2025-01-27T17:02:12-06:00 2023-09-30 410746749 CLIFTONLARSONALLEN LLP 121 WEST BRIDGE STREET OWATONNA MN 55060 990 2022-10-01 237156236 WEST SIDE COMMUNITY HEALTH SERVICES INC WEST 6516027500 153 CESAR CHAVEZ STREET ST PAUL MN 551072226 DUKE FOKUO DIRECTOR OF FINANCE 6516027500 2025-01-24 1 0 JUSTIN HARTERT P02236744 5074467100 2025-01-24 2022 2025-03-06 01:10:19Z MINNESOTA COMMUNITY CARE REUBEN MOORE 153 CESAR CHAVEZ STREET ST PAUL MN 551072226 47745272 0 X WWW.MNCARE.ORG X 1972 MN MCC PROVIDES MULTILINGUAL, MULTICULTURAL AND COMPREHENSIVE HEALTH CARE IN URBAN NEIGHBORHOODS, SCHOOLS, PUBLIC HOUSING AND HOMELESS SHELTERS. 8 8 563 20 0 0 20369597 16202439 28630330 30466057 4723 4398 424636 1072378 49429286 47745272 281943 1196488 0 0 33006714 32076934 0 0 0 17854854 18230522 51143511 51503944 -1714225 -3758672 22171803 18812335 9914538 10120263 12257265 8692072 MINNESOTA COMMUNITY CARE'S MISSION IS STRENGTHENING THE WELL-BEING OF OUR COMMUNITY THROUGH HEALTH CARE FOR ALL. 0 0 27708874 1196488 19262899 THE ORGANIZATION PROVIDES COMPREHENSIVE HEALTH CARE AND 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 AND WRAP-AROUND SERVICES SUCH AS TRANSPORTATION AND ASSISTANCE WITH HEALTH PLAN ENROLLMENT. WE ARE PROUD TO SERVE OVER 35,000 PATIENTS EACH YEAR. WE SERVE THE DIVERSE ST. PAUL METRO AREA COMMUNITY - PARTICULARLY THE LATINO AND HMONG POPULATIONS, ST. PAUL PUBLIC HOUSING RESIDENTS, THE HOMELESS, AND ADOLESCENTS - IN A SERVICE AREA THAT INCLUDES A SIGNIFICANT PORTION OF THE CITY OF ST. PAUL AND RAMSEY COUNTY. 4060456 0 2697074 THE ORGANIZATION PROVIDES PREVENTIVE, RESTORATIVE, AND EMERGENCY DENTAL SERVICES TO OVER 5,500 PATIENTS AT TWO CLINICS. WEST SIDE DENTAL CLINIC AND EAST SIDE FAMILY DENTAL CLINIC. OUR BRIGHT SMILES DENTAL PROGRAM IS A PARTNERSHIP WITH THE GREATER TWIN CITIES UNITED WAY & THE KNIGHT FOUNDATION. SERVICES ARE APPROVED FOR CHILDREN IN RAMSEY & DAKOTA COUNTIES. THE PARTNERSHIP FOR IMPROVING CHILDREN'S ORAL HEALTH IN RAMSEY COUNTY STRIVES TO IMPROVE THE ORAL HEALTH 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 HEALTH PRACTICES. THERE IS NO CHARGE FOR THESE SERVICES. 7986482 0 9578462 THE ORGANIZATION PROVIDES MEDICATION DISPENSING SERVICE AND MEDICATION THERAPY MANAGEMENT (MTM). MTM GOES BEYOND THE STANDARD COUNSELING ASSOCIATED WITH RECEIVING A NEW PRESCRIPTION, WORKING DIRECTLY WITH DOCTORS TO ENSURE THAT ALL MEDICATION NEEDS ARE BEING MET. UNINSURED PATIENTS RECEIVE SLIDING SCALE DISCOUNTS BASED UPON INCOME AND LOWER PRICED DRUGS. WHEN PRICES STILL REMAIN TOO HIGH, PHARMACISTS AID PATIENTS IN RECEIVING MEDICATION THROUGH MANUFACTURER PATIENT ASSISTANCE PROGRAMS, WHICH PROVIDES FREE MEDICATION TO QUALIFYING UNINSURED PATIENTS, OR THROUGH THE DISPENSING OF SAMPLE MEDICATION. 