2023-08-15T11:38:47-05:00 2022-09-30 593070669 MSL PA 500 E BROWARD BLVD SUITE 1550 FORT LAUDERDALE FL 33394 990 2021-10-01 592862537 AIDS SERVICE ASSOCIATION OF PINELLAS INC AIDS 7275864432 5771 ROOSEVELT BLVD CLEARWATER FL 33760 SAIDA BOUHAMID CFO 7275864432 2023-08-15 1 SAIDA BOUHAMID 999009999 VICKI L HINZ CPA P00356696 9548478910 3 AAL1 IAL1 2021 2023-04-26 12:10:37Z EMPATH PARTNERS IN CARE (EPIC) JONATHAN FLEECE 5771 ROOSEVELT BLVD CLEARWATER FL 33760 15764278 0 X WWW.MYEPIC.ORG X 1987 FL SERVING THE COMMUNITY AND IMPROVING THE LIVES OF THOSE INFECTED OR AFFECTED BY HIV/AIDS. 14 12 0 106 0 0 4299790 4617694 11192703 10979500 -41952 0 86394 154928 15536935 15752122 6491799 6651975 0 0 0 0 0 0 84969 8445104 9303451 14936903 15955426 600032 -203304 2880365 3172205 1207299 1702443 1673066 1469762 X AIDS SERVICE ASSOCIATION OF PINELLAS, INC. IS A NOT-FOR-PROFIT CORPORATION ORGAINIZED AND EXISTING FOR THE PURPOSE OF PROVIDING PROGRAMS AND SERVICES TO IMPROVE THE LIVES OF ALL THOSE INFECTED AND AFFECTED BY HIV/AIDS. AIDS SERVICE ASSOCIATION OF PINELLAS, INC. PROVIDES SERVICES AND IMPROVES THE LIVES OF THOSE INFECTED AND AFFECTED BY HIV/AIDS THROUGH PREVENTION EDUCATION, DIRECT SERVICES, AND ADVOCACY. DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2022, ASAP SERVED 1,903 CLIENTS THROUGH ITS MANY PROGRAMS. 0 0 1112634 1112634 1152442 THE RYAN WHITE PART A PROGRAM INCLUDES MEDICAL CASE MANAGEMENT AND MENTAL HEALTH COUNSELING. THE PROGRAM LINKS EPIC CLIENTS TO COMMUNITY SERVICES DESIGNED TO PROVIDE IMPROVED HEALTH AND ENHANCE QUALITY OF LIFE. CLIENTS ENROLLED IN THIS PROGRAM MUST PARTICIPATE IN PRIMARY CARE AND DISEASE MANAGEMENT. EPIC CLIENTS ACHIEVED A 98 PERCENT SUCCESS RATE WITH THESE REQUIREMENTS, WHICH RESULTED IN SLOWING DISEASE PROGRESSION AND ACCOUNTS FOR LOWER CHANCE OF OPPORTUNISTIC INFECTIONS, WHICH ARE DETRIMENTAL TO THOSE WITH COMPROMISED IMMUNE SYSTEMS. FURTHER, IT MEANS FEWER VISITS TO EMERGENCY ROOMS, LOWER GENERAL MEDICAL CARE COSTS (INCLUDING PRESCRIPTIONS), AND REDUCED MENTAL HEALTH ISSUES, RESULTING IN BETTER OVERALL WELLNESS. RYAN WHITE PART A MEDICAL CASE MANAGEMENT SERVED 1,367 UNDUPLICATED CLIENTS OVER TEH PAST YEAR AND PART A MENTAL HEALTH COUNSELING SERVED 53 UNDUPLICATED CLIENTS OVER THE PAST YEAR. 638547 638547 554763 THE RYAN WHITE PART B PROGRAM INCLUDES MEDICAL CASE MANAGEMENT, NON-MEDICAL CASE MANAGEMENT PROGRAMS, ALONG WITH LOCAL PHARMACY SERVICES TO PROVIDE BOTH EMERGENCY HIV MEDICATIONS (18 UNDUPLICATED CLIENTS) AND NON-HIV MEDICATIONS (182 UNDUPLICATED CLIENTS). THIS PROGRAM IS A "WRAP