2020-07-13T16:18:33-05:00 2019-06-30 680037990 GILBERT CPAS 2880 GATEWAY OAKS DR STE 100 SACRAMENTO CA 95833 990 2018-07-01 941713704 WELLSPACE HEALTH WELL 9163255556 777 12TH STREET NO 250 SACRAMENTO CA 95811 JONATHAN PORTEUS CEO 9163255556 2020-07-01 1 KEITH R GLEN P01317613 9166466464 2020-07-01 207.231.71.251 2020-07-01 11:53:47 PD P 67639D8D55F6B218ED5E382FB77B71D17F0527F1 67639D8D55F6B218ED5E382FB77B71D17F0527F1 2018 2020-09-22 18:59:49Z JONATHAN PORTEUS 777 12TH STREET NO 250 SACRAMENTO CA 95811 66488326 0 X WWW.WELLSPACEHEALTH.ORG X 1970 CA ACHIEVING REGIONAL HEALTH THROUGH HIGH QUALITY COMPREHENSIVE CARE. 9 9 867 39 47612 13322 11102036 10959833 42758697 55401069 2274 1033 0 126391 53863007 66488326 0 0 0 0 36472833 45277720 0 0 0 18898332 20662826 55371165 65940546 -1508158 547780 21032602 27412698 12666849 18498490 8365753 8914208 X A FEDERALLY QUALIFIED HEALTH CENTER (FQHC) SINCE JUNE 2008, WELLSPACE HEALTH PROVIDES HEALTH CARE SERVICES INCLUDING PRIMARY & DENTAL CARE, BEHAVIORAL HEALTH, SUBSTANCE ABUSE TREATMENT, COUNSELING, PREVENTION AND CRISIS INTERVENTION SERVICES TO SOCIO-ECONOMICALLY DIVERSE FAMILIES AND THEIR CHILDREN. 0 0 57327272 55401069 WELLSPACE HEALTH IS A FEDERALLY QUALIFIED HEALTH CENTER (FQHC) AS WELL AS A BROAD RANGING BEHAVIORAL HEALTH AND SOCIAL SERVICE PROVIDER IN THE SACRAMENTO REGION. A NETWORK OF COMMUNITY HEALTH CENTERS ACROSS THREE COUNTIES (SACRAMENTO, PLACER, AND AMADOR) PROVIDES PRIMARY HEALTH AND INTEGRATED BEHAVIORAL HEALTH CARE FOR ALL AGES, WOMEN'S HEALTH (INCLUDING COMPREHENSIVE PERINATAL CARE THROUGHOUT AND AFTER PREGNANCY AND SPECIALIZED CULTURE-SPECIFIC INFANT MORTALITY PREVENTION SERVICES), AND ORAL HEALTH CARE FOR CHILDREN AND TEENS (CO-LOCATED IN 6 SITES). ADDITIONAL BEHAVIORAL HEALTH LOCATIONS EXTEND THE ORGANIZATION'S CLINICAL REACH THROUGH PREVENTION AND SPECIALTY MENTAL HEALTH AND SUBSTANCE USE DISORDERS TREATMENT, INCLUDING: A FULL CONTINUUM OF CO-OCCURRING MENTAL HEALTH AND SUBSTANCE USE DISORDERS TREATMENT PROGRAMS (OUTPATIENT, RESIDENTIAL REHABILITATION, MEDICALLY-MONITORED DETOXIFICATION, MEDICALLY ASSISTED TREATMENTS, CORRECTIONS-BASED AND DRUG COURT SERVICES); NORTHERN CALIFORNIA'S 24-HOUR PRIMARY SUICIDE PREVENTION HOTLINE AND CRISIS SUPPORT LINES; OUTPATIENT CHILDREN'S MENTAL HEALTH AND YOUTH VIOLENCE PREVENTION PROGRAMS; CHILD ABUSE PREVENTION AND HOME VISITATION SERVICES; AND MULTIPLE CARE TRANSITION PROGRAMS (FOR EXAMPLE WITHIN HOSPITAL EMERGENCY DEPARTMENTS, NAVIGATING SERVICES IN THE COMMUNITY, AND TRANSITIONING PATIENTS FROM INPATIENT SETTINGS). WELLSPACE HEALTH EMBRACES THE HIGHEST QUALITY STANDARDS ACROSS THE BREADTH OF ITS SERVICES AND IS ACCREDITED BY THE JOINT COMMISSION FOR BOTH AMBULATORY CARE AND BEHAVIORAL HEALTH. THE EXTENT TO WHICH THE ORGANIZATION INTEGRATES CARE WITHIN ITS HEALTH CENTERS AND BETWEEN ITS ADDITIONAL PROGRAM SITES IS ALSO DOCUMENTED BY ITS ADDITIONAL CERTIFICATIONS FROM THE JOINT COMMISSION FOR BOTH PATIENT CENTERED MEDICAL HOME (PCMH) AND BEHAVIORAL HEALTH HOME (BHH) - THEREBY MAXIMIZING THE ORGANIZATION'S COMMITMENT TO 'WHOLE PERSON CARE.' WELLSPACE HEALTH'S DIVERSE PATIENT POPULATION SPANS THE RICH CULTURAL DIVERSITY OF THE SACRAMENTO REGION, AS WELL AS ALL AGES AND PERSONS WHO ARE HOMELESS. 