2025-11-07T18:06:32-06:00 2024-12-31 390859910 BAKER TILLY ADVISORY GROUP LP 805 SW BROADWAY STE 1400 PORTLAND OR 97205 990PF 2024-01-01 931100080 PACIFICSOURCE FOUNDATION FOR HEALTH IMPROVEMENT PACI 5416861242 PO BOX 7068 SPRINGFIELD OR 974750068 DR JOHN M ESPINOLA CORPORATE TAX OFFICER 5416861242 2025-10-31 1 1 MAGGIE ELLIOTT P01790721 5032421447 2025-10-31 2024 2025-03-06 01:10:19Z X 2168282 X 300000 390 390 135808 135808 -14953 2731501 0 3006 3006 424251 139204 43750 2188 41562 5618 2809 2809 50000 0 50000 2303 0 0 4949 0 4949 2006 0 2006 108626 4997 101326 1500000 1500000 1608626 4997 1601326 -1184375 134207 642999 153683 153683 18 12432 18 18 2718762 2006921 2006921 0 7660 7660 3374193 2168282 2168282 50000 0 3163 1740 53163 1740 X 0 0 0 0 3321030 2166542 3321030 2166542 3374193 2168282 3321030 -1184375 29887 2166542 0 2166542 PUBLICLY TRADED SECURITIES 2731501 2745530 -14029 -14029 -14029 1865 0 1865 0 1865 3241 0 0 0 3241 0 1376 1376 0 0 0 0 0 0 0 0 0 0 0 1 1 OR 1 0 0 0 0 1 WWW.PACIFICSOURCE.COM/COMMUNITY/FOUNDATION DR JOHN M ESPINOLA 5416861242 555 INTERNATIONAL WAY SPRINGFIELD OR 97477 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 CLARK W COMPTON PO BOX 7068 SPRINGFIELD OR 97475 PRESIDENT 1.00 7000 0 0 STEVEN DON MARKS PO BOX 7068 SPRINGFIELD OR 97475 VICE PRESIDENT 1.00 3500 0 0 THOMAS B SLICK PO BOX 7068 SPRINGFIELD OR 97475 TREASURER & SECRETARY 1.00 3500 0 0 PETER F DAVIDSON PO BOX 7068 SPRINGFIELD OR 97475 DIRECTOR, CORPORATE TAX OFFICER 1.00 0 0 0 EDWIN E DAHLBERG PO BOX 7068 SPRINGFIELD OR 97475 DIRECTOR 1.00 3500 0 0 JOHN C DEWENTER PO BOX 7068 SPRINGFIELD OR 97475 DIRECTOR 1.00 3500 0 0 MARTIN J GABICA PO BOX 7068 SPRINGFIELD OR 97475 DIRECTOR 1.00 3500 0 0 HEIDI WALLACE PO BOX 7068 SPRINGFIELD OR 97475 DIRECTOR 1.00 3500 0 0 KARL WATTS PO BOX 7068 SPRINGFIELD OR 97475 DIRECTOR 1.00 3500 0 0 DIANA NUNEZ PO BOX 7068 SPRINGFIELD OR 97475 DIRECTOR 1.00 3500 0 0 KENNETH PROVENCHER PO BOX 7068 SPRINGFIELD OR 97475 DIRECTOR 1.00 3500 0 0 KENNETH M SINGER PO BOX 7068 SPRINGFIELD OR 97475 DIRECTOR 1.00 1750 0 0 MEGAN HAASE PO BOX 7068 SPRINGFIELD OR 97475 DIRECTOR 1.00 1750 0 0 DUNETCHKA OTERO-SERRANO PO BOX 7068 SPRINGFIELD OR 97475 DIRECTOR 1.00 1750 0 0 NONE 0 NONE 0 0 2538342 639638 7660 3185640 0 0 3185640 47785 3137855 156893 156893 1865 1865 155028 0 155028 0 155028 1601326 0 1601326 155028 0 0 1522969 3417425 2000613 1794994 1443929 10179930 1601326 0 0 0 155028 1446298 0 0 11626228 0 0 0 0 0 0 1522969 10103259 3417425 2000613 1794994 1443929 1446298 MARIAN BLANKENSHIP EXECUTIVE DIRECT PO BOX 7068 SPRINGFIELD OR 97475 5416861242 CHARITABLEFOUNDATION@PACIFICSOURCE.COM APPLICATIONS MAY BE SUBMITTED ONLINE USING