AROUND" OF THE STATE OF FLORIDA AIDS DRUG ASSISTANCE PROGRAM (ADAP) AND IS USED TO PREVENT A LAPSE IN TREATMENT. THE PROGRAM LINKS EPIC CLIENTS TO COMMUNITY SERVICES DESIGNED TO PROVIDE IMPROVED HEALTH AND ENHANCE QUALITY OF LIFE.CLIENTS ENROLLED IN THIS PROGRAM MUST PARTICIPATE IN PRIMARY CARE AND DISEASE MANAGEMENT. EPIC CLIENTS ACHIEVED A 97 PERCENT SUCCESS RATE WITH THESE REQUIREMENTS, WHICH RESULTED IN SLOWING DISEASE PROGRESSION AND ACCOUNTS FOR LOWER CHANCE OF OPPORTUNISTIC INFECTIONS, WHICH ARE DETRIMENTAL TO THOSE WITH COMPROMISED IMMUNE SYSTEMS. FURTHER, IT MEANS FEWER VISITS TO EMERGENCY ROOMS, LOWER GENERAL MEDICAL CARE COSTS (INCLUDING PRESCRIPTIONS), AND REDUCED MENTAL HEALTH ISSUES, RESULTING IN BETTER OVERALL WELLNESS. MEDICAL CASE MANAGEMENT SERVED 537 UNDUPLICATED CLIENTS OVER THE PAST YEAR AND RYAN WHITE PART B NON-MEDICAL CASE MANAGEMENT SERVED 1,200 UNDUPLICATED CLIENTS OVER THE PAST YEAR. 483861 483861 556603 THE DEPARTMENT OF HEALTH (DOH) GRANT PROVIDES HIGH IMPACT PREVENTION SERVICES, THROUGH OUTREACH, TESTING, CONDOM DISTRIBUTION, PREP, CLEAR AND HOME AND COMMUNITY BASED INTERVENTION PROGRAMS. THE PROGRAMS TARGET THOSE WHO ARE PRACTICING HIGH-RISK BEHAVIORS. CLIENTS MAY BE HIV POSITIVE OR HIGH-RISK NEGATIVE. THE PROGRAM SEEKS TO EDUCATE CLIENTS ON SAFER SEX OPTIONS AND WAYS TO REDUCE RISKY BEHAVIORS AND LINK INDIVIDUALS TO CARE.THE PROGRAM STAFF COORDINATES WITH OUR CASE MANAGEMENT PROGRAM AND OTHER COMMUNITY PROVIDERS. HIGH RISK BEHAVIORS SUCH AS SUBSTANCE ABUSE AND MENTAL HEALTH ISSUES, SEX ADDICTION, HAVING SEX FOR MONEY, HOMELESSNESS, ETC., ARE DIRECTLY CORRELATED WITH INCREASED HIV INFECTIONS. STAFF MUST SERVICE 72 CLIENTS IN CLEAR (HIV NON-REACTIVE) AND 72 CLIENTS THROUGH THE HOME AND COMMUNITY BASED INTERVENTION (HIV REACTIVE) EACH YEAR. STAFF MUST TEST A MINIMUM OF 1,200 INDIVIDUALS THROUGH THE YEAR AS WELL AS PARTICIPATE IN A MINIMUM OF 12 OUTREACH/TESTING EVENTS IN THE CALENDAR YEAR. 11234101 4416932 8814955 EPIC'S BRIGHTER SEASONS FOR CHILDREN PROGRAM: THE PROGRAM IS A GRASSROOTS CAMPAIGN STARTED OVER 20 YEARS AGO BY COMMUNITY MEMBERS WHO WANTED TO MAKE A DIFFERENCE IN THE LIVES OF CHILDREN INFECTED AND AFFECTED BY HIV/AIDS LIVING IN PINELLAS COUNTY. EPIC CURRENTLY SERVES 42 FAMILIES, WHICH INCLUDE 100 CHILDREN. EACH YEAR, BRIGHTER SEASONS PROVIDES FAMILIES WITH HOLIDAY FOOD PACKAGES AT THANKSGIVING AND CHRISTMAS, A HOLIDAY PARTY WITH SANTA, A HOLIDAY GIFT DISTRIBUTION, AND A SPRING PICNIC AND EGG HUNT. THE PROGRAM ALSO PROVIDES BACK-PACKS AT THE BEGINNING OF EACH SCHOOL YEAR, FULLY LOADED WITH