2024-11-01T15:04:21-05:00 2023-12-31 205325889 ACCUITY LLP 999 BISHOP STREET STE 2300 HONOLULU HI 96813 990 2023-01-01 990246999 HAWAII DENTAL SERVICE FOUNDATION HAWA 8085211431 900 FORT STREET MALL SUITE 1900 HONOLULU HI 968133705 DIANE SL PALOMA PHD VICE PRESIDENT 8085211431 2024-11-01 1 0 RACHEL C ANTAL P01263071 8085313400 2023 2024-10-15 13:58:12Z MASON SAVAGE 900 FORT STREET MALL SUITE 1900 HONOLULU HI 968133705 4302725 0 X N/A X 1986 HI TO PROMOTE THE GENERAL WELFARE OF THE COMMUNITY AND ADVANCE HEALTH AND ORAL HYGIENE 6 6 0 0 0 0 1800000 497000 0 0 2851230 2398568 0 0 4651230 2895568 1320991 1973081 0 0 369408 350312 0 0 0 197176 258705 1887575 2582098 2763655 313470 52984817 60601387 47464 376566 52937353 60224821 X TO PROMOTE AND ENCOURAGE THE BETTERMENT OF THE GENERAL HEALTH AND WELFARE OF THE PEOPLE OF THE COMMUNITY AND ADVANCE RESEARCH, EDUCATION, STUDY AND LEARNING IN THE HEALTH AREAS SUCH AS DENTISTRY, ORAL HYGIENE AND RELATED SERVICE. (SEE SCHEDULE O). 0 0 2425591 1973081 DURING 2023, HDSF DISTRIBUTED $1,973,081 TO 13 ORGANIZATIONS WHO HAVE PROGRAMS IN PLACE TO SUPPORT ORAL HEALTH INITIATIVES IN HAWAII. SEE SCHEDULE I FOR ADDITIONAL DETAILS. 2425591 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 6 6 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X QUIN OGAWA 8085211431 900 FORT STREET MALL SUITE 1900 HONOLULU HI 968133705 MASON A SAVAGE DDS CHAIR 1.00 1.00 X 0 0 0 CHARLES R SUGIYAMA DDS VICE CHAIR 1.00 1.00 X 0 0 0 KERIANN ERNST DIRECTOR 1.00 1.00 X 0 0 0 DAVID K TODANI DIRECTOR 1.00 1.00 X 0 0 0 ALLISON P TRAN DDS DIRECTOR 1.00 1.00 X 0 0 0 EMI ENO ORIKASA DDS VICE CHAIR AND PRESIDENT 1.00 1.00 X X 0 0 0 KAIMANA GOO-RAHTZ DMD DIRECTOR 1.00 1.00 X 0 0 0 GARRETT BK OKA DDS DIRECTOR 1.00 1.00 X 0 0 0 SHERELEE SANEISHI-KIM DIRECTOR & SECRETARY 34.00 6.00 X 0 146997 81305 DIANE SL PALOMA PHD VICE PRESIDENT 1.00 41.00 X 0 538363 64512 QUIN OGAWA TREASURER 1.00 41.00 X 0 285853 64343 CARA NUMASAKI FORMER INTERIM TREASURER 1.00 41.00 X 0 164835 49132 0 1136048 259292 0 1 1 0 0 497000 497000 1120704 1120704 2685021 1407157 1277864 1277864 1277864 2895568 0 0 2398568 1973081 1973081 350006 350006 306 306 7759 7759 61478 61478 27272 27272 7852 7852 41165 41165 11122 11122 8740 8740 6146 6146 ORAL HEALTH 85236 85236 MISCELLANEOUS 1227 1227 MEALS AND ENTERTAINMENT 708 708 2582098 2425591 156507 0 1923054 148204 51060649 59953908 1114 499275 52984817 60601387 47464 376566 47464 376566 X 52937353 60224821 52937353 60224821 