CIRCLE HEALTH SERVICES: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- CIRCLE HEALTH SERVICES (EIN 23-7078501)
- Tax period
- 2013-07-01 to 2014-06-30
- Filed
- 2015-04-30
- IRS object ID
- 201501209349300940
- Schema version
- 2013v4.0
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule G
- Schedule J
- Schedule M
- Schedule O
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2015-04-30T15:09:17-05:00 | ReturnTs |
| Tax Period End | 2014-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 420714325 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MCGLADREY LLP | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1001 LAKESIDE AVE SUITE 200 | AddressLine1 |
| City | CLEVELAND | City |
| State | OH | State |
| ZIP Code | 441141152 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 237078501 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE FREE MEDICAL CLINIC OF GREATER CLEVELAND | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | FREE | BusinessNameControlTxt |
| Phone | 2167214010 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 12201 EUCLID AVENUE | AddressLine1 |
| City | CLEVELAND | City |
| State | OH | State |
| ZIP Code | 44106 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DANNY R WILLIAMS | PersonNm |
| Person Title | EXECUTIVE DIRECTOR | PersonTitleTxt |
| Phone | 2167214010 | PhoneNum |
| Signature | 2015-04-30 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | ZACHARY FORTSCH | PreparerPersonNm |
| PTIN | P00052575 | PTIN |
| Phone | 2165231900 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2016-03-07 17:11:31Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | DANNY R WILLIAMS | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 12201 EUCLID AVENUE | AddressLine1 |
| City | CLEVELAND | City |
| State | OH | State |
| ZIP Code | 44106 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $4,478,017 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.THEFREECLINIC.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1970 | FormationYr |
| Legal Domicile State | OH | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE FINANCIALLY BARRIER-FREE HEALTH CARE AND RELATED SERVICES, AND TO ADVOCATE FOR POLICY CHANGES THAT MAKE HEALTH CARE AVAILABLE TO ALL. | ActivityOrMissionDesc |
| Voting Members Governing Body | 14 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 14 | VotingMembersIndependentCnt |
| Total Employee | 63 | TotalEmployeeCnt |
| Total Volunteers | 873 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $2,776,605 | PYContributionsGrantsAmt |
| CY Contributions Grants | $2,182,350 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $1,610,746 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $1,917,315 | CYProgramServiceRevenueAmt |
| PY Investment Income | $5,940 | PYInvestmentIncomeAmt |
| CY Investment Income | $260,090 | CYInvestmentIncomeAmt |
| PY Other Revenue | $58,919 | PYOtherRevenueAmt |
| CY Other Revenue | $9,323 | CYOtherRevenueAmt |
| PY Total Revenue | $4,452,210 | PYTotalRevenueAmt |
| CY Total Revenue | $4,369,078 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $2,778,240 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $2,918,268 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $275,432 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $1,119,514 | PYOtherExpensesAmt |
| CY Other Expenses | $1,439,720 | CYOtherExpensesAmt |
| PY Total Expenses | $3,897,754 | PYTotalExpensesAmt |
| CY Total Expenses | $4,357,988 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $554,456 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $11,090 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $7,265,922 | TotalAssetsBOYAmt |
| Total Assets EOY | $7,570,390 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $500,786 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $659,014 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $6,765,136 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $6,911,376 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO ADDRESS VITAL COMMUNITY HEALTH NEEDS BY PROVIDING HIGH QUALITY HEALTH CARE AND RELATED SERVICES TO INDIVIDUALS AND FAMILIES, REGARDLESS OF THEIR ABILITY TO PAY, AND BY ADVOCATING FOR POLICY CHANGES THAT PROMOTE GREATER ACCESS FOR THE UNDERSERVED AND IMPROVED COMMUNITY-WIDE HEALTH AND WELLNESS. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $1,116,494 | ExpenseAmt |
| Revenue | $720,385 | RevenueAmt |
