Polk County Health Services

“Form 990 will be reviewed by the interim president. The organization is no longer in existence at the time of this filing.”

“Any director, officer, or key employee having an actual or potential interest in a contract or other transaction presented to the board of directors or a committee thereof for authorization, approval, or ratification, shall make a full and frank disclosure of his or her interest to the board or committee prior to its acting on such a contract or transaction. Such disclosure shall include any relevant and material facts known to such person about the contract or transaction which might reasonably be constructed to be adverse to the interests of pchs. Among the interests that would give rise to disclosure are interests of personal or familial owenrship of, employment by, fiduciary duty to, or other material interest in an entitiy with which pchs is contemplating a business transaction. The body to which such disclosure is made shall there upon determine, by majority vote, whether the disclosure shows that a conflict of interest exists or can reasonably be construed to exist. If a conflict is deemed to exist, such person shall not vote on, nor use his or her personal influence on, nor participate in the deliberations with respect to such contract or transaction. The foregoing requirement shall not be construed to prevent the individual deemed to have an actual or potential conflict from answering pertinent questions from other members of the body, since his or her knowledge may be of great assistance to the body in its deliberations. Such persons may be counted in determining the exstence of a quorum at any meeting where the contract or transaction is under discussion or is being voted upon. The minutes of the meeting shall reflect the discosure made, the vote on the conflict determination, and, where applicable, participations in discussion and abstention from voting on the transaction, and whether a quorum was present.”

“The salary range for the executvie director's position was adopted by the executive committee and board of directors following a review of the position's duties and responsibilities conducted by a sub-committee of the board of directors (compensation committee), and an independent human resources agency who analyzed agnecies of similary function and fiscal management responsibilities. The executive committee reviews the performance of the exectuvie director and approves any adjustments in salary indicated by that review. The minutes of the executive committee reflect the decision made by the committee. The executive director evaluates the performance of each employee using an emplyee performance review instrument and included in an operating budget which is approved by the executive committee and board of directors at the beginning of each fiscal year.”

“The governing documents, conflict of interest statements, and form 990 returns are available upon request. We can be reached via email, phone, or usmail.”

“Section a, parts d and e, and section b, line 1 have not been filed out due to a lack of information received from the organization.”

“Lines 5 and 6 have not been filed out due to a lack of information received from the organization.”

“The organization ceased operations during fy2023 and transfered its assets to connexus behavioral health and disability advocates.”

“Lines 1a, 1b, and 2a have not been filed out due to a lack of information received from the organization.”

“Line 5 has not been filed out due to a lack of information received from the organization.”

“Transfer of assets -7,244,062.”