52984817 60601387 313470 6973998 0 X X 0 1 X 1 0 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 ALOHA MEDICAL MISSION 200 N VINEYARD BLVD B-120 HONOLULU HI 96817 990234811 501(C)(3) 420000 0 FUNDING FOR PROCEDURES PERFORMED BY A DENTAL CLINIC SERVING UNINSURED AND UNDERSERVED DENTAL LIFELINE NETWORK HAWAII 1800 15TH STREET SUITE 100 DENVER CO 80202 846129064 501(C)(3) 20000 0 FUNDING FOR VOLUNTEER DENTISTS AND DENTAL LABS HAWAII PUBLIC HEALTH INSTITUTE 850 RICHARDS STREET SUITE 201 HONOLULU HI 96813 680637054 501(C)(3) 65510 0 FUNDING TO SUPPORT THE DEVELOPMENT OF THE HAWAII ORAL HEALTH COALITION'S FIRST STATEWIDE FIVE-YEAR STRATEGIC PLAN. A FIVE-YEAR STRATEGIC PLAN WILL GUIDE THE COALITION'S WORK DEVELOPING AND SUPPORTING COMMUNITY-BASED ORAL HEALTH INTERVENTIONS, ORAL HEALTH EDUCATION AND DISEASE PREVENTION PROMOTION, AND COMMUNITY FOCUSED LEGISLATIVE POLICY PRIORITIES. KAHUKU MEDICAL CENTER 56-1147 PUALALEA ST KAHUKU HI 96731 870805301 501(C)(3) 83217 0 FUNDING TO INCREASE CAPACITY TO PROVIDE ORAL HEALTH SERVICES TO ADULT MEDICAID PATIENTS. WAIANAE DISTRICT COMPREHENSIVE HEALTH AND HOSPITAL BOARD INC 86-260 FARRINGTON HWY WAIANAE HI 96792 990148164 501(C)(3) 436374 0 FUNDING FOR REAR DELIVERY ADEC UNIT AND CONSOLE AMERICAN HEART ASSOCIATION INC 7272 GREENVILLE AVE DALLAS TX 75231 135613797 501(C)(3) 268426 0 FUNDING TO ADDRESS HYPERTENSION, PROVIDE RESOURCES AND REFERRALS TO PATIENTS WHO NEED FURTHER ASSISTANCE, AND MEET PEOPLE WHERE THEY ARE. FRIENDS OF THE FUTURE 64-1032 MAMALAHOA HIGHWAY 311 KAMUELA HI 96743 990296604 501(C)(3) 30000 0 FUNDING TO LEVERAGE TWO-WAY PREVENTIVE TEXT MESSAGING PLATFORM TO PROMOTE FAMILIES TO FIND THEIR BABY'S FIRST DENTIST MOLOKAI OHANA HEALTH CARE INC 30 OKI PLACE KAUNAKAKAI HI 96748 510437659 501(C)(3) 14680 0 FUNDING TO ASSIST WITH BUILDING MODIFICATIONS FOR THE NEW COMPRESSOR AND VACUUM SYSTEM FOR THE DENTAL PRACTICE, AND TO PROVIDE BASIC DENTAL CARE AND HYGIENE INCLUDING ORAL HEALTH EDUCAITON TO PROMOTE ORAL HEALTH AND DECREASE NEED FOR RESTORATIVE CARE. UNIVERSITY OF HAWAII FOUNDATION - HAWAII KEIKI PO BOX 11270 HONOLULU HI 96828 990085260 501(C)(3) 245894 0 FUNDING FOR HAWAII KEIKI - HDS DENTAL SEALANT PROGRAM COMMUNITY CLINIC OF MAUI INC 1881 NANI ST WAILUKU HI 96793 990303304 501(C)(3) 92192 0 PROVIDED FUNDS FOR 3D PRINTER DESIGN AND PRODUCTION TECHNOLOGY THAT WILL REDUCE PATIENT WAIT TIME AND OUTSOURCING LABORATORY AND PRODUCTION COSTS FOR COMPLETE DENTURES, CROWNS, AND BRIDGES, AND FUNDING