Form990
Click to see attachment
Department of the Treasury
Internal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung benefit trust or private foundation)

MediumBullet The organization may have to use a copy of this return to satisfy state reporting requirements.
OMB No. 1545-0047
2010
Open to Public Inspection
A For the calendar year, or tax year beginning 10-01-2010 and ending 09-30-2011
BCheck if applicable:
CName of organization
DAKOTA MEDICAL CHARITIES
 
Doing Business As
 
 
Number and street (or P.O. box if mail is not delivered to street address)
4152 30TH AVE S NO 102
 
Room/suite
City or town, state or country, and ZIP + 4
FARGO, ND58104
D Employer identification number

45-0368679
E Telephone number

G Gross receipts $ 74,047,686
F Name and address of principal officer:
J PATRICK TRAYNOR
4152 30TH AVE S NO 102
FARGO,ND58104
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.DAKMED.ORG
H(a)
Is this a group return for
affiliates?
H(b)
Are all affiliates included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:
 
L Year of formation: 1982
M State of legal domicile: ND
Part I
Summary
Activities  & Governance 1 Briefly describe the organization’s mission or most significant activities: CARRY OUT THE CHARITABLE HEALTH RELATED PURPOSES OF DAKOTA MEDICAL FOUNDATION.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) .... 3 14
4 Number of independent voting members of the governing body (Part VI, line 1b) .... 4 14
5 Total number of individuals employed in calendar year 2010 (Part V, line 2a) ... 5 6
6 Total number of volunteers (estimate if necessary) .... 6 27
7a Total unrelated business revenue from Part VIII, column (C), line 12 .. 7a 0
b Net unrelated business taxable income from Form 990-T, line 34 .. 7b 0
Revenues; Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 1,634 336,721
9 Program service revenue (Part VIII, line 2g) ......... 19,111 17,221
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 1,943,995 2,283,984
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 0 0
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 1,964,740 2,637,926
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 1,024,621 1,062,628
14 Benefits paid to or for members (Part IX, column (A), line 4) .... 0 0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 727,138 764,521
16a Professional fundraising fees (Part IX, column (A), line 11e).... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet82,948    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24f).... 399,293 449,646
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 2,151,052 2,276,795
19 Revenue less expenses. Subtract line 18 from line 12...... -186,312 361,131
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............ 63,992,772 63,057,577
21 Total liabilities (Part X, line 26)............ 151,025 227,012
22 Net assets or fund balances. Subtract line 21 from line 20 ..... 63,841,747 62,830,565
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title.
Paid Preparer's Use Only Preparer's
signature
Big Right Arrow
Date
right pointing bullet image Preparer’s taxpayer identification number
(see instructions)
Firm’s name (or yours
if self-employed),
address, and ZIP + 4
Big Right Arrow




EIN right pointing bullet image
Phone no. right pointing bullet image
May the IRS discuss this return with the preparer shown above? (see instructions) .........
For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y
Form 990 (2010)
Form 990 (2010)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response to any question in this Part III . . . . . . . . . .
1
Briefly describe the organization’s mission: DAKOTA MEDICAL CHARITIES OPERATES EXCLUSIVELY FOR CHARITABLE, SCIENTIFIC AND EDUCATIONAL PURPOSES EXCLUSIVELY FOR THE BENEFIT OF, TO PERFORM THE FUNCTIONS OF, AND TO CARRY OUT THE CHARITABLE HEALTH-RELATED PURPOSES OF DAKOTA MEDICAL FOUNDATION.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ....................
If “Yes,” describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ..........................
If “Yes,” describe these changes on Schedule O.
4
Describe the exempt purpose achievements for each of the organization’s three largest program services by expenses.
Section 501(c)(3) and 501(c)(4) organizations and section 4947(a)(1) trusts are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 1,112,958 including grants of $ 808,095 ) (Revenue $ 17,221 )
DAKOTA MEDICAL CHARITIES (DMC) AND ITS PARENT ORGANIZATION, DAKOTA MEDICAL FOUNDATION (DMF), (THE "FOUNDATIONS") ARE RECOGNIZED LEADERS DEDICATED TO MEASURABLY IMPROVING HEALTH AND ACCESS TO HEALTHCARE SERVICES WITH A SPECIAL EMPHASIS ON CHILDREN. THE FOUNDATIONS PLACE PARTICULAR EMPHASIS ON PROJECTS THAT ADDRESS THE SPECIAL NEEDS OF THE COMMUNITY WITHIN ITS TRADITIONAL SERVICE AREA. THE FOUNDATIONS FOCUSED THEIR SUPPORT IN 2011 ON GRANT PROGRAMS AND INITIATIVE PROGRAM SUPPORT ON ACCESS TO HEALTHCARE, CHRONIC DISEASE PREVENTION, AND NONPROFIT ORGANIZATIONAL EFFECTIVENESS.ACCESS TO HEALTHCARE -SEE SCHEDULE O FOR CONTINUATION
4b (Code:   ) (Expenses $ 531,131 including grants of $ 254,533 ) (Revenue $   )
CHRONIC DISEASE PREVENTION -SEE SCHEDULE O FOR CONTINUATION
4c (Code:   ) (Expenses $ 175,819 including grants of $   ) (Revenue $   )
ORGANIZATIONAL EFFECTIVENESS -SEE SCHEDULE O FOR CONTINUATION
4d Other program services. (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet$ 1,819,908
Form 990 (2010)
Form 990 (2010)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If “Yes,” complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors? Click to see attachment........
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If “Yes,” complete Schedule C, Part I..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities? If “Yes,” complete Schedule C,
Part II
.........................
4
 
No
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If “Yes,” complete Schedule C, Part III........................
5
 
 
6
Did the organization maintain any donor advised funds or any similar funds or accounts where donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If “Yes,” complete
Schedule D, Part I
Click to see attachment
.......................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas or historic structures? If “Yes,” complete Schedule D, Part IIClick to see attachment
...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If “Yes,” complete Schedule D, Part III Click to see attachment....................
8
 
No
9
Did the organization report an amount in Part X, line 21; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If “Yes,”
complete Schedule D, Part IV
Click to see attachment
...................
9
 
No
10
Did the organization, directly or through a related organization, hold assets in term, permanent,or quasi-endowments? If “Yes,” complete Schedule D, Part VClick to see attachment
10
Yes
 
11
If the organization’s answer to any of the following questions is ‘Yes,’ then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable:
a
Did the organization report an amount for land, buildings, and equipment in Part X, line10? If “Yes,” complete Schedule D, Part VI.Click to see attachment
11a
 
No
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VII.Click to see attachment
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VIII.Click to see attachment
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part IX.Click to see attachment
11d
 
No
e
Did the organization report an amount for other liabilities in Part X, line 25? If “Yes,” complete Schedule D, Part X.Click to see attachment
11e
 
No
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If “Yes,” complete Schedule D, Part X.Click to see attachment
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year? If “Yes,” complete Schedule D, Parts XI, XII, and XIII Click to see attachment
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If “Yes,” and if the organization answered ‘No’ to line 12a, then completing Schedule D, Parts XI, XII, and XIII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If “Yes,” complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, and program service activities outside the United States? If “Yes,” complete Schedule F, Part I.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or assistance to any organization or entity located outside the U.S.? If “Yes,” complete Schedule F, Part II..
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or assistance to individuals located outside the U.S.? If “Yes,” complete Schedule F, Part III..
16
 
No
17
Did the organization report a total of more than $15,000, of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If “Yes,” complete Schedule G, Part I
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If “Yes,” complete Schedule G, Part II..........
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If “Yes,” complete Schedule G, Part III...................
19
 
No
Form 990 (2010)
Form 990 (2010)
Page 4
Part IV
Checklist of Required Schedules (continued)
20a
Did the organization operate one or more hospitals? If “Yes,” complete Schedule H.....
20a
 
No
b
Did the organization attach its audited financial statement to this return? Note: All Form 990 filers that operate one or more hospitals must attach audited financial statements. .....
20b
 
 
21
Did the organization report more than $5,000 of grants and other assistance to governments and organizations in the United States on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.. Click to see attachment
21
Yes
 
22
Did the organization report more than $5,000 of grants and other assistance to individuals in the United States on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III..... Click to see attachment
22
 
No
23
Did the organization answer “Yes” to Part VII, Section A, questions 3, 4, or 5, about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If “Yes,” complete Schedule J................ Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer questions 24b–24d and complete Schedule K. If “No,” go to line 25................
24a
 
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
 
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?
......................
24c
 
 
d
Did the organization act as an “on behalf of” issuer for bonds outstanding at any time during the year?...
24d
 
 
25a
Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If “Yes,” complete Schedule L, Part I......
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If “Yes,” complete Schedule L, Part I................
25b
 
No
26
Was a loan to or by a current or former officer, director, trustee, key employee, highly compensated employee, or disqualified person outstanding as of the end of the organization’s tax year? If “Yes,” complete Schedule L,
Part II
...........................
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor, or a grant selection committee member, or to a person related to such an individual? If “Yes,” complete Schedule L, Part III...............
27
 
No
28
Was the organization a party to a business transaction with one of the following parties? (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If “Yes,” complete Schedule L, Part IV .........................
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If “Yes,”
complete Schedule L, Part IV
...................
28b
 
No
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or owner? If “Yes,” complete Schedule L, Part IV..
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If “Yes,” complete Schedule M
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If “Yes,” complete Schedule M............
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If “Yes,” complete Schedule N,
Part I
...........................
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If “Yes,” complete Schedule N, Part II.......................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If “Yes,” complete Schedule R, Part I........ Click to see attachment
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If “Yes,” complete Schedule R, Parts II, III, IV, and V, line 1..................... Click to see attachment
34
Yes
 
35
Is any related organization a controlled entity within the meaning of section 512(b)(13)? .....
35
 
No
a
Did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If “Yes,” complete Schedule R, Part V, line 2... Click to see attachment
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If “Yes,” complete Schedule R, Part V, line 2........... Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If “Yes,” complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11 and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2010)
Form 990 (2010)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response to any question in this Part V . . . . . . . . . .
Yes
No
1a
Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable. .......
1a
2
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable.
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and Tax Statements filed for the calendar year ending with or within the year covered by this return .....................
2a
6
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?

Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file. (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?.............................
3a
 
No
b
If “Yes,” has it filed a Form 990-T for this year? If “No,” provide an explanation in Schedule O.....
3b
 
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account or securities account)?.......................
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If “Yes” to line 5a or 5b, did the organization file Form 8886-T? ........
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible?..........
6a
 
No
b
If “Yes,” did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
 
No
b
If “Yes,” did the organization notify the donor of the value of the goods or services provided?.....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
No
d
If “Yes,” indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?..........................
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?...................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?...............
7h
 
 
8
Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting organizations. Did the supporting organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year?................
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the organization make any taxable distributions under section 4966?.........
9a
 
 
b
Did the organization make a distribution to a donor, donor advisor, or related person?......
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If “Yes,” enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note.
All 501(c)(29) organizations must list in Schedule O each state in which they are licensed to issue qualified health plans, the amount of reserves required by each state, and the amount of reserves the organization allocated to each state.
13a
 
 
b
Enter the aggregate amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans.
13b
 
c
Enter the aggregate amount of reserves on hand.
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
 
b
If "Yes," has it filed a Form 720 to report these payments? If “No,” provide an explanation in Schedule O..
14b
 
 
Form 990 (2010)
Form 990 (2010)
Page 6
Part VI
Governance, Management, and Disclosure For each “Yes” response to lines 2 through 7b below, and for a “No” response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response to any question in this Part VI . . . . . . . . . .
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year ..............
1a
14
b
Enter the number of voting members included in line 1a, above, who are independent .................
1b
14
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
Yes
 
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? ..
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed?
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Does the organization have members or stockholders? ................
6
Yes
 
7a
Does the organization have members, stockholders, or other persons who may elect one or more members of the governing body? .........................
7a
Yes
 
b
Are any decisions of the governing body subject to approval by members, stockholders, or other persons? ..
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If “Yes,” provide the names and addresses in Schedule O .....
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal
Revenue Code.)
Yes
No
10a
Does the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If “Yes,” does the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with those of the organization? ....
10b
 
 
11a
Has the organization provided a copy of this Form 990 to all members of its governing body before filing the form?
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review the Form 990. .....
12a
Does the organization have a written conflict of interest policy? If “No,” go to line 13.......
12a
Yes
 
b
Are officers, directors or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ...........................
12b
Yes
 
c
Does the organization regularly and consistently monitor and enforce compliance with the policy? If “Yes,” describe in Schedule O how this is done ....................
12c
Yes
 
13
Does the organization have a written whistleblower policy? ...............
13
Yes
 
14
Does the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
 
No
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line a or b, describe the process in Schedule O. (See instructions.)
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
 
