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NATIONAL ASSOCIATION OF FREE AND CHARITABLE CLINICS INC: Form 990, tax year 2017

View the entire original 990 at ProPublica ↗

Organization
NATIONAL ASSOCIATION OF FREE AND CHARITABLE CLINICS INC (EIN 56-2273242)
Tax period
2017-01-01 to 2017-12-31
Filed
2018-09-13
IRS object ID
201822569349301222
Schema version
2017v2.3
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2018-09-13T15:30:40-05:00ReturnTs
Tax Period End2017-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN521645472PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Weil Akman Baylin & Coleman PABusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1201 West Padonia Road Suite 600AddressLine1Txt
CityTimoniumCityNm
State AbbreviationMDStateAbbreviationCd
ZIP210932186ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2017-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN562273242EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1National Association of Free andBusinessNameLine1Txt
Business Name Line2Charitable Clinics IncBusinessNameLine2Txt
FieldValueIRS element (for citing)
Business Name ControlNATIBusinessNameControlTxt
Phone7036477427PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11800 Diagonal Road Suite 600AddressLine1Txt
CityAlexandriaCityNm
State AbbreviationVAStateAbbreviationCd
ZIP22314ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonNicole Lamoureux BusbyPersonNm
Person TitleExecutive DirectorPersonTitleTxt
Phone7036477427PhoneNum
Signature2018-08-29SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonAllan C Sanders CPAPreparerPersonNm
PTINP00919875PTIN
Phone4105614411PhoneNum