| Desc | PRIMARY ADULT MEDICAL CARE (3,534 ENCOUNTERS, 1,932 PATIENTS) OFFERS SERVICES FOR CHRONIC AND ACUTE CARE TO PATIENTS, THE MAJORITY OF WHOM ARE MEDICAID-ELIGIBLE, OR ARE UNINSURED OR UNDERINSURED. SERVICES INCLUDE TREATMENT OF CHRONIC DISEASES LIKE HYPERTENSION, DIABETES, ASTHMA AND HIGH CHOLESTEROL AND SPECIALTY CLINICS IN PHYSICAL THERAPY, DERMATOLOGY, NEUROLOGY, OPTHALMOLOGY AND RHEUMATOLOGY. AN ADDITIONAL CLINIC IS OFFERED TO ADOLESCENTS (771 ENCOUNTERS, 556 PATIENTS) FOCUSING ON FAMILY PLANNING SERVICES. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $568,374 | ExpenseAmt |
| Revenue | $323,199 | RevenueAmt |
| Desc | HIV/AIDS SERVICES CONSISTS OF THREE DISTINCT SERVICE AREAS: HIV TESTING - THE FREE CLINIC PROVIDES ANONYMOUS RAPID HIV TESTS (3,488 ENCOUNTERS); EARLY INTERVENTION PROGRAM - THE FREE CLINIC PROVIDES MEDICAL, MENTAL HEALTH AND SUBSTANCE ABUSE TREATMENT; SYRINGE EXCHANGE PROGRAM - THROUGH SYRINGE EXCHANGES (297,115 NEEDLES) THE FREE CLINIC FOCUSES ON CONTROLLING THE SPREAD OF DISEASE BY REDUCING THE TRANSMISSION OF HIV/AIDS THROUGH INTRAVENOUS DRUG USE. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $924,124 | ExpenseAmt |
| Revenue | $509,571 | RevenueAmt |
| Desc | THE FREE CLINIC'S BEHAVIORAL HEALTH PROGRAM PROVIDES PSYCHIATRIC AND PSYCHOLOGICAL INDIVIDUAL COUNSELING SERVICES (3,921 ENCOUNTERS, 662 PATIENTS) TO ADULTS, MOST OF WHOM LACK INSURANCE FOR TREATMENT OF MENTAL HEALTH PROBLEMS. THERE ARE ALSO ISSUE-ORIENTED COUNSELING SERVICES AVAILABLE FOR DEPRESSION. A SEPARATE SUBSTANCE ABUSE PROGRAM (2,166 ENCOUNTERS, 223 PATIENTS) PROVIDES INTENSIVE OUTPATIENT TREATMENT, WHICH INCLUDES BOTH GROUP SERVICES AND INDIVIDUAL COUNSELING. | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp (4 entries)
| ExpenseExpenseAmt | RevenueRevenueAmt | DescDesc |
|---|---|---|
| $390,912 | $177,117 | THE FREE CLINIC'S DENTAL PROGRAM (2,990 ENCOUNTERS, 1,642 PATIENTS) PROVIDES FOR PATIENTS, THE MAJORITY OF WHOM ARE MEDICAID-ELIGIBLE, OR ARE UNINSURED OR UNDERINSURED, RESTORATIVE SERVICES SUCH AS CLEANING, FILLINGS, ROOT CANALS AND PARTIALS PLUS AN EMERGENCY EXTRACTION CLINIC DURING EVENINGS AND WEEKEND HOURS. |
| $106,825 | THE FREE CLINIC'S ADVOCACY PROGRAM TAKES ACTION ON TIMELY AND TOPICAL POLITICAL AND HEALTH TRENDS THAT COULD POSITIVELY IMPACT THE MEDICALLY UNDERSERVED. ADVOCACY EFFORTS STRIVE TO INFLUENCE PUBLIC POLICY AND SOCIAL CHANGE BY ENGAGING PATIENTS AND VOLUNTEERS, OFTEN IN COLLABORATION WITH OTHER LIKE-MINDED AGENCY REPRESENTATIVES, IN THE PROCESS OF COMMUNICATING WITH LAWMAKERS AT THE LOCAL, STATE AND/OR NATIONAL LEVEL. | |
| $188,587 | $116,158 | OUTREACH AND ENROLLMENT - CERTIFIED APPLICATION COUNSELORS AND OTHERS PROVIDE OUTREACH, EDUCATION, AND ENROLLMENT ACTIVITIES TO PATIENTS AND OTHER CONSUMERS REQUESTING SUCH ASSISTANCE. THIS PROGRAM PROVIDES PUBLIC EDUCATION ACTIVITIES TO RAISE AWARENESS OF AVAILABLE QUALIFIED HEALTH PLANS WITHIN THE FEDERAL MARKETPLACE AND THE AVAILABILITY OF EXPANDED MEDICAID AND RELATED ELIGIBILITY. |
| $337,271 | $70,885 | PHARMACY THE FREE CLINIC HAS A PHARMACY DISPENSARY FOR OUR PATIENTS. OUR CLINIC DISPENSARY PROVIDES BASIC MEDICATIONS FREE OF CHARGE AND ASSISTS PATIENTS TO OBTAIN ADDITIONAL MEDICATIONS FROM THE DRUG COMPANIES. PROVIDERS AT THE FREE CLINIC APPRECIATE THE ASSISTANCE OF AN ONSITE PHARMACIST. CONSULTATION IS AVAILABLE TO PROVIDERS AND/OR THEIR PATIENTS WITH RESPECT TO MONITORING PARAMETERS FOR MEDICATIONS, LABORATORY RESULTS, SIDE EFFECTS AND INTERACTIONS, PATIENT ADHERENCE, MEDICATION RECONCILIATION, COST EFFECTIVE REMEDIES, SELF-CARE REMEDIES AND NATURAL PRODUCTS, EDUCATIONAL AND COMMUNITY RESOURCES, AND RECOMMENDATIONS FOR UNCONTROLLED CHRONIC DISEASE STATES. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $1,023,595 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Revenue | $364,160 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $3,632,587 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (1) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | Yes (1) | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 21 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 63 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | Yes (1) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (1) | QuidProQuoContriDisclInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 14 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 14 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | OH | StatesWhereCopyOfReturnIsFldCd |