39755812 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 135 0 1 563 1 0 0 0 0 0 0 0 0 0 0 0 0 X 8 8 1 0 0 0 0 0 0 1 0 0 0 1 1 1 1 1 1 1 1 0 MN X DUKE FOKUO 6516027500 153 CESAR CHAVEZ ST ST PAUL MN 55107 CORDELL HARDY CHAIR 1.00 0.00 X X 0 0 0 DANIEL RODRIGUEZ DIRECTOR 1.00 0.00 X 0 0 0 JANA NINCOVIK DIRECTOR 1.00 0.00 X 0 0 0 AMELIA HARDY DIRECTOR 1.00 0.00 X 0 0 0 ARNOLD LONDON DIRECTOR 1.00 0.00 X 0 0 0 MARSHA ALLEN DIRECTOR 1.00 0.00 X 0 0 0 CALLIE CHAMBERLAIN DIRECTOR 1.00 0.00 X 0 0 0 ALEJANDRA LUSE-RIVERA DIRECTOR (LEFT 07/23) 1.00 0.00 X 0 0 0 CHRISTINE SINGER VICE PRESIDENT OF OPERATIONS (LEFT 11/22) 40.00 0.00 X 153656 0 32731 CYNTHIA BROOKE WOODS SVP OF MEDICAL CARE 40.00 0.00 X 253699 0 7722 DR LAUREN GRABER VP POPULATION HEALTH (LEFT 11/22) 40.00 0.00 X 261313 0 36323 MIGUEL POZO INTERNAL GENERAL COUNSEL (LEFT 10/22) 40.00 0.00 X 375852 0 35674 REUBEN MOORE CHIEF EXECUTIVE OFFICER 40.00 0.00 X 320193 0 37471 BOAKAI MURPHY DORLEY VP FINANCE 40.00 0.00 X 0 0 0 MARAH CZAJA MEDICAL DIRECTOR (LEFT 12/22) 40.00 0.00 X 154932 0 12421 BRITTANY NELSON INTERIM CFO (LEFT 02/23) 8.00 0.00 X 7884 0 0 DR MUAJ LO PHYSICIAN 40.00 0.00 X 208143 0 40512 JASON COMO PHYSICIAN (LEFT 07/23) 40.00 0.00 X 211990 0 23780 KENNETH NELSON DIRECTOR OF PHARMACY 40.00 0.00 X 155206 0 43183 SONIJA BATALDEN DIRECTOR OF PERINATAL CARE 40.00 0.00 X 158494 0 43107 ILENE MOORE PHYSICIAN 40.00 0.00 X 138707 0 24956 2400069 0 337880 78 0 1 0 MEN IN BLACK SECURITY 6040 EARLE BROWN DRIVE BROOKLYN CENTER MN 55430 SECURITY SERVICE FOR WORKING ENVIRONMENT 232789 BROWN'S MEDICAL IMAGING 14315 C CIRCLE OMAHA NE 68144 MEDICAL EQUIPMENT PURCHASES/REPAIR & MAI 101965 2 14879363 1323076 16202439 NET PATIENT SERVICE REVENUE 624100 30466057 30466057 30466057 4398 4398 VALUE BASED PAYMENTS 900099 921435 921435 OTHER 900099 150943 150943 1072378 47745272 31538435 0 4398 1196488 1196488 846646 846646 25550828 19861347 5689481 542463 408147 134316 3250656 2445780 804876 1886341 1419275 467066 369877 20850 349027 98377 98377 151060 151060 2691362 1322826 1368536 322552 1668 320884 434738 280993 153745 2095805 1657906 437899 2268299 2081083 187216 18078 12620 5458 69301 89185 -19884 247030 229120 17910 1330473 1199957 130516 121936 2191 119745 MEDICAL SUPPLIES & DRUG 6294883 6225630 69253 BAD DEBT 826866 826866 0 MN CARE TAX 400976 340477 60499 DUES & LICENSES 104124 19316 84808 384785 114087 270698 51503944 39755812 11748132 0 2788067 845968 894916 235224 835708 1754018 3629845 2738682 169354 298488 449874 260982 26859180 14432638 13359627 12426542 44412 252431 22171803 