THE ONLINE GRANT PORTAL LOCATED AT THE FOLLOWING WEBSITE: HTTPS://WWW.GRANTINTERFACE.COM/HOME/LOGON?URLKEY=PACIFICSOURCE. THE APPLICATION PROCESS BEGINS WITH THE SUBMISSION OF A LETTER OF INTENT (LOI). LOI(S) ARE REVIEWED SEMIANNUALLY (GENERALLY ON A QUARTERLY BASIS) AND SOME ORGANIZATIONS ARE INVITED TO SUBMIT A COMPLETE APPLICATION WITHIN THE PORTAL. APPLICATIONS INCLUDE A DESCRIPTION OF THE ORGANIZATION, THE POPULATION SERVED, THE PROPOSED PROJECT, AND THE SUBMISSION OF RECENT FINANCIAL STATEMENTS AND RELEVANT PROGRAM BUDGETS. MORE INFORMATION MAY BE FOUND HERE: HTTPS://PACIFICSOURCE.COM/COMMUNITY/FOUNDATION. SEE STATEMENT 12 FOR SUBMISSION DEADLINES SEE STATEMENT 11 FOR RESTRICTIONS AND LIMITATIONS ON AWARDS BEFRIENDERS 807 N TRACY AVE BOZEMAN MT 59715 PC SOCIAL SUPPORT FOR ISOLATED SENIORS & ASSISTANCE WITH ESSENTIAL TASKS 10000 BLACK PARENT INITIATIVE 901 NE GLISAN ST PORTLAND OR 97232 PC EARLY CHILDHOOD & FAMILY SUPPORT THROUGH CULTURALLY SPECIFIC HOME VISITING & PARENT EDUCATION 25000 BORLAND FREE CLINIC 3550 SW BORLAND RD TUALATIN OR 97062 PC COMMUNITY HEALTH WORKER TO SUPPORT HEALTHCARE ACCESS & RESOURCE NAVIGATION IN A "FREE" CLINIC 30000 CATHOLIC CHARITIES 2740 SE POWELL BLVD PORTLAND OR 97202 PC HEALTHCARE OUTREACH WORKER IN HOUSING SETTING 20000 CATHOLIC COMMUNITY SERVICES OF THE MID-WILLAMETTE VALLEY & CENTRAL COAST PO BOX 20400 SALEM OR 97307 PC CULTURALLY SPECIFIC SUPPORT FOR PRENATAL & NEWLY PARENTING HOUSEHOLDS 40000 CENTER FOR COMMUNITY COUNSELING 1465 COBURG RD EUGENE OR 97401 PC AFFORDABLE ACCESS TO MENTAL HEALTH COUNSELING 35000 CENTRAL DISTRICT HEALTH DEPARTMENT 707 N ARMSTRONG PL BOISE ID 83704 GOV NUTRITION ACCESS & EDUCATION SUPPORT FOR VULNERABLE PEOPLE 30000 CLACKAMAS VOLUNTEERS IN MEDICINE 700 MOLALLA AVE OREGON CITY OR 97045 PC ACCESS TO HEALTHCARE SERVICES FOR LOW-INCOME, UNINSURED PEOPLE 35000 COMMUNITY FOOD & AGRICULTURE COALITION 5404 W HARRIER MISSOULA MT 59807 PC INCREASING CAPACITY FOR NUTRITION ACCESS FOR RURAL & NATIVE COMMUNITIES 25000 COMMUNITY HEALTH PARTNERS INC 112 W LEWIS ST LIVINGSTON MT 59047 PC SCHOOL-BASED SUPPORT FOR YOUTH MENTAL & BEHAVIORAL HEALTH 25000 COMMUNITY OUTREACH 865 REIMAN AVE CORVALLIS OR 97330 PC INTEGRATED HEALTH & SOCIAL SERVICES FOR LOW-INCOME PEOPLE 30000 COMMUNITY OUTREACH THROUGH RADICAL EMPOWERMENT 3003 W 11TH AVE 277 EUGENE OR 97402 PC HEALTH SUPPORT & HARM REDUCTION FOR HOMELESS YOUTH & PEOPLE IN POVERTY 25000 CRISIS CONNECTIONS 215 10TH ST SEATTLE WA 98121 PC CRISIS PREVENTION & EMERGENCY PHONE LINES TO SUPPORT YOUTH & PEOPLE EXPERIENCING A MENTAL HEALTH CRISIS 25000 FREE CLINIC OF SOUTHWEST WASHINGTON 4100 PLOMONDON ST VANCOUVER WA 98661 PC ACCESS TO HEALTHCARE