2023-10-12T14:59:58-05:00 2022-12-31 410746749 CLIFTONLARSONALLEN LLP 420 SOUTH ORANGE AVENUE SUITE 900 ORLANDO FL 32801 990 2022-01-01 843155527 EMPIRE HEALTH COMMUNITY ADVOCACY FUND EMPI 5093217506 PO BOX 244 SPOKANE WA 99210 THOMAS E 'ZEKE' SMITH PRESIDENT 5093217506 2023-10-09 1 THOMAS ZEKE SMITH 999009999 0 TINA HENTON P00630282 4078021200 2023-10-09 3 AAL1 IAL1 2022 2023-04-26 12:10:37Z THOMAS E 'ZEKE' SMITH PO BOX 244 SPOKANE WA 99210 4160495 0 X N/A X 2019 WA PROMOTE IMPROVED HEALTH CARE ACCESS, EDUCATION, COMMUNITY HEALTH/WELLNESS, AND RESEARCH. 6 3 0 6 0 0 1920000 212195 0 0 663380 -148601 0 0 2583380 63594 795000 110000 0 0 48944 62052 0 0 0 37011 91428 880955 263480 1702425 -199886 22406271 18895512 26465 48768 22379806 18846744 X PROMOTE IMPROVED HEALTH CARE ACCESS; PROMOTE HEALTH PROFESSIONS EDUCATION; PROMOTE COMMUNITY HEALTH/WELLNESS; PROMOTE ENHANCED HEALTHCARE THROUGH RESEARCH; IMPROVE PUBLIC POLICY DISCOURSE FOR SOLUTIONS TO LOCAL HEALTH CHALLENGES. 1 0 61012 50000 12195 THROUGH THE COMMUNITY STORY FUND, THE ORGANIZATION ENGAGES A DIVERSE SET OF COMMUNITY PARTNERS, FROM ACROSS ITS REGION, IN A STORY-TELLING PROJECT. SPECIFICALLY, THE ORGANIZATION RESOURCES COMMUNITIES TO TELL A SPECIFIC STORY ABOUT THEIR IDENTITY, STRENGTHS, NEEDS, AND/OR VISION. PAST, PRESENT, OR FUTURE, THESE STORIES PROVIDE CRITICAL INFORMATION ABOUT WHERE THE ORGANIZATION AND OTHERS MIGHT BUILD DEEPER AND AUTHENTIC RELATIONSHIP WITH COMMUNITIES, INVEST IN COMMUNITY-DEFINED CAPACITY, OR MORE EFFECTIVELY SUPPORT AN ADVOCACY AGENDA DRIVEN BY COMMUNITY VISION. GRANT FUNDS RECEIVED ORGINALLY IN 2020, WITH RENEWED FUNDING IN 2021 TO CONTINUE THE WORK IN 2022 AND BEYOND. GRANT FUNDS RECEIVED 12/21/2022, 3 GRANTS GIVEN TO ORGANIZATIONS TO SUPPORT SOCIAL WELFARE. 0 0 200000 CAPITAL LEVERAGE FUND WILL BE USED TO ASSIST CHARITABLE ORGANIZATIONS WITH ACCESSING AND/OR LEVERAGING AMERICAN RESCUE PLAN ACT (ARPA) FUNDING FOR ACQUISITION OR CONSTRUCTION OF REAL PROPERTY AND/OR CAPITAL ASSETS. FUNDING FROM THE ORGANIZATION MAY BE IN THE FORM OF DIRECT GRANTS OR IN THE FORM OF GRANTWRITING OR TECHNICAL ASSISTANCE. FUNDING WAS RECEIVED IN BOTH 2021 AND 2022 FOR WORK TO BE PERFORMED IN 2023 AND LATER. THIS EFFORT MAY LEVERAGE THE LEARNINGS AND CONNECTIONS MADE FROM THE COMMUNITY STORY FUND WORK REPORTED ABOVE. 45000 45000 0 ENHANCING HEALTH CARE AND RELATED PUBLIC POLICY DISCOURSE ON A STATE AND LOCAL LEVEL, WITH A LENS OF HEALTH EQUITY. TWO GRANTS TO ENCOURAGE VOTER TURN OUT AND TO SUPPORT A HEALTH CARE FACILITY PUBLIC BOND MEASURE. 15000 15000 0 OTHER GENERAL CHARITABLE WORK: ANY WORK THAT GENERALLY SATISFIES THE NONPROFIT MISSION OF THE ORGANIZATION. ONE GRANT TO AN INDIGENOUS STARTUP ORGANIZATION 15000 15000 0 121012 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 4 0 1 0 0 0 0 0 0 0 0 0 X 6 3 0 0 1 0 1 1 1 1 0 1 0 1 1 1 1 0 0 1 1 0 X LILY H ZHANG CHIEF FINANCIAL OFFICER 5093217506 1020 W RIVERSIDE AVENUE SPOKANE WA 99201 JO ANN KAUFFMAN BOARD CHAIR 0.50 0.50 X X 0 0 0 BILL BOUTEN BOARD VICE CHAIR 0.50 0.50 X X 0 0 0 LUISITA FRANCIS SECRETARY 0.50 0.50 X X 0 0 0 JEFF THOMAS TREASURER 0.50 0.50 X X 0 0 0 RHOSETTA RHODES DIRECTOR 