No
b
If “Yes,” has the organization adopted a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and taken steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you make these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how), the organization makes its governing documents, conflict of interest policy, and financial statements available to the public.
20
State the name, physical address, and telephone number of the person who possesses the books and records of the organization: MediumBullet
DAVID GIBB
4152 30TH AVE SOUTH SUITE 102
FARGO,ND58104
(701) 271-0263
Form 990 (2010)
Form 990 (2010)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response to any question in this Part VII . . . . . . . . . .
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation, and current key employees. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organizations compensated any current or former officer, director, or trustee.
(A)
Name and Title
(B)
Average hours per week (describe hours for related organizations in Schedule O)
(C)
Position (check all that apply)
(D)
Reportable compensation from the organization (W- 2/1099-MISC)
(E)
Reportable compensation from related organizations (W- 2/1099-MISC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(1) JOEL HAUGEN MD
CHAIR
1.00 X   X       0 0 0
(2) RICHARD VETTER MD
VICE CHAIR
1.00 X   X       0 0 0
(3) JON WANZEK
SECRETARY
1.00 X   X       0 0 0
(4) CURT NOYES
TREASURER
1.00 X   X       0 0 0
(5) DAVID CLUTTER MD
DIRECTOR
1.00 X   X       0 0 0
(6) JAY EISENBEIS
DIRECTOR
1.00 X           0 0 0
(7) CHRIS KENNELLY
DIRECTOR
1.00 X           0 0 0
(8) LARRY LEITNER
DIRECTOR
1.00 X           0 0 0
(9) DEB MAGNUSON BSN RN
DIRECTOR
1.00 X           0 0 0
(10) FADEL NAMMOUR MD
DIRECTOR
1.00 X           0 0 0
(11) JANE SKALSKY RN
DIRECTOR
1.00 X           0 0 0
(12) MIKE WARNER
DIRECTOR
1.00 X           0 0 0
(13) SUSAN MATHISON MD
DIRECTOR
1.00 X           0 0 0
(14) SINDY KELLER
DIRECTOR
1.00 X           0 0 0
(15) J PATRICK TRAYNOR
PRESIDENT
20.00     X       0 212,275 58,970
(16) DAVID GIBB
DIRECTOR OF FINANCE
20.00     X       106,062 0 39,105


Form 990 (2010)
Form 990 (2010)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title
(B)
Average hours per week (describe hours for related organizations in Schedule O)
(C)
Position (check all that apply)
(D)
Reportable compensation from the organization (W- 2/1099-MISC)
(E)
Reportable compensation from related organizations (W- 2/1099-MISC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;


























1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 106,062 212,275 98,075
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 in reportable compensation from the organizationMediumBullet1
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If “Yes,” complete Schedule J for such individual .............
3
 
No
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If “Yes,” complete Schedule J for such individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If “Yes,” complete Schedule J for such person .....
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization.
(A)
Name and business address
(B)
Description of services
(C)
Compensation
SEI INVESTMENT MANAGEMENT
1 FREEDOM VALLEY DRIVE
OAKS,PA19456
INVESTMENT MANAGEMENT 177,613
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 in compensation from the organization MediumBullet1
Form 990 (2010)
Form 990 (2010)
Page 9
Part VIII
Statement of Revenue
(A)
Total revenue
(B)
Related or
exempt
function
revenue
(C)
Unrelated
business
revenue
(D)
Revenue
excluded from
tax under sections
512, 513, or 514
Contributions, gifts, grants and other similar amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c  
d Related organizations...1d  
e Government grants (contributions)1e  
f All other contributions, gifts, grants, and
similar amounts not included above
1f
336,721
g Noncash contributions included in lines 1a-1f:$  
h Total. Add lines 1a-1f.......MediumBullet 336,721
 Program Service Revenue Business Code
2a STREETS ALIVE REGISTRA 900,099 17,221 17,221    
b
c
d
e
f All other program service revenue .        
g Total. Add lines 2a–2f........MediumBullet 17,221
 Other Revenue 3 Investment income (including dividends, interest
and other similar amounts).....MediumBullet 1,823,858     1,823,858
4 Income from investment of tax-exempt bond proceeds..MediumBullet        
5 Royalties............MediumBullet        
(i) Real (ii) Personal
6a Gross Rents    
b Less: rental expenses    
c Rental income or (loss)    
d Net rental income or (loss).......MediumBullet        
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 71,869,886  
b Less: cost or other basis and sales expenses 71,409,760  
c Gain or (loss) 460,126  
d Net gain or (loss)..........MediumBullet 460,126     460,126
8a Gross income from fundraising events (not including
$  
of contributions reported on line 1c). See Part IV, line 18 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from fundraising events..MediumBullet      
9a Gross income from gaming activities.
See Part IV, line 19 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities...MediumBullet        
10a Gross sales of inventory, less
returns and allowances .
a  
b Less: cost of goods sold ..b  
c Net income or (loss) from sales of inventory..MediumBullet        
Miscellaneous Revenue Business Code
11a            
b            
c            
d All other revenue ....        
e Total. Add lines 11a–11d ......MediumBullet  
12 Total revenue. See Instructions....MediumBullet 2,637,926 17,221 0 2,283,984
Form 990 (2010)
Form 990 (2010)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A) but are not required to complete columns (B), (C), and (D).
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII.
(A)
Total expenses
(B)
Program service expenses
(C)
Management and general expenses
(D)
Fundraising expenses
1 Grants and other assistance to governments and organizations in the U.S. See Part IV, line 21 1,062,628 1,062,628
2 Grants and other assistance to individuals in the U.S. See Part IV, line 22    
3 Grants and other assistance to governments, organizations, and individuals outside the U.S. See Part IV, lines 15 and 16    
4 Benefits paid to or for members    
5 Compensation of current officers, directors, trustees, and key employees .... 293,031 102,229 161,721 29,081
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....        
7 Other salaries and wages 343,654 217,794 105,924 19,936
8 Pension plan contributions (include section 401(k) and section 403(b) employer contributions) .... 51,517 30,456 14,282 6,779
9 Other employee benefits ....... 38,637 22,558 10,710 5,369
10 Payroll taxes ........... 37,682 22,999 10,821 3,862
11 Fees for services (non-employees):        
a Management ......        
b Legal ......... 113 113    
c Accounting ........... 8,800   8,800  
d Lobbying ...........        
e Professional fundraising. See Part IV, line 17..    
f Investment management fees ...... 217,838 204,768 13,070  
g Other .......... 7,335 5,943 1,352 40
12 Advertising and promotion .... 68,890 67,477 1,413  
13 Office expenses ....... 40,052 27,258 11,068 1,726
14 Information technology ...... 18,062 13,684 4,139 239
15 Royalties ..        
16 Occupancy ........... 36,882 14,476 7,917 14,489
17 Travel ............ 8,952 6,282 2,583 87
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ......        
19 Conferences, conventions, and meetings .... 12,689 9,876 2,813  
20 Interest ...........        
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization ..... 13,750 9,459 2,951 1,340
23 Insurance .............. 11,564   11,564  
24 Other expenses. Itemize expenses not covered above. (Expenses grouped together and labeled miscellaneous may not exceed 5% of total expenses shown on line 25 below.)
a
b
c
d
e
f All other expenses 4,719 1,908 2,811  
25 Total functional expenses. Add lines 1 through 24f 2,276,795 1,819,908 373,939 82,948
26 Joint costs. Check here MediumBullet if following
SOP 98-2 (ASC 958-720). Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation
       
Form 990 (2010)
Form 990 (2010)
Page 11
Part X Balance Sheet
(A)
Beginning of year
(B)
End of year
Assets 1 Cash—non-interest-bearing ..........   1  
2 Savings and temporary cash investments ....... 324,205 2 416,866
3 Pledges and grants receivable, net .........   3 675
4 Accounts receivable, net .........   4  
5 Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..........   5  
6 Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B). Complete Part II of
Schedule L ..........   6  
7 Notes and loans receivable, net .............   7  
8 Inventories for sale or use ..............   8  
9 Prepaid expenses and deferred charges ............   9  
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a  
b Less: accumulated depreciation. ..... 10b     10c  
11 Investments—publicly traded securities .......... 55,971,893 11 62,489,676
12 Investments—other securities. See Part IV, line 11 ...... 7,696,674 12  
13 Investments—program-related. See Part IV, line 11 ..   13  
14 Intangible assets .........   14  
15 Other assets. See Part IV, line 11 ........... 0 15 150,360
16 Total assets. Add lines 1 through 15 (must equal line 34)... 63,992,772 16 63,057,577
Liabilities 17 Accounts payable and accrued expenses . 119,009 17 137,239
18 Grants payable ..........   18 89,773
19 Deferred revenue ..........   19  
20 Tax-exempt bond liabilities ..........   20  
21 Escrow or custodial account liability. Complete Part IV of Schedule D..   21  
22 Payables to current and former officers, directors, trustees, key
employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L..........   22  
23 Secured mortgages and notes payable to unrelated third parties ..   23  
24 Unsecured notes and loans payable to unrelated third parties ....   24  
25 Other liabilities. Complete Part X of Schedule D..... 32,016 25 0
26 Total liabilities. Add lines 17 through 25..... 151,025 26 227,012
Net Assets or Fund Balance Organizations that follow SFAS 117, check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets ..... 63,782,648 27 62,547,780
28 Temporarily restricted net assets .....   28 223,686
29 Permanently restricted net assets ..... 59,099 29 59,099
Organizations that do not follow SFAS 117, check here MediumBullet and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds .....   30  
31 Paid-in or capital surplus, or land, building or equipment fund .....   31  
32 Retained earnings, endowment, accumulated income, or other funds   32  
33 Total net assets or fund balances ..... 63,841,747 33 62,830,565
34 Total liabilities and net assets/fund balances ..... 63,992,772 34 63,057,577
Form 990 (2010)
Form 990 (2010)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response to any question in this Part XI . . . . . . . . . .
1
Total revenue (must equal Part VIII, column (A), line 12) . . .
1
2,637,926
2
Total expenses (must equal Part IX, column (A), line 25) . . . . .
2
2,276,795
3
Revenue less expenses. Subtract line 2 from line 1 . . . .
3
361,131
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) . .
4
63,841,747
5
Other changes in net assets or fund balances (explain in Schedule O) . . . .
5
-1,372,313
6
Net assets or fund balances at end of year. Combine lines 3, 4, and 5 (must equal Part X, line 33, column (B)) . . . . . .
6
62,830,565
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response to any question in this Part XII . . . . . . . . . .
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?..
2a
 
No
b
Were the organization’s financial statements audited by an independent accountant?........
2b
Yes
 
c
If “Yes,” to 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
...........................
2c
Yes
 
d
If “Yes” to line 2a or 2b, check a box below to indicate whether the financial statements for the year were issued on a separate basis, consolidated basis, or both:
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133? ................
3a
 
No
b
If “Yes,” did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits. ..
3b
 
 
Form 990 (2010)
Additional Data


Software ID:  
Software Version:  
Form 990, Special Condition Description:
Special Condition Description
SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ. right arrow See separate instructions.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
DAKOTA MEDICAL CHARITIES
 
Employer identification number

45-0368679
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
f
g
(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the the supported organization? ................
11g(i)
 
No
(ii) a family member of a person described in (i) above? ......................
11g(ii)
 
No
(iii) a 35% controlled entity of a person described in (i) or (ii) above? ................
11g(iii)
 
No
h
(i)
Name of supported organization
(ii)
EIN
(iii)
Type of organization (described on lines 1- 9 above or IRC section (see instructions))
(iv)
Is the organization in col. (i) listed in your governing document?
(v)
Did you notify the organization in col. (i) of your support?
(vi)
Is the organization in col. (i) organized in the U.S.?
(vii)
Amount of support?
Yes No Yes No Yes No
(1) DAKOTA MEDICAL FOUNDATION
 
456012318 7 Yes           1,062,628
Total                 1,062,628

For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 2
Part II
Support Schedule for Organizations Described in IRC 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year(or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....            
2 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......            
3 The value of services or facilities furnished by a governmental unit to the organization without charge..            
4 Total. Add lines 1 through 3..            
5 The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..            
6 Public Support. Subtract line 5 from line 4.            
Section B. Total Support
Calendar year(or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
7 Amounts from line 4..            
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
9 Net income from unrelated business activities, whether or not the business is regularly carried on..            
10 Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..            
11 Total support (Add lines 7 through 10).            
12
12
 
13
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 3
Part III
Support Schedule for Organizations Described in IRC 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year(or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .            
2 Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......            
3 Gross receipts from activities that are not an unrelated trade or business under section 513..            
4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...            
5 The value of services or facilities furnished by a governmental unit to the organization without charge..            
6 Total. Add lines 1 through 5.            
7a Amounts included on lines 1, 2, and 3 received from disqualified persons...            
b Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.            
c Add lines 7a and 7b..            
8 Public Support (Subtract line 7c from line 6.)            
Section B. Total Support
Calendar year (or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
9 Amounts from line 6...            
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.            
c Add lines 10a and 10b.            
11 Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.            
12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)            
13 Total support (Add lines 9, 10c, 11 and 12.).            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 4
Part IV
Supplemental Information. Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Explanation
 
 
 
 
Schedule A (Form 990 or 990-EZ) 2010

Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors
Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
OMB No. 1545-0047
2010
Name of organization
DAKOTA MEDICAL CHARITIES
 
Employer identification number

45-0368679
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ





Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule—
Special Rules
......................... Arrow Bullet   $    
Caution. An Organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2 of its Form 990, or check the box in the heading of its
Form 990-EZ, or on line 2 of its Form 990-PF, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).
For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.
Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
Page 1 of 1 of Part I
Name of organization
DAKOTA MEDICAL CHARITIES
 
Employer identification number

45-0368679
Part I
Contributors (see Instructions)
     