57327272 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 57 0 1 867 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 9 9 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X JONATHAN PORTEUS CEO 9163138455 777 12TH STREET SUITE 250 SACRAMENTO CA 95814 LISA STEWART PRESIDENT/CONSUMER DIRECTO 1.00 X X 0 0 0 LARRY MAAS VICE PRESIDENT/NON-CONSUME 1.00 X X 0 0 0 RUZWA COOPER TREASURER/NON-CONSUMER DIR 1.00 X X 0 0 0 MARGIE MEZA SECRETARY/CONSUMER DIRECTO 1.00 X X 0 0 0 JIM TILTON NON-CONSUMER DIRECTOR 1.50 X 0 0 0 JODY GRAY CONSUMER DIRECTOR 1.00 X 0 0 0 TIMOTHY MARTIN CONSUMER DIRECTOR 1.00 X 0 0 0 TODD MURRAY CONSUMER DIRECTOR 1.00 X 0 0 0 GILBERT PEREZ CONSUMER DIRECTOR 1.00 X 0 0 0 ALASDAIR JONATHAN PORTEUS CHIEF EXECUTIVE OFFICER 40.00 X 260693 0 4625 KATHY WALKER CHIEF FINANCIAL OFFICER 40.00 X 165769 0 5137 JANINE BERA CHIEF MEDICAL OFFICER 40.00 X 345969 0 10804 BRENDA SHIPP CHIEF OPERATIONS OFFICER 40.00 X 142625 0 20522 NATHAN ALLEN MD-OB/GYNECOLOGIST 40.00 X 514524 0 6294 TROY SINGH MD-INTERNIST 40.00 X 492756 0 8375 LATA SANTHAKUMAR MD-OB/GYNECOLOGIST 40.00 X 439382 0 4625 SUEJIN KIM MD-OB/GYNECOLOGIST 40.00 X 427630 0 5302 TIFFANY ISLES MD-OB/GYNECOLOGIST 40.00 X 299026 0 8111 3088374 0 73795 68 0 1 0 HOLLY BRACY 2503 LA JOLLA STREET WEST SACRAMENTO CA 95691 PHYSICIAN SERVICES (ON CALL) 284800 PRUDENCIO GABRIEL SAMSON 2102 BROKEN RAIL LANE ROCKLIN CA 95765 PSYCHIATRIST SVCS 199808 2 3362390 7597443 787782 10959833 FEE FOR SERVICE 624100 52669923 52669923 OTHER PROGRAM REVENUE 624100 2724989 2724989 CLIENT RESEARCH FEE 624100 6040 6040 PHARMACY REVENUE 624100 117 117 55401069 1033 1033 126391 0 126391 126391 47612 78779 66488326 55401069 47612 79812 1038554 931796 106758 37396683 33543454 3853229 354422 319531 34891 3503557 3158642 344915 2984504 2702719 281785 171379 67124 104255 37750 14786 22964 2754677 2101796 652881 120091 102707 17384 1567990 1387470 180520 1603314 1096682 506632 5283288 4911995 371293 252957 198312 54645 258497 177804 80693 192458 133872 58586 1417768 1342482 75286 1193065 1071070 121995 PATIENT SUPPLIES 2889594 2863161 26433 SETTLEMENT EXPENSE 1653994 0 1653994 EQUIPMENT EXPENSE 534055 494728 39327 BAD DEBT EXPENSE 253990 253990 477959 453151 24808 65940546 57327272 8613274 0 1458796 3078164 1988111 2736 6942858 8363178 527952 538108 23504392 8096289 10093151 15408103 21734 22409 21032602 27412698 8042002 7694717 