18812335 3682981 4423925 413661 0 5817896 5628400 0 67938 9914538 10120263 X 12234220 8483905 23045 208167 12257265 8692072 22171803 18812335 X -3758672 193479 X X 0 1 X 1 1 1 X 14269011 20030474 17193662 20369597 16202439 88065183 14269011 20030474 17193662 20369597 16202439 88065183 88065183 147530 20428 12580 4723 4398 189659 1133068 1050718 496952 394636 1042378 4117752 92372594 131894452 0.95340 0.92870 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: VALUE BASED PAYMENTS MEANINGFUL USE OTHER RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 791640 791640 19180997 9932953 9248044 855589 855589 6030954 4499685 1531269 12426542 INTERCOMPANY PAYABLE 67938 67938 X PART X, LINE 2: MCC HAS BEEN RECOGNIZED AS EXEMPT FROM INCOME TAXES UNDER SECTION 501 OF THE INTERNAL REVENUE CODE AND A SIMILAR PROVISION OF STATE LAW. HOWEVER, MCC IS SUBJECT TO FEDERAL INCOME TAX ON ANY UNRELATED BUSINESS TAXABLE INCOME. 1 EVICTION PREVENTION - UTILITY ASSISTANCE, SANITATION, RENTAL ASSISTANCE, OTHER DIRECT PATIENT ASSISTANCE 710 1196488 N/A N/A PART I, LINE 2: AN INDIVIDUAL INTERESTED PERSON CONTACTS THE HOUSE CALLS PROGRAM TO REQUEST ASSISTANCE PERIOD. HOUSE CALLS DETERMINES ELIGIBILITY FOR ASSISTANCE BASED ON FUNDER RULES. DATA REGARDING THE AMOUNT AND PURPOSE OF THE ASSISTANCE, WITH CLIENT IDENTIFIERS, ARE DOCUMENTED IN THE STATE HOMELESS MANAGEMENT INFORMATION SYSTEM (HMIS) AND TRACKED ON SPREADSHEETS AT THE GRANTING LOCATION AND IN ACCOUNTING. IF APPROVED APPLICANT IS ELIGIBLE FOR ASSISTANCE FROM LARGER PROGRAMS BUT NEEDS ADDITIONAL ASSISTANCE TO PAY THE BILL IN TOTAL, OR IF THEY ARE NOT ELIGIBLE FOR THOSE PROGRAMS, MINNESOTA COMMUNITY CARE WILL ASSIST WITH RESOLVING THE BILL IN COMPLIANCE WITH FUNDING RULES. ALL PAYMENTS ARE MADE TO LANDLORD, UTILITY OR SANITATION COMPANIES. CHECKS ARE PROCESSED BY MCC WITH SPECIFIC NAMES AND ACCOUNT NUMBERS. THIS INFORMATION GOES TO THE COMPANIES, THE HOUSECALLS STAFF AND THE FUNDERS, WITH APPROPRIATE REDACTION, TO VERIFY AND RECORD. X X X 0 0 0 0 0 0 0 0 0 MIGUEL POZO INTERNAL GENERAL COUNSEL (LEFT 10/22 363307 0 0 0 12545 0 12545 0 23129 0 411526 0 0 0 REUBEN MOORE CHIEF EXECUTIVE OFFICER 299693 0 0 0 20500 0 20500 0 16971 0 357664 0 0 0 DR LAUREN GRABER VP POPULATION HEALTH (LEFT 11/22) 240813 0 0 0 20500 0 20500 0 15823 0 297636 0 0 0 CYNTHIA BROOKE WOODS SVP OF MEDICAL CARE 246083 0 0 0 7616 0 7616 0 107 0 261422 0 0 0 DR MUAJ LO PHYSICIAN 181143 0 0 0 27000 0 27000 0 13512 0 248655 0 0 0 JASON COMO PHYSICIAN (LEFT 07/23) 206155 0 0 0 5835 0 5835 0 17946 0 235771 0 0 0 SONIJA BATALDEN DIRECTOR OF PERINATAL CARE 144413 0 0 0 14081 0 14081 0 29026 0 201601 0 0 0 KENNETH NELSON DIRECTOR