2018-09-04T08:42:31-05:00 2017-12-31 351346211 HARDING SHYMANSKI & CO PSC PO BOX 3677 EVANSVILLE IN 47735 990 2017-01-01 351935366 INDIANA BREAST CANCER AWARENESS TRUST INDI 8128688769 PO BOX 8212 EVANSVILLE IN 47716 SHEILA HAUCK PRESIDENT 8128688769 2018-07-30 1 MICHAEL J VOGEL P00075676 8124649161 2017 2022-09-23 18:48:47Z SHEILA HAUCK PO BOX 8212 EVANSVILLE IN 47716 498822 0 X WWW.BREASTCANCERPLATE.ORG X 1996 IN INCREASE AWARENESS AND IMPROVE ACCESS TO BREAST CANCER SCREENING AND DIAGNOSIS THROUGHOUT INDIANA. 10 10 1 11 0 0 508988 497674 0 0 1120 1148 0 0 510108 498822 374583 520780 0 0 48384 52211 0 0 2611 -5660 53696 417307 626687 92801 -127865 913389 840869 0 0 913389 840869 INCREASE AWARENESS AND IMPROVE ACCESS TO BREAST CANCER SCREENING AND DIAGNOSIS THROUGHOUT INDIANA. 0 0 500029 407175 THE PURPOSE OF THE PATIENT SERVICES GRANT PROGRAM IS TO DETECT BREAST CANCER THROUGH SCREENING AND/OR DIAGNOSTIC SERVICES. THE PROGRAMS PROVIDE INFORMATION ON BREAST CANCER RISK, AVAILABLE TREATMENT, AND FUNDING FOR MAMMOGRAPHY SCREENING SERVICES. IN 2017, THERE WERE 91 CLINICAL BREAST EXAMS, 1,516 SCREENING & DIAGNOSITIC MAMMOGRAMS, 355 BREAST ULTRASOUNDS, 51 BIOPSIES, 51 PATHOLOGIES, 19 MRI'S OR MBI'S AND 17 CASES OF CANCERS DETECTED. 102355 102355 THE PURPOSE OF THE SUPPORT SERVICES GRANT PROGRAM IS TO SUPPORT WOMEN GOING THROUGH TREATMENT FOR BREAST CANCER BY ASSISTING WITH PAYMENT OF ANCILLARY EXPENSES. EACH GRANT PROGRAM LOOKS A LITTLE DIFFERENT IN WHAT THEY PROVIDE. SERVICES FOR 2017 INCLUDED TRANSPORTATION ASSISTANCE, GROCERY ASSISTANCE, RENT/MORTGAGE ASSISTANCE, UTILITY EXPENSES, HEAD COVERINGS, INCONTINENCE SUPPLIES, LYMPHEDEMA SUPPLIES, MASTECTOMY SUPPLIES, INSURANCE CO-PAY FOR PHYSICIAN APPOINTMENTS AND PRESCRIPTION MEDICATIONS, COMFORT KITS, COMPLEMENTARY THERAPIES (MASSAGE, YOGA, EXERCISE CLASSES) AND HOUSEKEEPING SERVICES. 11250 11250 NANCY JAYNES MEMORIAL SCHOLARSHIP AWARD UP TO $1,500 FOR COLLEGE OR POST-SECONDARY TECHNICAL SCHOOLING TO AN INDIANA HIGH SCHOOL SENIOR WHOSE PARENT IS BATTLING BREAST CANCER OR WHO HAS LOST A PARENT TO BREAST CANCER. CONTINUATION SCHOLARSHIPS ARE ALSO AVAILABLE TO PAST AWARDEES UP TO $1,000. TO BE ELIGIBLE FOR A CONTINUATION AWARD, THE STUDENT MUST BE ENROLLED FULL-TIME AND MAINTAIN A 3.0 GPA. 613634 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 X 10 10 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 0 0 0 0 IN X X CARMEN TEED 3175027103 4510 NORTH PARK DR INDIANAPOLIS IN 46205 SHELIA HAUCK PRESIDENT & GRANT COMMITTE 2.00 X X 0 0 0 BETH ANN BOYER FINANCE & GRANT COMMITTEES 1.00 X 0 0 0 DUBBIE BUCKLER FINANCE & GOVERNANCE COMMI 1.00 X 0 0 0 BETTY COCKRUM MARKETING COMMITTEE 1.00 X 0 0 0 GRETCHEN GUTMAN FINANCE & GOVERNANCE COMMI 1.00 X 0 0 0 CARMEN TEED TREASURER, FINANCE & SCHOL 3.00 X