Seattle Indian Health Board

Nonprofit profile at a glance

EIN
910869056
IRS 990 coverage
2014–2024
Official website data refreshed
Sep 2026
Forms available
Form 990 2024
Location
Seattle, WA, USA
Phone
(206) 324-9360
Rating
78
Verdict
SUPPORTED
Rating confidence
Moderate
Sector
Ambulatory Health Center, Community Clinic

Official website

Reported finances

Revenue
$51,324,680
Expenses
$41,916,726
Assets
$67,444,686
Liabilities
$7,794,991

Source: IRS Form 990. Selected filing: tax year 2024. Amounts in USD.

Leadership & pay

21 people listed

Executive titles in this filing

  • ESTHER LUCERO MPP (PRESIDENT & CHIEF EXECUTIVE OFFICER)
  • ABIGAIL ECHO-HAWK MA (EXECUTIVE VICE PRESIDENT)
  • TOM WARREN SB ME (PRESIDENT)
  • CHRISTINA ROBERTS (VICE PRESIDENT)

Highest reported compensation

  • ESTHER LUCERO MPP (PRESIDENT & CHIEF EXECUTIVE OFFICER): $474,986 total reported compensation
  • ABIGAIL ECHO-HAWK MA (EXECUTIVE VICE PRESIDENT): $313,459 total reported compensation
  • SHAWNA GALLAGHER PSYD LICSW MA (MA, MSW, S-PSB, BEHAV HEALTH DIR): $289,243 total reported compensation

Source: IRS Form 990. Selected filing: tax year 2024. Names and roles reflect this filing, not necessarily current officeholders.

Overview

Mission

To provide quality health and human services to American Indians and Alaska Natives living in the Seattle area, grounded in Indigenous knowledge and cultural values.

What it reported doing in 2024

The seattle indian health board is a non-for-profit organization that has been in operation since 1970. Sihb provides vital community health and public health services for all people in a native way. In 2016, sihb established our indigenous knowledge informed system of care (indigiknow), to honor our history and to carry us into the future. Indigiknow emphasizes 5 key components of our organization: health & human services, workforce development, policy & advocacy, and public health. All are centered on traditional medicine.(continued in schedule o)sihb's health and human services division (hhs) is deemed an urban indian health organization and part of the indian health service system of care, we are also a 330 hrsa funded federally qualified health center. We operate a 340b pharmacy at 3 different locations. Our hhs teams have worked hard to implement indigiknow, the first integrated model of its kind, where our relatives (patients) receive truly holistic care, centered on traditional indian medicine. There is no other health system where relatives are served in this culturally specific way. The care teams consist of primary care providers, nurse care managers, medical assistants, clinical pharmacists, nutritionists, traditional indian medicine apprentices, care coordinators, and clinical social workers. Soon to add a dentist to each care team. The care teams can access specialty services either through internal (traditional medicine practitioners, podiatrist, pediatrician, behavioral health provider, nutritionist, lactation consulting, addiction medicine) or external referrals. Sihb offers indigiknow at 3 clinic sites and one mobile site, with a 92-bed residential treatment facility on the way. Sihb serves a diverse range of individuals and families through multiple sites around king county. The clinics provide health services to more than 6,000 patients per year through nearly 30,000 encounters.

Operating model

Revenue model
Grant-funded. 69% of the money available for current operations came from government grants.
Distribution model
Direct operator. The filing allocates 99% of reported program-service expenses outside its grant, affiliate-payment, and member-benefit lines. This expense classification does not rule out separately announced grant awards.

The verdict

SUPPORTED - A large share of total spending goes to programs and the filed numbers largely add up. A relatively small share of available resources goes toward mission work and total assets are small relative to annual expenses; liquid coverage is unknown.

Rating breakdown

  • Financial Efficiency: 64
  • Transparency & Controls: 79
  • Accountability: 100
  • Sustainability: 67
  • Growth: 100

Detailed rating inputs

Financial Efficiency

  • Mission deployment rate: 56.2%; rating input score 56
  • Program expense ratio: 68.1%; rating input score 68
  • Fundraising efficiency: $512.2 raised per $1 spent on fundraising; rating input score 94; 94th percentile among comparable filings

Transparency & Controls

  • Consistency checks: 100%; rating input score 100; 68th percentile among comparable filings
  • Pay-setting controls: 2 of 6 controls in place; rating input score 33
    • Compensation committee: Missing
    • Independent consultant: Missing
    • Other Form 990s reviewed: Missing
    • Written employment contract: Missing
    • Compensation survey or study: Pass
    • Board or committee approval: Pass
  • Foreign activity oversight: Limited
  • Grant itemization coverage: 100%; rating input score 100; 77th percentile among comparable filings
  • Major donor itemization: Yes; rating input score 100
  • Related-party transparency: Limited

Accountability

  • Independent voting board: 100%; rating input score 100; 77th percentile among comparable filings
  • Governance controls: 9 of 9 controls in place; rating input score 100
    • Conflict-of-interest policy: Pass
    • Whistleblower policy: Pass
    • Document-retention policy: Pass
    • CEO compensation review process: Pass
    • Other executive compensation review process: Pass
    • Form 990 shared with the board: Pass
    • Board meeting minutes documented: Pass
    • Audit committee oversight: Pass
    • Independent financial-statement audit: Pass

Sustainability

  • Operating margin: 18.3%; rating input score 86; 86th percentile among comparable filings
  • Total-asset coverage ratio: 1.61; rating input score 56; 56th percentile among comparable filings
  • Liabilities to assets ratio: 0.12; rating input score 80; 80th percentile among comparable filings
  • Officer compensation ratio: 7.8%; rating input score 6; 6th percentile among comparable filings

Growth

  • Program expense growth: 10.2% per year; rating input score 100; 75th percentile among comparable filings
  • Revenue growth: 13.6% per year; rating input score 100; 86th percentile among comparable filings
  • Asset growth: 16.7% per year; rating input score 100; 89th percentile among comparable filings

Details

  • What they do: 3 programs and campaigns described on the official site · 4 operating locations identified
  • Where the money goes: 56.2% of revenue deployed · 68.1% of spending went to programs
  • Governance: 9 of 9 board members independent · 9 of 9 filing controls reported
  • Programs: 2 filed program accomplishments · $28.6M in reported program spending
  • Leadership: top reported pay $475K · 21 people listed · 2 of 6 pay-setting controls reported
  • Highest-paid contractors: 5 contractors listed · $2M reported
  • Consistency: 39 of 39 current checks pass
  • Schedules: 9 filed schedules · includes major donors, grants, and executive pay
  • Filing history: 11 filing years from 2014 to 2024
  • Contacts: How to reach this organization
  • Money network: 12 filed money-flow records
  • Grant readiness: Federal tax and exclusion status, award history, and grant-maker relationships.
  • People: Everyone the filings name, and which of them the filings identify by more than a name.

Key Signals

Signals prioritize questions for review. They are not findings of misconduct.

Grant-readiness screening is separate from the live rating, not a measure of program quality. Review the source records before making a grant decision.

  • Review — Financial Efficiency: Mission deployment rate scored 56/100.
  • Review — Sustainability: Total-asset coverage ratio scored 56/100.
  • High — Sustainability: Officer compensation ratio scored 6/100.
  • High — Grant Readiness: Federal audit findings: this organization reported findings in its latest federal Single Audit.