The Center at Sierra Health Foundation

What it reported doing in 2024

California state opioid funding programthe state opioid funding program addresses the opioid epidemic by supporting the department of health care services (dhcs) in implementing various projects of dhcs' opioid response program, including creating expanded substance use disorder (sud) treatment infrastructure, addressing the needs of communities of color and vulnerable populations that are disproportionately impacted by sud, diversion of people with sud from the justice system into treatment, and interventions to prevent drug addiction in vulnerable youth. These projects include expanding mat in state-licensed facilities and/or certified sud and mental health facilities, increasing mat access points, and the increase of medication through mobile narcotic treatment programs and medication units. Through this $113,799,996 contract with dhcs, the state opioid funding program dispersed $20,063,213.60 to 39 organizations in 2024.California overdose prevention and harm reduction initiativethe California overdose prevention and harm reduction initiative (cophri) is a partnership between the center at sierra health foundation and the California department of public health that supports low-barrier, nonjudgmental, public health-focused harm reduction services through 68 community-based nonprofits, clinics, and local health departments throughout the state. To date, cophri has awarded $36,659,694 to promote health and safety for people who use drugs, including safer drug injection and smoking services, overdose prevention education and naloxone access, HIV and viral hepatitis services, access to medications for opioid use disorder and other substance use disorder care, and a wide range of social and health care services. Youth suicide prevention media and outreach campaign program youth suicide prevention media and outreach campaign program is a statewide program focused on youth suicide prevention. With funding from the California department of public health (cdph) from may 2023 to june 2025, our 33 program partners worked to prevent suicide among some of California's most marginalized youth who are disproportionately impacted by suicide and self-harm behavior. This includes american indian and alaskan native, hispanic and latinx, and african american/black youth, as well as intersectional populations such as youth with mental health conditions and/or substance use issues, those impacted by the foster care system, and two-spirit/lgbtq+ youth. Funded partners hosted 5,131 activities and events, accumulated over 114,000 program interactions with youth, delivered 5,886 messages via mixed media, and had 2.6 million campaign-related social media impressions. Additionally, the center hosted three partner convenings that cumulatively gathered 273 community-based organizations and youth attendees. The center team also facilitated 23 technical assistance webinars and completed 15 partner site visits. Black child legacy campaignthe black child legacy campaign is the community-driven movement established by the steering committee on reduction of african american child deaths in 2015. The campaign focuses on reducing african american child deaths across the top four causes of preventable death: deaths related to child abuse and neglect, third-party homicides, deaths related to perinatal conditions, and infant sleep-related deaths. In 2024, funded partners provided intensive case management to 1,141 african americans, and 3,630 youth participated in black child legacy campaign activities. The black child legacy campaign is funded by the county of sacramento, first 5 sacramento, and the board of state and community corrections and is managed by the center.

Financial Efficiency

• Mission deployment rate: 99%; rating input score 99
• Program expense ratio: 96.3%; rating input score 96
• Fundraising efficiency: Limited

Transparency & Controls

• Consistency checks: 93.8%; rating input score 94; 25th percentile among comparable filings
• Pay-setting controls: 0 of 6 controls in place; rating input score 0
  • Compensation committee: Missing
  • Independent consultant: Missing
  • Other Form 990s reviewed: Missing
  • Written employment contract: Missing
  • Compensation survey or study: Missing
  • Board or committee approval: Missing
• 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: 87.5%; rating input score 88; 34th percentile among comparable filings
• Governance controls: 7 of 9 controls in place; rating input score 78
  • Conflict-of-interest policy: Pass
  • Whistleblower policy: Pass
  • Document-retention policy: Pass
  • CEO compensation review process: Fail
  • Other executive compensation review process: Fail
  • Form 990 shared with the board: Pass
  • Board meeting minutes documented: Pass
  • Audit committee oversight: Pass
  • Independent financial-statement audit: Pass

Sustainability

• Operating margin: -2.6%; rating input score 17; 17th percentile among comparable filings
• Total-asset coverage ratio: 1; rating input score 40; 40th percentile among comparable filings
• Liabilities to assets ratio: 0.84; rating input score 16; 16th percentile among comparable filings
• Officer compensation ratio: 0.1%; rating input score 94; 94th percentile among comparable filings

Growth

• Program expense growth: 30.1% per year; rating input score 100; 96th percentile among comparable filings
• Revenue growth: 28% per year; rating input score 100; 97th percentile among comparable filings
• Asset growth: 28.5% per year; rating input score 100; 97th percentile among comparable filings