X 0 0 0 DONNA NICHOLS THRELKELD SECRETARY & GOVERNANCE COM 1.00 X X 0 0 0 ANN WHITE GRANT & SCHOLARSHIP COMMIT 1.00 X 0 0 0 TOM WYSS FINANCE COMMITTEE 1.00 X 0 0 0 CHERRISH PRYOR AT LARGE MEMBER 1.00 X 0 0 0 BETH A KNAPP EXECUTIVE DIRECTOR 25.00 X 48500 0 0 48500 0 0 0 0 0 0 0 497674 497674 1148 1148 498822 0 0 1148 509530 509530 11250 11250 48500 36375 9700 2425 3711 2783 742 186 735 735 733 733 44152 44152 3219 3219 1122 1122 924 924 1000 1000 TELEPHONE 1611 1611 DONATION 200 200 626687 613634 10442 2611 913389 840869 1590 1590 0 0 913389 840869 0 0 X 0 0 0 0 913389 840869 913389 840869 913389 840869 X -127865 55345 X 0 0 0 X 502596 513278 523704 508988 497674 2546240 502596 513278 523704 508988 497674 2546240 2546240 1078 826 954 1120 1148 5126 2551366 2551366 0.99800 0.99800 X 1590 1590 0 0 1 CANCER SERVICES OF EAST CENTRAL INDIANA - LITTLE RED DOOR 2311 WEST JACKSON MUNCIE IN 47303 350988703 501(C)3 20190 FUNDING RELATED TO BREAST CANCER DIAGNOSIS AND TREATMENT CANCER SERVICES OF GRANT COUNTY 305 SOUTH NORTON AVENUE MARION IN 46952 351058216 501(C)3 19980 FUNDING RELATED TO BREAST CANCER DIAGNOSIS AND TREATMENT COLUMBUS REGIONAL HOSPITAL - BREAST HEALTH CENTER 2326 18TH STREET SUITE 110 COLUMBUS IN 47201 351129669 501(C)3 5030 FUNDING RELATED TO BREAST CANCER DIAGNOSIS AND TREATMENT COMMUNITY HOSPITAL ANDERSON 1515 N MADISON AVENUE ANDERSON IN 46011 351069822 501(C)3 15835 FUNDING RELATED TO BREAST CANCER DIAGNOSIS AND TREATMENT DEARBORN COUNTY HOSPITAL BREAST CARE CENTER 600 WILSON CREEK ROAD LAWRENCEBURG IN 47025 356006595 501(C)3 8617 FUNDING RELATED TO BREAST CANCER DIAGNOSIS AND TREATMENT GENNESARET FREE CLINIC 615 N ALABAMA STREE GROUND FL STE B B INDIANAPOLIS IN 46204 351776518 501(C)3 14888 FUNDING RELATED TO BREAST CANCER DIAGNOSIS AND TREATMENT INTERLOCAL COMMUNITY ACTION PROGRAM 525 E 7TH STREET RUSHVILLE IN 46173 351116629 501(C)3 14159 FUNDING RELATED TO BREAST CANCER DIAGNOSIS AND TREATMENT LA PORTE HOSPITAL FOUNDATION PO BOX 250 LA PORTE IN 46352 310952775 501(C)3 18000 FUNDING RELATED TO BREAST CANCER DIAGNOSIS AND TREATMENT SAINT JOSEPH REGIONAL MEDICAL CENTER 707 E CEDAR STREET SUITE 175 SOUTH BEND IN 46617 350868157 501(C)3 19079 FUNDING RELATED TO BREAST CANCER DIAGNOSIS AND TREATMENT ST CATHERINE HOSPITAL 4321 FIR STREET EAST CHICAGO IN 46312 351738708 501(C)3 20000 FUNDING RELATED TO BREAST CANCER DIAGNOSIS AND TREATMENT ST ELIZABETH MEDICAL CENTER INC 1 MEDICAL VILLAGE DRIVE EDGEWOOD KY 41017 610445850 501(C)3 17064 FUNDING RELATED TO BREAST CANCER DIAGNOSIS AND TREATMENT ST MARY'S MEDICAL CENTER 3700 WASHINGTON AVENUE EVANSVILLE IN 47750 237045370 501(C)3 19987 FUNDING RELATED TO BREAST CANCER DIAGNOSIS AND TREATMENT YWCA GREATER LAFAYETTE 605 NORTH SIXTH STREET LAFAYETTE IN 47901 350868224 501(C)3 29509 