2011-08-15T15:10:44-05:00 2010-12-31 MITCHELL WIGGINS & COMPANY LLP 100 FLANK ROAD PETERSBURG VA 238059152 990 2010-01-01 541802019 VA ASSOCIATION OF FREE CLINICS INC VIRG 8043403434 711 MOOREFIELD PARK DRIVE NO C RICHMOND VA 23236 LOUIS M MARKWITH 8043403434 2011-08-15 1 M JAMES HARTSON JR CPA 8047335566 2010 2016-02-24 21:20:13Z LOUIS M MARKWITH 711 MOOREFIELD PARK DRIVE SUITE C RICHMOND VA 23236 4300895 0 X WWW.VAFREECLINICS.ORG X 1993 VA TO PROVIDE TRAINING AND TECHNICAL ASSISTANCE, RESEARCH, RESOURCE DEVELOPMENT AND ADVOCACY TO FREE CLINICS THROUGHOUT THE COMMONWEALTH OF VIRGINIA. THE VAFC REPRESENTS AND SUPPORTS VIRGINIA'S NETWORK OF 60 FREE CLINICS, WHICH ARE ONE OF VIRGINIA'S LARGEST PROVIDERS OF HEALTH CARE TO THE UNINSURED. 14 14 5 0 0 0 4066199 3849871 492685 448806 1957 2218 0 0 4560841 4300895 3917011 3766940 0 0 258710 268825 0 0 9271 197054 228033 4372775 4263798 188066 37097 780752 766663 78053 26867 702699 739796 X TO PROVIDE TRAINING AND TECHNICAL ASSISTANCE, RESEARCH, RESOURCE DEVELOPMENT AND ADVOCACY TO FREE CLINICS THROUGHOUT THE COMMONWEALTH OF VIRGINIA. THE VAFC REPRESENTS AND SUPPORTS VIRGINIA'S NETWORK OF 60 FREE CLINICS, WHICH ARE ONE OF VIRGINIA'S LARGEST PROVIDERS OF HEALTH CARE TO THE UNINSURED. 0 0 3766940 3577609 359558 THE ASSOCIATION ADMINISTERED FUNDING FROM THE COMMONWEALTH OF VIRGINIA AND MADE GRANTS TO ITS MEMBER CLINICS FOR THE PURPOSE OF PROVIDING ACCESS TO PRESCRIPTION MEDICATIONS FOR THEIR PATIENTS. 3000 THE ASSOCIATION ADMINISTERED FUNDING FROM THE ANTHEM BLUE CROSS AND BLUE SHIELD FOUNDATION AND MADE GRANTS TO ITS MEMBER CLINICS FOR THE PURPOSE OF BUILDING A STRONG AND VIBRANT NETWORK OF FREE CLINICS ACROSS THE COMMONWEALTH OF VIRGINIA. 89635 89248 THE ASSOCIATION PLANNED AND CONDUCTED AN ANNUAL CONFERENCE OF VIRGINIA'S FREE CLINICS, AN EXECUTIVE DIRECTORS RETREAT, MEDICAL DIRECTORS COUNCIL MEETINGS, A CLINICAL COORDINATORS WORKDAY, AND GOVERNANCE TRAINING. 305059 186332 THIS CATEGORY INCLUDES ALL OTHER UNALLOCATED PROGRAM EXPENSES. 305059 186332 4161634 1 1 0 1 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 8 0 5 1 0 0 0 0 0 0 0 0 X 14 14 0 0 1 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X THE ORGANIZATION 8043403434 711 MOOREFIELD PARK DRIVE SUITE C RICHMOND VA 23236 JAMES A KOHLER JR X X 0 0 0 CATHY LEWIS X X 0 0 0 JEAN NELSON X X 0 0 0 EV CLARKE X 0 0 0 COLIN DROZDOWSKI X 0 0 0 L TRICE GRAVATTE IV X 0 0 0 MARGARET HERSH X 0 0 0 DANIEL M JANNUZZI X 0 0 0 KEVIN MCCUSTY X 0 0 0 PAMELA PEARCE MURPHY X 0 0 0 DARRYL J PIROK X 0 0 0 SUZANNE SHERIDAN X 0 0 0 PAT YOUNG X 0 0 0 M CAROLINE MARTIN X 0 0 0 LOUIS M MARKWITH 40.00 X 97885 0 9120 97885 0 9120 0 0 0 0 0 59750 3747154 42967 20537 3849871 MANAGEMENT FEES 900099 359558 359558 