| States Where Copy Of Return Is Fld | FL | StatesWhereCopyOfReturnIsFldCd |
| States Where Copy Of Return Is Fld | IL | StatesWhereCopyOfReturnIsFldCd |
| States Where Copy Of Return Is Fld | CA | StatesWhereCopyOfReturnIsFldCd |
| States Where Copy Of Return Is Fld | NY | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DANNY R WILLIAMS | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 2167214010 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 12201 EUCLID AVENUE | AddressLine1 |
| City | CLEVELAND | City |
| State | OH | State |
| ZIP Code | 44106 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| SETH WOLF | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| ROBERT L JOHNSON | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JEAN SARLSON | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| MICHAEL R SERING | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| STEPHEN F THOME | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| ROBERT K WILEY | |||||||
| TREASURER | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| KIP BOLIN | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| DEBRA REX | |||||||
| VICE PRESIDENT | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| CAROL METZ | |||||||
| PRESIDENT | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| JANET BRIGGS | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| TRACY A KIPFSTUHL | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| MICHAEL R VEHOVEC | |||||||
| TREASURER | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| NICK J DANIELS | |||||||
| SECRETARY | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| RONALD B YOUNG | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| BRETT MILLER | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| THOMAS AGEE | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| DANNY R WILLIAMS | |||||||
| EXECUTIVE DIRECTOR | 40.00 | $176,382 | $0 | $13,850 | Yes (X) | ||
| REGINA SAVAGE | |||||||
| DENTAL DIRECTOR | 40.00 | $117,134 | $0 | $11,008 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $293,516 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $24,858 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 2 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp
Contractor Name ContractorName
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | OCHIN | BusinessNameLine1 |
Contractor Address ContractorAddress
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1881 SW NAITO PARKWAY | AddressLine1 |
| City | PORTLAND | City |
| State | OR | State |
| ZIP Code | 97201 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Services | ELECTRONIC HEALTH RECORDS VENDOR | ServicesDesc |
| Compensation | $113,996 | CompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 1 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $6,750 | FundraisingAmt |
| All Other Contributions | $2,175,600 | AllOtherContributionsAmt |
| Noncash Contributions | $191,242 | NoncashContributionsAmt |
| Total Contributions | $2,182,350 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| MEDICAL CARE | 621400 | $720,385 | $720,385 |
| BEHAVIORAL HEALTH | 621400 | $509,571 | $509,571 |
| HIV/AIDS SERVICES | 621400 | $323,199 | $323,199 |
| DENTAL PROGRAM | 621400 | $177,117 | $177,117 |
| OUTREACH & ENROLLMENT | 621400 | $116,158 | $116,158 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $70,885 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $70,885 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $1,917,315 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $35,510 | TotalRevenueColumnAmt |
| Exclusion | $35,510 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $323,359 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $98,779 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $224,580 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $224,580 | TotalRevenueColumnAmt |
| Exclusion | $224,580 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $19,483 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $6,750 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $10,160 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $9,323 | TotalRevenueColumnAmt |
| Exclusion | $9,323 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,369,078 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,917,315 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $269,413 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $190,232 | TotalAmt |