NEEDED SCHOOL SUPPLIES.OUR MEDICAL CO-PAY ASSISTANCE PROGRAM HELPS CLIENTS WITH LIMITED FINANCIAL AID FOR DOCTOR VISITS, LAB WORK, AND MEDICATIONS. TO QUALIFY, A CLIENT MUST BE HIV POSITIVE, EMPLOYED, INSURED, AND RESIDE IN PINELLAS COUNTY. IN ADDITION, CLIENTS ARE UNABLE TO RECEIVE THIS SERVICE IF THEY ARE ON DISABILITY, MEDICAID, OR MEDICARE ASSISTANCE PROGRAMS.EPIC PROVIDES FREE HIV TESTING FOR ANYONE AGE 13 AND UP, AS WELL AS EDUCATION AND PREVENTION PROGRAMS FOR THE ENTIRE COMMUNITY. INDIVIDUAL SUPPORT SERVICES ARE AVAILABLE FOR THOSE WHO ARE AT HIGH RISK FOR ACQUIRING HIV. EPIC PROVIDES SERVICES THAT COVER HIV POSITIVE NEW BORN BABIES OR BABIES WITH AN HIV POSITIVE PARENT. PROGRAMS AND SERVICES ARE FOR ALL PEOPLE OF ALL AGES. MANY EPIC CLIENTS ARE SENIOR ADULTS.EPIC OFFERS HIV EDUCATION, PREVENTION SERVICES, TESTING, CASE MANAGEMENT, FOOD AND PERSONAL NEEDS PANTRY, A CHILDREN'S PROGRAM, SOME FINANCIAL ASSISTANCE, AND MANY OTHER OPTIONS. CASE MANAGERS HELP THEIR EPIC CLIENTS FIND AVENUES OF CARE AND OTHER RESOURCES TO HELP THEM DEAL WITH THEIR INDIVIDUAL SITUATIONS. TESTING IS PROVIDED BY CERTIFIED TESTERS AND STAFF EDUCATORS PROVIDE VITAL INFORMATION ON PREVENTION AND OTHER TOPICS. EPIC PROVIDES SUPPORT GROUPS AND COUNSELING FOR THOSE LIVING WITH HIV/AIDS AND COLLABORATES WITH OTHER AIDS ORGANIZATIONS TO PROVIDE ADDITIONAL OPTIONS.EPIC'S HOME 3050 AND 340(B) PROGRAMS MEET ALL OF AN HIV CLIENT'S HEALTH CARE NEEDS IN ONE PLACE, A TRUE ONE-STOP SHOP, SERVING OVER 1,200 CLIENTS ANNUALLY. TREATMENTS INCLUDE MEDICAL CARE, MEDICAL CASE MANAGEMENT, COUNSELING SERVICES, CARE COORDINATION, AND PHARMACEUTICAL CONSULTS. THROUGH ITS 340(B) PROGRAM, 100% OF ALL PROCEEDS, REALIZED THROUGH EPIC'S PARTNERED PHARMACY, ARE ALLOCATED BACK TO MAINTAIN AND EXPAND EPIC'S SERVICES TO THE HIV COMMUNITY. 11234101 4416932 8814955 13469143 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 0 0 0 0 0 0 1 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 87 0 1 0 0 0 0 0 0 0 0 0 0 0 X 14 12 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X SAIDA BOUHAMID 7275864432 5771 ROOSEVELT BLVD CLEARWATER FL 33760 RAFAEL J SCIULLO CHIEF EXECUTIVE OFFICER 6.00 41.00 X X 0 909978 59885 JONATHAN FLEECE PRESIDENT 6.00 41.00 X X 0 910629 52399 SAIDA BOUHAMID CHIEF FINANCIAL OFFICER 1.00 46.00 X 0 426247 44537 JOY A WINHEIM EXECUTIVE DIRECTOR 40.00 0.00 X 0 112763 20947 LISA E COHEN CHAIR 1.00 0.00 X X 0 0 0 CRAIG BRYANT VICE CHAIR 1.00 0.00 X X 0 0 0 STEPHANIE MARHEFKA SECRETARY 1.00 0.00 X X 0 0 0 RYAN MEMOLI TREASURER 1.00 0.00 X X 0 0 0 DAVID BUBY