2015-04-30T15:09:17-05:00 2014-06-30 420714325 MCGLADREY LLP 1001 LAKESIDE AVE SUITE 200 CLEVELAND OH 441141152 990 2013-07-01 237078501 THE FREE MEDICAL CLINIC OF GREATER CLEVELAND FREE 2167214010 12201 EUCLID AVENUE CLEVELAND OH 44106 DANNY R WILLIAMS EXECUTIVE DIRECTOR 2167214010 2015-04-30 1 ZACHARY FORTSCH P00052575 2165231900 2013 2016-03-07 17:11:31Z DANNY R WILLIAMS 12201 EUCLID AVENUE CLEVELAND OH 44106 4478017 0 X WWW.THEFREECLINIC.ORG X 1970 OH TO PROVIDE FINANCIALLY BARRIER-FREE HEALTH CARE AND RELATED SERVICES, AND TO ADVOCATE FOR POLICY CHANGES THAT MAKE HEALTH CARE AVAILABLE TO ALL. 14 14 63 873 0 0 2776605 2182350 1610746 1917315 5940 260090 58919 9323 4452210 4369078 0 0 0 0 2778240 2918268 0 0 275432 1119514 1439720 3897754 4357988 554456 11090 7265922 7570390 500786 659014 6765136 6911376 X 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. 0 0 1116494 720385 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. 568374 323199 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. 924124 509571 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. 390912 177117 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. 106825 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. 188587 116158 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. 337271 70885 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. 1023595 364160 3632587 1 1 0 1 0 0 0 0 0 1 1 0 0 0 0 1 1 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 21 0 1 63 1 0 0 0 0 0 1 1 0 0 0 0 X 14 14 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 OH FL IL CA NY X DANNY R WILLIAMS 2167214010 12201 EUCLID AVENUE CLEVELAND OH 44106 SETH WOLF BOARD MEMBER 1.00 X 0 0 0 ROBERT L JOHNSON BOARD MEMBER 1.00 X 0 0 0 JEAN SARLSON BOARD MEMBER 1.00 X 0 0 0 MICHAEL R SERING BOARD MEMBER 1.00 X 0 0 0 STEPHEN F THOME BOARD MEMBER 1.00 X 0 0 0 ROBERT K WILEY TREASURER 2.00 X X 0 0 0 KIP BOLIN BOARD MEMBER 1.00 X 0 0 0 DEBRA REX VICE PRESIDENT 2.00 X X 0 0 0 CAROL METZ PRESIDENT 2.00 X X 0 0 0 JANET BRIGGS BOARD MEMBER 1.00 X 0 0 0 TRACY A KIPFSTUHL BOARD MEMBER 1.00 X 0 0 0 MICHAEL R VEHOVEC TREASURER 2.00 X X 0 0 0 NICK J DANIELS SECRETARY 2.00 X X 0 0 0 RONALD B YOUNG BOARD MEMBER 1.00 X 0 0 0 BRETT MILLER BOARD MEMBER 1.00 X 0 0 0 THOMAS AGEE BOARD MEMBER 1.00 X 0 0 0 DANNY R WILLIAMS EXECUTIVE DIRECTOR 40.00 X 176382 0 13850 REGINA SAVAGE DENTAL DIRECTOR 40.00 X 117134 0 11008 293516 0 24858 2 0 1 0 OCHIN 1881 SW NAITO PARKWAY PORTLAND OR 97201 ELECTRONIC HEALTH RECORDS VENDOR 113996 1 6750 2175600 191242 2182350 MEDICAL CARE 621400 720385 720385 BEHAVIORAL HEALTH 621400 509571 509571 HIV/AIDS SERVICES 621400 323199 323199 DENTAL PROGRAM 621400 177117 177117 OUTREACH & ENROLLMENT 621400 116158 116158 70885 70885 1917315 35510 35510 323359 98779 224580 224580 224580 19483 6750 10160 9323 9323 4369078 1917315 0 269413 190232 157916 18646 13670 2217628 1840902 217365 159361 7200 5883 802 515 296051 241905 32974 21172 207157 173404 19355 14398 35984 27841 7196 947 20848 16130 4169 549 276543 213960 55302 7281 10096 2246 1058 6792 159471 116525 23169 19777 126742 103611 19760 3371 14254 13016 703 535 30100 13565 15857 678 174007 151490 17390 5127 67731 59699 2774 5258 MEDICAL SUPPLIES AND PH 375427 374870 554 3 DUES & SUBSCRIPTIONS 52350 40234 3786 8330 SECURITY 49263 43238 2465 3560 46904 36152 6644 4108 4357988 3632587 449969 275432 711 45729 601503 489723 39858 113737 179963 29034 5051 5289069 1630175 3703087 3658894 2891729 3077293 7265922 7570390 176231 256335 200202 171918 12220 124353 218541 500786 659014 X 3602308 3158685 756756 1346619 2406072 2406072 6765136 6911376 7265922 7570390 11090 135150 0 X 0 1 X 1 1 1 X 3901229 2506334 2270521 2776605 2182350 13637039 3901229 2506334 2270521 2776605 2182350 13637039 13637039 15043 32773 33073 5940 35510 122339 17273 22397 18221 57891 13817269 6134324 0.98700 0.99050 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: OTHER REVENUE - 2009 AMOUNT: $ 17,273. 2010 AMOUNT: $ 22,397. 2011 AMOUNT: $ 18,221. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 0 0 0 1 635 0 0 635 0 2734895 329738 168350 2896283 1834436 771907 223111 94559 2734895 1884545 39879 -89988 1834436 1763629 -7763 142721 14042 1884545 1002957 567252 193420 1763629 0.83070 0.16930 1 0 322448 322448 4319720 1291257 3028463 646901 338918 307983 3658894 X 5375879 135150 892499 -20848 1006801 4369078 0 4369078 5229639 892499 -20848 871651 4357988 0 4357988 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. MICROBREW 19214 6750 12464 750 6726 1000 1684 BEACHLAND ROCK&REGGAE 3010 3010 3 4009 4009 26233 6750 19483 750 6726 1000 1684 10160 9323 X X X X 0 0 0 0 0 0 0 0 0 DANNY R WILLIAMS EXECUTIVE DIRECTOR 166382 0 10000 0 0 0 900 0 12950 0 190232 0 0 0 X 3 21406 FMV X 94 165814 FMV X EQUIPMENT 1 4022 FMV 0 1 0 PART I, COLUMN (B): THE ORGANIZATION IS REPORTING A COMBINATION OF THE NUMBER OF CONTRIBUTIONS AND THE NUMBER OF ITEMS RECEIVED. 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.