| Program Services | $157,916 | ProgramServicesAmt |
| Management And General | $18,646 | ManagementAndGeneralAmt |
| Fundraising | $13,670 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,217,628 | TotalAmt |
| Program Services | $1,840,902 | ProgramServicesAmt |
| Management And General | $217,365 | ManagementAndGeneralAmt |
| Fundraising | $159,361 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,200 | TotalAmt |
| Program Services | $5,883 | ProgramServicesAmt |
| Management And General | $802 | ManagementAndGeneralAmt |
| Fundraising | $515 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $296,051 | TotalAmt |
| Program Services | $241,905 | ProgramServicesAmt |
| Management And General | $32,974 | ManagementAndGeneralAmt |
| Fundraising | $21,172 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $207,157 | TotalAmt |
| Program Services | $173,404 | ProgramServicesAmt |
| Management And General | $19,355 | ManagementAndGeneralAmt |
| Fundraising | $14,398 | FundraisingAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $35,984 | TotalAmt |
| Program Services | $27,841 | ProgramServicesAmt |
| Management And General | $7,196 | ManagementAndGeneralAmt |
| Fundraising | $947 | FundraisingAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,848 | TotalAmt |
| Program Services | $16,130 | ProgramServicesAmt |
| Management And General | $4,169 | ManagementAndGeneralAmt |
| Fundraising | $549 | FundraisingAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $276,543 | TotalAmt |
| Program Services | $213,960 | ProgramServicesAmt |
| Management And General | $55,302 | ManagementAndGeneralAmt |
| Fundraising | $7,281 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,096 | TotalAmt |
| Program Services | $2,246 | ProgramServicesAmt |
| Management And General | $1,058 | ManagementAndGeneralAmt |
| Fundraising | $6,792 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $159,471 | TotalAmt |
| Program Services | $116,525 | ProgramServicesAmt |
| Management And General | $23,169 | ManagementAndGeneralAmt |
| Fundraising | $19,777 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $126,742 | TotalAmt |
| Program Services | $103,611 | ProgramServicesAmt |
| Management And General | $19,760 | ManagementAndGeneralAmt |
| Fundraising | $3,371 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,254 | TotalAmt |
| Program Services | $13,016 | ProgramServicesAmt |
| Management And General | $703 | ManagementAndGeneralAmt |
| Fundraising | $535 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $30,100 | TotalAmt |
| Program Services | $13,565 | ProgramServicesAmt |
| Management And General | $15,857 | ManagementAndGeneralAmt |
| Fundraising | $678 | FundraisingAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $174,007 | TotalAmt |
| Program Services | $151,490 | ProgramServicesAmt |
| Management And General | $17,390 | ManagementAndGeneralAmt |
| Fundraising | $5,127 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $67,731 | TotalAmt |
| Program Services | $59,699 | ProgramServicesAmt |
| Management And General | $2,774 | ManagementAndGeneralAmt |
| Fundraising | $5,258 | FundraisingAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| MEDICAL SUPPLIES AND PH | $375,427 | $374,870 | $554 | $3 |
| DUES & SUBSCRIPTIONS | $52,350 | $40,234 | $3,786 | $8,330 |
| SECURITY | $49,263 | $43,238 | $2,465 | $3,560 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $46,904 | TotalAmt |
| Program Services | $36,152 | ProgramServicesAmt |
| Management And General | $6,644 | ManagementAndGeneralAmt |
| Fundraising | $4,108 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,357,988 | TotalAmt |
| Program Services | $3,632,587 | ProgramServicesAmt |
| Management And General | $449,969 | ManagementAndGeneralAmt |
| Fundraising | $275,432 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $711 | BOYAmt |
| EOY | $45,729 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $601,503 | BOYAmt |
| EOY | $489,723 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $39,858 | BOYAmt |
| EOY | $113,737 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $179,963 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $29,034 | BOYAmt |
| EOY | $5,051 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $5,289,069 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,630,175 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,703,087 | BOYAmt |