TRUSTEE 2.00 1.00 X 0 0 0 JOAN CHRISTIE TRUSTEE 2.00 1.00 X 0 0 0 KAREN GOFORTH TRUSTEE 1.00 0.00 X 0 0 0 JULIA MCGINTY TRUSTEE 1.00 0.00 X 0 0 0 CHARLOTTE NOBLE TRUSTEE 1.00 0.00 X 0 0 0 FRANK RODER TRUSTEE 1.00 0.00 X 0 0 0 RYAN YOUNG TRUSTEE 1.00 0.00 X 0 0 0 SCOTT KISTLER TRUSTEE 1.00 1.00 X 0 250127 55177 0 2609744 232945 0 0 1 0 EMPATH HEALTH INC 5771 ROOSEVELT BLVD CLEARWATER FL 33760 MANAGEMENT & PROGRAM SERVICES 1096566 CARDINAL HEALTH 11210 MCKINLEY DR TAMPA FL 33612 PROFESSIONAL SERVICES 210952 ST JOSEPHS HOSP DBA PINELLAS CARE CLINIC 4600 NORTH HABANA AVE STE 23 TAMPA FL 33614 PROFESSIONAL SERVICES 158868 3 4533123 84571 4617694 340B PRESCRIPTION PROGRAM 10803277 10803277 OTHER PROGRAM SERVICE REVENUE 176223 176223 10979500 67821 12156 55665 55665 MISCELLANEOUS REVENUE 99263 99263 99263 15752122 11078763 0 55665 X 6651975 6651975 1049096 1049096 30471 24343 5998 130 3601226 2770326 790321 40579 835 835 114857 65321 48742 794 1989583 1477565 474229 37789 17640 11573 3989 2078 22562 8606 13956 27917 22996 4921 MEDICAL SUPPLIES 2152339 2151014 1325 DIETARY 166952 166542 410 TRAINING 54940 54812 128 MISCELLANEOUS 49285 48835 450 25748 14400 7749 3599 15955426 13469143 2401314 84969 1200 1200 1753145 1783628 898385 1171078 76277 83271 364384 235798 64111 128586 87247 4442 2880365 3172205 1207299 1135264 0 567179 1207299 1702443 X 1017253 1413635 55781 56127 1673066 1469762 2880365 3172205 -203304 0 X X 0 1 X 1 1 1 X 176444 3045582 3136742 4256925 4617694 15233387 176444 3045582 3136742 4256925 4617694 15233387 15233387 3157 838 3995 15237382 31674852 0.99970 0.99880 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: MISCELLANEOUS - 2017 AMOUNT: $ 3,157. 2018 AMOUNT: $ 838. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 67528 60787 6741 296856 175011 121845 128586 DUE TO/FROM AFFILIATES, NET 567179 567179 X 15764278 0 15764278 -12156 -12156 15752122 15967582 12156 12156 15955426 0 15955426 PART X, LINE 2: EPIC HAS RECEIVED A DETERMINATION LETTER FROM THE INTERNAL REVENUE SERVICE ("IRS") THAT IT IS EXEMPT FROM FEDERAL INCOME TAX AS AN ORGANIZATION DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE ("IRC"). IT IS ALSO EXEMPT FROM STATE INCOME TAX PURSUANT TO FLORIDA LAW. FURTHER, EPIC IS NOT A PRIVATE FOUNDATION FOR FEDERAL TAX PURPOSES AND QUALIFIES FOR THE CHARITABLE CONTRIBUTION DEDUCTION UNDER IRC SECTION 170 AS WELL AS TAX DEDUCTIBLE BEQUESTS, DEVISES, TRANSFERS OR GIFTS UNDER SECTION 2055, 2106, OR 2522. EPIC IS ANNUALLY REQUIRED TO FILE A RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX (FORM 