CONFERENCE REGISTRATIO 900099 57598 57598 CONFERENCE SPONSORSHIP 900099 31650 31650 448806 2218 2218 4300895 448806 0 2218 3766940 3766940 97885 72435 23492 1958 123767 104040 19727 29509 25866 3461 182 17664 14304 3217 143 2982 2982 6800 6800 18000 18000 25937 15615 8001 2321 16608 11626 4152 830 14109 9876 1411 2822 89635 89635 2875 2875 4290 4290 RETREAT 13397 13397 BOARD AND COMMITTEE SUP 12335 9940 1796 599 DUES FEES & PUBLICATION 9001 9001 CONSULTANTS 6356 6356 STAFF DEVELOPMENT 4157 2494 1247 416 1551 1110 441 4263798 4161634 92893 9271 633129 646255 28818 28821 113526 86854 1150 8321 4738 5279 3583 780752 766663 73092 24295 4961 2572 78053 26867 X 512598 392050 190101 347746 702699 739796 780752 766663 37097 0 X X 0 1 1 X 0 X 2547323 2166268 3782270 4066199 3849871 16411931 2547323 2166268 3782270 4066199 3849871 16411931 1171021 15240910 12131 11283 9446 1957 2218 37035 16448966 1679902 0.92660 0.91360 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 4312 52562 56874 4206924 4263798 363190 90798 0 0 276630 343767 368639 363190 1352226 2028339 49862 39904 43883 56874 190523 69158 85942 92160 90798 338058 507087 11364 10591 14125 4312 40392 8321 4738 3583 3583 EMPLOYEE PAYROLL DEDUCTIONS 2572 2572 4300895 4263798 37097 0 37097 4300895 0 4300895 0 4300895 4263798 0 4263798 0 4263798 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE ORGANIZATION IS A NOT-FOR-PROFIT ORGANIZATION THAT IS EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE ORGANIZATION HAS ALSO BEEN CLASSIFIED AS AN ENTITY THAT IS NOT A PRIVATE FOUNDATION WITHIN THE MEANING OF SECTION 509(A) AND QUALIFIES FOR DEDUCTIBLE CONTRIBUTIONS AS PROVIDED IN SECTION 170(B)(1)(A)(VI). EFFECTIVE JANUARY 1, 2009, THE ORGANIZATION ADOPTED THE ACCOUNTING STANDARD REGARDING "ACCOUNTING FOR UNCERTAIN TAX POSITIONS". THIS ACCOUNTING STANDARD PROVIDES DETAILED GUIDANCE FOR FINANCIAL STATEMENT RECOGNITION, MEASUREMENT, AND DISCLOSURE OF UNCERTAIN TAX POSITIONS RECOGNIZED IN THE ORGANIZATION'S FINANCIAL STATEMENTS. IT REQUIRES AN ENTITY TO RECOGNIZE THE FINANCIAL STATEMENT IMPACT OF A TAX POSITION WHEN IT IS MORE LIKELY THAN NOT THAT THE POSITION WILL NOT BE SUSTAINED UPON EXAMINATION. THE ADOPTION OF THIS STANDARD HAD NO MATERIAL EFFECT ON THE ORGANIZATION'S FINANCIAL POSITION, RESULTS OF OPERATIONS, OR CASH FLOWS. THE TAX YEARS 2007 TO 2010 REMAIN SUBJECT TO EXAMINATION BY THE TAXING AUTHORITIES. THE ORGANIZATION INCLUDES PENALTIES AND INTEREST ASSESSED BY INCOME TAXING AUTHORITIES IN OPERATING EXPENSES. NO PENALTIES OR INTEREST WERE INCURRED FOR THE YEARS ENDED DECEMBER 31, 2010 AND 2009. 