| EOY | $3,658,894 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,891,729 | BOYAmt |
| EOY | $3,077,293 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,265,922 | BOYAmt |
| EOY | $7,570,390 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $176,231 | BOYAmt |
| EOY | $256,335 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $200,202 | BOYAmt |
| EOY | $171,918 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $12,220 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $124,353 | BOYAmt |
| EOY | $218,541 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $500,786 | BOYAmt |
| EOY | $659,014 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,602,308 | BOYAmt |
| EOY | $3,158,685 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $756,756 | BOYAmt |
| EOY | $1,346,619 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,406,072 | BOYAmt |
| EOY | $2,406,072 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,765,136 | BOYAmt |
| EOY | $6,911,376 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,265,922 | BOYAmt |
| EOY | $7,570,390 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $11,090 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $135,150 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $3,901,229 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,506,334 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,270,521 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,776,605 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,182,350 | CurrentTaxYearAmt |
| Total | $13,637,039 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $3,901,229 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,506,334 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,270,521 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,776,605 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,182,350 | CurrentTaxYearAmt |
| Total | $13,637,039 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $13,637,039 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $15,043 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $32,773 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $33,073 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $5,940 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $35,510 | CurrentTaxYearAmt |
| Total | $122,339 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $17,273 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $22,397 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $18,221 | CurrentTaxYearMinus2YearsAmt |
| Total | $57,891 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $13,817,269 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $6,134,324 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.98700 | PublicSupportCY170Pct |
| Public Support PY170 | 0.99050 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Form990 Schedule A Part IV Form990ScheduleAPartIVGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: | FormAndLineReferenceDesc |
| Explanation | OTHER REVENUE - 2009 AMOUNT: $ 17,273. 2010 AMOUNT: $ 22,397. 2011 AMOUNT: $ 18,221. | ExplanationTxt |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | Yes (1) | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | Yes (1) | DirectContactLegislatorsInd |
| Direct Contact Legislators | $635 | DirectContactLegislatorsAmt |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | 0 | OtherActivitiesInd |
| Total Lobbying Expenditures | $635 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,734,895 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $329,738 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $168,350 | OtherExpendituresAmt |
| End Year Balance | $2,896,283 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,834,436 | BeginningYearBalanceAmt |
| Contributions | $771,907 | ContributionsAmt |
| Investment Earnings Or Losses | $223,111 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $94,559 | AdministrativeExpensesAmt |
| End Year Balance | $2,734,895 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,884,545 | BeginningYearBalanceAmt |
| Contributions | $39,879 | ContributionsAmt |
| Investment Earnings Or Losses | -$89,988 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $1,834,436 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,763,629 | BeginningYearBalanceAmt |
| Contributions | -$7,763 | ContributionsAmt |
| Investment Earnings Or Losses | $142,721 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $14,042 | AdministrativeExpensesAmt |