990) WITH THE IRS. IN ADDITION, EPIC IS POTENTIALLY SUBJECT TO INCOME TAX ON NET INCOME THAT IS DERIVED FROM ACTIVITIES THAT ARE UNRELATED TO ITS EXEMPT PURPOSES, IF ANY. EPIC HAD NO UNRELATED BUSINESS INCOME DURING THE YEARS ENDED SEPTEMBER 30, 2022 OR 2021. ACCORDINGLY, THESE FINANCIAL STATEMENTS INCLUDE NO PROVISION OR LIABILITY FOR INCOME TAXES. PART XI, LINE 4B - OTHER ADJUSTMENTS: FUNDRAISING EXPENSE -12,156. PART XII, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EXPENSE 12,156. DINING OUT FOR LIFE 35983 35983 174 2061 3356 42 SOFA 31838 31838 187 2160 778 2873 525 67821 67821 361 4221 778 6229 567 12156 55665 1 340B PRESCRIPTION MEDICINE 400 6651975 FMV PRESCRIPTION MEDICINE PART I, LINE 2: SEVERAL PROGRAMS HAVE BEEN ESTABLISHED TO HELP CLIENTS WITH LIMITED FINANCIAL AID FOR DOCTOR VISITS, LAB WORK, AND MEDICATIONS. TO QUALIFY, A CLIENT MUST BE HIV POSITIVE, EMPLOYED, INSURED, AND RESIDE IN PINELLAS COUNTY. IN ADDITION, CLIENTS ARE UNABLE TO RECEIVE THIS SERVICE IF THEY ARE ON DISABILITY, MEDICAID, OR MEDICARE. FUNDING IS ALSO AVAILABLE TO CLIENTS IN NEED OF PERSONAL CARE AND FOOD PANTRY ITEMS. A FUNDING LEVEL IS ESTABLISHED ANNUALLY BASED ON RESOURCES AVAILABLE AND TO ENSURE A LIMIT TO THE FINANCIAL ASSISTANCE PROVIDED. INDIVIDUAL CLIENT MAXIMUM ASSISTANCE IS ALSO ESTABLISHED ON AN ANNUAL BASIS. TO ENSURE GRANTS ARE USED FOR THEIR INTENDED PURPOSE, ALL CHECKS ARE WRITTEN OUT TO THE INTENDED VENDOR AND THE GRANT RECIPIENT SIGNS A WRITTEN AGREEMENT THAT OUTLINES THE SPECIFIC USE OF THE FUNDS. 0 0 0 0 0 0 0 0 0 RAFAEL J SCIULLO CHIEF EXECUTIVE OFFICER 0 819429 0 0 0 90549 0 26000 0 33885 0 969863 0 0 JONATHAN FLEECE PRESIDENT 0 698800 0 0 0 211829 0 26000 0 26399 0 963028 0 0 SAIDA BOUHAMID CHIEF FINANCIAL OFFICER 0 388899 0 0 0 37348 0 26000 0 18537 0 470784 0 0 SCOTT KISTLER TRUSTEE 0 241127 0 0 0 9000 0 26000 0 29177 0 305304 0 0 PART I, LINE 3 THE COMPENSATION OF THE PRESIDENT/CEO AND THE EXECUTIVE DIRECTOR IS DETERMINED BY EMPATH HEALTH, INC. ("EHI"), A RELATED 501(C)(3) ORGANIZATION. EHI USES THE FOLLOWING TO DETERMINE THEIR COMPENSATION: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - FORM 990 OF OTHER ORGANIZATIONS - COMPENSATION SURVEYS OR STUDIES - APPROVAL BY THE BOARD OF DIRECTORS/COMPENSATION COMMITTEE FORM 990, PART VI, SECTION A, LINE 1A THE BOARD OF DIRECTORS HAS AN EXECUTIVE COMMITTEE, WHICH CONSISTS OF THE CHAIRMAN OF THE BOARD, THE VICE CHAIRMAN OF THE BOARD, THE PRESIDENT/CHIEF EXECUTIVE OFFICER, THE SECRETARY, AND THE TREASURER. THE BOARD OF DIRECTORS MAY DESIGNATE, FROM ITS MEMBERS, UP TO