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address35.196.26.67IPv4AddressTxt
FieldValueIRS element (for citing)
IP2018-08-29IPDt
IP Tm13:01:25IPTm
IP TimezoneEDIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id96C3A11488E1367728D11DE31040CD50C0B6C6DAAtSubmissionCreationDeviceId
At Submission Filing Device Id35CD6757F7CB484114815A8AAEFD307EABA095A5AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2017TaxYr
Build TS2018-06-14 16:35:46ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerNicole Lamoureux BusbyPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11800 Diagonal Road Suite 600AddressLine1Txt
CityAlexandriaCityNm
State AbbreviationVAStateAbbreviationCd
ZIP22314ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$1,307,488GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.nafcclinics.orgWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2003FormationYr
Legal Domicile StateVALegalDomicileStateCd
Activity Or MissionTo ensure that the medically underserved have access to affordable quality health care.ActivityOrMissionDesc
Voting Members Governing Body12VotingMembersGoverningBodyCnt
Voting Members Independent12VotingMembersIndependentCnt
Total Employee3TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$650,945PYContributionsGrantsAmt
CY Contributions Grants$1,067,854CYContributionsGrantsAmt
PY Program Service Revenue$242,406PYProgramServiceRevenueAmt
CY Program Service Revenue$160,053CYProgramServiceRevenueAmt
PY Investment Income$30,836PYInvestmentIncomeAmt
CY Investment Income$11,925CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$924,187PYTotalRevenueAmt
CY Total Revenue$1,239,832CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$230,500CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$421,608PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$398,199CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$38,141CYTotalFundraisingExpenseAmt
PY Other Expenses$1,272,609PYOtherExpensesAmt
CY Other Expenses$777,710CYOtherExpensesAmt
PY Total Expenses$1,694,217PYTotalExpensesAmt
CY Total Expenses$1,406,409CYTotalExpensesAmt
PY Revenues Less Expenses-$770,030PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$166,577CYRevenuesLessExpensesAmt
Total Assets BOY$653,147TotalAssetsBOYAmt
Total Assets EOY$713,087TotalAssetsEOYAmt
Total Liabilities BOY$153,669TotalLiabilitiesBOYAmt
Total Liabilities EOY$334,816TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$499,478NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$378,271NetAssetsOrFundBalancesEOYAmt
MissionCreate and maintain a national Organization for the benefit of free clinics through out the country.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$246,707ExpenseAmt
Revenue$160,053RevenueAmt
DescThe NAFC Annual Symposium is the only national meeting solely dedicated to providing health education and training for NAFC staff and volunteers who provide health care to the medically underserved.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$869,960ExpenseAmt
Grant$230,500GrantAmt
DescClinics establish and maintain services that support and benefit the work of the members in their efforts to provide health care to the uninsured and underinsured.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$1,116,667TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other SecYes (1)ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related Entity0RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document9IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee3EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members12GoverningBodyVotingMembersCnt
Independent Voting Member12IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy0ConflictOfInterestPolicyInd
Whistleblower Policy0WhistleblowerPolicyInd
Document Retention Policy0DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldVAStatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is FldWVStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1The OrganizationBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone7036477427PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11800 Diagonal Road Suite 600AddressLine1Txt
CityAlexandriaCityNm
State AbbreviationVAStateAbbreviationCd
ZIP22314ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (17 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeInd
ANGIE MCLAUGHLIN
SECRETARY3.00Yes (X)Yes (X)$0$0$0
ANTHONY YOUNG ESQ
GENERAL COUNSEL5.00Yes (X)$0$0$0
Ariana Gordillo
Director of Outreach40.00Yes (X)$0$0$0
BOBBY KAPUR
CHAIRMAN3.00Yes (X)Yes (X)$0$0$0
Isi Ikharebha Green MPH
BOARD MEMBER3.00Yes (X)$0$0$0
JOHANNA HENZ
BOARD MEMBER3.00Yes (X)$0$0$0
Kerry Thompson
Vice President40.00Yes (X)$107,625$0$0
LARRY ROBINS
BOARD MEMBER3.00Yes (X)$0$0$0
LINDA D WILKINSON
BOARD MEMBER3.00Yes (X)$0$0$0
Maureen Tomoschuk
Board MEMBER3.00Yes (X)$0$0$0
NANCY W HUDSON
BOARD MEMBER3.00Yes (X)$0$0$0
Randy Jordan
BOARD MEMBER3.00Yes (X)$0$0$0
SHANNON WATSON
TREASURER3.00Yes (X)Yes (X)$0$0$0
SHERI WOOD
BOARD MEMBER3.00Yes (X)$0$0$0
STEPHANIE NELSON GARRIS
VICE CHAIRMAN3.00Yes (X)Yes (X)$0$0$0
Will Woodlee
GENERAL COUNSEL5.00Yes (X)$0$0$0
NICOLE LAMOUREUX BUSBY
CHIEF EXECUTIVE OFFICER40.00$190,320$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$297,945TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$0TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K2IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
Membership Dues$210,389MembershipDuesAmt
All Other Contributions$857,465AllOtherContributionsAmt
Total Contributions$1,067,854TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescSymposiumDesc
Business621400BusinessCd
Total Revenue Column$160,053TotalRevenueColumnAmt
Related Or Exempt Func Income$160,053RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$160,053TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$16,366TotalRevenueColumnAmt
Exclusion$16,366ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$63,215SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$67,656SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities-$4,441SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$4,441TotalRevenueColumnAmt
Exclusion-$4,441ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,239,832TotalRevenueColumnAmt
Related Or Exempt Func Income$160,053RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$11,925ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$230,500TotalAmt
Program Services$230,500ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$297,945TotalAmt
Program Services$218,694ProgramServicesAmt
Management And General$59,709ManagementAndGeneralAmt
Fundraising$19,542FundraisingAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$55,654TotalAmt
Program Services$40,851ProgramServicesAmt
Management And General$11,153ManagementAndGeneralAmt
Fundraising$3,650FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$44,600TotalAmt
Program Services$25,432ProgramServicesAmt
Management And General$16,891ManagementAndGeneralAmt
Fundraising$2,277FundraisingAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$137,314TotalAmt
Program Services$137,314ProgramServicesAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$69,538TotalAmt
Program Services$19,715ProgramServicesAmt
Management And General$49,823ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$38,407TotalAmt
Program Services$2,173ProgramServicesAmt
Management And General$31,160ManagementAndGeneralAmt
Fundraising$5,074FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$37,845TotalAmt
Program Services$32,803ProgramServicesAmt
Management And General$5,042ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$1,214TotalAmt
Program Services$344ProgramServicesAmt
Management And General$870ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$114,529TotalAmt
Program Services$84,068ProgramServicesAmt
Management And General$22,863ManagementAndGeneralAmt
Fundraising$7,598FundraisingAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$31,386TotalAmt
Program Services$30,971ProgramServicesAmt
Management And General$415ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$22,778TotalAmt
Program Services$2,608ProgramServicesAmt
Management And General$20,170ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$10,337TotalAmt
Management And General$10,337ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$15,614TotalAmt
Program Services$8,499ProgramServicesAmt
Management And General$7,115ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Symposium Expense$246,707$246,707
Telephone & Website$19,249$18,777$472
Postage/Shipping$16,822$16,761$61
Bank Fees$12,033$12,033

