASHINGTON COUNTY OR SOUTHEAST PORTLAND LOCATIONS. THE ORGANIZATION PROVIDES PUBLIC INFORMATION REGARDING DRUG AND ALCOHOL ISSUES FACING THE PORTLAND METROPOLITANAREA. WORK ALSO IS DONE TO EDUCATE THE PUBLIC ABOUT ADDICTION AND TO CHANGE THE STIGMA ATTACHED TO ALCOHOLISM AND OTHER ADDICTION DISEASES. 179699 THE YOUTH AND FAMILY SERVICES SITE IN NORTHEAST PORTLAND PROVIDED UP TO 44 BEDS TO INTENSIVE RESIDENTIAL TREATEMENT FOR ADOLESCENTS, INDIVIDUAL AND FAMILY COUNSELING, OUTPATIENT, AND AN ALTERNATIVE HIGH SCHOOL FOR ADOLESCENTS AGES 12 TO 17. DURING THE YEAR ENDED JUNE 30, 2022, THE ORGANIZATION CLOSED THE YOUTH AND FAMILY SERVICES SITE, BUT IS CONTINUING TO EVALUATE ONGOING YOUTH AND FAMILY SERVICES AT THIS SITE. 10799066 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 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 1 0 0 0 1 7 0 1 208 1 0 0 0 0 0 1 1 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 OR X PAMELA BELLI 5035351151 10230 SE CHERRY BLOSSOM DRIVE PORLTAND OR 97216 JAMES POLO CHAIR 1.00 X X 0 0 0 ANDY DARKINS VICE-CHAIR 1.00 X X 0 0 0 JASON NASH TREASURER/SECRETARY 1.00 X X 0 0 0 PAUL CONTI DIRECTOR 1.00 X 0 0 0 KELSIE CRIPPEN DIRECTOR 1.00 X 0 0 0 DR TERRY JOHNSSON DIRECTOR 1.00 X 0 0 0 JAY MINOR DIRECTOR 1.00 X 0 0 0 GRAEME QUEEN DIRECTOR 1.00 X 0 0 0 AMIT SHAH DIRECTOR 1.00 X 0 0 0 RACHEL PRUSAK DIRECTOR 1.00 X 0 0 0 KEVIN VALK DIRECTOR 1.00 X 0 0 0 MELISSA TOPP DIRECTOR 1.00 X 0 0 0 MAREE WACKER CEO 40.00 X 350892 0 35600 PAMELA BELLI CFO 30.00 X 292323 0 30402 EOWYN RIEKE MEDICAL DIRECTOR 40.00 X 227163 0 50473 JESSICA GREGG CHIEF MEDICAL OFFICER 40.00 X 206033 0 12357 JENNIFER HARTLEY DIR. OF INNOVATION 40.00 X 202849 0 14184 NERISSA HELLER ADULT OUTPATIENT DIR. 40.00 X 170696 0 23329 KEVIN MCADAMS CONTROLLER (FORMER) 40.00 X 163048 0 32393 1613004 0 198738 12 0 1 0 0 172360 841638 964521 1978519 CLIENT FEES 621400 10912647 10912647 CCO INCENTIVE REVENUE 624200 1632656 1632656 12545303 216258 216258 0 172360 139364 -139364 -139364 MISCELLANEOUS 900099 41745 41745 41745 14642461 12587048 0 76894 737906 188017 428765 121124 8001195 6227411 1586579 187205 187467 155142 29972 2353 644211 487123 139543 17545 650938 480015 148599 22324 1221993 921447 268399 32147 116100 71529 232 44339 707596 556469 129427 21700 48519 42278 5346 895 272 272 378219 334183 41568 2468 277465 222134 47232 8099 FOOD SERVICES 423271 422873 388 10 CLIENT ASSISTANCE AND P 296378 285022 10981 375 REPAIRS & MAINTENANCE 232843 201814 29493 1536 MISCELLANEOUS 109894 49615 58075 2204 248479 153994 80646 13839 14282746 10799066 3005517 478163 2600431 2542438 240912 358034 736062 985552 146932 56946 6249510 3591981 2841549 2657529 360351 410549 18570305 18079122 25496542 25090170 1327382 1484997 136782 2177000 2177000 350000 150000 7125 81342 3998289 3893339 X 20427212 21196831 1071041 0 21498253 21196831 25496542 25090170 X 359715 -661137 X X 0 1 X 1 0 X 3045947 3548861 4058047 4277479 1978519 16908853 3045947 3548861 4058047 