| End Year Balance | $1,884,545 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,002,957 | BeginningYearBalanceAmt |
| Contributions | $567,252 | ContributionsAmt |
| Investment Earnings Or Losses | $193,420 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $1,763,629 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prmnnt Endowment Balance EOY | 0.83070 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.16930 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | Yes (1) | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $322,448 | OtherCostOrOtherBasisAmt |
| Book Value | $322,448 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,319,720 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,291,257 | DepreciationAmt |
| Book Value | $3,028,463 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $646,901 | OtherCostOrOtherBasisAmt |
| Depreciation | $338,918 | DepreciationAmt |
| Book Value | $307,983 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $3,658,894 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $5,375,879 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $135,150 | NetUnrealizedGainsInvstAmt |
| Donated Services And Use Fclts | $892,499 | DonatedServicesAndUseFcltsAmt |
| Other Revenue | -$20,848 | OtherRevenueAmt |
| Revenue Not Reported | $1,006,801 | RevenueNotReportedAmt |
| Revenue Subtotal | $4,369,078 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $4,369,078 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $5,229,639 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $892,499 | DonatedServicesUseFcltsAmt |
| Other Expenses Included | -$20,848 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $871,651 | ExpensesNotReportedAmt |
| Expenses Subtotal | $4,357,988 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $4,357,988 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 4: | THE FREE CLINIC'S ENDOWMENT CONSISTS OF A FUND HELD AT THE CLEVELAND FOUNDATION WHOSE PRIMARY PURPOSE IS TO INVEST CAPITAL TO PROVIDE INCOME FOR THE FREE CLINIC, AS WELL AS A SMALL FUND HELD AT KEY BANK. UNLESS OTHERWISE INDICATED BY THE DONOR, IT IS THE INTENTION OF THE FREE CLINIC TO PRESERVE THE PRINCIPAL OF ITS ENDOWMENT FUNDS, AND USE THE ENDOWMENT FUND DISTRIBUTIONS IN ACCORDANCE WITH THE TERMS AND CONDITIONS ESTABLISHED BY THE DONOR. |
| PART X, LINE 2: | THE FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) PROVIDES GUIDANCE FOR HOW UNCERTAIN INCOME TAX POSITIONS SHOULD BE RECOGNIZED, MEASURED, DISCLOSED AND PRESENTED IN THE FINANCIAL STATEMENTS. THIS REQUIRES THE EVALUATION OF TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN IN THE COURSE OF PREPARING THE FREE CLINIC'S TAX RETURNS TO DETERMINE WHETHER THE TAX POSITIONS ARE MORE-LIKELY-THAN-NOT OF BEING SUSTAINED WHEN CHALLENGED OR WHEN EXAMINED BY THE APPLICABLE TAX AUTHORITY. TAX POSITIONS NOT DEEMED TO MEET THE MORE-LIKELY-THAN-NOT THRESHOLD WOULD BE RECORDED AS A TAX BENEFIT OR EXPENSE AND LIABILITY IN THE CURRENT YEAR. FOR THE YEAR ENDED JUNE 30, 2014 AND 2013, MANAGEMENT HAS DETERMINED THERE ARE NO UNCERTAIN TAX POSITIONS. WITH FEW EXCEPTIONS, THE FREE CLINIC IS NO LONGER SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE FOR YEARS ENDING BEFORE 2011. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | INVESTMENT MANAGER FEES NETTED AGAINST DIVIDEND INCOME -20,848. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | INVESTMENT MANAGER FEES NETTED AGAINST DIVIDEND INCOME -20,848. |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | MICROBREW | NameOfEvent1Amt |
| Gross Receipts Event1 | $19,214 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $6,750 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $12,464 | GrossRevenueEvent1Amt |
| Rent Facility Costs Event1 | $750 | RentFacilityCostsEvent1Amt |
| Food And Beverage Event1 | $6,726 | FoodAndBeverageEvent1Amt |
| Entertainment Event1 | $1,000 | EntertainmentEvent1Amt |
| Other Direct Expenses Event1 | $1,684 | OtherDirectExpensesEvent1Amt |
| Name Of Event2 | BEACHLAND ROCK®GAE | NameOfEvent2Amt |
| Gross Receipts Event2 | $3,010 | GrossReceiptsEvent2Amt |
| Gross Revenue Event2 | $3,010 | GrossRevenueEvent2Amt |
| Other Events Total | 3 | OtherEventsTotalCnt |
| Gross Receipts Other Events | $4,009 | GrossReceiptsOtherEventsAmt |
| Gross Revenue Other Events | $4,009 | GrossRevenueOtherEventsAmt |