0.50 0.50 X 0 0 0 KIM PEARMAN-GILLMAN DIRECTOR 0.50 0.50 X 0 0 0 THOMAS E SMITH PRESIDENT 2.10 37.90 X 13144 234917 58114 LILY H ZHANG CHIEF FINANCIAL OFFICER 0.60 39.40 X 2639 176394 35807 15783 411311 93921 0 0 1 0 0 212195 212195 244749 244749 3703551 4096901 -393350 -393350 -393350 63594 0 0 -148601 X 110000 110000 19352 1580 17772 29057 4194 24863 1734 241 1493 6396 1278 5118 5513 723 4790 185 185 1890 1890 21824 21824 50400 400 50000 2915 2356 559 3790 3790 57 57 750 750 1127 1127 4289 4289 BOARDS AND COMMITTEES 3000 3000 MEALS AND CATERING 1047 183 864 DUES MEMBERSHIPS LICENS 130 130 BANK AND CREDIT CARD FE 24 24 263480 121012 142468 0 110656 51813 138550 1910384 1920000 200000 341 359 20212272 16705803 24452 27153 22406271 18895512 26465 48768 26465 48768 X 21409806 17716905 970000 1129839 22379806 18846744 22406271 18895512 -199886 -3333176 0 X 0 1 X 0 0 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 X PART X, LINE 2: MANAGEMENT EVALUATED THE ORGANIZATION'S TAX POSITIONS AND CONCLUDED THAT THE ORGANIZATION HAD TAKEN NO UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENT TO THE FINANCIAL STATEMENTS. 1 MUSLIMS FOR COMMUNITY ACTION & SUPPORT 423 N FARR RD SPOKANE VALLEY WA 99206 874300323 501(C)(3) 25000 0 N/A N/A GENERAL OPERATIONS SUPPORT INCLUDING STORY FUND SLAGLE GROUP LLC 926 W SPRAGUE AVENUE 301 SPOKANE WA 99201 813971746 15000 0 N/A N/A GENERAL OPERATIONS SUPPORT INCLUDING GENERAL ADMINISTRATION CITIZENS FOR PULLMAN REGIONAL HOSPITAL PO BOX 604 PULLMAN WA 99163 833136687 20000 0 N/A N/A GENERAL OPERATIONS SUPPORT INCLUDING GENERAL ADMINISTRATION GREATER SPOKANE PROGRESS 25 W MAIN AVENUE SUITE 222 SPOKANE WA 99201 844613078 501(C)(3) 25000 0 N/A N/A GENERAL OPERATIONS SUPPORT INCLUDING GENERAL ADMINISTRATION THRIVE INTERNATIONAL 110 E 4TH AVE SPOKANE WA 99202 873567688 501(C)(3) 25000 0 N/A N/A GENERAL OPERATIONS SUPPORT INCLUDING STORY FUND 3 2 PART I, LINE 2: GRANTS AWARDED IN 2022 WERE INTENDED AS GENERAL OPERATING FUNDS FOR THE GRANTEES' APPROVED PROJECT PROPOSALS. THE GRANTOR WILL NOT REQUIRE A DETAILED BUDGET, PRE-AUTHORIZATION OR APPROVAL OF EXPENSES, OR A FINANCIAL ACCOUNTING OF GRANTEES' EXPENDITURE OF GRANT FUNDS. A WRITTEN DESCRIPTION OF THE PROGRESS THAT GRANTEES HAVE MADE TOWARD ACHIEVING THE PURPOSES FOR WHICH THESE GRANTS WERE MADE WILL NOT BE REQUIRED. GRANTEES MAY BE INVITED TO INFORM THE PLANNING OF AND PARTICIPATE IN A PROJECT END CELEBRATION AND LEARNING COLLABORATIVE, AS INITIATED BY THE GRANTOR WITHIN ONE YEAR OF THE PROJECT COMPLETION. ADDITIONALLY, THE GRANTOR MAY REQUEST AN INTERVIEW WITH GRANTEE REPRESENTATIVES AT THE COMPLETION OF THE PROJECT TO UNDERSTAND HOW THIS GRANT HAS CONTRIBUTED TO COMMUNITY STORYTELLING. 