1 ALLEGHANY HIGHLANDS FREE CLINIC POST OFFICE BOX 216 LOW MOOR VA 24457 541904342 501(C)(3) 63505 FREE CLINIC SUPPORT AMERICAN RED CROSS ADULT DENTAL CLINIC 611 WEST BRAMBLETON AVENUE NORFOLK VA 23510 540505864 501(C)(3) 37968 FREE CLINIC SUPPORT ARLINGTON FREE CLINIC 3833 N FAIRFAX DRIVE SUITE 400 ARLINGTON VA 22203 541671883 501(C)(3) 142806 FREE CLINIC SUPPORT AUGUSTA REGIONAL FREE CLINIC POST OFFICE BOX 153 FISHERVILLE VA 22939 541651896 501(C)(3) 79960 FREE CLINIC SUPPORT BEACH HEALTH CLINIC 3396 HOLLAND ROAD SUITE 102 VIRGINIA BEACH VA 23542 541366960 501(C)(3) 81309 FREE CLINIC SUPPORT BEDFORD CHRISTIAN FREE CLINIC POST OFFICE BOX 357 BEDFORD VA 24523 541630812 501(C)(3) 23809 FREE CLINIC SUPPORT BRADLEY FREE CLINIC 1240 THIRD STREET SW ROANOKE VA 24016 237380491 501(C)(3) 98106 FREE CLINIC SUPPORT BROCK HUGHES FREE CLINIC 100 EDGEMONT ROAD WYTHEVILLE VA 24382 202353144 501(C)(3) 73156 FREE CLINIC SUPPORT CHARLOTTESVILLE FREE CLINIC 1138 ROSE HILL DRIVE 200 CHARLOTTESVILLE VA 22903 541610405 501(C)(3) 102860 FREE CLINIC SUPPORT CHESAPEAKE CARE FREE CLINIC 2145 MILITARY HIGHWAY SOUTH CHESAPEAKE VA 23320 541642754 501(C)(3) 97019 FREE CLINIC SUPPORT LOVE OF JESUS FORMERLY COMMONWEALTH CLINIC 10930 HULL STREET ROAD MIDLOTHIAN VA 23112 030450006 501(C)(3) 60691 2821 FMV FURNITURE, ETC. FREE CLINIC SUPPORT CROSS OVER MINISTRY 108 COWARDIN AVENUE RICHMOND VA 23224 541371067 501(C)(3) 126370 4348 FMV FURNITURE, ETC. FREE CLINIC SUPPORT CROSSROADS MEDICAL MISSION POST OFFICE BOX 16852 BRISTOL VA 24209 542038877 501(C)(3) 40894 FREE CLINIC SUPPORT DR RICHARD F CLARK HELP FREE CLINIC POST OFFICE BOX 190 HAMPTON VA 23669 541209213 501(C)(3) 75031 FREE CLINIC SUPPORT FAN FREE CLINIC POST OFFICE BOX 6477 RICHMOND VA 23230 540927792 501(C)(3) 118509 FREE CLINIC SUPPORT FAUQUIER FREE CLINIC POST OFFICE BOX 3138 WARRENTON VA 20188 541669652 501(C)(3) 86593 FREE CLINIC SUPPORT FREE CLINIC OF CENTRAL VIRGINIA 1016 MAIN STREET LYNCHBURG VA 24504 541420756 501(C)(3) 110898 453 FMV FURNITURE, ETC. FREE CLINIC SUPPORT FREE CLINIC OF CULPEPER 610 LAUREL STREET SUITE 3 CULPEPER VA 22701 521366700 501(C)(3) 39947 FREE CLINIC SUPPORT FREE CLINIC OF DANVILLE POST OFFICE BOX 665 DANVILLE VA 24543 541667654 501(C)(3) 62638 FREE CLINIC SUPPORT FREE CLINIC OF FRANKLIN COUNTY POST OFFICE BOX 764 ROCKY MOUNT VA 24151 541634138 501(C)(3) 61850 FREE CLINIC SUPPORT GOOCHLAND FREE CLINIC & FAMILY SERVICES POST OFFICE BOX 898 GOOCHLAND VA 23063 541967650 501(C)(3) 68845 FREE CLINIC SUPPORT CARING HEARTS FREE CLINIC OF PULASKI COUNTY POST OFFICE BOX 1088 PULASKI VA 24301 141909014 501(C)(3) 51247 FREE CLINIC SUPPORT FREE CLINIC OF NEW RIVER VALLEY 215 ROANOKE STREET CHRISTIANSBURG VA 24073 510247098 501(C)(3) 100131 FREE CLINIC SUPPORT FREE CLINIC OF THE TWIN COUNTIES POST OFFICE BOX 1708 GALAX VA 24333 541632194 501(C)(3) 35571 FREE CLINIC SUPPORT FREE