SERVICES FOR LOW-INCOME, UNINSURED PEOPLE 40000 FRIENDS OF THE CHILDREN - MONTANA 400 W BROADWAY SUITE 101 MISSOULA MT 59802 PC LONG-TERM PROFESSIONAL MENTORING & FAMILY SUPPORT FOR HIGH NEEDS KIDS & FAMILIES 40000 GENESIS COMMUNITY HEALTH 215 W 35TH ST BOISE ID 83714 PC ACCESS TO HEALTHCARE SERVICES FOR LOW-INCOME, UNINSURED PEOPLE 50000 IDAHO HUNGER RELIEF TASK FORCE PO BOX 15692 BOISE ID 83715 PC PRODUCE PRESCRIPTION PROGRAM SUPPORT & ADMINISTRATIVE COSTS 45000 INSTITUTE FOR MEDICAID INNOVATION INC PO BOX 40619 WASHINGTON DC 20016 PC DOULA LEARNING & ACTION COLLABORATIVE TEAM FROM OREGON 15000 MEDICAL TEAMS INTERNATIONAL 14150 SW MILTON CT TIGARD OR 97224 PC MOBILE DENTAL & HEALTH SERVICES FOR PEOPLE ACROSS OREGON 25000 MIKE PROGRAM 9155 SW BARNES RD SUITE 219 PORTLAND OR 97225 PC HEALTH EDUCATION & MENTORING FOR DISADVANTAGED YOUTH 25000 MISSOULA AGING SERVICES 337 STEPHENS AVE MISSOULA MT 59801 PC CARE MANAGEMENT PROGRAM FOR VULNERABLE SENIORS WITH HEALTH & SOCIAL NEEDS 25000 MISSOULA FOOD BANK & COMMUNITY CENTER 1720 WYOMING ST MISSOULA MT 59801 PC APPLICATION ASSISTANCE PROGRAM TO SUPPORT ACCESS TO HEALTH & SOCIAL RESOURCES BEYOND NUTRITION 30000 MOUNTAIN HOME MONTANA 2606 SOUTH AVE W MISSOULA MT 59804 PC EXPANSION OF SERVICES FOR HIGH NEEDS MOTHERS & CHILDREN, INCLUDING TRAUMA INFORMED CHILDCARE 50000 MOUNTAIN SHADOW ASSOCIATION PO BOX 133 LODGE GRASS MT 59050 PC CULTURALLY SPECIFIC EARLY CHILDHOOD & KINSHIP CAREGIVER EDUCATORS FOR TRIBAL COMMUNITY MEMBERS 25000 NEIGHBORHOOD HEALTH CENTER 7320 SW HUNZIKER RD 300 TIGARD OR 97223 PC COMMUNITY HEALTH WORKER TO SUPPORT RESOURCE NAVIGATION & ACCESS TO HEALTHCARE & SOCIAL SUPPORTS 30000 NORTHWEST CATHOLIC COUNSELING 8383 NE SANDY BLVD 205 PORTLAND OR 97220 PC AFFORDABLE BEHAVIORAL HEALTHCARE ACCESS & CULTURALLY SPECIFIC COUNSELING 30000 NURTURELY 56 EAST 15TH AVE EUGENE OR 97401 PC DOULA CARE & SUPPORTS TO IMPROVE INFANT & MATERNAL HEALTH 60000 OLD MILL CENTER FOR CHILDREN AND FAMILIES 1650 SW 45TH PLACE CORVALLIS OR 97333 PC WRAP AROUND SUPPORT & CASE MANAGEMENT FOR FAMILIES WITH KIDS 6000 OPHELIAS PLACE 1577 PEARL ST SUITE 100 EUGENE OR 97401 PC BEHAVIORAL HEALTH SUPPORT & COUNSELING ACCESS FOR BICULTURAL & BILINGUAL YOUTH/GIRLS 30000 OSLC DEVELOPMENTS INC 10 SHELTON MCMURPHEY BLVD EUGENE OR 97401 PC SUPPORT FOR A COMMUNITY HEALTH WORKER TO SUPPORT HOMELESS YOUTH 25000 POCATELLO FREE CLINIC 1001 N 7TH AVE POCATELLO ID 83201 PC ACCESS TO HEALTHCARE SERVICES FOR LOW-INCOME, UNINSURED PEOPLE 54000 PORTLAND STREET MEDICINE 2717 NE BROADWAY ST PORTLAND OR 97232 PC STREET-BASED, MOBILE HEALTHCARE SERVICES FOR HOMELESS PORTLANDERS 50000 SALEM FREE CLINICS 1300 BROADWAY ST NE SUITE 104 SALEM