FOR EQUIPMENT NEEDED TO PROVIDE COMPREHENSIVE DENTAL TREATMENT IN LAHAINA. HUI NO KE OLA PONO INC 95 MAHALANI ST RM 21 WAILUKU HI 96793 990287193 501(C)(3) 22072 0 FUNDING TO FINALIZE THE EQUIPPING AND PROVISIONING OF ORGANIZATION'S MOBILE VAN WHICH WILL ENABLE THEM TO PROVIDE COMPREHENSIVE DENTAL CARE ESPECIALLY TO THOSE DISPLACED BY THE LAHAINA WILDFIRES. UNIVERSITY OF HAWAII FOUNDATION - MAUI COUNTY PO BOX 11270 HONOLULU HI 96828 990085260 501(C)(3) 100000 0 UH MAUI COLLEGE - DENTAL HYGIENE PROGRAM: CONTINUE WORK TO EXPAND DENTAL CARE AND SERVICES TO UNDER-SERVED POPULATIONS WEST HAWAII COMMUNITY HEALTH CENTER INC (AKA HAWAII ISLAND COMMUNITY HEALTH 75-5751 KUAKINI HIGHWAY SUITE 203 KAILUAKONA HI 96740 200495394 501(C)(3) 109716 0 FUNDING FOR DENTAL IMPANT EQUIPMENT AND TRAINING TO IMPROVE RESTORATIVE SERVICES FOR THE UNINSURED AND UNDERINSURED ADULTS ON HAWAII ISLAND. ADDITIONALLY, FUNDING TRAVEL TO KALAUPAPA TO PROVIDE ORAL HEALTH EDUCATION, MODELED ON THE HDS INITIATIVE KUPUNA SMILES, TO THE NURSING STAFF ON THE TOPIC OF GERIATRIC ORAL HEALTH FOR PATIENTS WITH HANSEN'S DISEASE WEST HAWAII COMMUNITY HEALTH CENTER INC (AKA HAWAII ISLAND COMMUNITY HEALTH 75-5751 KUAKINI HIGHWAY SUITE 203 KAILUAKONA HI 96740 200495394 501(C)(3) 60000 0 FUNDING TO IMPROVE THE ORAL HEALTH OF THE UNINSURED AND UNDERINSURED ADULTS ON HAWAI'I ISLAND THROUGH INCREASING CAPACITY AND AWARENESS OF THE CHANGE IN MEDICAID COVERAGE FOR ADULT DENTAL SERVICES IN 2023 14 FORM 990, SCHEDULE I THERE IS A FORMAL PROCESS FOR APPLICANTS TO REQUEST GRANTS OF $5,000 OR MORE FROM THE FOUNDATION. APPLICANTS NEED TO SUBMIT GRANT PURPOSE, PROPOSED BUDGET FOR GRANTS, AND PROOF OF TAX-EXEMPT STATUS. AT THE END OF THE YEAR, APPLICANTS WHO RECEIVED GRANTS ARE REQUIRED TO SUBMIT A REPORT OF HOW THE GRANT WAS SPENT. REQUESTS FOR GRANTS ARE REVIEWED BY THE DIRECTOR OF THE HDS FOUNDATION AND VICE PRESIDENT AND SUBMITTED TO THE BOARD OF DIRECTORS FOR APPROVAL. EFFECTIVE SEPTEMBER 2021, THE BOARD OF DIRECTORS APPROVED A SECOND WAY FOR NON-PROFIT ORGANIZATIONS TO RECEIVE GRANTS LESS THAN $5,000. THE SMILE FUND GRANTS CAN BE REQUESTED AT ANY TIME DURING THE YEAR AND DOES NOT REQUIRE BOARD APPROVAL. THE HDS FOUNDATION DIRECTOR HAS THE DISCRETION TO FUND THE NON-PROFIT OR NOT DEPENDING ON EVALUATION OF THE ORGANIZATION'S GRANT APPLICATION. 