4277479 1978519 16908853 1144838 15764015 13813 69703 216307 216279 216258 732360 47625 41500 46303 15420 150848 40249 32274 40866 55527 41745 210661 18002722 52681396 0.87560 0.85410 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 9700 9700 14273046 14282746 864137 216034 0 0 765998 739110 801294 864137 3170539 4755809 16000 16000 19806 9700 61506 191500 184778 200324 216034 792636 1188954 16000 16000 19806 9700 61506 37300 37300 3832144 2294597 1537547 2245345 1233961 1011384 134721 63423 71298 2657529 NOTE RECEIVABLE 15650200 INVESTMENT IN DE PAUL QALICB, INC. 2348769 OPERATING LEASE RIGHT-OF-USE ASSETS 80153 18079122 FINANCE LEASE LIABILITY 1189 OPERATING LEASE LIABILITIES 80153 81342 X PART X, LINE 2: MANAGEMENT DOES NOT BELIEVE FORA HEALTH, INC. HAS ANY UNCERTAIN TAX POSITIONS. FORA HEALTH, INC. FILES INFORMATIONAL RETURNS WHICH ARE GENERALLY SUBJECT TO EXAMINATION BY INCOME TAX AUTHORITIES FOR THREE YEARS FROM THE FILING OF A RETURN. THERE ARE CURRENTLY NO EXAMINATIONS IN PROGRESS FOR ANY PERIODS. ANNUAL FREEDOM AWARD FUNDRAISER 172360 172360 139364 172360 172360 139364 139364 -139364 X X X X X 0 0 0 0 0 0 0 0 0 MAREE WACKER CEO 350892 0 0 0 0 0 17315 0 18285 0 386492 0 0 0 PAMELA BELLI CFO 292323 0 0 0 0 0 16309 0 14093 0 322725 0 0 0 EOWYN RIEKE MEDICAL DIRECTOR 227163 0 0 0 0 0 12507 0 37966 0 277636 0 0 0 JESSICA GREGG CHIEF MEDICAL OFFICER 206033 0 0 0 0 0 12357 0 0 0 218390 0 0 0 JENNIFER HARTLEY DIR. OF INNOVATION 202849 0 0 0 0 0 0 0 14184 0 217033 0 0 0 KEVIN MCADAMS CONTROLLER (FORMER) 163048 0 0 0 0 0 9773 0 22620 0 195441 0 0 0 NERISSA HELLER ADULT OUTPATIENT DIR. 170696 0 0 0 0 0 8031 0 15298 0 194025 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B THE BOARD OF DIRECTORS REVIEWS THE FORM 990 PRIOR TO FILING, PROVIDING AN OPPORTUNITY FOR QUESTIONS AND FEEDBACK. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS ARE ASKED TO REVIEW AND SIGN CONFLICT OF INTEREST AND CODE OF CONDUCT AND ETHICS DOCUMENTS AT THE COMMENCEMENT OF THEIR SERVICE AS A DIRECTOR, AND ANNUALLY THEREAFTER. FORM 990, PART VI, SECTION B, LINE 15 CEO COMPENSATION IS SET BASED ON DATA COLLECTED ANNUALLY BY HUMAN RESOURCES STAFF AND INCLUDES THE USE OF THE MBL GROUP'S ANNUAL NONPROFIT SALARY SURVEY, AND INTERVIEWS WITH OTHER HUMAN RESOURCE DEPARTMENTS OF OTHER NONPROFITS. ADDITIONALLY, THE BOARD EVALUATES AND COMPARES OTHER NON-PROFIT AND COMPARABLE ORGANIZATION CEO COMPENSATION PACKAGES TO REVIEW AND APPROVE THE CEO COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: DECREASE IN INVESTMENT IN QALIC B -661,137. FORM 990, PART XII, LINE 2C: THE ORGANIZATION'S BOARD OF DIRECTORS ASSUMES RESPONSIBILITY FOR THE OVERSIGHT OF THE ANNUAL AUDIT OF THE FINANCIAL STATEMENTS. THERE HAS BEEN NO CHANGE IN THE OVERSIGHT OR SELECTION PROCESS SINCE THE PRIOR YEAR. DE PAUL QALICB INC 1312 SW WASHINGTON ST PORTLAND OR 97205 844475246 SUPPORTING ORGANIZATION OR 501(C)(3) LINE 12B, II N/A 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0