TWO ADDITIONAL DIRECTORS TO SERVE AS MEMBERS OF THE EXECUTIVE COMMITTEE. WHEN THE BOARD OF DIRECTORS IS NOT IN SESSION, THE EXECUTIVE COMMITTEE HAS AND MAY EXERCISE ALL OF THE POWERS OF THE BOARD OF DIRECTORS, EXCEPT TO THE EXTENT, IF ANY, THAT SUCH AUTHORITY SHALL BE LIMITED BY A RESOLUTION ADOPTED BY A MAJORITY OF DIRECTORS IN OFFICE. FORM 990, PART VI, SECTION A, LINE 2 RAFAEL SCIULLO AND SCOTT KISTLER ARE OFFICERS OR BOARD MEMBERS OF HOSPICE SYSTEMS, INC., A RELATED, FOR-PROFIT COMPANY. FORM 990, PART VI, SECTION A, LINE 6 PURUSANT TO THE ORGANIZATION'S GOVERNING DOCUMENTS, THE SOLE VOTING MEMBER OF AIDS SERVICE ASSOCIATION OF PINELLAS, INC. (ASAP) SHALL BE EMPATH HEALTH, INC. (EHI), A RELATED TAX-EXEMPT ORGANIZATION. AS THE ORGANIZATION'S SOLE CORPORATE MEMBER, EHI HAS THE RIGHT TO PARTICIPATE IN THE ORGANIZATION'S GOVERNANCE. FORM 990, PART VI, SECTION A, LINE 7A PURSUANT TO THE ORGANIZATION'S GOVERNING DOCUMENTS, THE SOLE CORPORATE MEMBER, EHI, HAS THE RIGHT TO ELECT, APPOINT, OR REMOVE ANY DIRECTOR OF ASAP WITHOUT CAUSE AT ANY TIME. FORM 990, PART VI, SECTION A, LINE 7B THE SOLE CORPORATE MEMBER, EHI, HAS THE RIGHT TO APPROVE OR RATIFY SIGNIFICANT DECISIONS OF THE ORGANIZATION'S GOVERNING BODY. THE BOARD OF DIRECTORS OF ASAP SHALL NOT HAVE THE AUTHORITY TO MAKE SIGNIFICANT DECISIONS WITHOUT THE APPROVAL OF THE EHI BOARD. SIGNIFICANT DECISIONS INCLUDE, BUT ARE NOT LIMITED TO: THE RIGHT TO AMEND, REPEAL OR ALTER THEIR GOVERNING DOCUMENTS; SELL, LEASE OR OTHERWISE DISPOSE OF SUBSTANTIALLY ALL OF THE ORGANIZATION'S ASSETS; AND MERGE OR CONSOLIDATE THE ORGANIZATION WITH ANOTHER ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11B UPON COMPLETION AND BEFORE SUBMISSION, THE FORM 990 IS PROVIDED TO EACH BOARD MEMBER ALONG WITH A SUMMARY OF IMPORTANT HIGHLIGHTS, NOTING THE PAGE NUMBERS AND LINES FOR ITEMS OF PARTICULAR IMPORTANCE TO REVIEW. FORM 990, PART VI, SECTION B, LINE 12C ALL OFFICERS, DIRECTORS, TRUSTEES, KEY EMPLOYEES, AND HIGHEST PAID EMPLOYEES (INTERESTED PERSONS) OF THE ORGANIZATION HAVE A DUTY TO AVOID CONFLICTS OF INTEREST, BOTH REAL AND PERCEIVED, WHICH MAY NEGATIVELY IMPACT THE ORGANIZATION OR THOSE IT SERVES. THE ORGANIZATION'S INTERESTED PERSONS ARE TO BE GUIDED BY THE ORGANIZATION'S MISSION, VISION AND VALUES, AND TO SERVE PATIENTS, FAMILIES, AND THE GENERAL PUBLIC WITHOUT NEED FOR ANY PERSONAL FAVOR OR GAIN. THE ORGANIZATION'S ETHICS AND COMPLIANCE PLAN EMPHASIZES THE DUTY INTERESTED PERSONS HAVE TO DISCLOSE ANY ACTUAL OR POTENTIAL CONFLICTS OF INTEREST THAT MAY BENEFIT THEIR PRIVATE INTERESTS OR RESULT