Governor and Executive Council Agenda item PDF - 2026-02-11 - agenda 22

Meeting Date

2026-02-11

Attachment Kind Label

Agenda item PDF

Attachment Relation

primary_meeting_attachment

Agenda Numbers

22

Agency Names

Department Of Business And Economic Affairs

Parent Meeting Title

Governor and Executive Council meeting - 2026-02-11

3l1FEB 1 1 2026

4

B E A

New Hampshire Department of

BUSINESS AND

ECONOMIC AFFAIRS

■4!

January 20, 2026

Her Excellency, Governor Kelly A. Ayotte

and the Honorable Executive Council

State House

Concord, NH 03301

REQUESTED ACTION

Authorize the Department of the Business and Economic Affairs (BEA), Office of Workforce Opportunity, to enter

Into a RETROACTIVE amendment to an existing contract (contract # 1103776) with Coos County Family Health

Services, Inc. (VC# 155327), Berlin, NH to support the Family Medical Residency Program with American Rescue

Plan Act (ARPA) State Fiscal Recovery Funds (SFRF) by extending the completion date from December 31, 2025

to June 30, 2026, with no change to the price limitation of $500,000, effective retroactive to January 1, 2026 upon

Governor and Council approval. The original contract was approved by Governor and Council on November 13,

2024, Item #71. This Is an allowable use of ARPA SFRF under Section 602(c)(1)(A) to respond to the public

health emergency or Its negative economic Impacts. 100% Federal Funds.

EXPLANATION

This amendment Is retroactive due to the timing of the extension request and meeting dates along with the time It

takes to compile all documentation and process, including the time to negotiate the amendment terms and verify

the scope of work moving forward and the ability to expend the remaining funds.

The Coos County Family Health Services has requested a time extension of the contract to complete their setup

of the family medicine residency program In New Hampshire's rural North Country. This program has $182,042.11

remaining on the contract after November 2025.

Approval of this action will support project completion and continuation of the successful program In advance of

ARPA-related deadlines. It also preserves flexibility, as GOFERR has confirmed the ability to reallocate funding

should the program conclude prior to the requested completion date In this action.

During the proposed no-cost extension period, the program will build on established planning and partnerships to

fully Implement key components necessary for a successful and sustainable residency program. Planned

activities Include establishing a Continuity Clinic for resident primary care training at Weeks Medical Center,

expanding Community Health rotation opportunities through engagement with additional North Country healthcare

organizations, and developing new clinical rotation experiences with Littleton Regional Hospital beyond the

existing OB/GYN rotation. The program will strengthen Its educational Infrastructure through Implementation of

Residency Curriculum Resources and collaboration with the Maple Mountain Family Medicine Residency

Program In Vermont to enhance education outcomes of residents. Faculty development will be further advanced

through Increased participation In regional and national training opportunities focused on resident education. In

addition, the extension period will allow for critical work to secure long-term Graduate Medical Education funding

through meetings with Dartmouth Health and other Rural Referral Centers and to Implement required ACGME-

AMENDMENT #1 of P-37 Contract Agreement

NEW HAMPSHIRE DEPARTMENT OF BUSINESS AND ECONOMIC AFFAIRS

OFFICE OF WORKFORCE OPPORTUNITY

SUBJECT: FAMILY MEDICAL RESIDENCY PROGRAM

COOS COUNTY FAMILY HEALTH SERVICES

This first amendment is by and between the New Hampshire Department of Business and

Economic Affairs, Office of Workforce Opportunity (hereinafter "OWO") or its successor and

the Coos County Family Health Services (hereinafter "Grantee"), whereby the parties do hereby

mutually agree to a no-cost amendment to the subaward for the design of the development of the

framework for a family medicine residency program in New Hampshire's rural North Country,

previously approved by Govemor and Council on November 13, 2024, Item #71, by extending

the agreement term by six months, finm December 31,2025 to Jtme 30,2026.

WHEREFORE, the parties hereto agree to amend as follows:

1. Amend Section 1.7 (page 1) of the Grant Agreement by deleting the Completion Date

December 31,2025 and inserting the completion date June 30,2026.

2. Amend Paragraph 10 of Exhibit A (page 6) by deleting in its entirety and replacing

with "Any portion of the award not expended by Grantee for allowable costs by June

30,2026 shall l^se and shall not be paid."

3. Amend Paragraph 11 of Exhibit A (page 6) by deleting the first sentence in its

entirety and replacing with "Closeout shall be completed by October 28,2026, as

directed by the State."

All other provisions of the Grant Agreement shall remain the same.

This amtrnHmanr shall be effective upon the date of Govemor and Executive Council approval.

[ WITNESS WHEREOF, the parties have set tiieir hands as of the date written below.

Date: ^

Business and Economic Af&irs - Office of Workforce Opportunity

Date: \ /<^

NH Busmess and Jbcc

' I /

Coos'Sounty Fmnily Health Services, Inc. CEO

Approved: Date: 1/22/26Department of Justice

Approved Date:

Govemor and Executive Coimcil

State of New Hampshire

Department of State

CERTIFICATE

I, David M. Scanlan, Secretary of State of the State of New Hampshire, do hereby certify that COOS COUNTY FAMILY

HEALTH SERVICES, INC. is a New Hampshire Nonprofit Corporation registered to transact business in New Hampshire on

December 14, 1979.1 further certify that all fees and documents required by the Secretary of State's office have been received and

is in good standing as far as this office is concerned.

Business ID: 63204

Certificate Number: 0007142399

u.

IN TESTIMONY WHEREOF,

I hereto set my hsind and cause to be affixed

the Seal of the State of New Hampshire,

this 1st day of April A.D. 2025.

David M. Seanlan

Secretary of State

NEW HAMPSHIRE SECRETARY OF STATE

DEPARTMENT OF STATE DAVID M. SCANLAN

Back to Flome

Business Information

Business Details

COOS COUNTY FAMILY HEALTH SERVICES,

Business Name:INC.

Business ID: 63204

Business Type: Domestic Nonprofit Corporation Business Status: Good Standing

Business Creation Date: 12/14/1979

Name in State of,, ^,Not Available

Incorporation:

Date of Formation in ^2/14/1979

Jurisdiction:

Principal Office Address: ^ Mailing Address: Coos County Family Healtti, 133 Pleasant St.,

Berlin, NH, 03570, USA

Citizenstiip / State of Hampstiire

Incorporation:

Last Nonprofit Report If

Yean^"^^

Next Report Year 2030 f

Duration: Perpetual

1 Business Email: kgordon@ccftis.org Pfione #: NONE:

Notification Email: kgordon@ccftis.org Fiscal Year End Date: NONE:'.. '

Principal Purpose

S.NO NAICS Code NAI«Subcode

No records to view. P1 - ■ ST

i c* g? 15 □ Cl.)) ^

CERTIFICATE OF AUTHORITY

1, Kassie EafratI, hereby certify that;

(Nome o/ the elected Officer of the CorporotionAlC; connot be contract signatory)

1.1 am a duly elected Clerk/Secretary/Officer of Coos County Family Health Services. Inc..

(CorporotScn/LLC Nome)

2. The following is a true copy of a vote taken at a meeting of the Board of Directors/shareholders, duly called

and held on June 19"*. 20 25. at which a quorum of the Directors/shareholders were present and voting.

VOTED: That Ken Gordon. CEO (may list more than one person]

(Nome and Title of Contract Signatory)

is duly authorized on behalf of Coos Countv Familv Health Services. Inc. to enter into contracts or agreements

(Nome of Corporation/ LLC)

with the State of New Hampshire and any of its agencies or departments and further is authorized to execute

any and all documents, agreements and other instruments, and any amendments, revisions, or modifications

thereto, which may in his/her judgment be desirable or necessary to effect the purpose of this vote.

3.1 hereby certify that said vote has not been amended or repealed and remains in full force and effect as of the

date of the contract/contract amendment to which this certificate is attached. This authority was valid thirty (30)

days prior to and remains valid for thirty (30) days from the date of this Certificate of Authority. I further certify

that It Is understood that the State of New Hampshire will rely on this certificate as evidence that the person(s)

listed above currently occupy the position(s) indicated and that they have full authority to bind the corporation.

To the extent that there are any limits on the authority of any listed individual to bind the corporation in contracts

with the State of New Hampshire, all such limitations are expressly stated herein.

Dated: 01/16/2026

Sigrmture of Elected Officer

Name: Kassie Eafrati

Title: Chairperson CCFHS Board of Directors

CERTIFICATE OF LIABILITY INSURANCE DATE (MMAlDOrYYY)

01/09/2026

THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS

CERTIFICATE DOES NOT AFFIRMATTVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POUCIES

BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED

REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.

IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the poHcy(ies) must have ADDITIONAL INSURED provisions or be endorsed.

If SUBROGATION IS WAIVED, sul^ect to the terms and conditions of the policy, certain policies may require an endorsement A statement on

this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).

PRODUCER

Cross Insurance-Manchester

1100 Elm Street

Manchester NH 03101

gg5[g<^ Michele Palmer

{603)669-3218 | (803)64W331

AM^ss- P^anch.cert$@crossagency.com

WSURER(S)AFFOROINQ COVERAGE NAICf

INSURER A Philadelphia Indemnity Ins Co 18058

INSURED

Coos County FamSy Health Serviws, Inc.

133 Pleasant Street

Berfin NH 03570-2006

INSURER B Granite State Health Care and Human Services Self-

INSURER C

INSURER D

INSURER E

INSURER F

COVERAGES CERTIFICATE NUMBER: CL261941108 REVISION NUMBER:

U18R

LYR

THIS IS TO CERTIFY THAT THE PQUCIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD

INDICATED. NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS

CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS.

EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.

TYP£ OF INSURANCE l!'l!fllvA»i POLICY NUMBER

COMMB^CIAL GENERAL UABUTY

CLAIM&MAOE

GENl AGGREGATE LIMIT APPUES PER:

POUCY □

OTHER:

X I PRO.JECT □ LOG

PHPK2S69299

IMMiDOmrYY)

07A)1/2025

Pducvexp

iMiurorrYYYi

07/01/2026

UMITS

EACH OCCURRENCE

DAMAtsETOREKTCC

PREMISES IEji occuiTBneal

MED EXP (Any one pefion)

PERSONAL S ADV INJURY

GENERAL AGGREGATE

PRODUCTS - COMP/OP AGO

1.000,000

1.000,000

20,000

1.000,000

2,000.000

2.000.000

AUTOMOBILE LIABILITY

ANY AUTO

COMBINED SINGLE UMIT

(Eaacddwrt) 1.000.000

BODILY INJURY {Per person)

OVmEO

AUTOS ONLY

HIRED

AUTOS ONLY

SCHEDULED

AUTOS

NON.O\M<EO

AUTOS ONLY

PHPK2S6930S 07/01/2025 07/01/2026 BODILY INJURY (Per ecddent)

PROPERTY DAMAGE

fPer eccklertt^

UMBRELLA UAB

EXCESS LiAB

DEO X

OCCUR

CIAIMS4XA0E

EACH OCCURRENCE 5.000,000

PHUB869424 07/01/2025 07/01/2026 5.000.000

RETENTION S 10,000

PER

STATUTEWORKERS COMPENSATION

AND EMPLOYERS' UABIUTY

ANY PROPRiETOR/MRTNER/EXECUTIVE

OFFICERAfBSBER EXCLUDED?

(Mantfeteiy In NH)

If yes, describe under

DESCRIPTION OF OPERATIONS below

X

0 ROie61HCHS202&4)1 (3a.) NH 01/01/2026 01/01/2027 E.L EACH ACaoeNT 1.000,000

E.L DISEAS6«EA EMPLOYEE 1,000,000

E.L DISEASE-POUCY UMIT 1,000,000

Employee Dishonesty PHPK2569299 07/01/2025 07/01/2026

Limit

Deductible

$500,000

$5,000

DESCRlPnON OF OPBLATIONS / LOCATIONS / VEHICLES (ACORO 101, AddWenil Remsfhs Schedule, mey be stteched if mere epace ie required)

Refer to policy for exclusionary endorsements and special provisions.

NH Department of Business and Economic Affairs

100 North Main Street

Suite 100

Concord NH 03301

\

SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE

THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN

ACCORDANCE WITH THE POLICY PROVISIONS.

AUTHORBEO REPRESENTArtVE

ACORD 25 (2016/03)

©1988-2015 ACORD CORPORATION. All rights reserved.