MEDICAL CLINIC OF MARTINSVILLE AND HENRY COUNTY 22 EAST CHURCH SUITE 311 MARTINSVILLE VA 24112 202908001 501(C)(3) 44333 FREE CLINIC SUPPORT FREE MEDICAL CLINIC OF NORTHERN SHENANDOAH VALLEY POST OFFICE BOX 44 WINCHESTER VA 22604 541373296 501(C)(3) 143073 FREE CLINIC SUPPORT GLOUCESTER-MATHEWS FREE CLINIC 2276 GEORGE WASHINGTON HIGHWAY HAYES VA 23072 541875619 501(C)(3) 82429 FREE CLINIC SUPPORT GREENE CARE CLINIC POST OFFICE BOX 54 STANARDSVILLE VA 22973 721602744 501(C)(3) 24776 FREE CLINIC SUPPORT HARRISONBURG-ROCKINGHAM FREE CLINIC 25 WEST WATER STREET HARRISONBURG VA 22801 541568909 501(C)(3) 78128 FREE CLINIC SUPPORT HEALING HANDS HEALTH CENTER 210 MEMORIAL DRIVE BRISTOL VA 37620 780001847 501(C)(3) 26967 FREE CLINIC SUPPORT JEANIE SCHMIDT FREE CLINIC POST OFFICE BOX 5143 HERNDON VA 20172 710877944 501(C)(3) 114249 FREE CLINIC SUPPORT LACKEY FREE FAMILY MEDICINE CENTER 1620 OLD WILLIAMSBURG ROAD YORKTOWN VA 23690 541850915 501(C)(3) 108885 FREE CLINIC SUPPORT LLOYD F MOSS FREE CLINIC 1301 SAM PERRY BOULEVARD SUITE 100 FREDERICKSBURG VA 22401 541677934 501(C)(3) 107053 184 FMV FURNITURE, ETC. FREE CLINIC SUPPORT LOUDOUN COMMUNITY FREE CLINIC 224 CORNWALL STREET NW LEESBURG VA 20176 541921059 501(C)(3) 101641 FREE CLINIC SUPPORT CHRISTIAN FREE CLINIC BOTETOURT 7330 ROANOKE ROAD FINCASTLE VA 24092 204342697 501(C)(3) 11013 FREE CLINIC SUPPORT MADISON FREE CLINIC 12343 SIR JAMES COURT RICHMOND VA 23233 311654015 501(C)(3) 32173 FREE CLINIC SUPPORT NORTHERN NECK FREE HEALTH CLINIC POST OFFICE BOX 1694 KILMARNOCK VA 22482 541679279 501(C)(3) 93642 FREE CLINIC SUPPORT PRINCE WILLIAM AREA FREE CLINIC 9301 LEE AVENUE MANASSAS VA 20110 541619202 501(C)(3) 137113 FREE CLINIC SUPPORT PRO BONO COUNSELING PROGRAM 303 CHURCH STREET BLACKSBURG VA 24060 311579158 501(C)(3) 16653 FREE CLINIC SUPPORT REDDY TRI-COUNTY HEALTH CLINIC POST OFFICE BOX 202 RICHLANDS VA 24641 541590912 501(C)(3) 31519 FREE CLINIC SUPPORT RESCUE MISSION HEALTH CARE CENTER POST OFFICE BOX 11525 ROANOKE VA 24022 540573900 501(C)(3) 54237 FREE CLINIC SUPPORT RICHMOND AREA HIGH BLOOD PRESSURE CENTER POST OFFICE BOX 5039 RICHMOND VA 23220 521303481 501(C)(3) 78046 212 FMV FURNITURE, ETC. FREE CLINIC SUPPORT ROANOKE VALLEY MH CARE COLLABORATIVE POST OFFICE BOX 592 ROANOKE VA 24004 540703132 501(C)(3) 19324 FREE CLINIC SUPPORT ROCKBRIDGE AREA FREE CLINIC POST OFFICE BOX 1573 LEXINGTON VA 24450 541642220 501(C)(3) 95782 FREE CLINIC SUPPORT SHENANDOAH COUNTY FREE CLINIC POST OFFICE BOX 759 WOODSTOCK VA 22664 542032008 501(C)(3) 88178 FREE CLINIC SUPPORT SMYTH COUNTY FREE CLINIC POST OFFICE BOX 1273 MARION VA 24354 541993876 501(C)(3) 37857 FREE CLINIC SUPPORT ST DAVID'S FREE HEALTH CLINIC 11241 WEST RIVER ROAD AYLETT VA 23009 