IN A POSSIBLE EXCESS BENEFIT TRANSACTION. CONFLICTS ARE DISCLOSED ANNUALLY ON A CONFLICT OF INTEREST QUESTIONNAIRE THAT IS DISTRIBUTED TO THE OFFICERS, DIRECTORS, KEY EMPLOYEES, AND HIGHEST COMPENSATED EMPLOYEES. IN THE EVENT OF ANY ACTUAL OR POTENTIAL CONFLICTS OF INTEREST, INTERESTED PERSONS MUST DISCLOSE THE EXISTENCE OF THEIR FINANCIAL INTEREST AND DISCLOSE ALL MATERIAL FACTS TO THE BOARD CHAIR, CEO, OR OTHER DESIGNATED PERSONS. IF IT IS DETERMINED THAT AN ACTUAL CONFLICT OF INTEREST EXISTS BETWEEN THE ORGANIZATION AND AN INTERESTED PERSON, THE PARTY WITH A CONFLICT OF INTEREST BUT ABSTAIN FROM ANY DISCUSSION OR VOTING ON THE TRANSACTION OR ARRANGEMENT INVOLVING THE CONFLICT OF INTEREST. AT EACH BOARD MEETING, BOARD MEMBERS ARE REMINDED THAT THEY HAVE SIGNED A CONFLICT OF INTEREST DISCLOSURE AND ARE ASKED TO REVIEW THE AGENDA. AT THAT TIME, FOR THE RECORD, THEY ARE TO DISCLOSE ANY ITEMS WITH WHICH THEY MAY HAVE A CONFLICT OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL IS THE PRESIDENT AND CEO OF EMPATH HEALTH, INC. (EHI), A RELATED ORGANIZATION. THE CEO'S COMPENSATION IS DETERMINED BY AND PAID FOR BY EHI. THE EXECUTIVE COMMITTEE OF THE EHI BOARD MEETS ANNUALLY TO REVIEW AND APPROVE THE COMPENSATION OF THE PRESIDENT AND CEO. THE EXECUTIVE COMMITTEE'S REVIEW OF CEO COMPENSATION INCLUDES INFORMATION PROVIDED IN THE MOST RECENT EXTERNAL COMPENSATION REVIEW. THE COMPENSATION OF THE ORGANIZATION'S OTHER OFFICERS IS ALSO DETERMINED BY EHI. THE COMPENSATION OF OTHER OFFICERS IS REVIEWED ON AN ANNUAL BASIS BY THE CEO OF EHI. AFTER REVIEWING OFFICER COMPENSATION, THE CEO'S RECOMMENDATIONS ARE THEN APPROVED BY EHI'S BOARD OF DIRECTORS. THESE REVIEWS ARE DOCUMENTED IN EACH EMPLOYEE'S FILE. THE REVIEW OF OTHER OFFICERS' COMPENSATION INCLUDES INFORMATION PROVIDED IN THE MOST RECENT EXTERNAL COMPENSATION REVIEW. EXTERNAL COMPENSATION REVIEWS ARE PERFORMED ACCORDING TO THE FOLLOWING PROCESS: EVERY 3-5 YEARS HUMAN RESOURCES WILL EMPLOY A WELL-RECOGNIZED, INDEPENDENT COMPENSATION CONSULTANT TO REVIEW THE MARKET RANGES FOR THE CEO OF EHI. THE REVIEW WILL INCLUDE A NATIONAL COMPARISON OF SIMILAR JOBS AT SIMILARLY SITUATED COMPANIES IN ORDER TO MAKE CERTAIN THAT THESE KEY EMPLOYEES ARE PAID WITHIN A REASONABLE AND APPROPRIATE RANGE. THE RESULTING RECOMMENDATIONS WILL BE REVIEWED BY THE EXECUTIVE COMMITTEE TO RECOMMEND ANY MARKET-BASED CHANGES OR TO ENSURE THAT THE CURRENT COMPENSATION OF THESE INDIVIDUALS ARE CORRECT. DURING THIS REVIEW, HUMAN RESOURCES WILL ALSO GIVE THE EXECUTIVE COMMITTEE A BROAD OVERVIEW OF THE STRUCTURE OF THE FULL