The ACORD name and logo are registered mailts of ACORO

ADDITIONAL COVERAGES

Ref# Description

Premium Adjustments

Coverage Code

1_412

Form No. EdMon Date

Limiti Umit 2 Limits Deductible Amount Deductible fVpe Premium

Ref# Description Coverage Code Form No. Edition Date

Umitl Umit 2 Umit 3 Deductible Amount Deductible Type Premium

Ref# Description Coverage Code Form No. Edttion Date

Umitl Umit 2 Limits Deductible Amount Oeductilde type Premium

Ref# Description Coverage Code Form Na Edition Date

Umitl Umit 2 Limits Deductible Amount Deductible type Premium

Ref# Description Coverage Code Form No. Edition Date

Umit 1 Umit 2 Limits Deductible Amount Deductible type Premium

Ref# Description Coverage Code Form No. Edition Date

Umlt1 Umit 2 Limits Deductible Amount Deductible IVpe Premium

Ref# Description Coverage Code Form No. Edition Date

Umitl UmH2 Limits Deductible Amount Deductible type Premium

Ref# Description Coverage Code Form No. Edition Date

Umitl Umit 2 Limits Deductible Amount Deductible Type Premium

Ref# Description Coverage Code Form Na Edition Date

Umtti Umit 2 Limns Deductible Amount Deductible type Premium

Ref# Description Coverage Code Form Na Edition Date

Umitl Umit 2 LimttS Deductible Amount Deductible iype Premium

Ref# Description Coverage Code Form Na EdWon Date

Umitl Umit 2 LimttS Deductible Amount Deductible Type Premium

OFAOTLCV Copyright 2001, AMS Services, Ina

NONPROFIT COVER SHEET

A. Entity Name: Coos County Family Health Services, Inc.

B. Entity's Contact Information for Records Requests (e.g., resumes of key personnel;

audited financial statements):

Phil Kneer, CFO - nknocr (/ cclh.s.i'iu / 603-752-2040

Ken Gordon, CEO — / 603-915-6871

C. List Board of Directors and Afliliations

Name (Identify any additional roieis) in

Parentheses)

E.g., John Doe (President)

Kassie Eafrati, Board Chair

Pauline Tibbetts, Vice-Chair

Cynthia Desmond, Secretary

Dawn Cross, Treasurer

Annette Cole

Ben Mayerson

David Morin

Fernando Lopez Nayra

H. Guy Stever, Jr.

Heidi Barker

Patti Stolte

Peter Rowan

Affiliations

Northem Human Services

Retired

Retired

Bank of New Hampshire

White Mtn. Community College

Retired

Retired

Bank of New Hampshire

Retired

UNH Extension Service

Retired

Retired

I]

D. List Key Personnel (Resumes must be available upon request to the person(s) listed in

section B or may be attached):

Name

Phil Kneer

Ken Gordon

William Gessner, MD

Sergio Zullich, RPh

Tanya Tupick, DO

Role

CFO

CEO

Program Director

Program Coordinator

Faculty

Annual Salary

$120,000

$200,000

$50,000 (p/t)

$50,000 (p/t)

$40,000 (p/t)

Amount Paid From

This Contract

$0

$0

$ 40,000 ®

$ 50,000

i $ 40,000

y

z

ix:

DISCLOSURE OF LEGAL ACTIVITIES INVOLVING THE STATE OF NEW

HAMPSHIRE OR ANOTHER GOVERNMENT ENTITY

E. Check one of the following:

[ ] The entity is not currently or has not been party to any legal proceeding involving the

State of New Hampshire (or any agency or subdivision thereof) or any other state/federal

government entity before any adjudicative body in any jurisdiction OR

[X ] The entity is or has been party to one or more legal proceedings as set forth above.

Identify the Jurisdiction, court or other adjudicative body, case number, and briefly

describe the nature of the proceeding (Attached extra sheet if necessary).

Malpractice claims made over the years against the organization by patients defended by the

US Attorney's Office through coverage afforded to community health centers through the

Federal Tort Claims Act (FTCA).

CHARITABLE TRUSTS UNIT COMPLIANCE CERTIFICATION

F. Check one of the following:

[ X ] is registered and in good standing with the New Hampshire Department of Justice

Charitable Trusts Unit (** see note below) or has submitted a complete application for

registration to the Charitable Trusts Unit and is awaiting a registration determination OR

[ ] is not required to register with the Charitable Trusts Unit because it is neither tax-exempt

under section 501(c)(3) of the Internal Revenue Code nor engages in charitable

solicitations in the State of New Hampshire OR

[ ] is exempt from registration with the Charitable Trusts Unit because it is a federal or state

government, agency, or subdivision or is a religious organization, an integrated auxiliary

of a religious organization, or is a convention or association of churches.

♦♦ Note: Attached screen shot from the DOJ Registered Charities List found at:

https:, mm.nh.jov lllcs upload.^ Joj rcmoic-docs icuistercd-charities.pdf

FINANCIAL DISCLOSURES

G. Check one the following:

pC] The organization hired an outside firm to audit its financial statements or to prepare

GAAP-compliant financial statements for its most recently completed fiscal year. If so,

please ensure that the financial statements and audit results are available to be requested

from the contact listed on Page 1 (audited fmancials may be attached)

[ ] The above does not apply, but the organization filed an IRS Form 990 or Form 990-E2

for its most recently completed fiscal year. Please attach that IRS Form 990 or Form 990-

EZ to the submission. (Form 990 Schedule B is not required) OR

[ ] If neither of the above apply, complete the Income Statement and Balance Sheet below

with the following basic financial information from the organization's most recently

completed fiscal year:

1. INCOME STATEMENT

Revenue Expenses

Grants j $

Donations $

Program

Services $

Revenue

Interest & $

Dividends

All other \ j

Revenue \

Total Revenue, $

i$

Compensation of

officers, directors,

and key personnel

Other salaries &

wages

Payroll taxes &

employee benefits

Occupancy, rent,

utilities, and

insurance

Printing,

publications, postage, $

office supplies, and IT;

All other expenses $

Total Expenses j $

2. BALANCE SHEET

Cash & Equivalents

Investments

Real Estate (less any

depreciation)

Assets

$

$

$

Liabilities

Other Property &

Equipment (less any

depreciation)

Pledges, grants,

accounts receivable

All other assets

Total Assets

Accounts Payable ! j

j

Loans Payable j

All other liabilities \ $I

Total Liabilities $

B) BerryDunn

coos county

Family Health

FINANCIAL STATEMENTS

and

REPORTS IN ACCORDANCE WITH GOVERNMENT AUDITING

STANDARDS AND THE UNIFORM GUIDANCE

June 30, 2025 and 2024

With Independent Auditor's Report

BerryDunn

BDMP Assurance, LLP

INDEPENDENT AUDITOR'S REPORT

Board of Directors

Coos County Family Health Services, Inc.

Report on the Audit of the Financial Statements

Opinion

We have audited the accompanying financial statements of Coos County Family Health Services, Inc.

(the Organization), which comprise the balance sheet as of June 30, 2025, and the related statements of

operations and changes in net assets, functional expenses and cash flows for the year then ended, and

the related notes to the financial statements.

In our opinion, the 2025 financial statements referred to above present fairly, in all material respects, the

financial position of the Organization as of June 30, 2025, and the results of its operations, changes in

its net assets and its cash flows for the year then ended, in accordance with U.S. generally accepted

accounting principles (U.S. GAAP).

Basis for Opinion

We conducted our audit in accordance with U.S. generally accepted auditing standards (U.S. GAAS) and

the standards applicable to financial audits contained in Government Auditing Standards, issued by the

Comptroller General of the United States. Our responsibilities under those standards are further

described in the Auditor's Responsibilities for the Audit of the Financial Statements section of our report.

We are required to be independent of the Organization and to meet our other ethical responsibilities in

accordance with the relevant ethical requirements relating to our audit. We believe that the audit evidence

we have obtained is sufficient and appropriate to provide a basis for our audit opinion.

Prior Period Financial Statements

The financial statements of the Organization as of and for the year ended June 30, 2024 were audited

by Berry, Dunn, McNeil & Parker, LLC, whose report, dated October 10, 2024, expressed an unmodified

opinion on those statements.

berrydunn.com

Board of Directors

Coos County Family Health Services, Inc.

Responsibilities of Management for the Financial Statements

Management is responsible for the preparation and fair presentation of these financial statements in

accordance with U.S. GAAP, and for the design, implementation and maintenance of internal control

relevant to the preparation and fair presentation of financial statements that are free from material

misstatement, whether due to fraud or error.

In preparing the financial statements, management is required to evaluate whether there are conditions

or events, considered in the aggregate, that raise substantial doubt about the Organization's ability to

continue as a going concern within one year after the date that the financial statements are available to

be issued.

Auditor's Responsibilities for the Audit of the Financial Statements

Our objectives are to obtain reasonable assurance about whether the financial statements as a whole

are free from material misstatement, whether due to fraud or error, and to issue an auditor's report that

includes our opinion. Reasonable assurance is a high level of assurance but is not absolute assurance

and therefore is not a guarantee that an audit conducted in accordance with U.S. GAAS and Government

Auditing Standards will always detect a material misstatement when it exists. The risk of not detecting a

material misstatement resulting from fraud is higher than for one resulting from error, as fraud may involve

collusion, forgery, intentional omissions, misrepresentations or the override of internal control.

Misstatements are considered material if there is a substantial likelihood that, individually or in the

aggregate, they would influence the judgment made by a reasonable user based on the financial

statements.

In performing an audit in accordance with U.S. GAAS and Government Auditing Standards, we:

• Exercise professional judgment and maintain professional skepticism throughout the audit.

• Identify and assess the risks of material misstatement of the financial statements, whether due to

fraud or error, and design and perform audit procedures responsive to those risks. Such

procedures include examining, on a test basis, evidence regarding the amounts and disclosures

in the financial statements.

• Obtain an understanding of internal control relevant to the audit in order to design audit

procedures that are appropriate in the circumstances, but not for the purpose of expressing an

opinion on the effectiveness of the Organization's internal control. Accordingly, no such opinion

is expressed.

• Evaluate the appropriateness of accounting policies used and the reasonableness of significant

accounting estimates made by management, as well as evaluate the overall presentation of the

financial statements.

• Conclude whether, in our judgment, there are conditions or events, considered in the aggregate,

that raise substantial doubt about the Organization's ability to continue as a going concern for a

reasonable period of time.

We are required to communicate with those charged with governance regarding, among other matters,

the planned scope and timing of the audit, significant audit findings and certain internal control related

matters that we identified during the audit.

2 -

Board of Directors

Coos County Family Health Services, Inc.

Supplementary information

Our audit was conducted for the purpose of forming an opinion on the financial statements as a whole.

The accompanying schedule of expenditures of federal awards (SEFA), as required by Title 2 U.S. Code

of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit

Requirements for Federal Awards, and related notes to the SEFA, is presented for purposes of additional

analysis and is not a required part of the financial statements. Such information is the responsibility of

management and was derived from and relates directly to the underlying accounting and other records

used to prepare the financial statements. The information has been subjected to the auditing procedures

applied in the audit of the financial statements and certain additional procedures, including comparing

and reconciling such information directly to the underlying accounting and other records used to prepare

the financial statements or to the financial statements themselves, and other additional procedures in

accordance with U.S. GAAS. In our opinion, the SEFA is fairly stated, in all material respects, in relation

to the financial statements as a whole.

Other Reporting Required by Government Auditing Standards

In accordance with Government Auditing Standards, we have also issued our report dated December 22,

2025 on our consideration of the Organization's internal control over financial reporting and on our tests

of its compliance with certain provisions of laws, regulations, contracts, and grant agreements and other

matters. The purpose of that report is solely to describe the scope of our testing of internal control over

financial reporting and compliance and the results of that testing, and not to provide an opinion on the

effectiveness of the Organization's internal control over financial reporting or on compliance. That report

is an integral part of an audit performed in accordance with Government Auditing Standards in

considering the Organization's internal control over financial reporting and compliance.

-(Mf duiuanu^uP

Manchester, New Hampshire

December 22, 2025

- 3 -

coos COUNTY FAMILY HEALTH SERVICES, INC.

Balance Sheets

June 30, 2025 and 2024

ASSETS

Current assets

Cash and cash equivalents

Patient accounts receivable

Grants receivable

Due from third-party payers

Other current assets

Total current assets

Investments

Beneficial interest in funds held by others

Operating lease right-of-use assets

Property and equipment, net

Total assets

2025

8,711,292

1,143,911

35,289

1,050,682

6,798,717

2024

$ 5,481,520

2,063,568

758,079

100,000

308,125

$ 5,101,125

1,471,895

298,997

248,708

343,544

7,464,269

1,081,963

32,991

1,194,258

5,138,079

$ 17,739,891 $ 14,911,560

LIABILITIES AND NET ASSETS

Current liabilities

Accounts payable and accrued expenses

Accrued payroll and related expenses

Current portion of operating lease liabilities

672,012 $ 219,030

1,342,740 1,197,130

149,076 143,605

Total current liabilities 2,163,828 1,559,765

Operating lease liabilities, less current portion 898,436 1,047,513

Total liabilities 3,062,264 2,607,278

Net assets

Without donor restrictions 13,324,260 12,238,989

With donor restrictions 1,353,367 65,293

Total net assets 14,677,627 12,304,282

Total liabilities and net assets $ 17,739,891 $ 14,911,560

The accompanying notes are an integral part of these financial statements.

-4-

coos COUNTY FAMILY HEALTH SERVICES, INC.

Statements of Operations and Changes in Net Assets

For the Years Ended June 30, 2025 and 2024

2025 2024

Operating revenue

Net patient service revenue

Grants and contributions

Mitigating Funds for Community Health Centers

Other operating revenue

Net assets released from restriction for operations

Total operating revenue

Operating expenses

Salaries and wages

Employee benefits

Contract services

Program supplies

340B Program Expenses

Occupancy

Other operating expenses

Depreciation

Total operating expenses

Operating income (loss)

Other revenue and gains

Investment income

Change in fair value of investments

Total other revenue and gains

Excess (deficiency) of revenue over expenses

Grants for capital acquisition, purchased - in service

Increase (decrease) in net assets without donor restrictions

$ 16,934,209 $ 13,786,642

5,948,187 6,367,692

918,804 -

186,306 180,405

- 10,171

23,987,506 20,344,910

11,983,309 11,347,175

3,416,613 3,225,452

1,210,077 1,131,554

951,334 1,018,076

2,390,901 2,272,882

781,762 685,920

1,887,235 1,505,055

402,445 382,991

23,023,676 21,569,105

963,830 (1,224,195)

97,980 91,524

23,461 23,396

121,441 114,920

1,085,271 (1,109,275)

_

65,447

1,085,271 (1,043,828)

The accompanying notes are an integral part of these financial statements.