OR 97301 PC ACCESS TO HEALTHCARE SERVICES FOR LOW-INCOME, UNINSURED PEOPLE 40000 SALEM PASTORAL COUNSELING CENTER 2001 COMMERCIAL ST SE SUITE 200 SALEM OR 97302 PC COUNSELING SERVICES FOR LOW-INCOME OR UNINSURED PEOPLE 15000 SNAKE RIVER COMMUNITY CLINIC 215 10TH ST LEWISTON ID 83501 PC ACCESS TO HEALTHCARE SERVICES FOR LOW-INCOME, UNINSURED PEOPLE 40000 THE FOUNDATION FOR MEDICAL EXCELLENCE 11740 SW 68TH PKWY SUITE 125 PORTLAND OR 97223 PC MENTAL HEALTH ACCESS & SUPPORT FOR MEDICAL PROVIDERS 25000 THE NEXT DOOR INC 965 TUCKER RD HOOD RIVER OR 97031 PC CULTURALLY SPECIFIC MENTAL HEALTH TRAINING FOR COMMUNITY HEALTH WORKERS & RURAL COMMUNITY MEMBERS 35000 THE WALLACE MEDICAL CONCERN 18633 SE STARK ST SUITE 401 PORTLAND OR 97233 PC HEALTHCARE ACCESS FOR YOUTH (MOBILE CLINIC THEN SCHOOL-BASED CARE) 10000 THE YWCA OF HELENA 501 N PARK AVE HELENA MT 59601 PC WRAP AROUND SUPPORT & MENTAL HEALTH ACCESS FOR WOMEN & CHILDREN 25000 TODOS JUNTOS PO BOX 645 CANBY OR 97013 PC TWO BILINGUAL FAMILY RESOURCE ADVOCATES FOR RURAL AREAS 40000 UNITED WAY OF TREASURE VALLEY PO BOX 16330 BOISE ID 83715 PC TO BUILD INTEGRATED HEALTH & SOCIAL SERVICES STATEWIDE IN IDAHO 30000 UNIVERSITY OF IDAHO FOUNDATION 875 PERIMETER DR MS 3143 MOSCOW ID 83844 PC EDUCATION FOR SCHOOL STAFF TO SUPPORT YOUTH BEHAVIORAL HEALTH 30000 VOLUNTEERS IN MEDICINE CLINIC LANE 2260 MARCOLA RD SPRINGFIELD OR 97477 PC ACCESS TO HEALTHCARE SERVICES FOR LOW-INCOME, UNINSURED PEOPLE 40000 VOLUNTEERS IN MEDICINE CLINIC OF THE CASCADES 2300 NE NEFF RD BEND OR 97701 PC ACCESS TO HEALTHCARE SERVICES FOR LOW-INCOME, UNINSURED PEOPLE 40000 WELLNESS TREE CLINIC 173 MARTIN ST TWIN FALLS ID 83301 PC ACCESS TO HEALTHCARE SERVICES FOR LOW-INCOME, UNINSURED PEOPLE 40000 WOMENS AND CHILDRENS ALLIANCE INC 720 W WASHINGTON ST BOISE ID 83702 PC COUNSELING SERVICES FOR ADDICTS & CHILDREN IMPACTED BY TRAUMA 30000 YOUTH HOMES 550 N CALIFORNIA ST MISSOULA MT 59802 PC SHELTER & GROUP HOME SERVICES & SUPPORTS FOR VULNERABLE YOUTH 50000 1500000 0 14 390 14 135808 14 3006 18 -14953 0 124251 0 124251 0 0 0 0 0 0 0 0 0 1 PACIFIC HEALTH ASSOCIATES 501(C)(4) ORGANIZATIONS SHARE PARTIAL BOARD OVERLAP; PSFHI RECEIVES ANNUAL RESTRICTED GRANT FUNDS FROM PHA. X X 1 PACIFIC HEALTH ASSOCIATES 555 INTERNATIONAL WAY SPRINGFIELD OR 97477 300000 X ACCOUNTING FEES 5618 2809 2809 EXPLANATION: 990-PF, PART XIV, LINE 2C - ANY SUBMISSION DEADLINES SUBMISSION DEADLINES ARE ROLLING. THE COMMITTEE MEETS SEMI-ANNUALLY (GENERALLY ON A QUARTERLY BASIS) TO REVIEW APPLICATIONS FROM ORGANIZATIONS THAT WERE INVITED TO APPLY FOLLOWING THE SUBMISSION OF AN LOI. DEADLINES AND UPDATES MAY BE FOUND HERE:HTTPS://PACIFICSOURCE.COM/COMMUNITY/FOUNDATION