| Gross Receipts Total | $26,233 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $6,750 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $19,483 | GrossRevenueTotalEventsAmt |
| Rent Fclty Costs Total Events | $750 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $6,726 | FoodAndBeverageTotalEventsAmt |
| Entertainment Total Events | $1,000 | EntertainmentTotalEventsAmt |
| Oth Direct Expnss Total Events | $1,684 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $10,160 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $9,323 | NetIncomeSummaryAmt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DANNY R WILLIAMS | PersonNm |
| Title | EXECUTIVE DIRECTOR | TitleTxt |
| Base Compensation Filing Org | $166,382 | BaseCompensationFilingOrgAmt |
| Compensation Based On Rltd Orgs | $0 | CompensationBasedOnRltdOrgsAmt |
| Bonus Filing Organization | $10,000 | BonusFilingOrganizationAmount |
| Bonus Related Organizations | $0 | BonusRelatedOrganizationsAmt |
| Other Compensation Filing Org | $0 | OtherCompensationFilingOrgAmt |
| Other Compensation Rltd Orgs | $0 | OtherCompensationRltdOrgsAmt |
| Deferred Compensation Flng Org | $900 | DeferredCompensationFlngOrgAmt |
| Deferred Comp Rltd Orgs | $0 | DeferredCompRltdOrgsAmt |
| Nontaxable Benefits Filing Org | $12,950 | NontaxableBenefitsFilingOrgAmt |
| Nontaxable Benefits Rltd Orgs | $0 | NontaxableBenefitsRltdOrgsAmt |
| Total Compensation Filing Org | $190,232 | TotalCompensationFilingOrgAmt |
| Total Compensation Rltd Orgs | $0 | TotalCompensationRltdOrgsAmt |
| Comp Report Prior990 Filing Org | $0 | CompReportPrior990FilingOrgAmt |
| Comp Report Prior990 Rltd Orgs | $0 | CompReportPrior990RltdOrgsAmt |
Schedule M IRS990ScheduleM
Securities Publicly Traded SecuritiesPubliclyTradedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 3 | ContributionCnt |
| Noncash Contributions Rpt F990 | $21,406 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FMV | MethodOfDeterminingRevenuesTxt |
Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 94 | ContributionCnt |
| Noncash Contributions Rpt F990 | $165,814 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FMV | MethodOfDeterminingRevenuesTxt |
Other Non Cash Contri Table OtherNonCashContriTableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Desc | EQUIPMENT | Desc |
| Contribution | 1 | ContributionCnt |
| Noncash Contributions Rpt F990 | $4,022 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FMV | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | Yes (1) | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | 0 | ThirdPartiesUsedInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, COLUMN (B): | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION IS REPORTING A COMBINATION OF THE NUMBER OF CONTRIBUTIONS AND THE NUMBER OF ITEMS RECEIVED. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | AN ELECTRONIC COPY OF THE FORM 990 WAS SENT TO EACH BOARD MEMBER BEFORE IT WAS FILED. A HARD COPY WAS OFFERED AND PROVIDED TO BOARD MEMBERS REQUESTING ONE. |
| FORM 990, PART VI, SECTION B, LINE 12C | EACH BOARD MEMBER IS REQUIRED TO COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE ON AN ANNUAL BASIS. THOSE STATEMENTS ARE REVIEWED ANNUALLY FOR POTENTIAL CONFLICTS. ALL BOARD MEMBERS ARE COVERED UNDER THE POLICY. ANY PERSON WITH ANY CONFLICT IN A BOARD DECISION IS PROHIBITED FROM PARTICIPATING IN THE BOARD'S DELIBERATIONS AND DECISIONS ON THAT TRANSACTION.ALL EMPLOYEES ARE SUBJECT TO A CONFLICT OF INTEREST POLICY, AND ARE EXPECTED TO REPORT ON AN AS-NEEDED BASIS ANY POTENTIAL CONFLICTS. |
| FORM 990, PART VI, SECTION B, LINE 15A | THE EXECUTIVE COMMITTEE, SERVING AS THE COMPENSATION COMMITTEE OF THE BOARD, REVIEWS COMPARABLE SALARY DATA MADE AVAILABLE THROUGH COMMUNITY RESOURCES (I.E. UNITED WAY SERVICES OF GREATER CLEVELAND) IN DETERMINING AN APPROPRIATE SALARY LEVEL FOR THE EXECUTIVE DIRECTOR. THE INFORMATION IN THE FORM 990S OF ORGANIZATIONS OF SIMILAR SIZE AND MISSION ARE ALSO SURVEYED. A CONFIDENTIAL MEMORANDUM IS CONTEMPORANEOUSLY PREPARED FOR THE EXECUTIVE COMMITTEE. THE EXECUTIVE COMMITTEE MEETS IN EXECUTIVE SESSION WITH THE FULL BOARD OF TRUSTEES TO APPROVE THE COMPENSATION OF THE EXECUTIVE DIRECTOR. THE DECISION OF THE EXECUTIVE COMMITTEE IS APPROVED AND DOCUMENTED IN THE COMMITTEE MINUTES. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST AT THE ORGANIZATION'S OFFICES FOR THE SAME PERIOD OF TIME AS SET FORTH IN IRC SECTION 6104(D). THE FORM 990 WILL BE AVAILABLE ON THE ORGANIZATION'S WEBSITE. |