-5-

coos COUNTY FAMILY HEALTH SERVICES, INC.

Statements of Operations and Changes in Net Assets (Concluded)

For the Years Ended June 30, 2025 and 2024

Net assets with donor restrictions

Grants and contributions

Grants and contributions for capital acquisition,

purchased - not in service

Appropriation of endowment assets for expenditure

Net assets released from restriction for operations

Change in fair value of beneficial interest in funds

held by others

Increase (decrease) in net assets with donor restrictions

Change in net assets

Net assets, beginning of year

Net assets, end of year

2025 2024

- 280

1,285,776 _

(1,179) (1.158)

- (10,171)

3,477 2,966

1,288,074 (8,083)

2,373,345 (1,051,911)

12,304,282 13,356,193

$ 14,677,627 $ 12,304,282

The accompanying notes are an integral part of these financial statements.

-6-

coos COUNTY FAMILY HEALTH SERVICES, INC.

Statements of Functional Expenses

For the Years Ended June 30, 2025 and 2024

2025

Administration

Healthcare and Support

Services Services Total

Salaries and wages $ 10,549,140 $ 1,434,169 $ 11,983,309

Employee benefits 3,007,710 408,903 3,416,613

Contract services 937,752 272,325 1,210,077

Program supplies 951,334 - 951,334

340B program expenses 2,390,901 - 2,390,901

Occupancy 688,200 93,562 781,762

Other operating expenses 1,661,370 225,865 1,887,235

Depreciation 354,280 48,165 402,445

Total operating expenses $ 20,540,687 $ 2,482,989 $ 23,023,676

2024

Administration

Healthcare and Support

Services Services Total

Salaries and wages $ 9,737,463 $ 1,609,712 $ 11,347,175

Employee benefits 2,767,889 457,563 3,225,452

Contract services 856,812 274,742 1,131,554

Program supplies 1,018,076 - 1,018,076

340B program expenses 2,272,882 - 2,272,882

Occupancy 588,615 97,305 685,920

Other operating expenses 1,291,548 213,507 1,505,055

Depreciation 328,660 54,331 382,991

Total operating expenses $ 18,861,945 $ 2,707,160 $ 21,569,105

The accompanying notes are an integral part of these financial statements.

-7-

coos COUNTY FAMILY HEALTH SERVICES, INC.

Statements of Cash Flows

For the Years Ended June 30, 2025 and 2024

2025 2024

Cash flows from operating activities

Change in net assets $ 2,373,345 $ (1,051,911)

Adjustments to reconcile change in net assets to net cash

provided (used) by operating activities

Depreciation 402,445 382,991

Amortization of operating lease right-of-use assets 143,576 158,779

Change in fair value of investments (23,461) (23,396)

Grants and contributions for long-term purposes (1,285,776) (65,727)

Change in fair value of beneficial interest in funds

held by others (3,477) (2,966)

(Increase) decrease in the following assets

Patient accounts receivable (591,673) 209,111

Grants receivable (314,268) 75,306

Due from third-party payers 148,708 (27,571)

Other current assets 35,419 (189,166)

Increase (decrease) in the following liabilities

Accounts payable and accrued expenses 230,191 (15,272)

Accrued payroll and related expenses 145,610 (93,146)

Deferred revenue - (475,000)

Operating lease liabilities (143,606) (160,854)

Net cash provided (used) by operating activities 1,117,033 (1,278,822)

Cash flows from investing activities

Proceeds from the sale of investments 500,000 100,000

Purchases of investments (538,487) (128,347)

Capital acquisitions (1,840,292) (1,021,455)

Appropriation of endowment assets for expenditure 1,179 1,158

Net cash used by investing activities (1,877,600) (1,048,644)

Cash flows from financing activities

Grants and contributions received for long-term purposes 1,140,962 65,727

Net cash provided by financing activities 1,140,962 65,727

Net increase (decrease) in cash and cash equivalents 380,395 (2,261,739)

Cash and cash equivalents, beginning of year 5,101,125 7,362,864

Cash and cash equivalents, end of year $ 5,481,520 $ 5,101,125

The accompanying notes are an integral part of these financial statements.

-8-

coos COUNTY FAMILY HEALTH SERVICES, INC.

Statements of Cash Flows (Concluded)

For the Years Ended June 30, 2025 and 2024

Supplemental disclosures of cash flow information:

Capital acquisitions included in accounts payable and

accrued expenses

Grants and contributions for long-term purposes included

in grants receivable

Operating right-of-use asset obtained in exchange for

new operating lease liability

Operating right-of-use asset obtained as a result of an

operating lease liability term modification

2025 2024

$ 222,791 $

$ 144,814 $ _

$ $ 1,012,993

$ -

$ 31,366

The accompanying notes are an integral part of these financial statements.

-9-

coos COUNTY FAMILY HEALTH SERVICES, INC.

Notes to Financial Statements

June 30, 2025 and 2024

Organization

Coos County Family Health Services, Inc. (the Organization) is a not-for-profit corporation organized in

New Hampshire. The Organization is a Federally Qualified Health Center (FQHC) which provides

outpatient health care, dental, and disease prevention services to residents of Coos County, New

Hampshire, through direct services, referral, and advocacy.

1. Summary of Significant Accounting Policies

Basis of Presentation

The financial statements of the Organization have been prepared in accordance with U.S. generally

accepted accounting principles (U.S. GAAP), which requires the Organization to report information

in the financial statements according to the following net asset classifications:

Net assets without donor restrictions: Net assets that are not subject to donor-imposed

restrictions and may be expended for any purpose in performing the primary objectives of the

Organization. These net assets may be used at the discretion of the Organization's management

and the Board of Directors.

Net assets with donor restrictions: Net assets subject to stipulations imposed by donors and

grantors. Some donor restrictions are temporary in nature; those restrictions will be met by actions

of the Organization or by the passage of time. Other donor restrictions are perpetual in nature,

whereby the donor has stipulated the funds be maintained in perpetuity.

Use of Estimates

The preparation of financial statements in conformity with U.S. GAAP requires management to make

estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure

of contingent assets and liabilities at the date of the financial statements and the reported amounts

of revenues and expenses during the reporting period. Actual results could differ from those

estimates.

Income Taxes

The Organization is a public charity under Section 501(c)(3) of the Internal Revenue Code (IRC). As

a public charity, the Organization is exempt from state and federal income taxes on income earned

in accordance with its tax-exempt purpose. Unrelated business income is subject to state and federal

income tax. Management has evaluated the Organization's tax positions and concluded that the

Organization has no unrelated business income or uncertain tax positions that require adjustment to

the financial statements.

Cash and Cash Eguivalents

Cash and cash equivalents include highly liquid investments with an original maturity of three months

or less.

- 10 -

coos COUNTY FAMILY HEALTH SERVICES, INC.

Notes to Financial Statements

June 30, 2025 and 2024

The Organization maintains cash and cash equivalents accounts at several financial institutions. The

balances at each institution are insured by the Federal Deposit Insurance Corporation (FDIC) up to

$250,000. At various times throughout the year, the Organization's cash balances may exceed FDIC

insurance. The Organization has not experienced any losses in such accounts and management

believes it is not exposed to any significant risk.

Revenue Recognition and Patient Accounts Receivable

Net patient service revenue is reported at the amount that reflects the consideration to which the

Organization expects to be entitled in exchange for providing patient care. These amounts are due

from patients and third-party payers (including commercial insurers and governmental programs).

Generally, the Organization bills the patients and third-party payers several days after the services

are performed. Revenue is recognized as performance obligations are satisfied.

Performance obligations are determined based on the nature of the services provided by the

Organization. The Organization measures the performance obligations for medical, behavioral

health, dental, podiatry and ancillary services are measured from the commencement of an in-person

or virtual encounter with a patient to the completion of the encounter. Ancillary services provided the

same day are considered part of the performance obligation and are not deemed to be separate

performance obligations.

The majority of the Organization's performance obligations are satisfied at a point in time.

The Organization has determined that the nature, amount, timing and uncertainty of revenue and

cash flows are affected by the payer. In assessing collectability, the Organization has elected the

portfolio approach. The portfolio approach is being used as the Organization has a large volume of

similar contracts with similar classes of customers (patients). The Organization reasonably expects

that the effect of applying a portfolio approach to a group of contracts would not differ materially from

considering each contract separately. Management's judgment to group the contracts by portfolio is

based on the payment behavior expected in each portfolio category. As a result, aggregating all the

contracts (which are at the patient level) by the particular payer or group of payers will result in the

recognition of the same amount of revenue as applying the analysis at the individual patient level.

Significant payer concentrations are presented in Note 3.

A summary of payment arrangements follows:

Medicare

The Organization is primarily reimbursed for medical, behavioral health, podiatry, and ancillary

services provided to Medicare beneficiaries based on the lesser of actual charges or prospectively

set rates which essentially provides a fixed payment for each patient visit, regardless of the specific

services provided during that visit. Certain other services provided to patients are reimbursed based

on predetermined payment rates for each Current Procedural Terminology (CRT) code, which may

be less than the Organization's public fee schedule.

- 11 -

coos COUNTY FAMILY HEALTH SERVICES, INC.

Notes to Financial Statements

June 30, 2025 and 2024

Certain vaccines are reimbursed under a cost reimbursement methodology through submission of

an annual cost report. Nonmaterial amounts due from Medicare are included in due from third-party

payers in the accompanying balance sheets.

Medicaid

The Organization is primarily reimbursed for medical, behavioral health, podiatry and ancillary

services provided to Medicaid beneficiaries based on prospectively set rates which essentially

provides a fixed payment for each patient visit, regardless of the specific services provided during

that visit. Certain other services provided to patients are reimbursed based on predetermined

payment rates for each CRT code, which may be less than the Organization's public fee schedule.

Dental and certain other services provided to patients are reimbursed based on predetermined

payment rates for each CRT code, which may be less than the Organization's public fee schedule.

Commercial Ravers

The Organization has also entered into payment agreements with certain commercial insurance

carriers, health maintenance organizations and preferred provider organizations. Under these

arrangements, the Organization is reimbursed for services based on contractually obligated payment

rates for each CRT code, which may be less than the Organization's public fee schedule.

Ratients

The Organization provides care to patients who meet certain criteria under its sliding fee discount

program. The Organization estimates the costs associated with providing this care by calculating the

ratio of total cost to total charges and then multiplying that ratio by the gross uncompensated charges

associated with providing care to patients eligible for the sliding fee discount program. The estimated

cost of providing services to patients under the Organization's sliding fee discount program was

approximately $295,761 and $385,798 for the years ended June 30, 2025 and 2024, respectively.

The Organization is able to provide these services with a component of funds received through

federal grants.

For uninsured patients who do not qualify under the Organization's sliding fee discount program, the

Organization bills the patient based on the Organization's standard rates for services provided.

Ratient balances are typically due within 30 days of billing; however, the Organization does, in certain

instances, enter into payment agreements with patients that allow payments in excess of one year.

For those cases, the financing component is not deemed to be significant to the contract.

- 12 -

coos COUNTY FAMILY HEALTH SERVICES, INC.

Notes to Financial Statements

June 30, 2025 and 2024

Contract 340B Pharmacy Revenue

The Organization, as an FQHC, is eligible to participate in the 340B Drug Pricing Program. This

program requires drug manufacturers to provide outpatient drugs to FQHCs and other covered

entities at a reduced price. The Organization contracts with local pharmacies under this program.

The contract pharmacies dispense drugs to eligible patients of the Organization and bill commercial

insurances on behalf of the Organization. Reimbursement received by the contract pharmacies is

remitted to the Organization, less dispensing and administrative fees. The dispensing and

administrative fees are costs of the program and are not deemed to be implicit price concessions

which would reduce the transaction price. The Organization recognizes revenue in the amounts that

reflect the consideration to which it expects to be entitled in exchange for the prescription after the

amount has been determined by the pharmacy benefits manager.

Regulatory Uncertainties

Laws and regulations governing the Medicare, Medicaid and 340B programs are complex and

subject to interpretation. Management believes that the Organization is in compliance with all laws

and regulations. Compliance with such laws and regulations can be subject to future government

review and interpretation, as well as significant regulatory action including fines, penalties and

exclusion from the Medicare, Medicaid and 340B programs. Differences between amounts

previously estimated and amounts subsequently determined to be recoverable or payable are

included in patient service revenue in the year that such amounts become known.

The Organization's business could be impacted by federal and state legislation in the area of

healthcare reform. Changes in these areas could adversely impact the Organization's operations in

the future.

Patient Accounts Receivable

Patient accounts receivable are stated at the amount management expects to collect from

outstanding balances and are reduced by explicit and implicit price concessions. Management

estimates implicit price concessions based on its historical collection experience with patients. No

additional valuation allowance is necessary for possible credit losses based on historical experience,

current conditions, and reasonable and supportable forecasts.

Grants Receivable

Grants receivable are stated at the amount management expects to collect from outstanding

balances. All such amounts are considered collectible.

The Organization receives a significant amount of grants from the U.S. Department of Health and

Human Services (HHS). As with all government funding, these grants are subject to reduction or

termination in future years. For the years ended June 30, 2025 and 2024, grants from HHS (including

both direct awards and awards passed through other organizations) represented approximately 81%

and 78%, respectively, of grants and contributions.