260117479 501(C)(3) 30894 FREE CLINIC SUPPORT ST LUKE COMMUNITY CLINIC 316 NORTH ROYAL AVENUE FRONT ROYAL VA 22630 541801220 501(C)(3) 105504 FREE CLINIC SUPPORT SURRY AREA FREE CLINIC POST OFFICE BOX 32 SURRY VA 23883 541715186 501(C)(3) 21075 FREE CLINIC SUPPORT FREE CLINIC OF PULASKI COUNTY POST OFFICE BOX 1088 PULASKI VA 24301 521318621 501(C)(3) 57851 FREE CLINIC SUPPORT HANOVER INTERFAITH FREE CLINIC 125 BEVERLY ROAD ASHLAND VA 23005 412214314 501(C)(3) 35235 1805 FMV FURNITURE, ETC. FREE CLINIC SUPPORT HEALTH WAGON 119 NUMBER TEN STREET CLINCHCO VA 24266 043739083 501(C)(3) 35098 FREE CLINIC SUPPORT ORANGE COUNTY FREE CLINIC 450 N MADISON STREET ORANGE VA 22960 251922019 501(C)(3) 12118 FREE CLINIC SUPPORT PATHWAYS FREE SPECIALTY CLINIC 1200 W WASHINGTON STREET PETERSBURG VA 23803 541868900 501(C)(3) 16298 FREE CLINIC SUPPORT TAPPAHANNOCK FREE CLINIC 317 DUKE STREET TAPPAHANNOCK VA 22560 204715344 501(C)(3) 11013 FREE CLINIC SUPPORT WESTERN TIDWATER FREE CLINIC 2019 MEADE PARKWAY SUFFOLK VA 23434 263302837 501(C)(3) 38559 FREE CLINIC SUPPORT CULMORE CLINIC 6377 LANDESS STREET ALEXANDRIA VA 22312 540550102 501(C)(3) 5500 FREE CLINIC SUPPORTFREE CLINIC SUPPORT FREE CLINIC OF POWHATAN POST OFFICE BOX 544 POWHATAN VA 23139 261275136 501(C)(3) 10785 FREE CLINIC SUPPORT 58 FORM 990, PART VI, SECTION A, LINE 4 THE ORGANIZATION'S BYLAWS WERE AMENDED ON SEPTEMBER 17, 2010. FORM 990, PART VI, SECTION B, LINE 11 THE ORGANIZATION DISTRIBUTES A COPY OF THE FORM 990 TO ALL MEMBERS OF THE FINANCE & AUDIT COMMITTEE AND MAKES IT AVAILABLE FOR ALL OTHER BOARD MEMBERS PRIOR TO THE FORM BEING FILED. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS A WRITTEN "CONFLICT OF INTEREST" POLICY WHICH IS REAFFIRMED EACH JANUARY. EACH BOARD MEMBER COMPLETES A CONFLICT OF INTEREST FORM AND SIGNS THE FORM IN JANUARY. THE FORMS ARE MAINTAINED ON FILE IN THE ORGANIZATION'S OFFICE. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION POSTS ITS CURRENT AUDITED FINANCIAL STATEMENT ON ITS WEB SITE AND ON WWW.GIVERICHMOND.COM , EACH YEAR. IN ADDITION, COPIES OF THE AUDITED FINANCIAL STATEMENTS ARE SENT ELECTRONICALLY TO EACH MEMBER CLINIC. IT IS THE POLICY OF THE ORGANIZATION TO PROVIDE COPIES OF FINANCIAL STATEMENTS, GOVERNING DOCUMENTS AND CONFICT OF INTEREST INFORMATION AND OTHER DOCUMENTS TO THE MEMBERS OF THE PUBLIC UPON WRITTEN REQUEST. SINGLE COPIES ARE PROVIDED FREE OF CHARGE. MULTIPLE COPIES ARE SENT UPON THE RECEIPT OF FIFTY CENTS FOR EACH PAGE REQUESTED. THESE REQUESTS ARE PROCESSED AND THE INFORMATION IS FORWARDED WITHIN TWO WEEKS. FORM 990, PART XII, LINE 2C THE ORGANIZATION HAS A FORMAL AUDIT COMMITTEE THAT MAINTAINS THIS OVERSIGHT RESPONSBILITY. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.