0 0 0 0 0 0 0 0 0 THOMAS E SMITH PRESIDENT 13144 234917 0 0 0 0 799 14085 2312 40918 16255 289920 0 0 LILY H ZHANG CHIEF FINANCIAL OFFICER 2214 168321 425 8073 0 0 159 10583 299 24766 3097 211743 0 0 PART I, LINE 3 THE PRESIDENT'S COMPENSATION IS SET BY EMPIRE HEALTH FOUNDATION. THE FOLLOWING ARE USED BY EMPIRE HEALTH FOUNDATION TO SET THE PRESIDENT'S COMPENSATION: A) COMPENSATION COMMITTEE B) WRITTEN EMPLOYMENT CONTRACT C) COMPENSATION SURVEY OR STUDY D) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE FORM 990, PART III, LINE 2 ENHANCING HEALTH CARE AND RELATED PUBLIC POLICY DISCOURSE ON A STATE AND LOCAL LEVEL, WITH A LENS OF HEALTH EQUITY. FORM 990, PART VI, SECTION A, LINE 4 AMENDED BYLAWS IN 2022: BOARD ADVISORS, APPOINTED TO THE BOARD OF DIRECTORS, ARE CONSIDERED NON-VOTING MEMBERS OF THE BOARD. THE BOARD OF DIRECTORS MAY APPOINT TO EACH STANDING OR SPECIAL COMMITTEE BOARD ADVISORS WHO ARE NOT DIRECTORS OF THE CORPORATION. ANY NON-DIRECTOR SHALL HAVE NO VOTING RIGHTS AS RESPECTS TO THE BOARD BUT CAN ACT AS A FULL VOTING MEMBER OF WHATEVER STANDING OR SPECIAL COMMITTEE TO WHICH THEY ARE APPOINTED. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF EMPIRE HEALTH COMMUNITY ADVOCACY FUND IS EMPIRE HEALTH FOUNDATION. FORM 990, PART VI, SECTION A, LINE 7A THE MEMBER HAS THE RIGHT TO APPOINT/REMOVE ALL DIRECTORS, AMEND THE BYLAWS, SUBSTANTIALLY DISPOSE OF ASSETS AND TO APPROVE MERGERS OR DISSOLUTIONS. IN ADDITION, ANY OTHER RIGHTS BY OPERATION OF LAW. FORM 990, PART VI, SECTION A, LINE 7B THE MEMBER HAS THE RIGHT TO AMEND THE BYLAWS, SUBSTANTIALLY DISPOSE OF ASSETS AND TO APPROVE MERGERS OR DISSOLUTIONS. IN ADDITION, THE MEMBER HAS ANY OTHER RIGHTS AFFORDED BY OPERATION OF LAW. FORM 990, PART VI, SECTION A, LINE 8B THE ORGANIZATION HAS NO COMMITTEES. FORM 990, PART VI, SECTION B, LINE 11B EXECUTIVE DIRECTOR AND CFO WILL BE PROVIDED A PRE-FILING COPY FOR REVIEW AND COMMENT. AFTER THIS STEP, THE BOARD WILL BE PROVIDED WITH COPY FOR REVIEW AND COMMENTS. FORM 990, PART VI, SECTION B, LINE 12C WRITTEN POLICY REQUIRES AFFIRMATIVE DISCLOSURE OF ACTUAL OR POTENTIAL CONFLICTS ANNUALLY--REVIEWED BY BOARD. COVERS BOARD MEMBERS AND STAFFS FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION SHARES ITS EXECUTIVE LEADERSHIP WITH THE MEMBER ORGANIZATION. THE MEMBER ORGANIZATION'S COMPENSATION SCALES ARE REVIEWED BY ITS HUMAN RESOURCES DEPARTMENT AND WITH ASSISTANCE FROM OUTSIDE RESOURCES SUCH AS A CONSULTING FIRM. THE ORGANIZATION SHARES ITS EXECUTIVE LEADERSHIP WITH THE MEMBER ORGANIZATION. THE MEMBER ORGANIZATION'S BOARD APPROVES THE COMPENSATION FOR THE TOP MANAGEMENT OFFICIAL. THIS PROCESS WAS LAST COMPLETED IN 2022. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS OR CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC. THE FINANCIAL STATEMENTS ARE MADE AVAILABLE ON THE WEBSITE OF EMPIRE HEALTH FOUNDATION AND IN CONSOLIDATION WITH SAME. FORM 990, PART IX, LINE 11G OTHER SERVICES: PROGRAM SERVICE EXPENSES 400. MANAGEMENT AND GENERAL EXPENSES 50,000. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 50,400. FORM 990 PART VI LINE 9 JEFF THOMAS PASSED AWAY IN 2023. EMPIRE HEALTH FOUNDATION 1020 W RIVERSIDE AVENUE SPOKANE WA 99201 263375286 IMPROVING HEALTH WA 501(C)(3) PF N/A 0 FAMILY IMPACT NETWORK 1020 W RIVERSIDE AVENUE SPOKANE WA 99201 471405203 FAMILY SERVICES WA 501(C)(3) LINE 10 EMPIRE HEALTH FOUNDATION 0 PHILANTHROPY IN ACTION CO EMPIRE HEALTH FOUNDATION PO BOX 244 SPOKANE WA 99210 811438586 TO IMPROVE THE HEALTH OF PEOPLE IN WASHINGTON STATE. WA 501(C)(3) PF EMPIRE HEALTH FOUNDATION 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0