EXPLANATION: FORM 990-PF, PART XIV, LINE 2D - RESTRICTIONS AND LIMITATIONS ON AWARDS PROPOSALS MUST ADDRESS ONE OR MORE OF THE FOLLOWING FUNDING PRIORITY AREAS, LISTED BY GRANT PROGRAM, UNLESS OTHERWISE APPROVED BY THE BOARD. COVID-RELATED FUNDING IS RESPONSIVE AND MAY NOT BE ONGOING. THESE FUNDING PRIORITY AREAS ARE SUBJECT TO CHANGE PERIODICALLY. UPDATES MAY BE FOUND HERE: HTTPS://PACIFICSOURCE.COM/COMMUNITY/FOUNDATION.FUNDING PRIORITY AREAS:1. ACCESS TO HEALTHCARE SERVICES FOR VULNERABLE AND UNDERSERVED POPULATIONSA. DIRECT HEALTHCARE SERVICES - MENTAL/BEHAVIORAL HEALTH, MEDICAL, DENTALB. INDIRECT/SUPPORT SERVICES - NAVIGATION, PEER SUPPORT, TRADITIONAL/COMMUNITY HEALTH WORKERS, ETC.PRISCILLA GOULD HEALTHCARE ACCESS PARTNERS (HCAP) PROGRAM- AS A PART OF OUR WORK TO ADVANCE HEALTHCARE ACCESS, THE HCAP PROGRAM IS A STANDALONE GRANT PROGRAM AND PARTNERSHIP THAT SUPPORTS THE HEALTHCARE SAFETY NET.- THE HCAP PROGRAM IS FOCUSED ON COMMUNITY-SPONSORED, FREE & CHARITABLE CLINICS SERVING VULNERABLE AND UNDERSERVED COMMUNITY MEMBERS WITH SIGNIFICANT BARRIERS TO ACCESSING CARE. THE PROGRAM PROVIDES SEVERAL YEARS OF ONGOING FUNDING, SHARED LEARNING OPPORTUNITIES AND TECHNICAL ASSISTANCE.- THE HCAP PROGRAM IS BY INVITATION ONLY AND REQUIRES AT LEAST THREE YEARS OF PRIOR FUNDING HISTORY WITH THE FOUNDATION BEFORE BEING ELIGIBLE TO APPLY.2. PREVENTION OF HEALTH INEQUITIES THROUGH CLINICAL AND COMMUNITY-DRIVEN SOLUTIONS, INCLUDING INTERVENTIONS THAT ADVANCE EQUITY AND IMPROVE THE HEALTH AND WELLBEING FOR THOSE EXPERIENCING HEALTH DISPARITIESA. INFANT & MATERNAL HEALTH - I.E. HOME VISITING PROGRAMS, DEVELOPMENTAL SCREENING PROMOTION, LACTATION SUPPORT, ETC.B. EARLY CHILDHOOD & PARENT EDUCATION - I.E. ACES (ADVERSE CHILDHOOD EXPERIENCES) PREVENTION, DEVELOPMENTALLY APPROPRIATE PARENT EDUCATION, PROTECTIVE FACTORS.C. SUPPORTIVE HOUSING - SPECIFICALLY FOCUSED ON CO-LOCATED SERVICES, PERMANENT SUPPORTIVE HOUSING (PROGRAM, NOT CAPITAL), AND SERVICES THAT AIM TO IMPROVE HEALTH WITHIN A HOUSING CONTEXT.D. NUTRITION ACCESS & EDUCATION - I.E. NUTRITION SUPPORT AND EDUCATION TO PROMOTE OVERALL HEALTH, PREVENT NEGATIVE HEALTH OUTCOMES, OR TREAT DISEASE.E. BUILDING RESILIENCE - HEALING-CENTERED, COMMUNITY DRIVEN SOLUTIONS THAT STRENGTHEN THE RESILIENCE OF MARGINALIZED PEOPLE AND COMMUNITIES. I.E. NON-CLINICAL BEHAVIORAL HEALTH, ACCESSIBILITY, LGBTQ+, YOUTH DEVELOPMENT, SOCIAL CONNECTION, AND CLIMATE-RELATED HEALTH IMPACTS. ALLSPRING CONSERVATIVE INCOME FUND 2006921 2006921 ACCRUED INTEREST FMV 7660 7660 LICENSES AND FEES 2006 0 2006 3006 3006 3006 UNREALIZED GAIN ON INVESTMENTS 29887 INCOME TAX PAYABLE 3163 1740 CONSULTANT FEES 50000 0 50000 EXCISE TAX 2303 0 0