0 0 0 0 0 0 0 0 0 DIANE SL PALOMA PHD VICE PRESIDENT 0 343063 0 189750 0 5550 0 37211 0 27301 0 602875 0 0 QUIN OGAWA TREASURER 0 232337 0 53516 0 0 0 56842 0 7501 0 350196 0 0 SHERELEE SANEISHI-KIM DIRECTOR & SECRETARY 0 126099 0 20898 0 0 0 68242 0 13063 0 228302 0 0 CARA NUMASAKI FORMER INTERIM TREASURER 0 141397 0 23438 0 0 0 35958 0 13174 0 213967 0 0 PART I, LINE 3 THE FOUNDATION DOES NOT PAY COMPENSATION TO ITS DIRECTORS OR OFFICERS. COMPENSATION FOR OFFICERS REPORTED IS FOR A RELATED ORGANIZATION, HAWAII DENTAL SERVICE (HDS). HDS CEO AND OFFICER COMPENSATION IS DETERMINED BASED ON ADVICE FROM AN INDEPENDENT COMPENSATION CONSULTANT WHICH IS PRESENTED TO AND APPROVED BY HDS BOARD OF DIRECTORS COMPENSATION COMMITTEE AND DOCUMENTED IN THE MINUTES. PERIODICALLY AN INDEPENDENT CONSULTANT IS HIRED TO REVIEW THE COMPENSATION FOR MANAGEMENT AND STAFF POSITIONS. COMPENSATION FOR THESE POSITIONS ARE APPROVED ANNUALLY BY THE PRESIDENT/CEO AND EXECUTIVES. FORM 990, PART I & PART III, LINE 1 ORGANIZATION'S MISSION STATEMENT THE OVERALL EXEMPT PURPOSE OF HAWAII DENTAL SERVICE FOUNDATION, AS A VEHICLE FOR HAWAII DENTAL SERVICE, IS TO PROMOTE THE WELFARE OF THE COMMUNITY AND TO CONTRIBUTE TO THE CHARITABLE AND HEALTH ISSUES OF THE COMMUNITY. TO PROMOTE AND ENCOURAGE THE BETTERMENT OF THE GENERAL HEALTH, INCLUDING BUT NOT LIMITED TO MEDICAL AND DENTAL HEALTH, OF THE PUBLIC FOR THE COMMON GOOD AND GENERAL WELFARE OF THE PEOPLE OF THE COMMUNITY. TO PROMOTE AND ADVANCE RESEARCH, EDUCATION, STUDY AND LEARNING IN THE HEALTH AREAS SUCH AS THE FIELD OF DENTISTRY, ORAL HYGIENE AND RELATED SCIENCES. TO ESTABLISH, CONDUCT, MAINTAIN, SPONSOR AND PROMOTE STUDIES OF COMMUNITY HEALTH, SUCH AS MEDICAL AND DENTAL NEEDS, STATISTICAL STUDIES OF GENERAL HEALTH, SUCH AS MEDICAL AND DENTAL, REQUIREMENTS OF THE POPULOUS AND TO INVESTIGATE AND CONDUCT PROGRAMS PROVIDING GENERAL HEALTH, SUCH AS MEDICAL AND DENTAL CARE OVER A BROAD AREA. FORM 990, PART IV, LINE 12B AUDITED FINANCIAL STATEMENTS FOR THE ORGANIZATION ARE INCLUDED IN THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF HAWAII DENTAL SERVICE, HAWAII DENTAL SERVICE FOUNDATION, AND HAWAII CLIENT SERVICE CORPORATION, YEARS ENDED DECEMBER 31, 2023 AND 2022. THE AUDIT COMMITTEE OF HAWAII DENTAL SERVICE, WHICH CONSISTS OF BOARD MEMBERS, SELECTS THE AUDITORS AND REVIEWS THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS. FORM 990, PART VI, SECTION A, LINE 6 DESCRIPTION OF MEMBERS MEMBERS OR DIRECTORS OF THE HAWAII DENTAL SERVICE FOUNDATION ARE: -LIMITED TO INDIVIDUALS WHO SERVE AS DIRECTORS OF HAWAII DENTAL SERVICE -ALSO THE GOVERNING BODY OF THE FOUNDATION. FORM 