2183428 4907503 2441419 4896270 0 1000000 12666849 18498490 X 8288777 8891799 55242 0 21734 22409 8365753 8914208 21032602 27412698 547780 675 0 X X 0 1 X 1 1 1 X 6126363 6454043 9715610 11102036 10959833 44357885 6126363 6454043 9715610 11102036 10959833 44357885 44357885 289 2394 4425 2274 127424 136806 44494691 188116680 0.99690 0.99980 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 21734 675 22409 20130 1604 21734 17764 2366 20130 18401 -637 17764 0.00000 1.00000 1 0 1228704 1228704 8638711 1517544 7121167 4009608 2027568 1982040 6942418 4551177 2391241 2684951 2684951 15408103 LINE OF CREDIT 1000000 1000000 66585395 675 96394 97069 66488326 0 66488326 66036940 96394 96394 65940546 0 65940546 X X X 0 0 0 0 0 0 0 0 0 ALASDAIR JONATHAN PORTEUS CHIEF EXECUTIVE OFFICER 254333 0 0 0 6360 0 4625 0 0 0 265318 0 0 0 KATHY WALKER CHIEF FINANCIAL OFFICER 165769 0 0 0 0 0 0 0 5137 0 170906 0 0 0 JANINE BERA CHIEF MEDICAL OFFICER 345969 0 0 0 0 0 1750 0 9054 0 356773 0 0 0 BRENDA SHIPP CHIEF OPERATIONS OFFICER 142625 0 0 0 0 0 6125 0 14397 0 163147 0 0 0 NATHAN ALLEN MD-OB/GYNECOLOGIST 514524 0 0 0 0 0 6125 0 169 0 520818 0 0 0 TROY SINGH MD-INTERNIST 492756 0 0 0 0 0 0 0 8375 0 501131 0 0 0 LATA SANTHAKUMAR MD-OB/GYNECOLOGIST 439382 0 0 0 0 0 4625 0 0 0 444007 0 0 0 SUEJIN KIM MD-OB/GYNECOLOGIST 427630 0 0 0 0 0 0 0 5302 0 432932 0 0 0 TIFFANY ISLES MD-OB/GYNECOLOGIST 299026 0 0 0 0 0 0 0 8111 0 307137 0 0 0 X 57636 FMV X 60 701567 FMV X FOOD 22 21720 FMV X ENTERTAINMENT 7 5758 FMV X OTHER 3 951 FMV X GIFT CARDS 1 150 FMV 0 0 0 PART I, COLUMN (B): WELLSPACE HEALTH USES A COMBINATION OF FMV, THRIFT STORE VALUE AND FACE VALUE DEPENDING ON THE ITEM AND CONDITION THAT THE ITEM IS IN. ALL METHODS ARE TAKEN INTO ACCOUNT WHEN ASSIGNING A VALUE TO EACH INDIVIDUAL DONATION. FORM 990, PART VI, SECTION B, LINE 11B THE AUDIT COMMITTEE REVIEWS FORM 990. AFTER ALL QUESTIONS AND COMMENTS ARE RESOLVED, FORM 990 IS REVIEWED AND APPROVED BY THE FULL BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 12C ALL BOARD OF DIRECTOR MEMBERS ARE REQUIRED TO DECLARE THEIR TYPE OF INDUSTRY, WHICH ARE EXCLUDED FROM ANY REQUESTS FOR PROPOSALS OR ANY SITUATION WHERE FUNDS COULD CHANGE HANDS, OR A SERVICE WOULD BE COMPROMISED. FORM 990, PART VI, SECTION B, LINE 15 WELLSPACE HEALTH USES MARKET COMPARISONS WITH REGIONAL NON-PROFITS AS A GUIDE. ALSO, WELLSPACE HEALTH USES THE PRIVATE MARKET, BASED ON EXPERIENCE, AND QUALIFICATIONS. THIS PROCESS WAS LAST UNDERTAKEN IN 2017. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS ARE PROVIDED UPON REQUEST. THE DOCUMENTS ARE HOUSED AT THE 777 12TH STREET, SUITE 250, SACRAMENTO, CA 95814 FORM 990, PART XII, LINE 2C: THE PROCESS FOR OVERSIGHT OF THE FINANCIAL STATEMENT AUDIT AND THE PROCESS FOR SELECTION OF AN INDEPENDENT ACCOUNTANT HAS NOT CHANGED FROM THE PRIOR YEAR.