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Aggregate contributions
(d)
Type of contribution
RESTRICTED
RESTRICTED
 

     
RESTRICTED
RESTRICTED  
RESTRICTED, RESTRICTED   RESTRICTED

$RESTRICTED




(Complete Part II if there is
a noncash contribution.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Aggregate contributions
(d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Aggregate contributions
(d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Aggregate contributions
(d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Aggregate contributions
(d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Aggregate contributions
(d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
Page 1 of 1 of Part II
Name of organization
DAKOTA MEDICAL CHARITIES
 
Employer identification number

45-0368679
Part II
Noncash Property (see Instructions)
     
(a) No.
from
Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions)
(d)
Date received
 
$    
(a) No.
from
Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions)
(d)
Date received
 
$    
(a) No.
from
Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions)
(d)
Date received
 
$    
(a) No.
from
Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions)
(d)
Date received
 
$    
(a) No.
from
Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions)
(d)
Date received
 
$    
(a) No.
from
Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions)
(d)
Date received
 
$    
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
Page 1 of 1 of Part III
Name of organization
DAKOTA MEDICAL CHARITIES
 
Employer identification number

45-0368679
Part III
Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
aggregating more than $1,000 for the year. (Complete columns (a) through (e) and the following line entry.)
For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet $  
(a) No.
from
Part I
(b)
Purpose of gift
(c)
Use of gift
(d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I
(b)
Purpose of gift
(c)
Use of gift
(d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I
(b)
Purpose of gift
(c)
Use of gift
(d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I
(b)
Purpose of gift
(c)
Use of gift
(d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Additional Data


Software ID:  
Software Version:  
SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11, or 12.
SchDMd Bullet Attach to Form 990. SchDMd Bullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
DAKOTA MEDICAL CHARITIES
 
Employer identification number

45-0368679
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .......    
2 Aggregate contributions to (during year) ...    
3 Aggregate grants from (during year) ...    
4 Aggregate value at end of year .......    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds may be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit. ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a–2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ....................... 2a  
b Total acreage restricted by conservation easements .................. 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 8/17/06 ........ 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the taxable year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting and enforcing conservation easements during the year SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section
170(h)(4)(B)(i) and 170(h)(4)(B)(ii)? ....................................
9
In Part XIV, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under SFAS 116, not to report in its revenue statement and balance sheet works of
art, historical treasures, or other similar assets held for public exhibition, education or research in furtherance of public service,
provide, in Part XIV, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116, to report in its revenue statement and balance sheet works of art,
historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service,
provide the following amounts relating to these items:
(i)
Revenues included in Form 990, Part VIII, line 1 ........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ..............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 relating to these items:
a
Revenues included in Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 52283D
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s accession and other records, check any of the following that are a significant use of its collection
items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIV.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b
If "Yes," explain the arrangement in Part XIV and complete the following table:
Amount
c Beginning balance ................................. 1c  
d Additions during the year .............................. 1d  
e Distributions during the year ............................. 1e  
f Ending balance ................................... 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21? .....................
b
If “Yes,” explain the arrangement in Part XIV.
Part V
Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.
(a)Current Year (b)Prior Year (c)Two Years Back (d)Three Years Back (e)Four Years Back
1a Beginning of year balance .... 59,099 59,099  
b Contributions ........      
c Investment earnings or losses ...      
d Grants or scholarships .....      
e Other expenditures for facilities
and programs ........
     
f Administrative expenses ....      
g End of year balance ...... 59,099 59,099  
2
Provide the estimated percentage of the year end balance held as:
a
Board designated or quasi-endowment: SchDMd Bullet  
b
Permanent endowment: SchDMd Bullet100.000 %
c
Term endowment: SchDMd Bullet  
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
 
No
(ii) related organizations ........................
3a(ii)
 
No
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIV the intended uses of the organization's endowment funds.
Part VI
Investments—Land, Buildings, and Equipment. See Form 990, Part X, line 10.
Description of investment (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .................      
b Buildings ................        
c Leasehold improvements ............        
d Equipment ................        
e Other .................        
Total. Add lines 1a-1e. (Column (d) should equal Form 990, Part X, column (B), line 10(c).)........SchDMdBullet 0
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 3
Part VII
Investments—Other Securities. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)
(b)Book value (c) Method of valuation:
Cost or end-of-year market value
(1)Financial derivatives    
(2)Closely-held equity interests    
Other








Total. (Column (b) should equal Form 990, Part X, col.(B) line 12.)Small Bullet  
Part VIII
Investments—Program Related. See Form 990, Part X, line 13.
(a) Description of investment type (b) Book value (c) Method of valuation:
Cost or end-of-year market value








Total. (Column (b) should equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets. See Form 990, Part X, line 15.
(a) Description (b) Book value








Total. (Column (b) should equal Form 990, Part X, col.(B) line 15.)...........Small Bullet  
Part X
Other Liabilities. See Form 990, Part X, line 25.
1.(a) Description of Liability (b) Amount
Federal Income Taxes  








Total. (Column (b) should equal Form 990, Part X, col.(B) line 25.)Small Bullet  
2. Fin 48 (ASC 740) Footnote. In Part XIV, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC740).
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 4
Part XI Reconciliation of Change in Net Assets from Form 990 to Financial Statements
1 Total revenue (Form 990, Part VIII, column (A), line 12) .................... 1  
2 Total expenses (Form 990, Part IX, column (A), line 25) ..................... 2  
3 Excess or (deficit) for the year. Subtract line 2 from line 1 ............. 3  
4 Net unrealized gains (losses) on investments .......................... 4  
5 Donated services and use of facilities ............................. 5  
6 Investment expenses ................................... 6  
7 Prior period adjustments .................................. 7  
8 Other (Describe in Part XIV) ................................. 8  
9 Total adjustments (net). Add lines 4 - 8 ............................. 9  
10 Excess or (deficit) for the year per financial statements. Combine lines 3 and 9 ......... 10  
Part XII Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
1 Total revenue, gains, and other support per audited financial statements ....... 1  
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains on investments .......... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIV): ............ 2d  
e Add lines 2a through 2d ..................... 2e  
3 Subtract line 2e from line 1..................... 3  
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIV): ........... 4b  
c Add lines 4a and 4b....................... 4c  
5 Total Revenue. Add lines 3 and 4c. (This should equal Form 990, Part I, line 12.) ...... 5  
Part XIII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1 Total expenses and losses per audited financial statements ............. 1  
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities .......... 2a  
b Prior year adjustments .............. 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIV): ............ 2d  
e Add lines 2a through 2d...................... 2e  
3 Subtract line 2e from line 1..................... 3  
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIV): ............ 4b  
c Add lines 4a and 4b....................... 4c  
5 Total expenses. Add lines 3 and 4c. (This should equal Form 990, Part I, line 18.) ...... 5  
Part XIV
Supplemental Information
Complete this part to provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X; Part XI, line 8; Part XII, lines 2d and 4b; and Part XIII, lines 2d and 4b. Also complete this part to provide any additional information.
Identifier Return Reference Explanation
DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: INCOME IS USED TO SUPPORT THE ORGANIZATION'S MISSION.
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: DAKOTA MEDICAL CHARITIES BELIEVES IT HAS APPROPRIATE SUPPORT FOR ANY TAX POSITIONS TAKEN AFFECTING THE ANNUAL 990 FILING REQUIREMENTS, AND AS SUCH, DO NOT HAVE ANY UNCERTAIN TAX POSITIONS THAT ARE MATERIAL TO THE CONSOLIDATED FINANCIAL STATEMENTS. DAKOTA MEDICAL CHARITIES WOULD RECOGNIZE FUTURE ACCRUED INTEREST AND PENALTIES RELATED TO UNRECOGNIZED TAX LIABILITIES IN INCOME TAX EXPENSE IF SUCH INTEREST AND PENALTIES ARE INCURRED.
Schedule D (Form 990) 2010

Additional Data


Software ID:  
Software Version:  




Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
DAKOTA MEDICAL CHARITIES
 
Employer identification number
45-0368679
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ....................................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Governments and Organizations in the United States. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21 for any recipient that received more than $5,000. Check this box if no one recipient received more than $5,000. Use
Part IV and Schedule I-1 (Form 990) if additional space is needed
......................... lBullet
(a) Name and address of organization
or government
(b) EIN (c) IRC Code section
if applicable
(d) Amount of cash grant (e) Amount of non-cash
assistance
(f) Method of valuation
(book, FMV, appraisal,
other)
(g) Description of
non-cash assistance
(h) Purpose of grant
or assistance
(1) AMERICAN HEART ASSOCIATION1005 12 AVENUE SE
JAMESTOWN,ND58401
13-5613797 501(C)(3) 120,000       EKG EQUIPMENT AND OPERATIONS SUPPORT
(2) CCRI INC725 CENTER AVENUE
MOORHEAD,MN56560
41-1294489 501(C)(3) 5,000       SUPPORT PROGRAMS AND OPERATIONS
(3) CHARISM622 23 STREET S
FARGO,ND58103
45-0435273 501(C)(3) 5,000       SUPPORT PROGRAMS AND OPERATIONS
(4) CHILD CARE RESOURCE AND REFERRAL715 11 STREET N
MOORHEAD,MN56560
41-0905871 501(C)(3) 10,000       SUPPORT GO-FAR CHILDCARE PROGRAM
(5) CHILDRENS DENTAL SERVICES636 BROADWAY STREET N
MINNEAPOLIS,MN55413
41-0857929 501(C)(3) 5,000       SUPPORT FM SCHOOL DENTIST PROGRAM
(6) CHURCHES UNITED FOR HOMELESS1901 1 AVENUE N
MOORHEAD,MN56560
41-1594892 501(C)(3) 5,000       SUPPORT PROGRAMS AND OPERATIONS
(7) COMMUNITY OF CARE335 1 STREET
ARTHUR,ND58006
26-1488596 501(C)(3) 5,000       SUPPORT PROGRAMS AND OPERATIONS
(8) COMMUNITY VIOLENCE INTERVENTION211 S 4 STREET
GRAND FORKS,ND58201
45-0359167 501(C)(3) 5,000       SUPPORT PROGRAMS AND OPERATIONS
(9) FARGO CASS PUBLIC HEALTH401 3 AVENUE N
FARGO,ND58102
45-6002069 CITY OF FARGO ND 47,392       AED EQUIPMENT AND TRAINING AND SUPPORT SCHOOL WELLNESS PROGRAMS
(10) FARGO PUBLIC SCHOOLS415 N 4 STREET
FARGO,ND58102
45-6000294 CITY OF FARGO ND 8,769       SUPPORT HEALTHY PEOPLE WELLNESS PROGRAM
(11) FARGO UNION MISSION1902 3 AVENUE N
FARGO,ND58102
45-0228056 501(C)(3) 5,500       SUPPORT PROGRAMS AND OPERATIONS
(12) FUTURE BUILDERS TROLLWOOD1420 N 8 STREET
FARGO,ND58102
45-0448759 501(C)(3) 10,000       SUPPORT FOR STUDENTS AT RISK PROGRAM
(13) GRAND FORKS PARK DISTRICT1210 7 AVENUE S
GRAND FORKS,ND58201
26-0625504 CITY GRAND FORKS ND 25,000       SUPPORT HEALTHY KIDS PROGRAMS
(14) HANDI-WHEELS TRANSPORTATION2525 BROADWAY
FARGO,ND58102
45-0343910 501(C)(3) 5,000       SUPPORT PROGRAMS AND OPERATIONS
(15) HEART303 RAILWAY
ENDERLIN,ND58027
83-0345836 501(C)(3) 5,000       SUPPORT PROGRAMS AND OPERATIONS
(16) HERO2204 5 AVENUE N
MOORHEAD,MN56560
45-0457109 501(C)(3) 12,000       SUPPORT PROGRAMS AND OPERATIONS
(17) HOPE INC803 22 AVENUE S
MOORHEAD,MN56560
45-0425106 501(C)(3) 7,500       SUPPORT FOR OPERATIONS AND PROGRAMS
(18) IMPACT FOUNDATION4152 30 AVE S
FARGO,ND58104
20-0520386 501(C)(3) 153,000       SUPPORT IMPACT INSTITUTE AND HIGH IMPACT PHILANTHROPY
(19) LAKE REGION STATE COLLEGE1801 COLLEGE DRIVE N
DEVILS LAKE,ND58301
45-0281889 STATE OF MN 26,500       NURSING FACULTY IN GRADUATE SCHOOL PROGRAM
(20) LAKES & PRAIRIES COMMUNITY ACTION715 11 STREET N
MOORHEAD,MN56560
41-0905871 501(C)(3) 5,000       SUPPORT PROGRAMS AND OPERATIONS
(21) MAGIC WAND FOUNDATION60 KING STREET
ROSWELL,GA30075
65-1047135 501(C)(3) 9,039       SUPPORT ULTIMATE LIFE AND LIVE TO GIVE PROGRAMS
(22) MOORHEAD PUBLIC SCHOOLS2410 14 STREET S
MOORHEAD,MN56560
41-6008721 STATE OF MN 5,000       SUPPORT STUDENT HEALTH AND WELLNESS PROGRAMS
(23) MN STATE COMMUNITY & TECH COLLEGE1900 28 AVE S
MOORHEAD,MN56560
36-3366589 STATE OF MN 6,000       STUDENT SCHOLARSHIPS FOR MEDICAL RELATED PROGRAMS
(24) ND CARING FOUNDATION4510 13 AVENUE S
FARGO,ND58121
36-3606394 501(C)(3) 230,024       SUPPORT FOR ND WORKSITE WELLNESS INTITIATIVE
(25) ND ELKS ASSOCIATIONPO BOX F
DAWSON,ND58428
45-6012705 501(C)(3) 10,075       SUPPORT FOR CAMP GRASSICK PROGRAMS FOR CHILDREN
(26) ND SCOTTISH RITE LANGUAGE CENTER1405 N 3 STREET
FARGO,ND58102
45-0413594 501(C)(3) 5,000       SUPPORT PROGRAMS AND OPERATIONS
(27) NORTHLAND CHRISTIAN COUNSELING CENTER2315 LIBRARY CIRCLE
GRAND FORKS,ND58201
45-0430824 501(C)(3) 5,000       SUPPORT PROGRAMS AND OPERATIONS
(28) NORTHLANDS RESCUE MISSION420 DIVISION AVENUE
GRAND FORKS,ND58201
45-0251562 501(C)(3) 5,000       SUPPORT PROGRAMS AND OPERATIONS
(29) RAPE AND ABUSE CRISIS CENTERPO BOX 2984
FARGO,ND58108
41-1310289 501(C)(3) 10,000       SUPPORT PROGRAMS AND OPERATIONS
(30) RED RIVER CHILDRENS ADVOCACY100 S 4 STREET
FARGO,ND58103
45-6014870 501(C)(3) 16,500       SUPPORT SERVICES FOR CHILD VICTIMS OF ABUSE
(31) RED RIVER DENTAL ACCESS PROGRAMPO BOX 1748
FARGO,ND58107
91-2094334 501(C)(3) 15,000       SUPPORT URGENT CARE-WALKIN CLINIC PROGRAM
(32) RIVER VIEW HEALTH SYSTEM323 S MINNESOTA ST
CROOKSTON,MN56716
41-1699589 501(C)(3) 20,000       SUPPORT PROGRAMS AND OPERATIONS
(33) RONALD MCDONALD HOUSE1330 18 AVENUE S
FARGO,ND58103
45-0365598 501(C)(3) 10,175       SUPPORT PROGRAMS AND OPERATIONS
(34) ST GERARDS COMMUNITY NURSING HOME613 1 AVENUE SW
HANKINSON,ND58041
45-0234473 501(C)(3) 5,000       SUPPORT PROGRAMS AND OPERATIONS
(35) SALVATION ARMY304 ROBERTS
FARGO,ND58102
41-0698597 501(C)(3) 6,198       SUPPORT PROGRAMS AND OPERATIONS
(36) SOUTH CENTRAL ADULT SERVICESPO BOX 298
VALLEY CITY,ND58072
45-0373281 501(C)(3) 95,000       PRESCRIPTION ASSISTANCE PROGRAM
(37) SOUTHEAST ND COMMUNITY ACTION3233 S UNIVERSITY
FARGO,ND58104
45-6014870 501(C)(3) 87,592       SUPPORT FOR CHILDRENS MENTAL HEALTH INITITIATIVE
(38) THIRD STREET CLINIC311 S 4 STREET
GRAND FORKS,ND58201
45-0433253 501(C)(3) 5,000       SUPPORT PROGRAMS AND OPERATIONS
(39) UND RESEARCH DEVELOPMENT264 CENTENNIAL DRIVE
GRAND FORKS,ND58202
45-6002491 STATE OF ND 10,000       NURSING SCHOLARSHIPS AND NURSE EDUCATORS ACADEMY
(40) UNITED WAY CASS CLAY219 7 STREET S
FARGO,ND58103
41-0810008 501(C)(3) 5,000       WELL ANNUAL FUNDRAISING SUCCESS BY 6 PROGRAM
(41) YMCA CASS CLAY400 1 AVENUE S
FARGO,ND58103
45-0232096 501(C)(3) 15,000       SUPPORT PROGRAMS AND OPERATIONS
(42) YWCA CASS CLAY3100 12 AVENUE N
FARGO,ND58103
45-0226435 501(C)(3) 11,000       EMERGENCY SHELTER FOR WOMEN AND CHILDREN
2
Enter total number of section 501(c)(3) and government organizations ......................... Bullet Image
42
3
Enter total number of other organizations ................................ . Bullet Image
 