990, PART VI, SECTION A, LINE 7A DESCRIBE CLASSES OF PERSONS, DECISIONS REQUIRING APPROVAL & TYPE OF VOTING RIGHTS THE HDS FOUNDATION MEMBERSHIP, WHICH IS COMPRISED OF THE MEMBERS OF THE HAWAII DENTAL SERVICE BOARD OF DIRECTORS, ANNUALLY SETS THE NUMBER (CANNOT BE LESS THAN THREE) AND ELECTS THE DIRECTORS TO SERVE ON THE HAWAII DENTAL SERVICE FOUNDATION BOARD OF DIRECTORS FOR THE ENSUING YEAR. FORM 990, PART VI, SECTION B, LINE 11B DESCRIBE THE PROCESS USED BY MANAGEMENT &/OR GOVERNING BODY TO REVIEW 990 THE RETURN IS THOROUGHLY REVIEWED BY THE CONTROLLER OF HAWAII DENTAL SERVICE PRIOR TO FINAL REVIEW WITH THE TREASURER AND VICE PRESIDENT OF HDS FOUNDATION. A COPY OF THE FORM 990 IS PROVIDED TO THE DIRECTORS FOR REVIEW PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C DESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST PURSUANT TO THE HAWAII DENTAL SERVICE COMPANIES CONFLICTS OF INTEREST POLICY, DIRECTORS ARE PROVIDED WITH THE CONFLICTS OF INTEREST POLICY AND ARE REQUIRED TO SUBMIT A CONFLICTS OF INTEREST DISCLOSURE STATEMENT AND CERTIFICATION ANNUALLY. DIRECTORS ARE NOT ALLOWED TO PARTICIPATE IN DELIBERATIONS OR VOTE ON ISSUES/TRANSACTIONS WHICH THEY HAVE A CONFLICT OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15 PROCESS FOR DETERMINING COMPENSATION THE FOUNDATION DOES NOT PAY COMPENSATION TO ITS DIRECTORS OR OFFICERS. COMPENSATION FOR OFFICERS REPORTED IS FOR A RELATED ORGANIZATION, HAWAII DENTAL SERVICE (HDS). HDS CEO AND OFFICER COMPENSATION IS DETERMINED BASED ON ADVICE FROM AN INDEPENDENT COMPENSATION CONSULTANT WHICH IS PRESENTED TO AND APPROVED BY HDS BOARD OF DIRECTOR'S COMPENSATION COMMITTEE AND DOCUMENTED IN THE MINUTES. COMPENSATION FOR MANAGEMENT AND STAFF POSITIONS ARE EVALUATED AND DETERMINED BASED ON EMPLOYERS COUNCIL SURVEYS AND APPROVED BY THE PRESIDENT/CEO AND EXECUTIVES ANNUALLY. FORM 990, PART VI, SECTION C, LINE 18 RETURNS ARE AVAILABLE ON OTHER WEBSITES SUCH AS GUIDESTAR. FORM 990, PART VI, SECTION C, LINE 19 AVAILABILITY OF REQUIRED DOCUMENTS: TAX RETURNS AND OTHER REQUIRED DOCUMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART XII, LINE 2C NO CHANGE FROM PRIOR YEAR. HAWAII DENTAL SERVICE 900 FORT STREET MALL SUITE 1900 HONOLULU HI 968133705 990107971 DENTAL PLAN PROVIDER HI 501(C)(4) N/A N/A 0 HAWAII CLIENT SERVICES CORPORATION 900 FORT STREET MALL SUITE 1900 HONOLULU HI 968133705 452740308 ADMIN SERVICES HI HAWAII DENTAL SERVICE C 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0