FUNDING RELATED TO BREAST CANCER DIAGNOSIS AND TREATMENT UNITED HEALTH SERVICESBREAST HEALTH PROGRAMS 6910 N MAIN STREET BLDG 9 MAIL UNIT 10 GRANGER IN 46530 351118647 501(C)3 29621 FUNDING RELATED TO BREAST CANCER DIAGNOSIS AND TREATMENT DEACONESS HEALTH SYSTEM 600 MARY STREET EVANSVILLE IN 47747 350593390 501(C)3 14941 FUNDING RELATED TO BREAST CANCER DIAGNOSIS AND TREATMENT FRANCINE'S FRIENDS INC 709 CLAY STREET SUITE 300 FORT WAYNE IN 468022019 383730516 501(C)3 16348 FUNDING RELATED TO BREAST CANCER DIAGNOSIS AND TREATMENT JOHNSON COUNTY HEALTH DEPARTMENT 86 WEST COURT ST FRANKLIN IN 46131 356000164 501(C)3 6288 FUNDING RELATED TO BREAST CANCER DIAGNOSIS AND TREATMENT MAPLE CITY HEALTH CARE CENTER INC 213 MIDDLEBURY STREET GOSHEN IN 46528 351749398 501(C)3 20000 FUNDING RELATED TO BREAST CANCER DIAGNOSIS AND TREATMENT RUSH MEMORIAL HOSPITAL 1300 N MAIN ST RUSHVILLE IN 46173 203199892 501(C)3 28660 FUNDING RELATED TO BREAST CANCER DIAGNOSIS AND TREATMENT SHALOM HEALTH CARE CENTER INC 3400 LAFAYETTE RD 200 INDIANAPOLIS IN 46222 061645027 501(C)3 8000 FUNDING RELATED TO BREAST CANCER DIAGNOSIS AND TREATMENT CAMERON HOSPITAL FOUNDATION 416 E MAUMEE STREET ANGOLA IN 46703 351722087 501(C)3 8282 FUNDING RELATED TO BREAST CANCER DIAGNOSIS AND TREATMENT CANCER SERVICES OF NORTHEAST INDIANA 6316 MUTUAL DRIVE FORT WAYNE IN 46825 350965609 501(C)3 10000 FUNDING RELATED TO BREAST CANCER DIAGNOSIS AND TREATMENT CANCER SUPPORT COMMUNITY CENTRAL INDIANA 5150 WEST 71ST STREET INDIANAPOLIS IN 46268 351902427 501(C)3 10000 FUNDING RELATED TO BREAST CANCER DIAGNOSIS AND TREATMENT DAVIESS COMMUNITY HOSPITAL 1314 EAST WALNUT STREET WASHINGTON IN 47501 356001322 501(C)3 9450 FUNDING RELATED TO BREAST CANCER DIAGNOSIS AND TREATMENT FRANCISCAN ALLIANCE FOUNDATION 3510 PARK PLACE WEST SUITE 200 MISHAWAKA IN 46545 351955283 501(C)3 28300 FUNDING RELATED TO BREAST CANCER DIAGNOSIS AND TREATMENT HENDRICKS REGIONAL HEALTH 1000 EAST MAIN STREET DANVILLE IN 46122 351361243 501(C)3 12500 FUNDING RELATED TO BREAST CANCER DIAGNOSIS AND TREATMENT INDIANA WOMEN IN NEED FOUNDATION (IWIN) PO BOX 30648 INDIANAPOLIS IN 46220 912057735 501(C)3 10000 FUNDING RELATED TO BREAST CANCER DIAGNOSIS AND TREATMENT LITTLE RED DOOR CANCER AGENCY 1801 NORTH MERIDIAN STREET INDIANAPOLIS IN 46202 350914096 501(C)3 10000 FUNDING RELATED TO BREAST CANCER DIAGNOSIS AND TREATMENT NORTON HEALTHCARE FOUNDATION PO BOX 950183 LOUISVILLE KY 402950183 310914919 501(C)3 5538 FUNDING RELATED TO BREAST CANCER DIAGNOSIS AND TREATMENT PINK-4-EVER INC 8857 COMMERCE PARK PLACE SUITE C INDIANAPOLIS IN 46268 262994557 501(C)3 7142 FUNDING RELATED TO BREAST CANCER DIAGNOSIS AND TREATMENT ST MARY'S HEALTH FOUNDATION 3700 WASHINGTON AVENUE EVANSVILLE IN 47714 350869065 501(C)3 5000 FUNDING RELATED TO BREAST