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$3,937TotalAmt
Program Services$450ProgramServicesAmt
Management And General$3,487ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$1,406,409TotalAmt
Program Services$1,116,667ProgramServicesAmt
Management And General$251,601ManagementAndGeneralAmt
Fundraising$38,141FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$52,717BOYAmt
EOY$56,401EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$51,719BOYAmt
EOY$91,476EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$66,484BOYAmt
EOY$34,922EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$3,000BOYAmt
EOY$0EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$19,662BOYAmt
EOY$25,540EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$54,708LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$28,130LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$18,934BOYAmt
EOY$26,578EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$413,871BOYAmt
EOY$451,410EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$26,760BOYAmt
EOY$26,760EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$653,147BOYAmt
EOY$713,087EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$78,807BOYAmt
EOY$224,150EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$74,862BOYAmt
EOY$110,666EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$153,669BOYAmt
EOY$334,816EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$364,352BOYAmt
EOY$252,145EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$135,126BOYAmt
EOY$126,126EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$499,478BOYAmt
EOY$378,271EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$653,147BOYAmt
EOY$713,087EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$166,577ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$45,370NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,051,089CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$2,305,279CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,310,511CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$812,984CurrentTaxYearMinus1YearAmt
Current Tax Year$1,377,807CurrentTaxYearAmt
Total$6,857,670TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,051,089CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$2,305,279CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,310,511CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$812,984CurrentTaxYearMinus1YearAmt
Current Tax Year$1,377,807CurrentTaxYearAmt
Total$6,857,670TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$6,857,670PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$16,415CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$27,671CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$32,541CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$28,644CurrentTaxYearMinus1YearAmt
Current Tax Year$16,366CurrentTaxYearAmt
Total$121,637TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$16,415CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$27,671CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$32,541CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$28,644CurrentTaxYearMinus1YearAmt
Current Tax Year$16,366CurrentTaxYearAmt
Total$121,637TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,067,504CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$2,332,950CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,343,052CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$841,628CurrentTaxYearMinus1YearAmt
Current Tax Year$1,394,173CurrentTaxYearAmt
Total$6,979,307TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.98260PublicSupportCY509Pct
Public Support PY5090.98230PublicSupportPY509Pct
Investment Income CY0.01740InvestmentIncomeCYPct
Investment Income PY0.01770InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Schedule B IRS990ScheduleB

Schedule D IRS990ScheduleD

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$31,443OtherCostOrOtherBasisAmt
Depreciation$14,754DepreciationAmt
Book Value$16,689BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$23,265OtherCostOrOtherBasisAmt
Depreciation$13,376DepreciationAmt
Book Value$9,889BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$26,578TotalBookValueLandBuildingsAmt