13 -

coos COUNTY FAMILY HEALTH SERVICES, INC.

Notes to Financial Statements

June 30, 2025 and 2024

A portion of the Organization's revenue is derived from cost-reimbursable federal and state contracts

and grants, which are conditioned upon certain performance requirements and/or the incurrence of

allowable qualifying expenses. Amounts received are recognized as revenue when the Organization

has incurred expenditures in compliance with specific contract or grant provisions. Amounts received

prior to incurring qualifying expenditures are reported as deferred revenue.

The Organization has been awarded cost reimbursable grants of $1,618,708 that are available for

use through May 31, 2026.

Investments

The Organization reports investments at fair value. Investments include assets held for long-term

purposes. Accordingly, investments have been classified as non-current assets on the

accompanying balance sheets regardless of maturity or liquidity. The Organization has established

policies governing long-term investments.

Investment income and the change in fair value are included in the excess (deficiency) of revenue

over expenses, unless otherwise stipulated by the donor or State Law. Investments, in general, are

exposed to various risks, such as interest rate, credit, and overall market volatility risks. As such, it

is reasonably possible that changes in the values of investments will occur in the near term and that

such changes could materially affect the amounts reported in the financial statements.

Beneficial Interest in Funds Held bv Others

The Organization is a beneficiary of an agency endowment fund at The New Hampshire Charitable

Foundation (the Foundation). Pursuant to the terms of the resolution establishing the fund, property

contributed to the Foundation is held as a separate fund designated for the benefit of the

Organization. In accordance with its spending policy, the Foundation makes distributions from the

fund to the Organization. The distributions are approximately 4% of the market value of the fund per

year. The Organization's interest in the fund is recognized as a component of net assets with donor

restrictions.

Riqht-of-Use Assets and Lease Liabilities

U.S. GAAP requires lessees to recognize a lease liability and a right-of-use asset for all leases with

terms greater than 12 months on the balance sheets. Whether an arrangement contains a lease is

evaluated at the inception of the arrangement. The Organization estimates its lease liability at the

present value of future rent payments required under a lease using the imputed rate when identifiable

or a risk-free rate for a term approximating the lease term, including options to extend or terminate

the lease that the Organization is reasonably certain to exercise. As the leases do not provide an

implicit rate, the Organization elected the practical expedient to use the risk-free rate.

The Organization's right-of-use asset initially is equal to its lease liability, adjusted for any lease

incentives received or lease payments made. Lease expense for operating leases is recorded on a

straight-line basis over the term of a lease. Leases of 12 months or less at inception are not included

in the Organization's right-of-use assets and lease liabilities.

- 14

coos COUNTY FAMILY HEALTH SERVICES, INC.

Notes to Financial Statements

June 30, 2025 and 2024

Property and Eauioment

Property and equipment are carried at cost. Maintenance, repairs and minor renewals are expensed

as incurred and renewals and betterments are capitalized. Provision for depreciation is computed

using the straight-line method over the useful lives, which range from 3 to 40 years, of the related

assets. The Organization's capitalization policy is applicable for acquisitions greater than $5,000.

Contributions

Unconditional promises to give cash and other assets are reported at fair value at the date the

promise is received, which is then treated as cost. The gifts are reported as net assets with donor

restrictions if they are received with donor stipulations that limit use of the donated assets. When a

donor restriction expires, that is, when a stipulated time restriction ends or purpose restriction is

accomplished, net assets with donor restrictions are reclassified as net assets without donor

restrictions and reported in the statements of operations and changes in net assets as net assets

released from restriction. Contributions whose restrictions are met in the same period as the support

was received are recognized as net assets without donor restrictions.

The Organization reports gifts of property and equipment as support without donor restrictions unless

explicit donor stipulations specify how the donated assets must be used. Gifts of long-lived assets

with explicit restrictions that specify how the assets are to be used and gifts of cash or other assets

that must be used to acquire long-lived assets are reported as support with donor restrictions. Absent

explicit donor stipulations about how long those long-lived assets must be maintained, the

Organization reports expirations of donor restrictions when the donated or acquired long-lived assets

are placed in service.

Donated Goods and Services (Unaudited)

The Organization acts as a conduit for pharmaceutical company patient assistance programs. The

Organization provides assistance to patients in applying for and distributing prescription drugs under

the programs. The value of the prescription drugs distributed by the Organization to patients is not

reflected in the accompanying financial statements. The Organization estimates that the value of

prescription drugs distributed by the Organization for the years ended June 30, 2025 and 2024 was

$2,646,947 and $2,812,601, respectively.

Various programs' help and support for the daily operations of the Organization's Response Program

were provided by the general public of the surrounding communities. The donated services have not

been reflected in the accompanying financial statements because they do not meet the criteria for

recognition (specialized skills that would be purchased if not donated). Management estimates the

fair value of donated services received but not recognized as revenue or expense was $129,168 and

$121,831 for the years ended June 30, 2025 and 2024, respectively. The Response Program also

receives donations of supplies (clothing, food, household items, personal care items, toys, etc.) that

are provided to clients in the program. The fair value of supplies recognized as revenue and expense

was $2,585 and $3,500 for the years ended June 30, 2025 and 2024, respectively.

15

coos COUNTY FAMILY HEALTH SERVICES, INC.

Notes to Financial Statements

June 30, 2025 and 2024

Functional Expenses

The financial statements report certain categories of expenses that are attributable to more than one

program or supporting function; therefore, these expenses require allocation on a reasonable basis

that is consistently applied. As the Organization is a service organization, such expenses are

allocated between healthcare services and administrative support based on the percentage of direct

care wages to total wages.

Excess (Deficiency) of Revenue over Expenses

The statements of operations and changes in net assets reflect the excess (deficiency) of revenue

over expenses. Changes in net assets without donor restrictions which are excluded from the excess

(deficiency) of revenue over expenses include contributions of long-lived assets (including assets

acquired using grants which, by donor restriction, were to be used for the purposes of acquiring such

assets).

Subsequent Events

In July 2025, the Organization identified unauthorized access to certain information systems that

may have resulted in the disclosure of personal information and protected health information. The

Organization notified affected individuals and regulators and is cooperating with federal and state

authorities, including the HHS Office for Civil Rights ("OCR"). A putative class-action lawsuit related

to this incident was filed in August 2025, and a proposed settlement is subject to regulatory and

judicial review. No determination or approval of the proposed settlement had been made as of

December 22, 2025. The Organization may also be subject to civil monetary penalties arising from

OCR's ongoing investigation, the outcome of which cannot be reasonably estimated at this time. Due

to significant uncertainties regarding the ultimate resolution, management is unable to reasonably

estimate the amount or range of any potential loss related to this matter. The Organization maintains

cyber-liability insurance with coverage limits of $1.0 million; however, the amount and timing of any

potential recoveries remain uncertain.

For purposes of the preparation of these financial statements, management has considered

transactions or events occurring through December 22, 2025, the date that the financial statements

were available to be issued. Management has not evaluated subsequent events after that date for

inclusion in the financial statements.

- 16

coos COUNTY FAMILY HEALTH SERVICES, INC.

Notes to Financial Statements

June 30, 2025 and 2024

2. Availability and Liauiditv of Financial Assets

The Organization regularly monitors liquidity required to meet its operating needs and other

contractual commitments. The Organization has various sources of liquidity at its disposal, including

cash and cash equivalents, investments and a $500,000 line of credit (Note 6).

Financial assets available for general expenditure within one year were as follows at June 30:

2025 2024

Cash and cash equivalents $ 5,481,520 $ 5,101,125

Patient accounts receivable 2,063,568 1,471,895

Grants receivable 758,079 298,997

Due from third-party payers 100,000 248,708

Investments 1.143.911 1,081,963

Financial assets available 9,547,078 8,202,688

Less net assets with donor restrictions 32.302 32,302

Financial assets available for current use $ 9.514.776 $ 8.170.386

3. Patient Accounts Receivable and Net Patient Service Revenue

Patient accounts receivable and amounts due from third-party payers are stated at the amount

management expects to collect from outstanding balances and consisted of the following at June 30:

2025 2024 2023

Medical and dental $ 1,764,478 $ 1,230,060 $ 1,360,050

Contract 340B pharmacy program 299.090 241.835 320.956

Total patient accounts receivable $ 2.063.568 S 1.471.895 $ 1.681.006

Due from third-party payers $ 100.000 S 248.708 S 221.137

The Organization grants credit without collateral to its patients, most of whom are local residents and

are insured under third-party payer agreements. The composition of accounts receivable from

patients and third-party payers, net of allowances, were as follows at June 30:

2025 2024

Governmental plans:

Medicare 36% 29%

Medicaid 19% 24%

Commercial payers:

Anthem 13% 13%

All other 12% 16%

Patient 20% 18%

Total 100% 100%

- 17

coos COUNTY FAMILY HEALTH SERVICES, INC.

Notes to Financial Statements

June 30, 2025 and 2024

Net patient service revenue by payer was as follows for the years ended June 30;

2025 2024

Governmental plans:

Medicare

Medicaid

Commercial payers:

Anthem

All other

Patient

Total direct patient service revenue

Other patient revenue

Contract 340B pharmacy revenue

Net patient service revenue

4. Investments

$ 3,818,592 $

3,548,272

1,384,016

2,164,732

599.215

11,512,827

401,459

5.019.923

2,883,178

3,008,235

1,135,867

1,810,129

438.252

9,275,661

496,109

4.014.872

$ 16.934.209 $ 13 786 642

U.S. GAAR defines fair value as the price that would be received to sell an asset or paid to transfer

a liability (an exit price) in an orderly transaction between market participants and also establishes a

fair value hierarchy which requires an entity to maximize the use of observable inputs and minimize

the use of unobservable inputs when measuring fair value.

U.S. GAAR distinguishes three levels of inputs that may be utilized when measuring fair value:

Level 1: Quoted prices (unadjusted) for identical assets or liabilities in active markets that the

entity has the ability to access as of the measurement date.

Level 2: Significant observable inputs other than Level 1 prices, such as quoted prices for similar

assets or liabilities, quoted prices in markets that are not active, and other inputs that are

observable or can be corroborated by observable market data.

Level 3: Significant unobservable inputs that reflect an entity's own assumptions about the

assumptions that market participants would use in pricing an asset or liability.

- 18 -

coos COUNTY FAMILY HEALTH SERVICES, INC.

Notes to Financial Statements

June 30, 2025 and 2024

The fair market value of the Organization's investments are measured on a recurring basis. The

following table sets forth the Organization's assets by level within the fair value hierarchy at June 30:

2025

Level 1 Level 2 Level 3 Total

Cash and cash equivalents $ 100,868 $ - $ - $ 100,868

Corporate bonds - 858,770 - 858,770

Government agency obligations: 184.273: 184.273

Total investments 100,868 1,043,043 - 1,143,911

Beneficial interest in perpetual

trusts held by others:: 35.289 35.289

Total $ 100.868 $ 1 ■043.043 $ 35.289 9 1.179.200

2024

Cash and cash equivalents

Corporate bonds

Government securities

Total investments

Beneficial interest in perpetual

trusts held by others

Total

Level 1 Level 2 Level 3 Total

$ 40,509 $.

$ -

$ 40,509

-

796,261 -

796,261

-

245.193 -

245.193

40,509 1,041,454 - 1,081,963

32.991 32.991

$ 40.509 $ 1.041.454 $ 32.991 $ 1.114.954

Corporate bonds and government agency obligations are valued based on quoted market prices of

similar assets.

The fair value of the beneficial interest in funds held by others is measured on a non-recurring basis

using Level 3 inputs. The fair value is determined annually based on the fair value of the assets in

the trust using the market approach, as represented by the Foundation's management. The

Organization's management determines the reasonableness of the methodology by evaluating

market developments.

- 19 -

coos COUNTY FAMILY HEALTH SERVICES, INC.

Notes to Financial Statements

June 30, 2025 and 2024

5. Property and Equipment

Property and equipment consisted of ttie following at June 30:

2025 2024

Land and improvements $ 153,257 $ 153,257

Building and improvements 6,590,530 6,438,110

Furniture, fixtures, and equipment 3.316.823 3.267.084

Total cost 10,060,610 9,858,451

Less accumulated depreciation 5.122.817 4.720.372

4,937,793 5,138,079

Construction in progress 1.860.924 -

Property and equipment, net $ 6.798.717 $ 5.138.079

Projects in process relate to an elevator project that was placed in service in August 2025.

Property and equipment acquired with Federal grant funds are subject to specific federal standards

for sales and other dispositions. In many cases, the Federal government retains a residual ownership

interest in the assets, requiring prior approval and restrictions on disposition.

6. Line of Credit

The Organization has a $500,000 line of credit with a local bank through November 2025. The line

of credit is collateralized by the Organization's business assets with interest at the prime rate plus

0.5% (8.00% at June 30, 2024). There was no outstanding balance at June 30, 2025 and 2024.

7. Leases

Lease Arrangements

The Organization has entered into the following lease arrangements:

Operating Leases

The Organization has operating leases for clinic facilities and parking under non-cancelable leases

with maturities ranging from December 2027 through December 2033. These non-cancelable leases

have no remaining renewal options and contain no escalation clauses. Early termination of the leases

are generally prohibited unless there is a violation under the lease agreement.

Short-Term Leases

The Organization has certain leases that are for a period of 12 months of less or contain renewals

for periods of 12 months or less.