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2010

Schedule I (Form 990) 2010
Page 2
Part III
Grants and Other Assistance to Individuals in the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Use Schedule I-1 (Form 990) if additional space is needed.
(a)Type of grant or assistance (b)Number of
recipients
(c)Amount of
cash grant
(d)Amount of
non-cash assistance
(e)Method of valuation (book,
FMV, appraisal, other)
(f)Description of non-cash assistance













Part IV
Supplemental Information. Complete this part to provide the information required in Part I, line 2, and any other additional information.
Identifier Return Reference Explanation
PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: DAKOTA MEDICAL CHARITIES MONITORS THE GRANTEE'S USE OF GRANT FUNDS THROUGH A FORMAL APPLICATION AND WRITTEN AGREEMENT PROCESS. THE APPLICATION PROCESS INCLUDES DISCLOSING THE TYPE OF LEGAL ENTITY AND TAX EXEMPT STATUS OF ORGANIZATIONS, DESCRIBING THEIR MISSION AND PURPOSE, GOVERNANCE STRUCTURE, IDENTIFYING ANY CONFLICTS OF INTERESTS, PURPOSE AND OUTCOMES EXPECTED FOR THE PROJECT, AND A PROJECT BUDGET. THE GRANT AGREEMENT DETAILS THE CONDITIONS OF THE GRANT INCLUDING A CERTIFICATION OF TAX EXEMPT STATUS, START AND END DATES, INTERIM AND FINAL REPORTING REQUIREMENTS AND DATES, USE OF GRANT PROCEEDS AND RETURN OF UNUSED GRANT FUNDS.
Schedule I (Form 990) 2010


Additional Data


Software ID:  
Software Version:  


Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" to Form 990,
Part IV, question 23.
SchJMediumBullet Attach to Form 990. SchJMediumBullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
DAKOTA MEDICAL CHARITIES
 
Employer identification number

45-0368679
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement orprovision of all the expenses described above? If "No," complete Part III to explain....
1b
 
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
officers, directors, trustees, and the CEO/Executive Director, regarding the items checked in line 1a? ....
2
 
 
3
Indicate which, if any, of the following the organization uses to establish the compensation of the
organization's CEO/Executive Director. Check all that apply.
4
During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? ...............
4a
 
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? ........
4b
 
No
c
Participate in, or receive payment from, an equity-based compensation arrangement? ........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3) and 501(c)(4) organizations only must complete lines 5-9.
5
For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ...........................
5a
 
No
b
Any related organization? .........................
5b
 
No
If "Yes," to line 5a or 5b, describe in Part III.
6
For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ...........................
6a
 
No
b
Any related organization? .........................
6b
 
No
If "Yes," to line 6a or 6b, describe in Part III.
7
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
 
No
8
Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regs. section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................
8
 
No
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 50053T
Schedule J (Form 990) 2010

Schedule J (Form 990) 2010
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use Schedule J-1 if additional space needed.
For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.

Note. The sum of columns (B)(i)-(iii) must equal the applicable column (D) or column (E) amounts on Form 990, Part VII, line 1a.
(A) Name (B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and other deferred compensation (D) Nontaxable
benefits
(E) Total of columns
(B)(i)-(D)
(F) Compensation
reported in prior
Form 990 or
Form 990-EZ
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
(1) J PATRICK TRAYNOR (i)
(ii)
0
198,649
0
13,356
0
270
0
41,106
0
21,751
0
275,132
0
0















Schedule J (Form 990) 2010

Schedule J (Form 990) 2010
Page 3
Part III
Supplemental Information
Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 4c, 5a, 5b, 6a, 6b, 7, and 8. Also complete this part for any additional information.
Identifier Return Reference Explanation
SUPPLEMENTAL INFORMATION PART III THE ORGANZATION RELIED ON A RELATED ORGANIZATION, DAKOTA MEDICAL FOUNDATION, TO ESTABLISH THE COMPENSATION FOR J. PATRICK TRAYNOR. THE FOLLOWING METHODS WERE USED BY THE RELATED ORGANIZATION: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, FORM 990 OF OTHER ORGANIZATIONS, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OF DIRECTORS. THE COMPENSATION REPORTED FOR J. PATRICK TRAYNOR REPRESENTS TWENTY HOURS FOR HIS SERVICES FOR DAKOTA MEDICAL FOUNDATION AND TWENTY HOURS FOR DAKOTA MEDICAL CHARITIES.
Schedule J (Form 990) 2010

Additional Data


Software ID:  
Software Version:  
SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
DAKOTA MEDICAL CHARITIES
 