CANCER DIAGNOSIS AND TREATMENT TOUCH INC 904 S ST JAMES BLVD EVANSVILLE IN 47714 263989768 501(C)3 8000 FUNDING RELATED TO BREAST CANCER DIAGNOSIS AND TREATMENT TRI-CAP 727 JOHN STREET EVANSVILLE IN 47713 351121163 501(C)3 7900 FUNDING RELATED TO BREAST CANCER DIAGNOSIS AND TREATMENT 33 SCHOLARSHIP 12 11250 PART I, LINE 2: THE PURPOSE OF THE GRANT FUNDING IS TO PROVIDE SCREENING MAMMOGRAMS FOR MEDICALLY UNDERSERVED WOMEN. THERE IS A MAXIMUM OF $20,000 PER GRANT REQUEST AND IS LIMITED TO $85 PER SCREENING MAMMOGRAM AND $130 PER DIGITAL SCREENING MAMMOGRAM. GENERAL RESTRICTIONS INCLUDE THE FOLLOWING: PROJECT MUST BE SPECIFIC TO PROVIDING SCREENING MAMMOGRAMS TO UNDERSERVED WOMEN. AMERICAN CANCER SOCIETY (ACS) GUIDELINES FOR SCREENING MAMMOGRAPHY SHOULD BE FOLLOWED. MAMMOGRAPHY SERVICE PROVIDERS MUST BE AMERICAN COLLEGE OF RADIOLOGY (ACR) CERTIFIED. APPLICANTS MUST BE A U.S. NONPROFIT (FEDERALLY TAX-EXEMPT) ORGANIZATION. SERVICES ARE PROVIDED WITHIN THE STATE OF INDIANA. A GRANT CONTRACT WILL BE THE LEGAL MECHANISM FOR FUNDING OF GRANT. ONCE GRANT APPLICATIONS ARE RECEIVED, A GRANT REVIEW PANEL OF 4-6 MEMBERS RATE EACH APPLICATION, AND SCORES ARE TALLIED. THE REVIEW PANEL MEETS TO DETERMINE THE PROPOSED SLATE OF GRANTS. THE PROPOSAL IS PRESENTED TO THE BOARD OF DIRECTORS, WHO REVIEW AND VOTE ON THE SLATE. GRANTEES WILL SUBMIT MID-TERM AND FINAL GRANT REPORTS. REPORTS SHALL INCLUDE PROGRESS MADE TOWARD MEETING OBJECTIVES OUTLINED IN GRANT APPLICATIONS, NUMBER OF PEOPLE SERVED, OTHER SOURCES OF SUPPORT,DOCUMENTATION AND ARTICLES SUBMITTED FOR PUBLICATION, AND PRESENTATIONS MADE AT SCIENTIFIC CONFERENCES. FINAL REPORTS MUST INCLUDE AN ACCOUNTING OF THE GRANT FUNDS EXPENDED DURING THE TERM OF THE GRANT CONTRACT. FORM 990, PART VI, SECTION B, LINE 11B A COPY OF FORM 990 IS DISTRIBUTED TO DIRECTORS AND MADE AVAILABE TO ENTIRE BOARD OF DIRECTORS FOR ANY QUESTIONS/COMMENTS PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C REVIEWED EACH YEAR AT ANNUAL MEETING OF NEW CONFLICTS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VII CONTACT ADDRESSES FOR OFFICERS, DIRECTORS, ETC SHELIA HAUCK - 3400 WESTHAMPTON DR., NEWBURGH, IN 47630. BETH ANN BOYER - 11432 BROUGHAM RUN, FORT WAYNE, IN 46845. DUBBIE BUCKLER - 9917 CEDAR RIDGE DR., CARMEL, IN 46032. BETTY COCKRUM - 1221 GOLDEN HILL DR., INDIANAPOLIS, IN 46208. GRETCHEN GUTMAN - 1474 N NEW JERSEY STREET, INDIANAPOLIS, IN 46202. CARMEN TEED - 4510 NORTH PARK AVE., INDIANAPOLIS, IN 46205. DONNA NICHOLS THRELKELD - 6440 SHAMEL DR., INDIANAPOLIS, IN 46205. ANN WHITE - 5711 CALLE LAS BRISAS, EVANSVILLE, IN 47712. TOM WYSS - 12133 HARVEST BAY DR., FORT WAYNE, IN 46845. CHERRISH PRYOR - 5276 DEER CREEK DR, INDIANAPOLIS, IN 46254. FORM 990, PART XI, LINE 9: REVERSAL OF GRANT EXPENSES FROM PRIOR YEARS 55,345.