- 20 -

coos COUNTY FAMILY HEALTH SERVICES, INC.

Notes to Financial Statements

June 30, 2025 and 2024

Lease Cost

Lease cost, which approximates lease payments, was as follows for the years ended June 30:

2025 2024

Operating leases $ 185,936 $ 185,900

Short-term leases 200.586 118.211

Total 5 386.522 $ 304.111

Other Information

The weighted-average remaining lease term and discount rate for operating leases as of June 30,

2025 and 2024, were 7.55 years and 3.83% and 8.39 years and 3.82%, respectively.

Future Minimum Lease Payments and Reconciliation to the Balance Sheet

Future minimum payments due under lease agreements were as follows for the years ending June

30:

2026 $ 185,966

2027 185,966

2028 173,697

2029 120,000

2030 120,000

Thereafter 420.000

Total future undiscounted lease payments 1,205,629

Less present value discount 158.117

Total lease liabilities 1,047,512

Current portion of lease liabilities 149.076

Lease liabilities, less current portion $ 898.436

8. Net Assets

Net assets were as follows at June 30:

2025 2024

Net assets without donor restrictions

Undesignated $ 13,072,104 $ 11,986,833

Designated for working capital 252.156 252.156

Total $ 13.324.260 $ 12.238.989

21 -

coos COUNTY FAMILY HEALTH SERVICES, INC.

Notes to Financial Statements

June 30, 2025 and 2024

2025 2024

Net assets with donor restrictions for specific purpose

Temporary in nature

Program services $ 41,228 $ 38,930

Grants for capital acquisition, purchased - not in service 1,285,776

Permanent in nature

Endowment 26.363 26,363

Total ii 1.353.367 S 65.293

9. Mitigating Funds for Community Health Centers

In September 2024, the Organization received $918,804 from the State of New Hampshire,

Department of Health and Human Services under the Mitigating Funds for Community Health

Centers program, financed through the American Rescue Plan Act (ARPA). The purpose of the

payment was to assist community health centers in mitigating operating losses and increased

uncompensated care resulting from the expiration of continuous Medicaid coverage following the

COVID-19 Public Health Emergency, thereby supporting continued access to care for affected

individuals.

In accordance with 2 CFR 200.331, the State of New Hampshire identified the Organization as a

beneficiary, not a subrecipient. Consequently, the payment represents a beneficiary or relief

payment rather than a federal or state grant or contract. The payment is therefore not subject to a

federal compliance audit in accordance with the Uniform Guidance and is excluded from the

schedule of expenditures of federal awards (SEFA).

10. Malpractice Insurance

The Organization is protected from medical malpractice risk as an FQHC under the Federal Tort

Claims Act (FTCA). The Organization has additional medical malpractice insurance, on a

claims-made basis, for coverage outside the scope of the protection of the FTCA. As of June 30,

2025, there were no known malpractice claims outstanding which in the opinion of management, will

be settled for amounts in excess of both FTCA and additional medical malpractice insurance

coverage, nor are there any unasserted claims or incidents which require loss accrual. The

Organization intends to renew the additional medical malpractice insurance coverage on a

claims-made basis and anticipates that such coverage will be available.

11. Benefit Plans

The Organization has a defined contribution plan under Internal Revenue Code Section 401 (k) that

covers substantially all employees. The Organization contributed $400,220 and $381,142 for the

years ended June 30, 2025 and 2024, respectively.

The Organization provides health insurance to its employees through a self-insurance plan with a

re-insurance arrangement to limit exposure. The Organization estimates and records a liability for

claims incurred but not reported for employee health provided through the self-insured plan. The

liability is estimated based on prior claims experience and the expected time period from the date

such claims are incurred to the date the related claims are submitted and paid.

22 -

SUPPLEMENTARY INFORMATION

coos COUNTY FAMILY HEALTH SERVICES, INC.

Schedule of Expenditures of Federal Awards

For the Year Ended June 30, 2025

Federal Grant/Pass-Through

Grantor/Program Title

U.S. Department of Health and Human Services:

Direct:

Health Center Program Cluster

Health Center Program (Community Health Centers,

Migrant Health Centers, Health Care for the

Homeless, and Public Housing Primary Care)

Grants for New and Expanded Services Under the

Health Center Program

COVID-19 Grants for New and Expanded Services

Under the Health Center Program

Total AL 93.527

Total Health Center Program Cluster

Congressional Directives

Passthrouah:

Federal

Assistance Passthrough

Listing Contract

Number Number

93.224

93.527

93.527

93.493

New Hampshire Coalition Against Domestic and Sexual Violence

Injury Prevention and Control Research and State

and Community Based Programs 93.136

Family Violence Prevention and Services/

Domestic Violence Shelter and Supportive

Services 93.671

State of New Hampshire Department of Health and Human Services

Family Planning Services 93.217

477 Cluster

Temporary Assistance for Needy Families

Maternal and Child Health Services Block Grant

to the States

93.558

93.994

n/a

n/a

102-500734/

90080203

502-500891/

45130203

102-500731/

90080000

Total

Federal

Expenditures

$ 3,979,740

36,251

120,907

157,158

4,136,898

1,182,130

13,677

279,713

43,079

5,454

38,435

The accompanying notes are an integral part of this schedule.

23

coos COUNTY FAMILY HEALTH SERVICES, INC.

Schedule of Expenditures of Federal Awards (Concluded)

For the Year Ended June 30, 2025

Federal

Assistance Passthrough

Federal Grant/Pass-Through Listing

Grantor/Program Title Number

U.S. Department of Health and Human Services:

Passthrough:

Bi-State Primary Care Association. Inc.

Training in General, Pediatric, and Public

Health Dentistry 93.059

COVID-19 Immunization Cooperative Agreements 93.268

COVID-19 Activities to Support State, Tribal,

Local and Territorial (STLT) Health Department

Response to Public Health or Healthcare Crises 93.391

Total U.S. Department of Health and Human Services

U.S. Department of Justice:

Passthrough:

New Hampshire Coalition Aoainst Domestic and Sexual Violence

Sexual Assault Services Formula Program 16.017

Crime Victim Assistance 16.575

Total U.S. Department of Justice

Northern Border Regional Commission

Direct:

Northern Border Regional Development 90.601

Total Expenditures of Federal Awards, All Programs

Contract

Number

n/a

n/a

n/a

n/a

n/a

Total

Federal

Expenditures

9,466

91,077

62,699

5,862,628

67,872

323,251

391,123

34,610

$ 6,288,361

The accompanying notes are an integral part of this schedule.

24

coos COUNTY FAMILY HEALTH SERVICES, INC.

Notes to Schedule of Expenditures of Federal Awards

Year Ended June 30, 2025

1. Summary of Significant Accounting Policies

Expenditures reported in the schedule of expenditures of federal awards (Schedule) are reported on

the accrual basis of accounting. Such expenditures are recognized following the cost principles

contained In Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative

Requirements, Cost Principles, and Audit Requirements for Federal Awards (Uniform Guidance),

wherein certain types of expenditures are not allowable or are limited as to reimbursement.

2. De Minimis Indirect Cost Rate

Coos County Family Health Services, Inc. (the Organization) has elected not to use the 10% de

minlmis Indirect cost rate allowed under the Uniform Guidance.

3. Basis of Presentation

The Schedule Includes the federal grant activity of the Organization. The Information In this

Schedule Is presented In accordance with the requirements of the Uniform Guidance. Because the

Schedule presents only a selected portion of the operations of the Organization, It Is not Intended

to and does not present the financial position, changes In net assets, or cash flows of the

Organization.

- 25 -

b) BerryDunnBDMP Assurance, LLP

INDEPENDENT AUDITOR'S REPORT ON INTERNAL CONTROL OVER

FINANCIAL REPORTING AND ON COMPLIANCE AND OTHER MATTERS

BASED ON AN AUDIT OF FINANCIAL STATEMENTS PERFORMED

IN ACCORDANCE WITH GOVERNMENT AUDITING STANDARDS

Board of Directors

Coos County Family Health Services, Inc.

We have audited, in accordance with U.S. generally accepted auditing standards and the standards

applicable to financial audits contained in Government Auditing Standards issued by the Comptroller

General of the United States, the financial statements of Coos County Family Health Services, Inc. (the

Organization), which comprise the balance sheet as of June 30, 2025, and the related statements of

operations and changes in net assets, functional expenses and cash flows for the year then ended, and

the related notes to the financial statements, and have issued our report thereon dated December 22,

2025.

Report on Internal Control over Financial Reporting

In planning and performing our audit of the financial statements, we considered the Organization's

internal control over financial reporting (internal control) as a basis for designing audit procedures that

are appropriate in the circumstances for the purpose of expressing our opinion on the financial

statements, but not for the purpose of expressing an opinion on the effectiveness of the Organization's

internal control. Accordingly, we do not express an opinion on the effectiveness of the Organization's

internal control.

A deficiency in internal control exists when the design or operation of a control does not allow

management or employees, in the normal course of performing their assigned functions, to prevent, or

detect and correct, misstatements on a timely basis. A material weakness is a deficiency, or a

combination of deficiencies, in internal control such that there is a reasonable possibility that a material

misstatement of the entity's financial statements will not be prevented, or detected and corrected, on a

timely basis. A significant deficiency is a deficiency, or a combination of deficiencies, in internal control

that is less severe than a material weakness, yet important enough to merit attention by those charged

with governance.

Our consideration of internal control was for the limited purpose described in the first paragraph of this

section and was not designed to identify all deficiencies in internal control that might be material

weaknesses or significant deficiencies. Given these limitations, during our audit we did not identify any

deficiencies in internal control that we consider to be material weaknesses. However, material

weaknesses or significant deficiencies may exist that were not identified.

berrydunn.conn

Board of Directors

Coos County Family Health Services, Inc.

Report on Compliance and Other Matters

As part of obtaining reasonable assurance about whether the Organization's financial statements are free

from material misstatement, we performed tests of its compliance with certain provisions of laws,

regulations, contracts, and grant agreements, noncompliance with which could have a direct and material

effect on the financial statements. However, providing an opinion on compliance with those provisions

was not an objective of our audit and, accordingly, we do not express such an opinion. The results of our

tests disclosed no instances of noncompliance or other matters that are required to be reported under

Government Auditing Standards.

Purpose of this Report

The purpose of this report is solely to describe the scope of our testing of internal control and compliance

and the results of that testing, and not to provide an opinion on the effectiveness of the Organization's

internal control or on compliance. This report is an integral part of an audit performed in accordance with

Government Auditing Standards in considering the Organization's internal control and compliance.

Accordingly, this communication is not suitable for any other purpose.

duuA.anii,uP

Manchester, New Hampshire

December 22, 2025

- 27

BerryDunn

BDMP Assurance, LLP

INDEPENDENT AUDITOR'S REPORT ON COMPLIANCE

FOR EACH MAJOR FEDERAL PROGRAM AND ON INTERNAL CONTROL

OVER COMPLIANCE REQUIRED BY THE UNIFORM GUIDANCE

Board of Directors

Coos County Family Health Services, Inc.

Report on Compliance for Each Major Federal Program

Opinion on Each Major Federal Program

We have audited Coos County Family Health Services, Inc.'s (the Organization) compliance with the

types of compliance requirements identified as subject to audit in the Office of Management and Budget's

Compliance Supp/emenf that could have a direct and material effect on each of its major federal programs

for the year ended June 30, 2025. The Organization's major federal programs are identified in the

summary of auditor's results section of the accompanying schedule of findings and questioned costs.

In our opinion, the Organization complied, in all material respects, with the compliance requirements

referred to above that could have a direct and material effect on each of its major federal programs for

the year ended June 30, 2025.

Basis for Opinion on Each Major Federal Program

We conducted our audit of compliance in accordance with U.S. generally accepted auditing standards;

the standards applicable to financial audits contained in Government Auditing Standards issued by the

Comptroller General of the United States; and the audit requirements of Title 2 U.S. Code of Federal

Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements

for Federal Awards (Uniform Guidance). Our responsibilities under those standards and the Uniform

Guidance are further described in the Auditor's Responsibilities for the Audit of Compliance section of

our report.

We are required to be independent of the Organization and to meet our other ethical responsibilities in

accordance with relevant ethical requirements relating to our audit. We believe that the audit evidence

we have obtained is sufficient and appropriate to provide a basis for our opinion on compliance for each

major federal program. Our audit does not provide a legal determination of the Organization's compliance

with the compliance requirements referred to above.

Responsibilities of Management for Compliance

Management is responsible for compliance with the requirements referred to above and for the design,

implementation, and maintenance of effective internal control over compliance with the requirements of

laws, statutes, regulations, rules, and provisions of contracts or grant agreements applicable to the

Organization's federal programs.

berrydunn.com

Board of Directors

Coos County Family Health Services, Inc.

Auditor's Responsibilities for the Audit of Compliance

Our objectives are to obtain reasonable assurance about whether material noncompliance with the

compliance requirements referred to above occurred, whether due to fraud or error, and express an

opinion on the Organization's compliance based on our audit. Reasonable assurance is a high level of

assurance but is not absolute assurance and therefore is not a guarantee that an audit conducted in

accordance with U.S. generally accepted auditing standards. Government Auditing Standards and the

Uniform Guidance will always detect material noncompliance when it exists. The risk of not detecting

material noncompliance resulting from fraud is higher than for that resulting from error, as fraud may

involve collusion, forgery, intentional omissions, misrepresentations, or the override of internal control.