Employer identification number

45-0368679
Identifier Return Reference Explanation
FORM 990, PART VI, SECTION A, LINE 1   THE EXECUTIVE COMMITTEE WILL BE COMPRISED OF THE CHAIR, VICE CHAIR, SECRETARY, TREASURER, AND THE CHAIRS OF: THE GOVERNANCE COMMITTEE, FINANCIAL INVESTMENT COMMITTEE, GRANTS COMMITTEE, AND ONE BOARD MEMBER AT-LARGE. THE IMMEDIATE PAST CHAIRMAN SHALL ALSO SERVE ON THE EXECUTIVE COMMITTEE FOR A ONE-YEAR, NONVOTING TERM. THE BOARD MEMBER AT-LARGE SHALL BE ELECTED BY THE BOARD AT ITS ORGANIZATIONAL MEETING. FOUR (4) MEMBERS OF THE TOTAL COMMITTEE MEMBERSHIP SHALL BE MEMBERS OF THE MEDICAL STAFF OF HOSPITALS OR CLINICS. THE EXECUTIVE COMMITTEE: A. SHALL BE RESPONSIBLE FOR THE DAY-TO-DAY ACTIVITIES OF THE FOUNDATION. B. SHALL REVIEW STRATEGIC AND OPERATIONAL PLANS FOR RECOMMENDATION TO THE BOARD. C. MAY REVIEW ACTIONS OF THE THREE (3) OTHER STANDING COMMITTEES: GOVERNANCE, FINANCIAL INVESTMENT, AND GRANTS COMMITTEES, AND GIVE RECOMMENDATIONS TO THE BOARD. D. SHALL ANNUALLY EVALUATE THE PERFORMANCE OF THE PRESIDENT. E. SHALL UPON APPROVAL BY THE BOARD, SET THE PRESIDENT'S COMPENSATION AND TERMS OF EMPLOYMENT. F. SHALL REVIEW AND RECOMMEND TO THE BOARD THE NUMBER AND SALARY RANGES OF ALL STAFF OF DAKOTA MEDICAL FOUNDATION. G. SHALL REVIEW AND MAY MAKE EXPENDITURES UP TO AND INCLUDING FIFTY THOUSAND DOLLARS ($50,000) WITHOUT BOARD APPROVAL UNLESS OTHERWISE SPECIFICALLY PROHIBITED. H. SHALL EVALUATE THE PROPOSALS CONCERNING UNMET HEALTH NEEDS IN THE COMMUNITIES DAKOTA MEDICAL FOUNDATION SERVES, PRIORITIZE SUCH NEEDS, RECOMMEND APPROPRIATE GRANT BUDGET, TIME FRAME, AND DESIRED KEY PERFORMANCE CATEGORIES FOR EACH SUCH NEED, AND SEEK BOARD APPROVAL FOR INITIATIVES DESIGNED TO MEET SUCH NEEDS.
FORM 990, PART VI, SECTION A, LINE 2   J. PATRICK TRAYNOR, DAVID GIBB, JOEL HAUGEN, M.D., RICHARD VETTER, M.D., JON WANZEK, CURT NOYES, DAVID CLUTTER, M.D., JAY EISENBEIS, CHRIS KENNELLY, LARRY LEITNER, DEB MAGNUSON, RN, FADEL NAMMOUR, M.D., JANE SKALSKY, RN, MIKE WARNER, SUSAN MATHISON, M.D., AND SINDY KELLER HAVE BUSINESS RELATIONSHIPS AS COMMON OFFICERS AND BOARD MEMBERS FOR DAKOTA MEDICAL FOUNDATION AND DAKOTA MEDICAL CHARITIES.
FORM 990, PART VI, SECTION A, LINE 6   THE SOLE MEMBER OF THE ORGANIZATION IS DAKOTA MEDICAL FOUNDATION.
FORM 990, PART VI, SECTION A, LINE 7A   DAKOTA MEDICAL FOUNDATION ELECTS THE DAKOTA MEDICAL CHARITIES' BOARD OF DIRECTORS ANNUALLY.
FORM 990, PART VI, SECTION A, LINE 7B   THE SOLE MEMBER, DAKOTA MEDICAL FOUNDATION, HAS THE POWER AND RIGHT, PRIOR TO THE BOARD OF DIRECTORS TAKING FINAL ACTION, TO APPROVE OR REJECT OR CONSENT WITH ON THE FOLLOWING MATTERS: -THE ADOPTION AND IMPLEMENTATION OF ANNUAL OPERATING AND CAPITAL BUDGETS -CAPITAL EXPENDITURES IN EXCESS OF ANY SPECIFIC LIMIT THAT MAY FROM TIME TO TIME BE ESTABLISHED -THE SALE OR TRANSFER OF ASSETS OTHER THAN IN THE ORDINARY COURSE OF BUSINESS -ANY AMENDMENT OF THE ARTICLES OF INCORPORATION OR THE BYLAWS -MERGER, REORGANIZATION, DISSOLUTION, OR TRANSFER OF ANY SUBSTANTIAL PORTION OF THE ASSETS -THE INCURRENCE OF DEBT -THE COMPENSATION OF OFFICERS -THE ADOPTION AND MODIFICATION OF EMPLOYEE BENEFIT PLANS
FORM 990, PART VI, SECTION B, LINE 11   THE FORM 990 IS PROVIDED TO ALL BOARD MEMBERS PRIOR TO FILING. THE FILED COPY IS REVIEWED BY THE EXECUTIVE COMMITTEE.
  FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS AND STAFF ARE ANNUALLY REQUIRED TO REVIEW AND DECLARE CONFLICTS. ANNUAL RESULTS ARE PROVIDED TO THE PRESIDENT FOR ACTION. BOARD MEMBERS ABSTAIN FROM VOTING ON ANY ISSUES THAT CREATE A CONFLICT OF INTEREST.
  FORM 990, PART VI, SECTION B, LINE 15B THE PRESIDENT'S PERFORMANCE AND COMPENSATION ARE REVIEWED ANNUALLY BY A COMPENSATION COMMITTEE OF THE EXECUTIVE COMMITTEE OF A RELATED ORGANIZATION, DAKOTA MEDICAL FOUNDATION (DMF). THE PRESIDENT'S COMPENSATION CHANGES ARE APPROVED BY THE BOARD OF DMF. THE PRESIDENT'S COMPENSATION WAS REVIEWED BY MERCER CONSULTING IN AUGUST OF 2007 TO ESTABLISH A BASE COMPENSATION RANGE. CHANGES TO COMPENSATION IN SUBSEQUENT YEARS ARE BASED ON THE ESTABLISHED RANGE, PERFORMANCE AND CPI CHANGES, AND COMPARED WITH THE COUNCIL ON FOUNDATIONS' ANNUAL SALARY SURVEYS. THE COMPENSATION FOR THE DIRECTOR OF FINANCE IS REVIEWED BY DAKOTA MEDICAL CHARITIES' EXECUTIVE COMMITTEE AND COMPARED PERIODICALLY WITH THE COUNCIL ON FOUNDATIONS' SALARY SURVEY. THE PROCESS AND DECISIONS ARE RECORDED IN THE MINUTES OF THE MEETING.
  FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST.
  FORM 990, PART VII: J. PATRICK TRAYNOR AND DAVID GIBB EACH DEDICATE AN AVERAGE OF 20 HOURS PER WEEK TO DAKOTA MEDICAL CHARITIES AND AN AVERAGE OF 20 HOURS PER WEEK TO DAKOTA MEDICAL FOUNDATION, A RELATED ORGANIZATION. THE COMPENSATION REPORTED IN PART VII IS BASED ON THE COMBINED AVERAGE OF 40 HOURS PER WEEK THAT J. PATRICK TRAYNOR AND DAVID GIBB EACH DEDICATE TO BOTH DAKOTA MEDICAL FOUNDATION AND DAKOTA MEDICAL CHARITIES. IN ADDITION TO THE HOURS SERVED AT DAKOTA MEDICAL CHARITIES, THE FOLLOWING INDIVIDUALS SERVE THE NOTED TIME AT DAKOTA MEDICAL FOUNDATION: JOEL HAUGEN, M.D. 4 HOURS CURT NOYES 3 HOURS RICHARD VETTER, M.D. 2 HOURS JON WANZEK 2 HOURS DAVID CLUTTER, M.D. 2 HOURS LARRY LEITNER 2 HOURS JAY EISENBEIS 2 HOURS CHRIS KENNELLY 2 HOURS DEBRA MAGNUSON, R.N. 2 HOURS JANE SKALSKY, R.N. 2 HOURS SUSAN MATHISON, M.D. 2 HOURS MIKE WARNER 2 HOURS FADEL NAMMOUR, M.D. 2 HOURS SINDY KELLER 2 HOURS
CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -915,035. INTERCOMPANY TRANSFER -457,278. TOTAL TO FORM 990, PART XI, LINE 5: -1,372,313.
  FORM 990, PART III, PROGRAM A: ACCESS TO HEALTHCARE AUTOMATED EXTERNAL DEFIBRILLATOR INITIATIVE: THE FOUNDATIONS PARTNERED WITH FARGO CASS PUBLIC HEALTH, FARGO, ND IN 2001 TO STRATEGICALLY PLACE AUTOMATED EXTERNAL DEFIBRILLATOR (AED) EQUIPMENT THROUGHOUT THE COMMUNITIES SERVED TO PROVIDE IMMEDIATE ACCESS TO EMERGENCY MEDICAL TREATMENT FOR PERSONS IN CARDIAC ARREST. EDUCATION AND TRAINING ON THE PROPER CARE AND USE OF THE EQUIPMENT HAS BEEN PROVIDED WITH EQUIPMENT PLACEMENT. OVERALL STRATEGIES FOR THE INITIATIVE ARE AED PLACEMENT IN RURAL COMMUNITIES WHERE THE OVER-AGE-50 POPULATIONS ARE 250 OR GREATER AND TO PLACE THE EQUIPMENT WITH RURAL FIRST RESPONDERS IN SELECT COMMUNITY LOCATIONS TO PROVIDE LESS THAN 10 MINUTES ACCESS TO AED EQUIPMENT. SINCE INCEPTION, 548 AEDS HAVE BEEN PLACED WITH OVER 1,500 PERSONS TRAINED ON THE PROPER AED OPERATIONS. TWENTY-THREE (23) LIVES HAVE BEEN SAVED IN COMMUNITIES WHERE AEDS WERE PLACED. DMC HAS INVESTED OVER $1.3 MILLION TO SUPPORT THIS INITIATIVE SINCE PROGRAM INCEPTION. CHILDREN'S MENTAL HEALTH INITIATIVE: THE FOUNDATIONS PARTNERED WITH THE SOUTHEASTERN NORTH DAKOTA COMMUNITY ACTION AGENCY IN 2007 TO DEVELOP, IMPLEMENT AND MANAGE STRATEGIES TO PROVIDE ACCESS TO EARLY MENTAL HEALTH SCREENING, ASSESSMENT AND THERAPEUTIC CONSULTATION SERVICES FOR CHILDREN; IMPROVE EDUCATION AND AWARENESS OF EARLY CHILDHOOD MENTAL HEALTH; AND FACILITATE COLLABORATION AMONG PROVIDERS. IN 2009, THE INITIATIVE PARTNERED WITH THE ESSENTIA HEALTH PEDIATRICS DEPARTMENT TO PILOT A STATE-OF-THE-ART HAND HELD ELECTRONIC SCREENING TOOL THAT AIDS PHYSICIANS IN IDENTIFYING SOCIAL-EMOTIONAL AND MENTAL HEALTH ISSUES IN CHILDREN, AND PARTNERED WITH FIRSTLINK TO PROVIDE TELEPHONE AND EMAIL CONSULTATION SERVICE. WORKING WITH LOCAL HEALTHCARE PROVIDERS IN CASS COUNTY, ND AND CLAY COUNTY, MN, THE INITIATIVE HAS WORKED TO PROVIDE ACCESS TO SCREENING, ASSESSMENTS AND CONSULTATION SERVICES TO OVER 113 CHILDREN, INCLUDING FOLLOW-UP SURVEYS TO ALL PARTICIPANTS. COMMUNITY EDUCATION IS AN IMPORTANT COMPONENT OF THE INITIATIVE. DURING 2011 PROGRAM CONSULTANTS HAVE BECOME CERTIFIED NURTURED HEART APPROACH ADVANCED TRAINERS WHO ARM PARENTS, CAREGIVERS AND TEACHERS WITH THE TOOLS TO CREATE POSITIVE RELATIONSHIPS WITH CHILDREN. APPROXIMATELY 180 CHILDCARE PROVIDERS HAVE BEEN TRAINED. FUTURE SCREENINGS AND TRAINING SESSIONS ARE PLANNED FOR THE YWCA SHELTER PARENTS AND CONSULTATION SERVICES FOR CHURCHES UNITED HOMELESS SHELTER FAMILIES. TWO ONLINE TRAINING COURSES WERE CREATED WITH OVER 200 CHILDCARE PROVIDERS PARTICIPATING. THE INITIATIVE SUPPORTED THE DEVELOPMENT OF A RESOURCE GUIDE AT WWW.DAKMED.ORG/CHILDREN/ THAT IDENTIFIES INFORMATION ABOUT CHILDREN'S MENTAL HEALTH SERVICES AND PROVIDERS IN CASS AND CLAY COUNTIES. THE INITIATIVE HAS BEEN SUPPORTED THROUGH A FOUR-YEAR $395,000 ROBERT WOOD JOHNSON FOUNDATION GRANT MATCHED BY A $395,000 GRANT FROM THE FOUNDATIONS. HEALTHY STEPS OUTREACH INITIATIVE: THE FOUNDATIONS HAVE BEEN INSTRUMENTAL IN CONNECTING LOW-INCOME FAMILIES AND CHILDREN WITH HEALTH CARE COVERAGE. IN 2003 DMC PARTNERED WITH THE ROBERT WOOD JOHNSON FOUNDATION (RWJ) TO PARTICIPATE IN THE RWJ 4-YEAR COVERING KIDS AND FAMILIES PROGRAM DESIGNED TO REDUCE THE NUMBER OF UNINSURED CHILDREN IN NORTH DAKOTA BY FINDING AND CONNECTING LOW-INCOME FAMILIES IN THE REGION WITH HEALTH COVERAGE. WHILE THE FORMAL GRANT COMMITMENT ENDED IN 2007, THE STATE OF NORTH DAKOTA AND THE FOUNDATIONS CONTINUED OUTREACH TO MAXIMIZE THE USE OF EXISTING HEALTH COVERAGE PROGRAMS FOR LOW INCOME UNINSURED CHILDREN AND FAMILIES IN THE STATE. IN 2009, THE NORTH DAKOTA DEPARTMENT OF HUMAN SERVICES PROVIDED THE FOUNDATIONS WITH A 2-YEAR $650,000 GRANT (NDDHS GRANT) TO SUPPORT AND STAFF THE STATEWIDE HEALTHY STEPS PROGRAM OUTREACH ACTIVITIES. IN 2011, THE FOUNDATIONS RECEIVED ANOTHER 2-YEAR $650,000 CONTRACT FROM NDDHS TO CONDUCT STATEWIDE OUTREACH FOR HEALTHY STEPS. CURRENTLY, OVER 43,742 CHILDREN ARE ENROLLED IN MEDICAID, HEALTHY STEPS AND CARING FOR CHILDREN, AS COMPARED TO 36,576 IN 2009. SINCE THE FOUNDATIONS BEGAN SUPPORTING THE STATEWIDE HEALTHY STEPS OUTREACH, ENROLLMENT HAS INCREASED BY 19.5% FOR ALL THREE PROGRAMS. THE FOUNDATIONS' OUTREACH EFFORTS FOCUS ON SCHOOLS, HEAD START PROGRAMS, PUBLIC HEALTH UNITS, WIC PROGRAMS, COUNTY EXTENSION OFFICES, ND DEPT. OF HEALTH, ORAL HEALTH, WOMEN'S WAY PROGRAMS, HOSPITALS/CLINICS, AMERICAN INDIAN RESERVATIONS, AND FAITH COMMUNITIES. THE NDDHS GRANT PROVIDED OVER $412,600 IN 2011 TO COVER THE STAFF AND DIRECT COSTS IN SUPPORT OF THE NORTH DAKOTA HEALTHY STEPS OUTREACH PROGRAMS. DAKOTA MEDICAL CHARITIES PROVIDED AN ADDITIONAL $9,200 IN FINANCIAL SUPPORT FOR THE INITIATIVE IN 2011. HEALTHCARE WORKFORCE SHORTAGE INITIATIVE: IN 2001, THE FOUNDATIONS RECOGNIZED THE SIGNIFICANT PROBLEMS FACING NORTH DAKOTA WITH THE PROJECTED SHORTAGE OF FAMILY PRACTICE PHYSICIANS AND NURSES. THE INITIATIVE'S EFFORTS HAVE FOCUSED ON STRATEGIES TO MEASURABLY PRODUCE A SUFFICIENT NUMBER OF HIGHLY QUALIFIED HEALTH PROVIDERS BY EXPANDING AND SUPPORTING FAMILY PHYSICIAN RESIDENCY PROGRAMS; INCREASING NURSING EDUCATION SLOTS IN LOCAL COLLEGES; PROVIDING ACCESS TO DISTANCE EDUCATION AND SIMULATION EQUIPMENT; EXPANDING THE CERTIFIED NURSING ASSISTANT TRAINING PROGRAMS; AND SUPPORTING HEALTH CAREER SCHOLARSHIP PROGRAMS. THE FOUNDATIONS SUPPORTED A HEALTHCARE WORKFORCE SURVEY IN 