Other Securities OtherSecuritiesGrp

FieldValueIRS element (for citing)
DescInvestmentsDesc
Book Value$451,410BookValueAmt
Method ValuationFMethodValuationCd
FieldValueIRS element (for citing)
Total Book Value Securities$451,410TotalBookValueSecuritiesAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$1,411,102TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$45,370NetUnrealizedGainsInvstAmt
Donated Services And Use Fclts$125,900DonatedServicesAndUseFcltsAmt
Revenue Not Reported$171,270RevenueNotReportedAmt
Revenue Subtotal$1,239,832RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$1,239,832TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$1,532,309TotExpnsEtcAuditedFinclStmtAmt
Donated Services Use Fclts$125,900DonatedServicesUseFcltsAmt
Expenses Not Reported$125,900ExpensesNotReportedAmt
Expenses Subtotal$1,406,409ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$1,406,409TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart X, Line 2:FormAndLineReferenceDesc
ExplanationThe Association believes that it has appropriate support for any tax position taken, and as such, does not have any uncertain tax positions that are material to the financial statements. The Association files its Forms 990 in the U.S. federal jurisdiction and various states. The Association is generally no longer subject to examination by the Internal Revenue Service for years before 2009.ExplanationTxt

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records Maintained0GrantRecordsMaintainedInd

Recipient Table RecipientTable (18 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtPurpose Of GrantPurposeOfGrantTxt
CareMessage
332 Pine Street Ste 300San FranciscoCA94104273252911501(c)(3)$9,000To provide financial assistance with healthcare to uninsured and underinsured individuals.
Ohio Association of Free Clinics
35 N 4th St Ste 350ColumbusOH43215223769296501(c)(3)$4,000To provide financial assistance with healthcare to uninsured and underinsured individuals.
UBI Caritas
4442 Highland AveBeaumontTX77705760558225501(c)(3)$25,000To provide financial assistance with healthcare to uninsured and underinsured individuals.
Ibn Sina Foundation Inc
11226 South Wilcrest DrHoustonTX77099760698464501(c)(3)$20,000To provide financial assistance with healthcare to uninsured and underinsured individuals.
TOMAGWA Ministries Inc
455 School Suite 30TomballTX77375760280324501(c)(3)$20,000To provide financial assistance with healthcare to uninsured and underinsured individuals.
Christ Clinic Inc
2207 Shawnee CtFort CollinsCO805251849455300042501(c)(3)$20,000To provide financial assistance with healthcare to uninsured and underinsured individuals.
Loan Star Association of Charitable Clinics
PO Box 684127AustinTX76768331115138501(c)(3)$2,500To provide financial assistance with healthcare to uninsured and underinsured individuals.
San Jose Clinic
2615 Fannin StreetHoustonTX77002760373703501(c)(3)$20,000To provide financial assistance with healthcare to uninsured and underinsured individuals.
Texas International Institute of Health Professionals
8121 Broadway St Suite 103HoustonTX77061461267820501(c)(3)$10,000To provide financial assistance with healthcare to uninsured and underinsured individuals.
Mission Medical Center
9600 W Atlantic AveDelray BeachFL33446650861014501(c)(3)$10,000To provide financial assistance with healthcare to uninsured and underinsured individuals.
Crossing Community Clinic Inc
10255 N Pennsylvania AveOklahoma CityOK73120861115863501(c)(3)$10,000To provide financial assistance with healthcare to uninsured and underinsured individuals.
Snake River Community Clinic Inc
215 10th StLewistonID83501311726460501(c)(3)$15,000To provide financial assistance with healthcare to uninsured and underinsured individuals.
Helpcare Clinic
3015 Ave AKearneyNE68847465551263501(c)(3)$15,000To provide financial assistance with healthcare to uninsured and underinsured individuals.
Christian Health Care Center
301 Sicomac AveWyckoffNJ07481221546163501(c)(3)$15,000To provide financial assistance with healthcare to uninsured and underinsured individuals.
Health Access Inc
489 Washington AveClarksburgWV26301550715066501(c)(3)$10,000To provide financial assistance with healthcare to uninsured and underinsured individuals.
His Hands Ministries
400 12th St SECedar RapidsIA52403391878606501(c)(3)$5,000To provide financial assistance with healthcare to uninsured and underinsured individuals.
Hope Medical Clinic Inc
1125 Forrest AvenueDoverDE19904593791820501(c)(3)$10,000To provide financial assistance with healthcare to uninsured and underinsured individuals.
Ogemaw Hills Free Clinic
337 E Houghton AveWest BranchMI48661382401885501(c)(3)$10,000To provide financial assistance with healthcare to uninsured and underinsured individuals.
FieldValueIRS element (for citing)
Total501c3 Org18Total501c3OrgCnt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp

FieldValueIRS element (for citing)
PersonNICOLE LAMOUREUX BUSBYPersonNm
TitleCHIEF EXECUTIVE OFFICERTitleTxt
Base Compensation Filing Org$190,320BaseCompensationFilingOrgAmt
Compensation Based On Rltd Orgs$0CompensationBasedOnRltdOrgsAmt
Bonus Filing Organization$0BonusFilingOrganizationAmount
Bonus Related Organizations$0BonusRelatedOrganizationsAmt
Other Compensation Filing Org$0OtherCompensationFilingOrgAmt
Other Compensation Rltd Orgs$0OtherCompensationRltdOrgsAmt
Deferred Compensation Flng Org$0DeferredCompensationFlngOrgAmt
Deferred Comp Rltd Orgs$0DeferredCompRltdOrgsAmt
Nontaxable Benefits Filing Org$0NontaxableBenefitsFilingOrgAmt
Nontaxable Benefits Rltd Orgs$0NontaxableBenefitsRltdOrgsAmt
Total Compensation Filing Org$190,320TotalCompensationFilingOrgAmt
Total Compensation Rltd Orgs$0TotalCompensationRltdOrgsAmt
Comp Report Prior990 Filing Org$0CompReportPrior990FilingOrgAmt
Comp Report Prior990 Rltd Orgs$0CompReportPrior990RltdOrgsAmt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Section A, line 6THE MEMBERSHIP IS COMPOSED OF FREE CLINICS AROUND THE COUNTRY THAT PAY DUES TO BE A MEMBER. THE BOARD IS ELECTED AT AN ANNUAL MEETING OF THE MEMBERSHIP OF THE ORGANIZATION.
Form 990, Part VI, Section A, line 7aTHE MEMBERS ELECT OFFICERS AT THE ANNUAL MEETING OF THE MEMBERS.
Form 990, Part VI, Section B, line 11bDURING THE IRS'S DEVELOPMENT OF THIS FORM, THE AICPA SUGGESTED THAT COMPLIANCE AND FIDUCIARY DUTIES WOULD BE BEST MET IF A NON-PROFIT BOARD OF DIRECTORS, AUDIT COMMITTEE OR OTHER APPROPRIATE COMMITTEE RECEIVED CONFIRMATION FROM THE PARTY OR PARTIES RESPONSIBLE FOR FILING THE TAX RETURN THAT IT HAD BEEN PREPARED BY A QUALIFIED PERSON(S) OR FIRM AND HAD BEEN FILED IN A TIMELY MANNER, RATHER THAN REVIEWING THE FORM IN LINE-BY-LINE DETAIL WITH MANAGEMENT. WE ARE CONCERNED THAT THE VAST MAJORITY OF NON-PROFIT BOARD MEMBERS ARE NOT IN A POSITION TO REVIEW A FORM 990 AND FURTHER WILL BE CONCERNED TO DO SO AS TO WHAT THAT MAY IMPLY ABOUT COMPLIANCE. MOST NON-PROFITS HIRE CPA FIRMS OR OTHER TAX PROFESSIONALS TO PREPARE FORMS 990 AND BOARD MEMBERS GENERALLY FEEL THIS IS THE APPROPRIATE FIDUCIARY PROCESS. THE BOARD OR AUDIT COMMITTEE'S ROLE THEN IS TO EVALUATE THE COMPETENCY OF THE PERSON(S) OR FIRM HIRED TO PREPARE THE RETURN AND TO DETERMINE IT IS APPROPRIATELY FILED. WE HAVE TAKEN THESE STEPS WITH OUR BOARD.
Form 990, Part VI, Section C, line 19ALL DOCUMENTS ARE MADE AVAILABLE AT THE OFFICES OF THE ORGANIZATION UPON REQUEST.
Form 990, Part XII, Line 2cThe Association has made no changes to its oversight or selection processes from the prior year.