Noncompliance with the compliance requirements referred to above is considered material if there is a

substantial likelihood that, individually or in the aggregate, it would influence the judgment made by a

reasonable user of the report on compliance about the Organization's compliance with the requirements

of the major federal program as a whole.

In performing an audit in accordance with U.S. generally accepted auditing standards. Government

Auditing Standards and the Uniform Guidance, we:

• Exercise professional judgment and maintain professional skepticism throughout the audit.

• Identify and assess the risks of material noncompliance, whether due to fraud or error, and design

and perform audit procedures responsive to those risks. Such procedures include examining, on

a test basis, evidence regarding the Organization's compliance with the compliance requirements

referred to above and performing such other procedures as we considered necessary in the

circumstances.

• Obtain an understanding of the Organization's internal control over compliance relevant to the

audit in order to design audit procedures that are appropriate in the circumstances and to test

and report on internal control over compliance in accordance with the Uniform Guidance, but not

for the purpose of expressing an opinion on the effectiveness of the Organization's internal

control over compliance. Accordingly, no such opinion is expressed.

We are required to communicate with those charged with governance regarding, among other matters,

the planned scope and timing of the audit and any significant deficiencies and material weaknesses in

internal control over compliance that we identified during the audit.

Other Matters

The results of our auditing procedures disclosed an instance of noncompliance which is required to be

reported in accordance with the Uniform Guidance and which are described in the accompanying

schedule of findings and questioned costs as item 2025-001. Our opinion on each major federal program

is not modified with respect to this matter.

Government Auditing Standards requires the auditor to perform limited procedures on the Organization's

response to the noncompliance finding identified in our compliance audit described in the accompanying

schedule of findings and questioned costs. The Organization's response was not subjected to the other

auditing procedures applied in the audit of compliance and, accordingly, we express no opinion on the

response.

29 -

Board of Directors

Coos County Family Health Services, Inc.

Report on Internal Control Over Compliance

Our consideration of internal control over compliance was for the limited purpose described in the

Auditor's Responsibilities for the Audit of Compliance section above and was not designed to identify all

deficiencies in internal control over compliance that might be material weaknesses or significant

deficiencies in internal control over compliance and therefore, material weaknesses or significant

deficiencies may exist that were not identified. We did not identify any deficiencies in internal control over

compliance that we consider to be material weaknesses. However, as discussed below, we did identify

a deficiency in internal control over compliance that we consider to be a significant deficiency.

A deficiency in internal control over compliance exists when the design or operation of a control over

compliance does not allow management or employees, in the normal course of performing their assigned

functions, to prevent, or detect and correct, noncompliance with a type of compliance requirement of a

federal program on a timely basis. A material weakness in internal control over compliance is a deficiency,

or a combination of deficiencies, in internal control over compliance, such that there is a reasonable

possibility that material noncompliance with a type of compliance requirement of a federal program will

not be prevented, or detected and corrected, on a timely basis. A significant deficiency in internal control

over compliance is a deficiency, or a combination of deficiencies, in internal control over compliance with

a type of compliance requirement of a federal program that is less severe than a material weakness in

internal control over compliance, yet important enough to merit attention by those charged with

governance. We consider the deficiency in internal control over compliance described in the

accompanying schedule of findings and questioned costs as item 2025-001, to be a significant deficiency.

Our audit was not designed for the purpose of expressing an opinion on the effectiveness of internal

control over compliance. Accordingly, no such opinion is expressed.

Government Auditing Standards requires the auditor to perform limited procedures on the Organization's

response to the internal control over compliance finding identified in our compliance audit described in

the accompanying schedule of findings and questioned costs. The Organization's response was not

subjected to the other auditing procedures applied in the audit of compliance and, accordingly, we

express no opinion on the response.

The purpose of this report on internal control over compliance is solely to describe the scope of our testing

of internal control over compliance and the results of that testing based on the requirements of the

Uniform Guidance. Accordingly, this report is not suitable for any other purpose.

-iMf dMwmii^UP

Manchester, New Hampshire

December 22, 2025

30 -

coos COUNTY FAMILY HEALTH SERVICES, INC.

Schedule of Findings and Questioned Costs

Year Ended June 30, 2025

Section 1. Summary of Auditor's Results

Financial Statements

Type of auditor's report issued:

Internal control over financial reporting:

Unmodified

Material weakness(es) identified? [] Yes [X] No

Significant deficiency(ies) identified that are not

considered to be material weakness(es)? [] Yes [X] None reported

Noncompliance material to financial statements noted? [] Yes [X] No

Federal Awards

Internal control over major programs:

Material weakness(es) identified? [] Yes [X] No

Significant deficiency(ies) identified that are not

considered to be material weakness(es)? [X] Yes [] None reported

Type of auditor's report issued on compliance for major programs: Unmodified

Any audit findings disclosed that are required to be reported

in accordance with 2 CFR 200.516(a)? [X] Yes [] No

Identification of major programs:

Assistance Listing Number

93.493

Name of Federal Program or Cluster

Health Center Program Cluster

Congressional Directives

Dollar threshold used to distinguish between Type A and

Type B programs:

Auditee qualified as low-risk auditee?

Section 2. Financial Statement Findings

None noted

[X]

$750,000

Yes [] No

- 31

coos COUNTY FAMILY HEALTH SERVICES, INC.

Schedule of Findings and Questioned Costs (Continued)

Year Ended June 30, 2025

Section 3. Federal Award Findinos and Questioned Costs

Finding Number:

Finding Type:

Information on the

Federal Program:

Criteria:

Condition:

Cause:

Effect:

Questioned Costs:

Repeat Finding:

2025-001

Immaterial noncompliance and significant deficiency in internal controls over

compliance related to allowable costs

Program Name: Health Center Program (Community Health Centers, Migrant

Health Centers, Health Care for the Homeless, and Public Housing Primary

Care) (ALN 93.224)

Federal Awards Project Title: Health Center Program

Award Period: June 1, 2024 - May 31, 2025

Award Number: H80CS00508

Resources and Services Administration (HRSA)

Under 2 CFR §200.430(c)(2), compensation charged to federal awards must

comply with the Executive Level II salary limitation established by the Office of

Personnel Management (0PM). Salary costs allocated to the Health Center

Program may not exceed this cap, and only the allowable portion up to the

Executive Level II rate may be charged to the federal award.

During testing of payroll charges, 3 of the 25 employees tested had salary

charges which exceeded the Executive Level II cap. Upon further review of the

full population, a total of 4 employees were identified whose salary charges to

the grant exceeded the cap. Although the Organization calculated the capped

allowable salaries for each employee, the allocations entered into the payroll

system reflected full gross wages rather than the capped amounts, resulting in

the excess salaries.

The Organization did not have a system of internal controls that included

verification of accurate entry of salary allocations into the payroll system.

Unallowable salary amounts were initially charged to the grant. However, the

Organization was able to identify other allowable expenditures sufficient to

support the total amount of grant funds drawn.

None

No

- 32

coos COUNTY FAMILY HEALTH SERVICES, INC.

Schedule of Findings and Questioned Costs (Concluded)

Year Ended June 30, 2025

Section 3. Federal Award Findinas and Questioned Costs fConcluded)

Finding Number:

Recommendation:

Views of a Responsible

Official and Corrective

Action Plan:

2025-001 (Concluded)

We recommend the Organization update its policies and procedures to include

an independent review of payroll allocations entered into the payroll system to

ensure they agree to the calculated capped amounts. Additionally, periodic

reconciliation of salary charges to the Executive Level II limitation should be

performed to prevent similar errors in the future.

Management agrees with the finding and will update payroll policies and

procedures to include verification of salary allocations charged to federal

awards. An independent review process and periodic reconciliations to the

Executive Level II limitation will be implemented to prevent recurrence.

- 33 -

Kenneth E. Gordon

E-mail: kgordon@ccfhs.org

WORK EXPERIENCE

CHIEF EXECUTIVE OFFICER: Coos County Family Health Services, Berlin, New Hampshire

(2/15 — present)

• Provided administrative and strategic leadership to a Federally Qualified Health Center

serving approximately 12,000 patients.

• Work closely with the organization's Board of Directors to establish policy and to

monitor performance in the realms of finance, clinical quality, consumer and staff

satisfaction.

ADMINISTRATOR: North Country Health Consortium, Littleton, New Hampshire (8/13 —

2/15)

• Provide administrative leadership of the North Country Accountable Care Organization,

a newly formed non-profit entity comprised of four community health centers working

in collaboration to improve the health and well-being of North Country residents.

EXECUTIVE DIRECTOR: Area Agency on Aging for Northeastern Vermont, St. Johnsbury,

Vermont (9/02 — 7/13)

• Provided administrative leadership to a private, non-profit human service agency serving

older adults and family caregivers.

Financial management of the organization's budget.

Supervision of clinical and administrative staff.

SOCIAL SERVICES COORDINATOR: Caledonia Home Health Care and Hospice, St

Johnsbury, Vermont (8/97 - 8/02)

• Provided medical social work to individuals and families receiving home care and

hospice services.

Supervised and coordinated the work of four master's level staff members.

Provided consultation to medical staff regarding psycho-social issues.

Participated in discharge planning with other social service and health agencies.

CHILD PROTECTIVE SERVICE WORKER: Vermont Department of Social & Rehabilitation

Services, St. Johnsbury, Vermont (5/96 - 8/97)

• Coordinated multidisciplinary treatment teams providing services to families.

Kenneth E. Gordon

Resume/Pg. 2

• Psychosocial assessment & case planning.

• Care Management (Medicaid reimbursable).

• Individual and family counseling.

• Placement and supervision of children in foster care.

• Preparation of court reports.

ADOPTION SOCIAL WORKER: Vermont Department of Social & Rehabilitation Services,

St. Johnsbury & Newport, Vermont (4/90 -9/94)

• Recruitment, training and assessment of adoptive applicants.

• Placement and supervision of abused and neglected children with adoptive families.

• Counseling with birth parents considering the voluntary relinquishment of a child.

• Consultation with casework staff regarding adoption issues.

• Preparation of adoption homes studies and probate court reports.

FOSTER CARE COORDINATOR: Vermont Department of Social & Rehabilitation Services,

St. Johnsbury, Vermont (12/86 - 4/90)

• Managed a foster care program serving approximately fifty children.

• Fiscal administration, program planning and evaluation.

• Curriculum development and in-service training.

ASSISTANT DIRECTOR: Upward Bound Project, Lyndon State College (9/85 - 12/86)

• Co-directed a college preparatory program for disadvantaged youth.

• Formulated program goals and evaluated outcomes.

• Co-authored a successful federal grant proposal totaling more than $400.00.

• Training, supervision and evaluation of staff.

• Academic and career counseling.

EDUCATION

MASTERS OF SOCIAL WORK (M.S.W.) May 1996. University of Vermont

• F' year field internship; Reach Up Program, Vermont Department of Social Welfare

• 2"'' year clinical internship: Fletcher Allen Health Care, Inpatient Psychiatric Unit

BACHELOR OF SCIENCE (B.S.) Behavioral Science and Special Education. May, 1984.

Lyndon State College, LyndonviUe, Vermont

REFERENCES

Available upon request

Curriculum Vitae

Sergio G. Zullich

Education

Doctor of Pharmacy, State University of New York at Buffalo, May 1990.

Bachelor of Science (Magna Cum Laude), Arnold and Marie Schwartz College of Pharmacy, Long

Island University, Brooklyn, New York, May 1979.

State University of New York at Buffalo, Completed pre-pharmacy requirements 1974 -1976.

Professional Experience

Indian Stream Health Center Pharmacy Director (March 2019 to present). Chief Executive

Officer (February 2021 to present) Colebrook, New Hampshire

• Responsibility for planning, organizing, directing operations of a 340B pharmacy in a

Federally Qualified Health Center (FQHC).

• Supervise pharmacy and clinic staff and delegate responsibilities to appropriate

personnel.

• Develop, implement and evaluate policies, procedures, and standards of practices

affecting pharmacy and clinic operations and patient care consistent with departmental

and regulatory objectives.

• Develop strategic plan for expanding clinical pharmacy services including pharmacist led

anticoagulation protocol. Medication Therapy Management (MTM) services and opioid

stewardship.

• Maintain a positive working environment by providing feedback, coaching, managing

performance and recognition of pharmacy staff.

• Participate in various facility committees such as Management, Clinical, and Quality

Improvement.

• Oversee health care programs offered by Federally Qualified Health Center (FQHC) for

over 2700 patients in northern New Hampshire and Vermont.

• Supervise over 40 FTEs and $6 million dollar operating budget.

• Work with state and federal agencies to secure funding and requirements.

• Assure organizational adherence to all regulatory and operational requirements.

Guthrie Robert Packer Hospital Director oflnpatient Pharmacy (September 2014 to March

2019) Sayre, Pennsylvania

• Supervise pharmacy department of 43 FTEs and $27 million dollar operating budget.

• Responsible for planning, organizing, directing, and control operation of the pharmacy

department effectively and delegate responsibilities to appropriate personnel.

• Participate in the development, implementation, and evaluation of policies, procedures,

and standards of practices affecting patient care consistent with departmental and

regulatory objectives.

• Development of strategic plan for expanding clinical pharmacy services including

unit-based pharmacists, preceptor development, and residency program.

• Create a positive working environment by providing feedback, coaching, managing

performance and recognition of pharmacy staff.

• Interact with all levels of hospital organization to promote quality healthcare to all

patients.