2010 TO IDENTIFY THE HEALTHCARE WORKFORCE NEEDS, POTENTIAL SOLUTIONS, AND VACANCIES. THE SURVEY IDENTIFIED FOUNDATION SERVICE AREA VACANCIES FOR 131 RNS, 45 FAMILY MEDICINE PHYSICIANS, 38 CNAS AND 33 LPNS. (WWW.DAKMED.ORG/HEALTHCARE-WORKFORCE). NURSING SUPPORT: NURSE TRAINING EDUCATION: THE FOUNDATION PROVIDED FINANCIAL SUPPORT FOR STATEWIDE NURSING EDUCATION RESULTING IN 18 NURSE FACULTY COMPLETING THEIR MASTER'S DEGREE PROGRAM; PROVIDING 80 NEW NURSING EDUCATION SLOTS IN COLLEGE PROGRAMS; 50 CNAS TRAINED; AND 9 ADDITIONAL RURAL EMS PROVIDERS TRAINED. NURSING SCHOLARSHIP GRANTS: THE FOUNDATIONS HAVE SUPPORTED NURSING EDUCATION SINCE 2002 BY PROVIDING GRANT FUNDS TO THE AREA COLLEGES AND UNIVERSITIES WITH NURSING PROGRAMS TOTALING OVER $602,600. DURING 2011, THE FOUNDATIONS PROVIDED OVER $30,000 IN MATCHING FUNDS TO NURSING PROGRAMS FOR SCHOLARSHIPS BASED ON THE DOCUMENTED FUNDRAISING EFFORTS OF THE FOLLOWING SCHOOLS: UNIVERSITY OF NORTH DAKOTA, FARGO, ND; NORTH DAKOTA STATE UNIVERSITY, FARGO ND; MOORHEAD STATE UNIVERSITY, MOORHEAD, MN; AND CONCORDIA COLLEGE, MOORHEAD, MN. THE FOUNDATIONS RECEIVED A $250,000 GRANT IN 2007 FROM THE NORTHWEST HEALTH FOUNDATION AND THE ROBERT WOOD JOHNSON FOUNDATION TO ESTABLISH A NURSING CAREER LATTICE CONSORTIUM. THIS PROJECT EXPANDED THE PRODUCTION AND PLACEMENT OF HIGHLY QUALIFIED NURSES AND NURSING FACULTY IN RURAL REGIONS THROUGH AN INTEGRATED AND LONG-TERM CONSORTIUM AND ESTABLISHED STRATEGIC PARTNERSHIPS WITH EDUCATIONAL INSTITUTIONS, HEALTH CARE PROVIDERS, WORKFORCE AND OTHER GROUPS. THE FOUNDATIONS PARTNERED WITH THE UNIVERSITY OF NORTH DAKOTA'S SCHOOL OF NURSING TO DEVELOP AND ADMINISTER THIS MULTI-YEAR INITIATIVE. THE EFFORTS OF THE CONSORTIUM HAVE RESULTED IN THE DEVELOPMENT OF LONG-TERM PARTNERSHIPS WITH NORTH DAKOTA NURSING EDUCATION PROGRAMS IN AREA COLLEGES AND UNIVERSITIES; ACCESS TO THE ELSEVIER ELECTRONIC NURSING REFERENCE LIBRARY FOR 950 NURSING STUDENTS; STANDARDIZED NURSING EDUCATION PROGRAMS FOR NORTH DAKOTA EDUCATIONAL INSTITUTIONS; CLINICAL TRAINING RESOURCES FOR NURSING STUDENTS; AND THE FIRST ANNUAL MIDWEST NURSE EDUCATOR'S ACADEMY TO ENHANCE NURSING SKILL LEVELS WITH 240 NURSE EDUCATORS ATTENDING. THE FOUNDATIONS HAVE PROVIDED OVER $375,000 TO SUPPORT THE PARTNERS IN NURSING PROJECT. AREA HEALTH EDUCATION CENTER (AHEC): THE FOUNDATIONS HAVE PROVIDED GRANTS TOTALING $20,000 TO THE UNIVERSITY OF NORTH DAKOTA CENTER FOR RURAL HEALTH THAT HELPED LEVERAGE APPROXIMATELY $2,000,000 IN FEDERAL FUNDING TO ESTABLISH AHEC PILOT SITES IN THREE NORTH DAKOTA RURAL COMMUNITIES. THE PROGRAM WAS INITIALLY DESIGNED TO PROVIDE EDUCATIONAL AND CLINICAL OPPORTUNITIES FOR STUDENTS IN MEDICINE AND NURSING AT THE COLLEGE AND GRADUATE LEVEL TO ENSURE AN ADEQUATE HEALTHCARE WORKFORCE IN THE RURAL AREAS.
    DURING 2010, THE EASTERN AHEC LOCATION IN MAYVILLE, ND COORDINATED THE DEVELOPMENT OF A REPORT IDENTIFYING 30 HEALTHCARE OCCUPATIONS TO ASSIST IN WORKFORCE PLANNING. HIPAA TRAINING WAS PROVIDED TO 145 HIGH SCHOOL STUDENTS IN PREPARATION FOR A HEALTHCARE SHADOWING PROGRAM WITH PROFESSIONALS. INTER-PROFESSIONAL ROTATIONS IN HEALTH RELATED FIELDS WERE PROVIDED TO 25 STUDENTS IN MEDICAL FACILITIES. FAMILY MEDICINE PHYSICIAN INITIATIVE: THE FOUNDATIONS HAVE SUPPORTED THE REGION'S FAMILY MEDICINE PHYSICIAN RESIDENCY PROGRAMS SINCE 2002 IN ORDER TO AID IN THE PROGRAM EXPANSION AND PLACEMENT OF PHYSICIANS IN NORTH DAKOTA. THE PHYSICIANS AT THE ALTRU FAMILY MEDICINE RESIDENCY PROGRAM ESTABLISHED A MISSION PHYSICIAN PROGRAM IN 2007 WITH THE GOAL OF RECRUITING RURAL HIGH SCHOOL STUDENTS INTO CAREERS IN MEDICINE. A KEY STRATEGY OF THE PROGRAM INCLUDES PROVIDING STUDENTS WITH ONGOING CAREER PLANNING THROUGH COLLEGE AND MEDICAL SCHOOL. OVER 138 HIGH SCHOOL STUDENTS HAVE PARTICIPATED IN THE PROGRAM SINCE 2007. A MISSION PHYSICIAN FUND WAS ESTABLISHED BY THE FOUNDATION TO ASSIST IN FUNDRAISING EFFORTS TO SUPPORT THE PROGRAMS OF THE MISSION PHYSICIAN PROGRAM. SINCE INCEPTION, THE FUND HAS RECEIVED OVER $41,200 IN CONTRIBUTIONS AND DMF MATCHING FUNDS AND HAS PROVIDED GRANTS TO ALTRU'S MISSION PHYSICIAN PROGRAM TOTALING APPROXIMATELY $38,000. PRESCRIPTION ASSISTANCE INITIATIVE: SINCE 2000, DMC HAS SUPPORTED PROGRAMS IN ITS SERVICE AREA THAT PROVIDE APPLICATION ASSISTANCE FOR LOW-INCOME AND UNINSURED PERSONS ELIGIBLE FOR FREE OR REDUCED-COST PRESCRIPTION MEDICATIONS FROM MAJOR PHARMACEUTICAL COMPANY PROGRAMS. OVER 4,830 INDIVIDUALS HAVE COMPLETED APPROXIMATELY 24,600 APPLICATIONS FOR MEDICATION ASSISTANCE RESULTING IN OVER $14,300,000 IN PRESCRIPTIONS ACCESSED. DURING 2011, APPROXIMATELY $4,300,000 IN PRESCRIPTIONS WERE ACCESSED THROUGH THE PROGRAMS BY 616 CLIENTS, A GROWTH OF 35% OVER 2010. LEND A HAND INITIATIVE: IN 2007, THE FOUNDATIONS ESTABLISHED THE LEND A HAND INITIATIVE TO PROVIDE ASSISTANCE TO A DEFINED CHARITABLE CLASS OF FAMILIES AND INDIVIDUALS IN CASS COUNTY, ND AND CLAY COUNTY, MN THAT EXPERIENCE FINANCIAL HARDSHIPS DUE TO CATASTROPHIC MEDICAL ISSUES. A 29-MEMBER COMMUNITY ADVISORY COMMITTEE PROVIDES THE PROGRAM WITH GUIDANCE AND OVERSIGHT. A 13-MEMBER EXECUTIVE COMMITTEE PROVIDES MONTHLY REVIEWS AND ELIGIBILITY DETERMINATIONS REGARDING REQUESTS FOR UP TO $5,000 IN FOUNDATION MATCHING FUNDS AVAILABLE TO THE DEFINED CHARITABLE CLASS OF FAMILY BENEFIT FUNDS. DONORS MAY CONTRIBUTE TO: 1) THE DMF LEND A HAND GIVING FUND WHERE CONTRIBUTIONS OF $50 OR MORE ARE MATCHED; OR 2) DIRECTLY TO THE COMMUNITY ESTABLISHED FAMILY BENEFIT FUNDS THAT MEET THE PROGRAM'S ELIGIBILITY REQUIREMENTS. THE LEND A HAND PROGRAM PROVIDES A STEP-BY-STEP FUNDRAISING GUIDE AND TOOLKIT FOR VOLUNTEERS THAT INCLUDE PLANNING AND MARKETING TEMPLATES (WWW.DAKMED.ORG/LENDAHAND/). DONATIONS TO THE LEND A HAND PROGRAM MAY BE MADE ONLINE THROUGH THE IMPACT FOUNDATION WEBSITE LOCATED AT WWW.IMPACTGIVEBACK.ORG. SINCE INCEPTION, THE FOUNDATIONS' LEND A HAND PROGRAM HAS ASSISTED IN RAISING OVER $3.9 MILLION IN COMMUNITY FUNDS FOR 150 QUALIFIED FAMILY BENEFITS. DMF HAS PROVIDED MATCHING FUNDS TO THE FAMILY BENEFIT FUNDS TOTALING OVER $775,000.
  FORM 990, PART III, PROGRAM B: CHRONIC DISEASE PREVENTION CASS CLAY HEALTHY PEOPLE INITIATIVE: THE FOUNDATIONS JOINED WITH OTHER LIKE-MINDED ORGANIZATIONS IN 2009 TO PROMOTE AND FACILITATE A COMPREHENSIVE APPROACH FOR RESIDENTS LIVING IN CASS COUNTY, ND AND CLAY COUNTY, MN TO EAT HEALTHIER AND LEAD MORE ACTIVE LIFESTYLES, RESULTING IN DECREASED INCIDENCE OF OBESITY AND CHRONIC DISEASES. THE INITIATIVE'S OVERALL STRATEGY IS TO COORDINATE COMMUNITY COLLABORATION TO IMPROVE THE HEALTH OF CITIZENS AND TO INTEGRATE BEST PRACTICES THROUGH THE ENGAGEMENT OF GOVERNMENT, EDUCATION, FOOD INDUSTRY, WORKSITE WELLNESS, COMMUNITY-BASED ORGANIZATIONS, AND INSURERS TO MAKE CASS AND CLAY COUNTIES OF NORTH DAKOTA THE HEALTHIEST PLACE IN AMERICA TO LIVE, WORK, AND PLAY. THE GOAL IS TO REDUCE CHILDHOOD OBESITY RATES IN THOSE COUNTIES BY 20% BY 2020. THE INITIATIVE WORKS THROUGH AN ADVISORY COMMITTEE AND A STEERING COMMITTEE COMPRISED OF MEMBERS FROM THE VARIOUS SECTORS TO DEVELOP AND DIRECT THE INITIATIVE'S GOALS. DURING 2011 THE INITIATIVE FOCUSED ON HEALTHY CHILDCARE; HEALTHY SCHOOLS AND HEALTHY COMMUNITIES. THE FOUNDATIONS COLLABORATED WITH THE MOORHEAD, MN CHILD CARE RESOURCE AND REFERRAL TO INCREASE PHYSICAL ACTIVITY AND ENSURE HEALTHIER EATING IN CHILD CARE SETTINGS THROUGH THE GOFAR CHILDCARE PROGRAMS, NOW KNOW AS CHILDCAREALIVE. CHILDCAREALIVE IS A COLLABORATIVE OF CHILD CARE RESOURCE AND REFERRAL, FARGO CASS PUBLIC HEALTH AND THE FOUNDATIONS' HEALTHY PEOPLE INITIATIVE. EARLY CHILDHOOD PROFESSIONALS TAKE PART IN ONLINE AND FACE-TO-FACE TRAINING AROUND IMPROVING CHILDREN'S HEALTH. CHILDCAREALIVE HAS PROVIDED TRAINING TO OVER 866 CHILDCARE PROVIDERS AND PARENTS IN FUNCTIONS ADDRESSING CHILDHOOD OBESITY, INCREASED OUTDOOR ACTIVITY, AND NUTRITIONAL EDUCATION THROUGH 2011 AND PLANS ON OVER AN ADDITIONAL 50 IN 2012. THE INITIATIVE'S SCHOOLSALIVE PROGRAM WORKS WITH LOCAL SCHOOL SYSTEMS TO IMPLEMENT STRONGER WELLNESS POLICES THAT IMPACT OVER 27,000 K-12 STUDENTS. OVER 215 AREA HIGH SCHOOL STUDENTS ATTENDED A DAY-LONG YOUTH SUMMIT ON ACTIVE LIVING, HEALTHY EATING AND SCHOOL WELLNESS POLICIES DURING 2011. OVER 75 SCHOOL ADMINISTRATORS FROM ND AND MN ATTENDED A LOCAL CONFERENCE ON SCHOOL WELLNESS POLICY IMPLEMENTATION. A HEALTHY SNACK GUIDE WAS PREPARED BY STAFF OF THE INITIATIVE AND OVER 8,000 COPIES WERE DISTRIBUTED TO LOCAL SCHOOL FAMILIES. THE SCHOOLSALIVE PROGRAM PROVIDES A MEANS TO ASSESS THE STRENGTH OF THEIR POLICIES, PROVIDE MODEL POLICIES AND GUIDE THEM IN WAYS TO TURN POLICY INTO PRACTICE TOWARD IMPROVING FOOD AND FITNESS. SIX FARGO-MOORHEAD SCHOOL SYSTEMS HAVE REVISED AND ADOPTED STRONGER WELLNESS POLICIES THAT ADDRESS RECESS TIME, HEALTHY LUNCH OPTIONS AND THE TYPES OF FOODS STOCKED IN SCHOOL VENDING MACHINES. THE HEALTHY COMMUNITIES FOCUS IN 2011 INCLUDED A FARGO-MOORHEAD STREETS ALIVE! PROGRAM TO ENCOURAGE HEALTHIER LIFESTYLES IN THE COMMUNITY TO ENCOURAGE MOVEMENT THROUGH WALKING, RUNNING, BIKING, SKATING, DANCING AND ANY OTHER MEANS OF HUMAN MOVEMENT. PARTICIPANTS USED HUMAN-POWERED TRANSPORTATION TO NAVIGATE THE 5-MILE COURSE THROUGH FARGO/MOORHEAD AREA IN AUGUST AND SEPTEMBER 2011. OVER 30 COMMUNITY PARTNERS PARTICIPATED AND SUPPORTED THE STREETS ALIVE! EFFORTS BY ESTABLISHING HEALTHY FOOD BOOTHS, PROVIDING HEALTH EDUCATION AND MINI-ACTIVITY CLASSES THROUGHOUT THE DAYS. THE 2011 STREETSALIVE EVENT DREW OVER 5,500 PARTICIPANTS. STATEWIDE WORKSITE WELLNESS INITIATIVE: IN 2006, THE FOUNDATIONS PARTNERED WITH ND BLUE CROSS BLUE SHIELD, HEALTHY NORTH DAKOTA, AND THE ND DEPARTMENT OF HEALTH TO CREATE A MODEL THAT WOULD MEASURABLY IMPROVE THE HEALTH OF NORTH DAKOTA EMPLOYEES BY IMPLEMENTING EFFECTIVE, COST EFFICIENT WORKSITE WELLNESS PROGRAMS ACROSS THE STATE. THE NORTH DAKOTA CARING FOUNDATION HOUSES AND MANAGES THE INITIATIVE. IN 2010, A SURVEY GATHERED INFORMATION FROM THE ND PUBLIC EMPLOYEES RETIREMENT SYSTEM GROUPS, CHAMBERS OF COMMERCE BUSINESSES, AND WORKFORCE SAFETY INSURANCE BUSINESSES. THE SURVEY CONCLUDED THAT FEW BUSINESSES OFFERED A WORKSITE WELLNESS PROGRAM; EMPLOYEE HEALTH RISK ASSESSMENTS ARE NOT DONE; AND THAT THERE IS A NEED FOR MORE ACTIVE WORKSITE WELLNESS ENGAGEMENT ACROSS THE STATE. DURING 2010, TRAINING WAS HELD FOR 18 NORTH DAKOTA ORGANIZATIONS PLANNING TO OFFER COMPREHENSIVE, COST EFFECTIVE WORKSITE WELLNESS PROGRAM.