OF PHARMACY 138712 0 0 0 16494 0 16494 0 26689 0 198389 0 0 0 CHRISTINE SINGER VICE PRESIDENT OF OPERATIONS (LEFT 1 137577 0 0 0 16079 0 16079 0 16653 0 186388 0 0 0 MARAH CZAJA MEDICAL DIRECTOR (LEFT 12/22) 147670 0 0 0 7262 0 7262 0 5159 0 167353 0 0 0 ILENE MOORE PHYSICIAN 131192 0 0 0 7515 0 7515 0 17441 0 163663 0 0 0 FORM 990, PART VI, SECTION A, LINE 1A EXECUTIVE COMMITTEE IS COMPOSED OF THE BOARD CHAIR, VICE CHAIR, BOARD TREASURER, BOARD SECRETARY, COMMUNITY BOARD MEMBER, AND NON-VOTING BOARD MEMBER, CEO/PEO OF THE HEALTH CENTER. FORM 990, PART VI, SECTION A, LINE 2 DIRECTORS CORDELL HARDY AND AMELIA HARDY ARE SPOUSES. FORM 990, PART VI, SECTION A, LINE 8B NO COMMITTEES HAVE THE AUTHORITY TO ACT ON BEHALF OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11B THE RETURN WAS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM USING THE AUDITED FINANCIAL RECORDS OF THE ORGANIZATION. THEN, THE CEO, CFO, FINANCE COMMITTEE, AND BOARD OF DIRECTORS REVIEWED AND APPROVED THE RETURN PRIOR TO BEING FILED. 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 ORGANIZATONAL 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 TRANSACTIO WITH A COMPANY WHIHC 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. IF A CONFLICT OF INTEREST IS DEEMED TO EXIST, THE CONFLICTED BOARD MEMBER WOULD ABSTAIN FROM VOTING ON THE MATTER. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD OF DIRECTORS REVIEWS PRESIDENT & EXECUTIVE OFFICER PERFORMANCE AND COMPENSATION ON AN ANNUAL BASIS. THEY USE A NUMBER OF COMPENSATION STUDIES, PREPARED BY THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS (NACHC) AT THE TIME OF REVIEW AND MARKET BASED SURVEYS. THE EXECUTIVE COMMITTEE RECOMMENDED THE COMPENSATION STRUCTURE TO THE FULL BOARD FOR APPROVAL. ALL OTHER OFFICERS AND KEY SALARIES ARE REVIEWED AND APPROVED BY THE PRESIDENT & EXECUTIVE OFFICER ON AN ANNUAL BASIS. A REVIEW OCCURRED IN THE FINAL MONTH OF FY21 WITH COMPENSATION INCREASES TAKING EFFECT ON THE FIRST DAY OF FY22. THE PROCESS DESCRIBED HERE WAS LAST COMPLETED IN 2022. FORM 990, PART VI, SECTION C, LINE 19 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. FORM 990, PART XI, LINE 9: NET ASSETS RELEASED FROM RESTRICTIONS 193,479. FORM 990, PART XII, LINE 2C: THE PROCESS FOR SELECTION AND OVERSIGHT OF AN INDEPENDENT ACCOUNTANT HAS NOT CHANGED FROM THE PRIOR YEAR. EQUITY CONSULTING PARTNERS LLC 45 10TH ST W SUITE 1045 ST PAUL MN 55102 873038978 CONSULTING SERVICES MN WEST SIDE COMMUNITY HEALTH SERVICES INC C 195834 242614 1.00000 1 0 0 0 1 0 0 0 0 0 0 0 1 0 1 1 0 1 1 1 EQUITY CONSULTING PARTNERS LLC O 96792 ACTUAL COST EQUITY CONSULTING PARTNERS LLC Q 75777 ACTUAL COST