Portsmouth Regional Hospital Clinical Pharmacy Manager (February 2012 to July 2014)

Portsmouth, New Hampshire

Provides oversight of clinical program to ensure maximization and efficiency of clinical

processes.

Supervises pharmacists in clinical activities and appropriate documentation of clinical

activities.

Oversees and assists with formulary maintenance (new drug monographs, therapeutic

interchanges, annual class reviews) and present to Pharmacy and Therapeutics

Committee and other groups.

Develops policies, procedures, and order sets related to clinical services. Implements

and assesses programs that promote safe medication therapy.

Directs, coordinates, and participates in the design, collection, and reporting of drug

utilization evaluations to support proper utilization of medications in the clinical setting.

Participate as lead pharmacist for Antimicrobial Stewardship program.

Actively participates in competency training and assessment, and performance

evaluation of pharmacy staff.

Represents pharmacy at various hospital and medical staff committees and meetings.

Provides in-services and other education programs for physicians and other healthcare

professionals.

Assists in quality and performance improvement initiatives.

Participates in multidisciplinary initiatives to maintain compliance with Joint

Commission, CMS, and other accrediting agency standards.

Serves as a clinical resource for the facility.

Works as a staff pharmacist when needed.

Dartmouth-Hitchcock Medical Center Pharmacist-Clinical Specialist, Internal Medicine

(October 2008 to February 2012) Lebanon, New Hampshire

• Participate in daily rounds with medical staff on internal medicine unit.

• Review patient drug regimen for appropriate utilization, identify potential adverse drug

events, and promote cost-effective therapy.

• Initiate targeted drug use evaluations.

• Participate in quality improvement and utilization review programs.

• Develop and present education programs for hospital staff.

• Provide drug information to other pharmacists and health care professionals.

• Preceptor for undergraduate pharmacy students and pharmacy resident program.

• Participate in Patient Safety Orientation and Pharmacy Orientation for newly hired

medical, nursing, and hospital staff.

• Coordinate activities of Medication Safety Subcommittee and serve as

co-chairman.

• Participate on various committees such as: Pharmacy and Therapeutics, Falls, Residency

Steering, and Clinical Services.

• Experience with Microsoft Office, Cerner, Epic, and AcuDose programs.

Robert Packer Hospital Pharmacist - Clinical Specialist, Critical Care (May 2003 to October

2008) Sayre, Pennsylvania

• Participate in daily rounds with medical and surgical staff in critical care unit.

• Review drug therapy for appropriate utilization.

• Develop guidelines and protocols for appropriate drug use in critical care setting.

• Initiate targeted drug use evaluations.

• Provide pharmaceutical care to cardiothoracic outpatients including: education,

monitoring for adverse events, and physician follow up.

• Participate in quality improvement and utilization review programs.

• Perform review of inpatient chemotherapy regimens.

• Preceptor for undergraduate pharmacy students.

• Develop and present education programs for hospital staff.

• Provide drug information to other pharmacists and health care professionals.

• Participate on various committees such as: Pharmacy and Therapeutics, Critical Care,

Cardiothoracic Surgery, Anticoagulation, Falls, Antibiotic Subcommittee, Product

Acquisition Management, and Human Services.

• Experience with Microsoft Office, Epic, Cerner and AcuDose programs.

Kinney Drugs Pharmacist (April 2007 to October 2008) Trumansburg, New York

• Dispense and verify prescriptions in compliance with professional standards, and state

and federal laws.

• Counsel patients on appropriate use of medication and potential side effects.

• Maintain pharmacy records and database.

Wegmans Supermarket Pharmacist (May 2004 to April 2007) Ithaca, New York

• Dispense and verify prescriptions in compliance with professional standards, and state

and federal laws.

• Counsel patients on appropriate use of medication and potential side effects.

• Maintain pharmacy records and database.

Arnot Ogden Medical Center Pharmacist - Clinical Specialist (May 2001 to May 2003) Elmira,

New York

• Participate in multidisciplinary patient rounds.

• Provide consultant pharmacist service to long term care unit.

• Collaborate with infectious disease physician to develop antimicrobial management

program.

• Participate in quality improvement and utilization review programs.

• Responsible for management of formulary.

• Perform review of inpatient chemotherapy regimens.

• Preceptor for undergraduate pharmacy students.

• Develop pharmacokinetics monitoring procedure.

• Participation on various committees such as: Pharmacy and Therapeutics, Long Term

Care, Information Systems, and Infection Control.

• Develop method to document and report pharmaceutical care interventions.

• Experience with Microsoft Office, and Per Se programs.

WCA Hospital Clinical Pharmacist (November 1996 to May 2001) Jamestown, New York

• Responsible for management of formulary.

• Develop clinical programs to promote appropriate drug use.

• Develop quality improvement and utilization review programs.

• Present educational programs to hospital staff.

• Participation on various committees such as: Therapeutic Drug Monitoring, Pharmacy

and Therapeutics, Information Systems and Infection Control.

• Interpret medication orders and monitor appropriate use.

• Prepare all forms of medication as needed including chemotherapy.

• Experience with Microsoft Office, Nova, Mediware and Pyxis programs.

WellPoint Pharmacy Management Clinical Pharmacy Manager (October 1999 to August 2000)

Buffalo, New York

• Develop and implement cost containment programs for health maintenance

organization.

• Maintenance of formulary management programs.

• Participate in Utilization Management/Quality Management Committee.

• Research and present drug information materials for client.

• Participate in CHF, Hyperlipidemia, Allergic Rhinitis and Asthma Committees for

development of outpatient programs.

• Develop Clinical Business Plan for management of pharmacy benefits for client.

• Experience with Microsoft Office, TAG and ReViewPoint drug utilization program.

Pharmacist Consultant Service, P.C. Consultant Pharmacist (March 1984 to October 1999)

Buffalo, New York

• Oversight of all administrative and financial operations of consulting service.

• Manage staff of five consultant pharmacists and administrative assistant.

• Develop and implement cost containment programs for long term care facilities.

• Maintenance of formulary management programs.

• Participate on Infection Control, Quality Improvement and Psychotropic Drug Use

Committees.

• Provide drug information support for long term care facilities.

• Provide staff education programs for facilities on a variety of topics such as federal

guidelines for drug use in the elderly, psychotropic drug use and adverse effects of

medication in the elderly.

Erie County Medical Center Clinical Coordinator, Ambulatory Care and Program Director,

Anticoaguiation Clinic (June 1990 to August 1992) Buffalo, New York

• Provide pharmaceutical care for anticoaguiation clinic patients on warfarin including:

clinic visits, dosing per physician protocol, education, and phone follow-up.

• Participate in outpatient neurology clinic rounds with physician assistant to promote

rational drug therapy.

• Present education programs to hospital staff.

• Preceptor for ambulatory care rotation for Pharm.D. program.

• Preceptor for pharmacy resident program.

Sisters of Charity Hospital Staff Pharmacist (September 1983 to June 1988) Buffalo, New York

• Interpret physician orders and monitor appropriate use of medication.

• Prepare all forms of medication as needed including parenteral nutrition and

chemotherapy.

• Participate in cardiac resuscitation team.

Lafayette General Hospital Staff Pharmacist (May 1982 to September 1985) Buffalo, New York

• Interpret physician orders and monitor appropriate use of medication.

• Participate in cardiac resuscitation team.

• Provide drug information to hospital staff.

Veterans Administration Medical Center Staff Pharmacist (February 1982 to May 1982) Buffalo,

New York

• Interpret medication orders and monitor appropriate use for inpatient and outpatient

pharmacy.

• Prepare all forms of medication as needed.

Our Lady of Victory Hospital Staff Pharmacist (November 1980 to February 1982) Buffalo, New

York

• Interpret medication orders and monitor appropriate use.

• Prepare all forms of medication as needed including intravenous and total parenteral

nutrition products.

• Provide drug information to hospital staff.

Columbus Hospital Staff Pharmacist (September 1979 to November 1980) Buffalo, New York

• Interpret medication orders and monitor appropriate use.

• Prepare all forms of medication as needed.

• Provide drug information to hospital staff.

Teaching Experience

Franklin Pierce University Lecturer (April 2010 to February 2012) Lebanon, New Hampshire

• Lecturer in Pharmacology for Physician Assistant Program

University of Connecticut Clinical Instructor (September 2009 to February 2012) Storrs,

Connecticut

• Preceptor for Pharm.D. program

Albany College of Pharmacy Clinical Instructor (September 2000 to September 2008) Albany,

New York

• Preceptor for Pharm.D. program

Nazareth College Lecturer - Geriatric Nurse Practitioner Program (September 1996 to

September 2006) Rochester, New York

• Lecturer in Geriatric Pharmacology for Nurse Practitioner Program

State University of New York at Buffalo Clinical Instructor (1990 to 1998, January 2011 to

present) Buffalo, New York

• Preceptor for Pharm.D. program

Licensure

Registered Pharmacist, New York State, September 1979 to present

Registered Pharmacist, Pennsylvania, June 2003 to present

Registered Pharmacist, New Hampshire, August 2008 to present

• APhA Immunization Certification

• Collaborative Practice-Anticoagulation

Maine MPJE - Passed, Application Submitted to Maine Board of Pharmacy

Honors and Awards

1979 Rho Chi Society, A&M Schwartz College of Pharmacy

1990 Rho Chi Society, State University of New York at Buffalo

Certification

2009 American Pharmacists Association (APhA), Immunization Delivery Certification

2019 American Pharmacists Association (APhA), Diabetes Care Certification

2021 Bi-State Primary Care Association (BSPCA), Leadership Development Program

Leadership

1992 to 1993 Associate Member, Education Committee

American Society of Consultant Pharmacists

2016 to 2019 Secretary, Board of Directors

Southern Tier Society of Health System Pharmacists

Research Experience

"Assessment of Venous Thromboprophylaxis in Medically III Patients", Preceptor for Pharmacy

Residency Project (June 2010) Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire

"Cost-Effectiveness of Coumatrak Use in a Anticoagulation Clinic", Preceptor for Pharmacy

Residency Project (January 1992) Erie County Medical Center, Buffalo, New York

"Effect of Pharmacy Intervention in an Anticoagulation Service", Preceptor for Pharmacy

Residency Project (January 1992) Erie County Medical Center, Buffalo, New York

"Change in Prescribing Patterns in Long Term Care Facilities and Impact on Incidence of Adverse

Events", Doctor of Pharmacy Thesis (January to July 1990) T.H. Grasela, Pharm.D., Preceptor,

State University of New York at Buffalo.

Presentations

"Polypharmacy and the Older Adult", Presented at National Association for Mental Health - New

Hampshire Conference Concord, New Hampshire. March 2011

"Polypharmacy and the Older Adult", Presented at Geriatric Update 2010, Woodstock, Vermont.

April 2010

"Antibiotic Therapy in ICU for RNs" Presented to Critical Care Nursing Staff, Robert Packer

Hospital, Sayre, Pennsylvania. August 2008

"Critical Care IV Drugs for RNs" Presented to Critical Care Nursing Staff, Robert Packer Hospital,

Sayre, Pennsylvania. August 2008

"Triple Drug Therapy" Presented to Pharmacy Staff, Dartmouth Hitchcock Medical Center,

Lebanon, New Hampshire. May 2008

"Drug Dosing and Renal Function" Presented to Internal Medicine/Family Practice Residents

Noon Conference, Robert Packer Hospital, Sayre, Pennsylvania. April 2008

"Clinical Pharmacokinetics" Presented to Internal Medicine/Family Practice Residents Noon

Conference, Robert Packer Hospital, Sayre, Pennsylvania. March 2008

"Clostridium Difficile" Presented to Internal Medicine/Family Practice Residents Noon

Conference, Robert Packer Hospital, Sayre, Pennsylvania. September 2007

"Antimicrobial Use in the ICU" Presented to Critical Care Nursing Staff, Robert Packer Hospital,

Sayre, Pennsylvania. September 2007

"Commonly Used IV Drugs in the ICU" Presented to Critical Care Nursing Staff, Robert Packer

Hospital, Sayre, Pennsylvania. September 2007

"Dosing Medication in the Morbidly Obese Patient" Presented to Internal Medicine/Family

Practice Residents Noon Conference, Robert Packer Hospital, Sayre, Pennsylvania. June 2007

"Sedative Use in Critical Care" Presented to Internal Medicine/Family Practice Residents Noon

Conference, Robert Packer Hospital, Sayre, Pennsylvania. March 2007

Complete list of presentations available upon request.

Publications

Zullich SG, Grasela TH, Fiedler-Kelly JB, Gengo FM. Changes in Prescribing Patterns in Long-Term

Care Facilities and Impact on Incidence of Adverse Events. NIDA Res Monograph

1993;131:294-308.

Zullich SG, Grasela TH, Gengo FM, Fiedler-Kelly JB. Effect of Triplicate Prescription Legislation

on Psychotropic Drug Use Annals of Pharmacotherapy 1992; 20:536-42.

Goss TF, Birmingham M, Zullich SG. Use of Third Generation Cephalosporins in Long Term Care

Facilities Consultant Pharmacist 1992; 7:1201-10.

Tanya A. Tupick D.O.