  FORM 990, PART III, PROGRAM C: ORGANIZATIONAL EFFECTIVENESS THE FOUNDATIONS BELIEVE IT IS IMPERATIVE FOR NONPROFIT ORGANIZATIONS TO BUILD THEIR CAPACITY TO BECOME EFFICIENT HIGH-IMPACT, SUSTAINABLE NONPROFITS TO PROVIDE MORE EFFECTIVE HEALTH OUTCOMES FOR THE CLIENTS THEY SERVE OVER THE LONG TERM. THE FOUNDATIONS RECOGNIZE THE CHALLENGES THAT MANY NONPROFIT HEALTH RELATED ORGANIZATIONS ENCOUNTER IN DELIVERING NEEDED PROGRAMS THAT IMPROVE HEALTH AND ACCESS TO HEALTHCARE. THE FOUNDATIONS PROVIDE FINANCIAL SUPPORT TO THE IMPACT INSTITUTE TRAINING AND EDUCATION PROGRAMMING MADE AVAILABLE TO NONPROFIT ORGANIZATIONS. SINCE INCEPTION IN 2005, THE IMPACT INSTITUTE HAS PROVIDED TRAINING TO OVER 350 PARTNER NONPROFIT ORGANIZATIONS. BOARD AND MANAGEMENT TRAINING: TRAINING BOARDS AND KEY MANAGEMENT PERSONNEL TO OPERATE THEIR ORGANIZATIONS IN A HIGHLY EFFECTIVE AND EFFICIENT MANNER IS A KEY EDUCATION FOCUS FOR THE FOUNDATIONS. THE FOUNDATIONS HAVE ENCOURAGED MANY AREA NONPROFIT ORGANIZATIONS TO ATTEND THE IMPACT INSTITUTE'S VARIOUS EDUCATION AND TRAINING PROGRAMS. STRATEGIC PLANNING TRAINING AND SERVICES: THE INSTITUTE PROVIDES NONPROFIT ORGANIZATIONS WITH EDUCATION AND TRAINING ON STRATEGIC PLANNING, ORGANIZATIONAL ASSESSMENTS WITH FOLLOW-UP TECHNICAL SUPPORT ON PLAN IMPLEMENTATIONS. OVER 60 NONPROFIT ORGANIZATIONS HAVE PARTICIPATED IN THE TRAINING AND SERVICES PROVIDED TO DEVELOP AND IMPLEMENT ORGANIZATIONAL STRATEGIC PLANS. IN 2011, THE FOUNDATIONS DEVELOPED A NEW "STRATEGY MADE SIMPLE" STRATEGIC PLANNING TOOLKIT AND WEBINAR SERIES. A NUMBER OF NONPROFIT EXECUTIVES AND BOARD MEMBERS PARTICIPATED IN THE PILOT PROGRAM. THE "STRATEGY MADE SIMPLE" PROGRAM IS AVAILABLE AT WWW.IMPACTGIVEBACK.ORG AND INCLUDES THREE 90-MINUTE WEBINAR SESSION AND AN ACCOMPANYING TOOLKIT. HIGH IMPACT FUNDRAISING TRAINING: EDUCATING AND TRAINING ORGANIZATIONS TO BECOME EFFECTIVE FUNDRAISERS IS A KEY PROGRAM AT THE IMPACT INSTITUTE. PROFESSIONAL TRAINERS USING HIGHLY STRUCTURED AND EFFECTIVE TRAINING METHODS AND FOLLOW-UP ACTIVITIES HAVE PROVIDED INTENSIVE TRAINING TO OVER 180 ORGANIZATIONS. AN ASSESSMENT OF 92 NONPROFIT ORGANIZATIONS THAT PARTICIPATED IN FUNDRAISING TRAINING INDICATED A 24% INCREASE IN FUNDS RAISED BETWEEN 2007 AND 2009 RESULTING IN APPROXIMATELY $20 MILLION MORE FOR "DOING GOOD." DMF PROVIDED DIRECT GRANTS TO HEALTH-RELATED NONPROFIT ORGANIZATIONS THAT ENABLE THEM TO ATTEND THE IMPACT INSTITUTE'S FUNDRAISING EDUCATION AND TRAINING SESSIONS AND RECEIVE TECHNICAL SUPPORT FOLLOW-UP. DMF HAS PROVIDED OVER $588,850 IN GRANTS TO ITS PARTNER NONPROFIT ORGANIZATIONS TO ALLOW THEM TO RECEIVE THIS INTENSIVE FUNDRAISING TRAINING AND TECHNICAL ASSISTANCE SINCE INCEPTION IN 2007. GRANT WRITING SERVICES: IN 2005, THE DMC PROVIDED A MULTI-YEAR GRANT TO IMPACT FOUNDATION TO FUND EFFECTIVE GRANT WRITING ASSISTANCE TO HEALTH-RELATED NONPROFIT ORGANIZATIONS TO GENERATE SUCCESSFUL GRANT APPLICATIONS TO OBTAIN ADDITIONAL FINANCIAL RESOURCES FOR THEIR PROGRAMS. SINCE THE FORMAL ADDITION OF GRANT WRITING ASSISTANCE, THE FOUNDATIONS, IMPACT FOUNDATION AND OTHER REGIONAL NONPROFIT ORGANIZATIONS HAVE GENERATED OVER $12.1 MILLION IN GRANT FUNDING. SHARED SERVICES INITIATIVE: THE FOUNDATIONS, IN COLLABORATION WITH THE IMPACT FOUNDATION, DEVELOPED A PILOT MANAGEMENT SERVICES ORGANIZATION (MSO) CONCEPT TO PROVIDE SHARED ADMINISTRATIVE SERVICES IN ORDER TO REDUCE THE COSTS ASSOCIATED WITH MANAGING THEIR PROGRAMS. THE INSTITUTE HELD SEMINARS IN 2010 WITH OVER 180 NONPROFIT BOARD AND STAFF MEMBERS IN ATTENDANCE COVERING TOPICS AND ISSUES INCLUDING SHARED SERVICES, COLLABORATIONS AND MERGERS. THE INSTITUTE CONDUCTED A NONPROFIT REDESIGN SEMINAR IN 2011 TO EDUCATE BOARD MEMBERS AND STAFF ABOUT OPTIONS FOR SHARING RESOURCES AND CONSIDERING MERGERS TO REDUCE ADMINISTRATIVE OVERHEAD. OVER 80 NONPROFIT REPRESENTATIVES ATTENDED. HIGH IMPACT SEAL OF DISTINCTION PROGRAM: THE FOUNDATIONS, IN COLLABORATION WITH THE IMPACT INSTITUTE, DEVELOPED THIS PROGRAM AS THE "CAPSTONE" FOR ITS SERIES OF EDUCATION AND TRAINING PROGRAMS. THIS PROGRAM INCLUDES AN ORGANIZATIONAL ASSESSMENT AND DEVELOPMENT PLAN, ADDITIONAL EXECUTIVE LEADERSHIP TRAINING, PLAN IMPLEMENTATION SUPPORT AND ANNUAL RENEWALS. COMPLETION OF THE PROGRAM WAS DESIGNED TO BUILD THE CAPACITY OF EXECUTIVES TO TAKE THEIR ORGANIZATIONS FROM FUNCTIONING WELL TO SUPERIOR PERFORMING, HIGH IMPACT ORGANIZATIONS. THE 2010 INAUGURAL PROGRAM INCLUDED THE PARTICIPATION OF THE FOUNDATIONS, IMPACT FOUNDATION AND 12 OTHER NONPROFIT ORGANIZATIONS' EXECUTIVE STAFF. THE HIGH IMPACT SEAL OF DISTINCTION WAS AWARDED TO 14 NONPROFIT ORGANIZATIONS IN MAY 2011. HIGH IMPACT PHILANTHROPY (HIP): THE FOUNDATIONS, IN COLLABORATION WITH IMPACT FOUNDATION, INITIATED THIS PROGRAM IN 2009 TO UNITE OUTSTANDING COMMUNITY FUNDING ORGANIZATIONS AND INDIVIDUALS TO RESEARCH AND DISCUSS VARIOUS SOCIETAL PROBLEMS AND ISSUES IN THE REGION WITH THE GOAL OF A COMMON FOCUS AND STRATEGIES TO ACHIEVE A GREATER IMPACT IN THE COMMUNITY. THE INITIAL 2010 GROUP OF 15 ORGANIZATIONS AND COMMUNITY LEADERS CAME TO A CONSENSUS TO FOCUS THE HIP GROUP'S INITIAL EFFORTS ON IMPROVING THE INTERNAL AND EXTERNAL ASSETS OF YOUTH IN THE FARGO-MOORHEAD (FM) AREA. THE INITIAL GOALS ESTABLISHED FOR THE HIP INITIATIVE WERE: 1) ENGAGING YOUTH, YOUTH DEVELOPMENT ORGANIZATIONS AND OTHERS TO DEVELOP A COORDINATED STRATEGY TO MAKE THE FM AREA A PLACE WHERE ALL YOUTH CAN MAXIMIZE THEIR POTENTIAL; 2) HOLD A YOUTH DEVELOPMENT SUMMIT; 3) RELEASE AN ENVIRONMENTAL SCAN OF ORGANIZATIONS SERVING YOUTH IN THE FM AREA THAT INCLUDES ORGANIZATION SIZE, AREAS OF FOCUS, AND COLLABORATION ACTIVITIES; 4) DEVELOP A BUDGET AND IDENTIFY AN INDIVIDUAL TO COORDINATE, PLAN AND IMPLEMENT THE NEXT PHASES FOR THE HIP GROUP. THE HIP INITIATIVE IS SUPPORTED WITH GRANTS FROM DAKOTA MEDICAL FOUNDATION, THE OTTO BREMER FOUNDATION, BUSH FOUNDATION, GROTTO FOUNDATION AND OTHER FINANCIAL SUPPORT FROM THE UNITED WAY OF CASS CLAY, AND ALEX STERN FAMILY FOUNDATION. THE GOAL OF HIP IS TO INSPIRE FUNDERS TO ADOPT A NEW APPROACH TO MORE STRATEGICALLY AND COLLABORATIVELY SOLVE SOCIETAL ISSUES IN THE REGION. THE HIP STEERING COMMITTEE IS COMPRISED OF FOUNDATION, CORPORATE AND INDIVIDUAL DONORS THAT INVEST OVER $75 MILLION ANNUALLY TO SUPPORT VARIOUS CHARITABLE ENDEAVORS IN THE REGION. THE STEERING COMMITTEE'S INITIAL FOCUS IS TO BUILD THE ASSETS OF YOUTH LIVING IN CASS AND CLAY COUNTIES. DR. RATHGE OF THE NORTH DAKOTA DATA CENTER HAS CONDUCTED AN INVENTORY OF ALL ORGANIZATIONS IN CASS AND CLAY COUNTIES THAT ARE WORKING ON YOUTH ASSET BUILDING, INCLUDING: ORGANIZATIONAL BUDGET SIZE, YOUTH ASSET BUILDING AREAS, MEASURES OF PERFORMANCE, AND INTERACTION WITH OTHER ORGANIZATIONS IN THE AREA. A HIP COORDINATOR WAS HIRED IN APRIL 2011 TO OVERSEE THE INITIATIVE. A SERIES OF SIX COMMUNITY CONVERSATIONS WERE HELD IN 2011 WITH CROSS-SECTOR COMMUNITY MEMBERS FROM: SCHOOLS, CITY, BUSINESS, NONPROFITS, FAITH COMMUNITY, PARENTS, AND YOUTH. A COMMUNITY TASK FORCE WAS ASSEMBLED TO ASSIST THE HIP COORDINATOR WITH SELECTING A BLUEPRINT FRAMEWORK, COLLECTING ADDITIONAL DATA INFORMATION, IDENTIFYING BEST PRACTICES FOR YOUTH DEVELOPMENT, AND MAKING RECOMMENDATIONS FOR THE NEXT PHASE OF THE HIP INITIATIVE. A YOUTH DEVELOPMENT CONFERENCE WAS HELD IN DECEMBER 2011 WITH OVER 100 PARTICIPANTS FROM 54 DIFFERENT ORGANIZATIONS IN THE F-M AREA. SUBGROUPS WERE CREATED TO FOLLOW-UP ON RECOMMENDATIONS FROM THE SUMMIT AND MEETINGS WITH YOUTH AND YOUTH DEVELOPMENT ORGANIZATIONS TO DEVELOP A COORDINATED COLLABORATIVE STRATEGY FOR OUR COMMUNITY OVER THE NEXT SEVERAL MONTHS. PLANNING TEAMS WERE FORMED FOLLOWING THE CONFERENCE WITH OVER 60 CROSS-SECTOR PARTICIPANTS. THE TEAMS WERE RESPONSIBLE FOR HELPING TO IDENTIFY AND WRITE THE OUTCOMES, INDICATORS, STRATEGIES AND PARTNERSHIPS FOR EACH OF THE FIVE DEVELOPMENTAL AREAS OF THE BLUEPRINT. VOLUNTEER INITIATIVE: THE FOUNDATIONS PARTNERED WITH IMPACT FOUNDATION IN 2007 TO IMPLEMENT A VOLUNTEER INITIATIVE DESIGNED TO HELP NONPROFIT ORGANIZATIONS MORE EFFECTIVELY RECRUIT, TRAIN, MANAGE AND RETAIN VOLUNTEERS. VOLUNTEER MANAGEMENT TRAINING WAS HELD WITH 25 NONPROFIT ORGANIZATIONS REPRESENTED BY 30 INDIVIDUALS PARTICIPATING IN THE TRAINING. THE SUCCESS OF THE TRAINING PROGRAMS LED TO THE ESTABLISHMENT OF VOLUNTEER MANAGEMENT ADVANCED LEADERSHIP TRAINING PROGRAMS RESULTING IN 11 NONPROFIT ORGANIZATIONS PARTICIPATING IN FOCUSED MONTHLY TRAINING SESSIONS.
    THE FOUNDATIONS PARTNERED WITH FIRSTLINK TO SPONSOR A REGIONAL CONFERENCE ON VOLUNTEER MANAGEMENT AND LEADERSHIP SEMINAR IN 2009 RESULTING IN OVER 100 PARTICIPANTS FROM NORTH DAKOTA AND MINNESOTA ATTENDING. THE GIVEBACK WEBSITE WWW.IMPACTGIVEBACK.ORG INCLUDES A VOLUNTEER PAGE THAT PROVIDES THE CAPABILITY FOR NONPROFIT ORGANIZATIONS TO LIST THEIR VOLUNTEER OPPORTUNITIES AND TO TRACK THE VOLUNTEER'S TIME SPENT. AN IMPACT INSTITUTE STUDY CONDUCTED WITH 6 PARTNER NONPROFIT ORGANIZATIONS OVER A 7-MONTH PERIOD IDENTIFIED A MONTHLY AVERAGE OF 615 VOLUNTEERS IN DIFFERENT POSITIONS GENERATING OVER 2,478 VOLUNTEER HOURS CORRELATING TO AN ECONOMIC IMPACT OF APPROXIMATELY $337,668 IN WAGES. THE FOUNDATIONS AND THE IMPACT INSTITUTE PARTNERED WITH NORTH DAKOTA STATE UNIVERSITY IN 2010 TO ENCOURAGE STUDENT VOLUNTEERISM IN THE COMMUNITY. GIVEBACK INITIATIVE: THE FOUNDATIONS PARTNERED WITH IMPACT FOUNDATION TO DEVELOP A GIVEBACK INITIATIVE THAT FOCUSES ON DEVELOPING STRATEGIES AND PROGRAMS TO INSPIRE AND SUBSTANTIALLY INCREASE THE GIVING OF TIME, TALENT AND TREASURE BY DONORS IN NORTH DAKOTA AND WESTERN MINNESOTA. THE INITIATIVE CREATED NEW WAYS OF THINKING AND NEW APPROACHES SURROUNDING WEALTH TRANSFER AND VOLUNTEERISM IN NORTH DAKOTA AND WESTERN MINNESOTA. A GIVEBACK WEBSITE (WWW.IMPACTGIVEBACK.ORG) PROVIDES THE CAPABILITY FOR NONPROFIT ORGANIZATIONS TO ACCEPT ONLINE CONTRIBUTIONS FROM DONORS; SHARE THEIR STORIES; ENGAGE VOLUNTEERS AND RECORD VOLUNTEER ACTIVITIES; COORDINATE EVENT REGISTRATIONS; AND TO HOLD ONLINE AUCTIONS. SIGNIFICANT EFFORTS AND COMMITMENTS HAVE BEEN MADE BY IMPACT FOUNDATION TO ENHANCE THE WEBSITE IN ORDER TO BETTER CONNECT DONORS WITH NONPROFIT ORGANIZATIONS THAT FIT THE DONOR'S CHARITABLE GOALS. THE FOUNDATIONS HAVE PROVIDED OVER $661,200 TO IMPACT FOUNDATION SINCE 2006 TO SUPPORT THE PROGRAMS, OPERATIONS, AND WEBSITE DEVELOPMENT OF THE GIVEBACK INITIATIVE. THE ONLINE GIVING WEBSITE HAS PROCESSED OVER 21,857 CONTRIBUTIONS TOTALING APPROXIMATELY $3.75 MILLION SINCE ITS 2007 IMPLEMENTATION. GIVING HEARTS DAY INITIATIVE: THE FOUNDATIONS PARTNERED WITH IMPACT FOUNDATION TO ESTABLISH THIS INITIATIVE TO PROMOTE CHARITABLE GIVING IN THE REGION. THE ONLINE GIVING ENVIRONMENT IMPROVES THE CAPACITY OF AREA NONPROFIT ORGANIZATIONS TO EFFICIENTLY RAISE FUNDS FOR THEIR PROGRAMS. THE ONLINE GIVING WEBSITE AT WWW.IMPACTGIVEBACK.ORG IS USED TO PROMOTE THE ANNUAL GIVING HEARTS DAY EACH FEBRUARY AND PROVIDES DONORS WITH AN EASY-TO-USE WEBSITE TO MAKE ONLINE CONTRIBUTIONS TO THEIR FAVORITE CHARITABLE ORGANIZATIONS. THE GIVING HEARTS DAY INITIATIVE HAS GENERATED OVER 17,200 DONOR CONTRIBUTIONS TOTALING OVER $3.0 MILLION SINCE ITS 2008 IMPLEMENTATION. THE INITIATIVE HAS RESULTED IN OVER $4.16 MILLION IN CONTRIBUTIONS TO COMMUNITY NONPROFIT ORGANIZATIONS. THE FOUNDATIONS HAVE PROVIDED OVER $960,800 IN MATCHING FUND GRANTS TO PARTICIPATING ORGANIZATIONS AND FUNDS SINCE INCEPTION OF THIS INITIATIVE.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2010