ORGANIZATION'S COMPENSATION SYSTEM, INCLUDING THE PHILOSOPHY AND SYSTEMS SET IN PLACE TO MANAGE IT. FORM 990, PART VI, SECTION C, LINE 19 FINANCIAL STATEMENTS, GOVERNING DOCUMENTS, AND CONFLICT OF INTEREST POLICIES ARE NOT REQUIRED DISCLOSURES PURSUANT TO IRC SECTION 6104. THESE DOCUMENTS ARE NOT AVAILABLE TO THE PUBLIC AT THIS TIME. FORM 990, PART IX, LINE 11G CONTRACT LABOR: PROGRAM SERVICE EXPENSES 247,620. MANAGEMENT AND GENERAL EXPENSES 1,119. FUNDRAISING EXPENSES 9,000. TOTAL EXPENSES 257,739. PATIENT CARE: PROGRAM SERVICE EXPENSES 17,577. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 31,579. TOTAL EXPENSES 49,156. MEDICAL TRANSPORTATION: PROGRAM SERVICE EXPENSES 13,531. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 13,531. SALARIES AND BENEFITS ALLOCATION: PROGRAM SERVICE EXPENSES 2,491,598. MANAGEMENT AND GENERAL EXPENSES 789,202. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,280,800. FORM 990, PART XII, LINE 2C THE SOLE CORPORATE MEMBER, EMPATH HEALTH, INC., IS RESPONSIBLE FOR THE OVERSIGHT OF THE ORGANIZATION'S FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THERE WAS NO CHANGE IN THIS PROCESS FROM THE PRIOR YEAR. STRATUM HEALTH SYSTEM INC 5955 RAND BLVD SARASOTA FL 34238 472508009 PROVIDE A COMPREHENSIVE CONTINUUM OF SERVICES FL 501(C)(3) LINE 12A, I EMPATH-STRATUM INC 0 TIDEWELL HOSPICE INC 5955 RAND BLVD SARASOTA FL 34238 591911861 PROVIDE HOSPICE CARE FL 501(C)(3) LINE 7 STRATUM HEALTH SYSTEM INC 0 TIDEWELL FOUNDATION INC 5955 RAND BLVD SARASOTA FL 34238 850729071 PROVIDE FUNDS TO SUPPORT THE MISSION AND PROGRAMS OF TIDEWELL HOSPICE FL 501(C)(3) LINE 7 STRATUM HEALTH SYSTEM INC 0 EMPATH HEALTH INC 5771 ROOSEVELT BLVD CLEARWATER FL 33760 263605761 PROVIDE A COMPREHENSIVE CONTINUUM OF SERVICES FL 501(C)(3) LINE 12B, II EMPATH-STRATUM INC 0 THE HOSPICE OF THE FLORIDA SUNCOAST INC 5771 ROOSEVELT BLVD CLEARWATER FL 33760 591744006 HOSPICE FL 501(C)(3) LINE 10 EMPATH HEALTH INC 0 THE HOSPICE INSTITUTE OF THE FLORIDA SUNCOAST INC 5771 ROOSEVELT BLVD CLEARWATER FL 33760 593176721 INACTIVE FL 501(C)(3) LINE 7 EMPATH HEALTH INC 0 THE HOSPICE FOUNDATION OF THE FLORIDA SUNCOAST INC 5771 ROOSEVELT BLVD CLEARWATER FL 33760 592252045 FUNDRAISING FL 501(C)(3) LINE 7 EMPATH HEALTH INC 0 SUNCOAST PACE INC 5771 ROOSEVELT BLVD CLEARWATER FL 33760 452980257 PACE PROGRAM FL 501(C)(3) LINE 10 EMPATH HEALTH INC 0 EMPATH-STRATUM INC 5771 ROOSEVELT BLVD CLEARWATER FL 33760 851356625 PROVIDE A COMPREHENSIVE CONTINUUM OF SERVICES FL 501(C)(3) LINE 12A, I 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 0 0 0