PROFESSIONAL WORK EXPERIENCE

Ursent Care Physician

May 2016 to Present. (Full time 5/2016 to 5/2022 and per diem 5/2022 to present)

Catholic Medical Center Urgent Care in Bedford, NH

Emersencv Room Physician

September 1, 2013 to April 2016

Androscoggin Valley Hospital located in Berlin, NH

Family Practice Physician

August 2010 to July 31, 2013

Deny Medical Center/Londonderry Family Practice located in Deny/Londonderry, NH

General Staff: Parkland Medical Center

November 15, 2010 to September 2013

Address: 1 Parkland Drive; Deny, NH 03038 Phone Number: (603) 432-1500

Family Practice Residency/Internship

July 2007 to June 30, 2010

St. Joseph's Medical Center, Reading PA

EDUCATION

Family Practice Residency/Internship

July 2007 to June 30, 2010

St. Joseph's Medical Center, Reading PA

Doctor of Osteopathy

August 2003 to May 2007

University of New England College of Osteopathic Medicine (UNECOM), Biddeford ME

Bachelor of Science, Biology with a minor in English—Magna Cum Laude

September 1997 to May 2001

University of New Hampshire (UNH), Durham NH

BOARD CERTIFICATION

American Osteopathic Board of Family Physicians

September 13"' 2010

Certified in Family Practice and Osteopathic Manipulative Treatment

LICENSES

> New Hampshire State Medical License - June 2, 2010 - Present

> Pennsylvania Osteopathic Physician & Surgeon - Unrestricted License 12/10/09 -

10/31/2010

> Pennsylvania Osteopathic Training License July I, 2007 - June 30. 2010

1

VOLUNTEER WORK

Manchester NH Health Board -> October 2016 to July 2022

Volunteer member appointed by the mayor and aldermen of Manchester NH to serve on the

Manchester Health Board. Chair of the Board 2018 to 2022

Misrant Farm Workers -> 2005-2010

Migrant Farm Workers Health Care Volunteer for the State of PA 2005 to 2010

Biddeford Maine Soup Kitchen 2003-2005

Volunteer at the Biddeford Maine Soup Kitchen

TEACHING EXPERIENCE

Fall 2016 to 2020

Precepting Nurse Practitioner Students for Rivier University and for UNH Durham.

□ Assistant Affiliate Faculty for UNH Department of Nursing since Fall of 2017-2020

August 2004 - June 2005 University of New England Biddeford, ME

GMT Teaching Assistant

□ Helped teach first year medical students OMT in the practical laboratory setting.

August 2001 - June 2002 Conway School District SAU #9 Conway, NH

High School Physical Science Teacher

□ Taught fulltime Honors and College Technical Preparatory Physical Science classes, which

were laboratory intensive courses.

RESEARCH EXPERIENCE

Spring 1999 - May 2001 Dept. of Animal and Nutritional Sciences UNH, Durham

Lab Assistant and Researcher: Under Dr. Robert L. Taylor Jr.

□ Studying the dose effects of the major histocompatibility complex on Rous sarcoma tumor

progression and regression.

□ Assisting with DNA extractions, chromosome dose analysis, tumor measurement, statistical

analysis, and research presentation.

JOURNAL PUBLICATIONS

T.A. Tupick, S.E. Bloom and R.L. Taylor, Jr. Major Histocompatibility (5) Complex Gene Dose

Effects on Rous Sarcoma Virus Tumor Growth; International Journal of Poultry Science 4 (5): 286-

291,2005

Taylor, R. L., Jr. and T. A. Tupick, 2002. Combinations of Tumor Regressor and Progressor Major

Histocompatibility (5) Complex Haplotypes Exhibit Gene Dose Effects on Rous Sarcomas. Poultry Sci.

81(Suppl. 1):6

CONFERENCE PRESENTATIONS

> January 2023: Urgent Care Procedures at the New Hampshire Osteopathic Winter Symposium

in Bartlett, NH.

> August 2020: Summer Potpourri of Urgent Care at the Virtual Pennsylvanian Osteopathic

Family Practice Summer Symposium.

> August 2020: Summer Potpourri of Urgent Care at the New Hampshire Osteopathic Summer

Symposium in Portsmouth, NH.

> August 2018: Urgent Care in the Family Practice Office in Hershey Pennsylvania at the

Pennsylvanian Osteopathic Family Practice Symposium.

> August 2017: OMT Table Trainer at the ACOFP Board Review in Chicago

> October 2009: Northeast Society of Family Medicine Teachers Regional Conference:

Presenting "Osteopathy for Dummies" and "Ministry in Medicine."

> October 2008: Northeast Society of Family Medicine Teachers Regional Conference:

Presenting "Effects of Osteopathic Manipulative Treatments on Post-Operative Patients."

> May 2001: COLSA Research Conference (UNH): Presentation of "The Dose Effects of the

Major Histocompatibility Complex on Rous Sarcoma Tumor Growth."

> December 2000: Genetics Graduate Seminar (UNH): Presentation of "The Dose Effects of

the Major Histocompatibiiity Complex on Rons Sarcoma Tumor Growth."

MINISTERIAL LICENSE

> ICFG Ordination - November 12* 2017 - Present

> ICFG U.S. License - September 10"" 2015 - November 12"" 2017

> ICFG International Ministerial License — December 17"" 2009 — March 22"'' 2012

> ICFG District Ministerial License - November 3"* 2007 - December 17"' 2009

> ICFG Church Staff Ministerial License - April 15"" 2003 - November 3""* 2007

MINISTERIAL EXPERIENCE

2022-Present Senior Pastor Harvest Christian Fellowship Berlin, NH

2015-2022 Pastor of Global Mission Trinity Life Community Church Bedford, NH

2014-2015 Vice President of Board The Well Community Church Berlin, NH

2013 August Short Term Medical Mission Kenya Africa with Hope Chapel Keene, NH

2009-2012 Assistant Pastor New Life Community Church Manchester, NH

2007-2009 Assistant Pastor Norristown Foursquare Church Norristown, PA

2003-2007 Staff Pastor Harvest Christian Fellowship Berlin, NH

March 2003 - October 2005 Northern New England District Concord, NH

□ Mission Representative for Foursquare Missions International for ME, NH & VT

□ Organized and led Short Term Mission Teams to Turrialba Costa Rica 7/2005 & 5/2007.

June 2002 - September 2002 Foursquare Missionary Bangkok, Thailand

□ Teaching English as a second language at the Good News Study Center

AWARDS AND HONORS

> Dr. John J. Woynarowski Memorial Fund for clinical achievement and humanitarian

characteristics in the St. Joseph Medical Center Family Practice Residency Program 2009

> Sewall Osteopathic Foundation Scholarship 2006

> Title One Graduate Award 2002

> Fellowships for Research on "Dose Effects of the Major Histocompatibiiity Complex on Rous

Sarcoma Tumor Progression and Regression."

o Undergraduate Research Opportunity Program (UROP) Fellowship 2001

o Summer Undergraduate Research Fellowship (SURF) 2000

o Oliver Hubbard Summer Undergraduate Research Fellowship 2000

> Golden Key Honor Society Member: Lifetime membership beginning in 1999.

> Military Academic Excellence Award 1997

> American Legion Award 1996

> Boston College Book Award 1996

CERTIFICATIONS

> Basic Life Support from the American Heart Association

> Advance Cardiac Life Support from the American Heart Association

> Pediatric Advance Life Support from the American Heart Association

PROFESSIONAL SOCIETIES

> American Osteopathic Association (ADA)

> American College of Osteopathic Family Physicians (ACOFP)

> New Hampshire Osteopathic Association (NHOA)

o Board Member at Large January 2021 - January 2023

o Vice President of the board January 2023 - Present

> New Hampshire Medical Society (NHMS)

CURRICULUM YTTAE

YVflBnn Genwr, MD, Medical Director

ProfBsrional Emcrtence:

Medical Director • Coos County Family Health Services • August, 2014 - presot

Staff Physician, Coos County Family Health Soviccs • September, 2012 - 2014

Institute for Family Health - January - 2010 - August - 2012

Co-Medical Director- Hudson Valley Health Specialties - 2000 - 2012

Co-Medical Director - Ulster Greene ARC • 2000 • 2012

Medical Director - UGARC - 1994 - 2000

Medical Director • Ulster Association for Retarded Citizens (currently Ulster Greene ARC) Kingston, New

York 1993 - 2012

Medical Director - Ulster Rehabilitation Clinic Kingston, New

York 1993 - 2000

Co-Medical Director- Ulster Greene ARC 2000 - 2012

Cu-Medical Director - Muuiilaitiside Residential Care Ccnta Margaretvillc, New

York 1998 - 2012

Co-Medical Director - Maigaretville Hospital Margaretville,

New York 2001-2012

Attending Physician, Kingston Family Practice Centa Kingston, New

York 1991 -2000

Senior VP Academic Affairs - Mid Hudson Family Health Institute Kingston, New York

1991 -2000

Program Director, Mid-Hudson Rural Family Practice Residency Program Kingston, New York

1990 - 2000

Associate Progtam Director, Ulster County Rural Family Practice Residency Program Kingston, New York 1985 -

1990

Assistant Program Director, Ulster County Rural Family Practice Residency Program Kingston, New Yoik 1984 -

1985

AnendingPhysician,WoodstDdcFainilyHealthCcrterWoodstock, New York 1983- 1991

Medical Director, Woodstock Family Health Center Woodstock, New York 1993-1984

Private Practice of Family Medicine Newport, New Hampshire 1978-1983

Pre-Medical Education:

University of New Hampshire

BA Mathematics 1969-1973

Sutnma Cum Laude, Phi Beta Kappa

Medical Education:

Dartmouth Medical School Hanover, NH

I972-I97S M.D. Degree Honors awarded in Internal Medicine Maternal and Child Health, Ambulatory

Care

Internship:

University of Colorado Medical Center Family Medicine 1975-1976

Residency:

University of Colorado Medical Center Family Medicine 1976-1978

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1457 Coos County Family Health Services. Inc 133 Pleasant Street Berfin NH 03S70 G S/lS/2026

13582 Coos County Job Creation Assodatton 653 Main Street lancaster NH 03584 X 5/15/2020

30446 Coos Cydini Qub POBok92 Gorham NH 03581 G 5/15/2026

5999 Coos Economic Development Corporation PO Box 205 Lancaster NH 03S84-020S G 5/15/2026

16287 COPO Foundation. Inc 3675 Crestwood Paricway NW Suite 350 Duluth GA 30036 G S/lS/2026

2050 Copper Cannon Corporatkm PO Box 124 Francorda NH 03358 G 2/15/2026

30754 Cops Direct 1959 Palomar Oaks Way. Ste 300 Carlsbad CA 92011 X 5/15/2024

33399 Coptic Orphans Support Association PO Box 2881 Merrlfield VA 22116 G 5/15/2026

18355 Coral RcefAiliaisce 548 Martat Street Suite 29802San Frandsco. CA 9410 San Frandsco CA 94104 6 5/15/2026

6355 Coral Ridge Ministries 5SSS North Federal Klahwey. Suite 1 Fort Ljuderdale FL 33308 X 11/15/2024

33659 Cord Ministries international PO Box 620760 Littleton CO 80162-0760 G 5/15/2026

35151 CORE Community Organbad Reliaf Effort 910 N Hill Street Los Angeles CA 900U G S/lS/2026

17285 Core Physicians, UC 5 Alumni Drive Exeter NH 03833 G 2/1S/2026

34555 CoreGivina Co. 233 South Wacher Drive, Suite 4700 Chicago IL 60606 G 5/15/2026

30666 Corey's Qosat. inc C/0158 Norfork Street Manchester NH 03103 6 5/15/2026

10710 Corky and Carl Foundation. Inc. c/o BninoFalrfleld. n] 07004 Falrfletd nj 07004 X 5/15/2025

11222 CormofTt Music 89JESSEMAN RD SUGAR Hia NH 03586 6 5/15/2026

17188 Cormlia da Lange Syndrome Foundation, tnc 30 Tower Lane MOO Avon a 06001 G 5/15/2026

32092 Cornafl Collate 600 First Street SWMount Vamoa lA 52314 Mount Vemon lA 52314 G 5/15/2026

10809

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341 Pine Tree Road Ithaca NY 14850 X 5/15/2025

14839 Comer Kingdom Pr^ect Inc. 17 Buckingham Drive Londonderry NH 03053 X 12/15/2022

35681 Cornerstone Chartered Public School PO Box 129 Lvme NH 03768 G 11/15/2026

17486 Cornerstone Housing North. Inc. 30 Exchange Sbeet Berlin NH 03570 G 11/14/2026

6318 Cornerstone Outreach Ministries, inc PO Box 10541 Swaruey NH 03446 G 1/15/2026

11378 Cornerstone Policy Research PO Box 4683 Manchester NH 03108 G 5/15/2026

33712 Cornerstone PubQc Asset Fund, IrK. C/O 3675 Crestwood Parkway, Suite 350 Duluth GA 30096 G S/15/2026

10039 Ccmerstone School 146 High Street Stratham NH 03885 G 11/14/2026

2775 Cornerstone VNA 178 Farmington Road Rochester NH 03867-4352 G 5/15/2026

32328 Cornerstones. Inc C/O 19S9 Palomar Oaks Way, Suite 300 Carlsbad CA 92011 X 11/15/2024

34431 Comish Commurtity initiative P06oxl23 Comish NH 03745 6 11/14/2026

32625 Cornish Community Parent Teacher Organisation 274 Town House Road Comish NH 03745 X 5/15/2021

3874 Comish Fair Association PC Box 245 Comish Flat NH 03746 G 3/15/2026

2278 Comish Fire Department. Inc POBoxS Comish Flat NH 03746 X S/lS/2022

Updated: January IS. 2026