Additional Data


Software ID:  
Software Version:  
SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" to Form 990, Part IV, line 33, 34, 35, 36, or 37.
MediumBulletAttach to Form 990. MediumBullet See separate instructions.

OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
DAKOTA MEDICAL CHARITIES
 
Employer identification number

45-0368679
Part I
Identification of Disregarded Entities (Complete if the organization answered "Yes" on Form 990, Part IV, line 33.)
(a)
Name, address, and EIN of disregarded entity


(b)
Primary activity


(c)
Legal domicile (state
or foreign country)

(d)
Total income



(e)
End-of-year assets


(f)
Direct controlling
entity



















Part II
Identification of Related Tax-Exempt Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.)
(a)
Name, address, and EIN of related organization


(b)
Primary activity


(c)
Legal domicile (state
or foreign country)

(d)
Exempt Code section



(e)
Public charity status
(if section 501(c)(3))

(f)
Direct controlling
entity

(g)
Section 512(b)(13) controlled organization
Yes No
(1) DAKOTA MEDICAL FOUNDATION

4152 30TH AVE S SUITE 102

FARGO,ND58104
45-6012318
CONTRIBUTIONS & ASSISTANCE TO OTHER NON-PROFIT ORGANIZATIONS ND 501(C)(3) LINE 7 N/A
 
No












For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.)
(a)
Name, address, and EIN of
related organization



(b)
Primary activity




(c)
Legal
domicile
(state or foreign
country)


(d)
Direct controlling
entity



(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




(g)
Share of end-of-year
assets



(h)
Disproprtionate allocations?




(i)
Code V—UBI
amount in box 20 of
Schedule K-1
(Form 1065)
(j)
General or
managing
partner?



(k)
Percentage
ownership


Yes No Yes No












Part IV
Identification of Related Organizations Taxable as a Corporation or Trust (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.)
(a)
Name, address, and EIN of related organization



(b)
Primary activity



(c)
Legal domicile
(state or
foreign
country)
(d)
Direct controlling
entity


(e)
Type of entity
(C corp, S corp,
or trust)

(f)
Share of total income



(g)
Share of
end-of-year
assets

(h)
Percentage
ownership














Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 3
Part V
Transactions With Related Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35, 35A, or 36.)
Note. Complete line 1 if any entity is listed in Parts II, III or IV.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest (ii) annuities (iii) royalties (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .
1a
 
No
b Gift, grant, or capital contribution to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
 
No
c Gift, grant, or capital contribution from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
 
No
d Loans or loan guarantees to or for other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
 
No
e Loans or loan guarantees by other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
 
No
f Sale of assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Purchase of assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Exchange of assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Lease of facilities, equipment, or other assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
 
No
j Lease of facilities, equipment, or other assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
 
No
k Performance of services or membership or fundraising solicitations for other organization(s) . . . . . . . . . . . . . . . . . . . . . .
1k
 
No
l Performance of services or membership or fundraising solicitations by other organization(s) . . . . . . . . . . . . . . . . . . . . . .
1l
 
No
m Sharing of facilities, equipment, mailing lists, or other assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1m
Yes
 
n Sharing of paid employees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1n
Yes
 
o Reimbursement paid to other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
Yes
 
p Reimbursement paid by other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
 
No
q Other transfer of cash or property to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
 
No
r Other transfer of cash or property from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
 
No
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of other organization
(b)
Transaction
type(a-r)
(c)
Amount involved
(d)
Method of determining amount involved
(1)
(2)

(3)

(4)

(5)

(6)

Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 37.)
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity
(b)
Primary activity
(c)
Legal domicile
(state or foreign
country)
(d)
Are all
partners
section
501(c)(3)
organizations?
(e)
Share of
end-of-year
assets
(f)
Disproprtionate allocations?
(g)
Code V—UBI
amount in box
20 of Schedule K-1
(Form 1065)
(h)
General or
managing
partner?
Yes No Yes No Yes No






























Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 5
Part VII
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule R (see instructions).
Identifier Return Reference Explanation
Additional Data


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