2024-10-29T09:18:13-05:00 2023-12-31 873231666 PKF O'CONNOR DAVIES ADVISORY LLC 500 MAMARONECK AVENUE SUITE 301 HARRISON NY 105281633 990 2023-01-01 133330672 AFFINITY LEGACY INC AFFI 7187947700 2885 DILL PLACE BRONX NY 10465 RACHEL AMALFITANO CFO 7187947700 2024-10-29 1 1 EVA MRUK P00543254 9143818900 2024-10-29 2023 2024-10-15 13:58:12Z X CLARA HANSEN 2885 DILL PLACE BRONX NY 10465 56967486 0 X WWW.AFFINITYLEGACY.ORG X 1986 NY IMPROVE THE HEALTH AND WELL-BEING OF THE PEOPLE IN THE COMMUNITIES WE SERVE. 9 9 1 0 0 0 0 0 0 0 356942 6510173 1522977 0 1879919 6510173 5000000 18837426 0 0 655218 918211 0 0 0 1089903 990437 6745121 20746074 -4865202 -14235901 104244580 90656064 437739 311017 103806841 90345047 THE MISSION OF AFFINITY LEGACY, INC., F/K/A AFFINITY HEALTH PLAN (AFFINITY), IS TO IMPROVE THE HEALTH AND WELL-BEING OF THE PEOPLE IN THE COMMUNITIES WE SERVE. 0 0 18837426 18837426 0 COMMUNITY GRANT PROGRAM: DURING 2022, AFFINITY ESTABLISHED A COMMUNITY GRANT PROGRAM (THE PROGRAM) FUNDED BY A PORTION OF THE PROCEEDS FROM THE SALE TO MOLINA HEALTHCARE. UNDER THE PROGRAM, GRANTS ARE DISTRIBUTED TO ELIGIBLE COMMUNITY-BASED ORGANIZATIONS THROUGH AN APPLICATION PROCESS. GRANT FUNDING IS MADE AVAILABLE FOR PROJECTS THAT ARE PROVIDED FOR THE BENEFIT OF RESIDENTS WITHIN THE 10-COUNTY SERVICE AREA PREVIOUSLY SERVED BY AFFINITY HEALTH PLAN AND THAT ARE FOCUSED ON ONE OF FOUR FUNDING PRIORITIES: 1) MENTAL HEALTH; 2) FOOD INSECURITY; 3) FORMERLY INCARCERATED INDIVIDUALS; AND 4) WORKFORCE ADVANCEMENT AND CONSUMER EDUCATION. 18837426 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 1 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 109 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 X 9 9 0 0 1 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 NY X X RACHEL AMALFITANO 5169821146 2885 DILL PLACE BRONX NY 10465 X PALOMA IZQUIERDO-HERNANDEZ CHAIR 1.00 0.25 X X 25000 0 0 LYNN SHERMAN TREASURER 1.00 0.25 X X 18000 0 0 LINDA MULLER SECRETARY 1.00 0.25 X X 13000 0 0 JOHN SARDELIS TRUSTEE, THRU JULY 2023 1.00 0.25 X 25000 0 0 YVETTE WALKER MD TRUSTEE 1.00 0.25 X 25000 0 0 NANETTE FALKENBERG TRUSTEE 1.00 0.25 X 24000 0 0 JUDITH FAIRWEATHER TRUSTEE 1.00 0.25 X 18000 0 0 VERONA GREENLAND TRUSTEE 1.00 0.25 X 17000 0 0 BRIAN MCINDOE TRUSTEE 1.00 0.25 X 15000 0 0 CLARA MERCEDES HANSEN EXECUTIVE DIRECTOR 40.00 0.00 X 345000 0 93420 RACHEL AMALFITANO CFO/CONSULTANT 10.00 0.00 X 180600 0 0 AMY KNAPP TRUSTEE, THRU OCTOBER 2022 1.00 0.25 X 11000 0 0 716600 0 93420 2 1 1 0 GREENBERG TRAURIG LLP 54 STATE STREET ALBANY NY 12207 LEGAL SERVICES 225342 KPMG LLP PO BOX 120511 DALLAS TX 75312 ACCOUNTING SERVICES 115878 2 1141636 1141636 50582850 5243000 50457313 0 125537 5243000 5368537 5368537 6510173 0 0 6510173 18837426 18837426 810020 810020 108191 108191 152797 152797 41069 41069 76649 76649 23806 23806 6309 6309 15726 15726 3608 3608 291776 291776 WRITE-OFF OF PHARMACY R 378697 378697 20746074 18837426 1908648 0 18341212 2837918 15010783 5492693 1723631 1368811 23402569 30588458 45766385 50368184 104244580 90656064 437739 311017 437739 311017 X 103806841 90345047 0 0 103806841 90345047 104244580 90656064 -14235901 774108 -1 0 X X 0 1 X 1 0 X 1304530050 1354403147 1311867660 0 0 3970800857 1304530050 1354403147 1311867660 3970800857 0 0 0 3970800857 2647573 2372084 1957343 1142534 1141636 9261170 2647573 2372084 1957343 1142534 1141636 9261170 12221197 22667749 626941 1244626 36760513 1319398820 1379442980 1314451944 2387160 1141636 4016822540 0.98850 0.99020 0.00230 0.00190 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: OTHER INCOME - 2019 AMOUNT: $ 12,221,197. 2020 AMOUNT: $ 22,667,749. 2021 AMOUNT: $ 626,941. 2022 AMOUNT: $ 569,442. PHARMACY REBATES - 2022 AMOUNT: $ 675,184. 0 DUE FROM MOLINA 49950116 PHARMACY REBATE RECEIVABLE 418068 50368184 X 7284281 774108 774108 6510173 0 6510173 20746074 0 20746074 0 20746074 PART X, LINE 2: THE ORGANIZATION RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT TO BE SUSTAINED. MANAGEMENT HAS DETERMINED THAT THE ORGANIZATION HAD NO UNCERTAIN TAX POSITIONS THAT WOULD REQUIRE FINANCIAL STATEMENT RECOGNITION OR DISCLOSURE. THE ORGANIZATION IS NO LONGER SUBJECT TO EXAMINATIONS BY THE APPLICABLE TAXING JURISDICTIONS FOR PERIODS PRIOR TO 2020. 1 914 UNITED INC 54 MCGOERY LL BRONXVILLE NY 10708 850919332 501(C)(3) 45000 0 COMMUNITY GRANT PROGRAM ACKERMAN INSTITUTE FOR THE FAMILY 936 BROADWAY 2ND FL NEW YORK NY 10010 131923959 501(C)(3) 180000 0 COMMUNITY GRANT PROGRAM ADDO FOUNDATION INC 503 ROGERS AVENUE BROOKLYN NY 11225 800582989 501(C)(3) 60000 0 COMMUNITY GRANT PROGRAM ADVANCED CARE ALLIANCE OF NY 1410 BROADWAY 2ND FLOOR NEW YORK NY 10018 465489816 501(C)(3) 365000 0 COMMUNITY GRANT PROGRAM ANDROMEDA COMMUNITY INITIATIVE INC 49-12 31ST PLACE LONG ISLAND CITY NY 11101 824497530 501(C)(3) 85000 0 COMMUNITY GRANT PROGRAM ARTHUR ASHE INSTITUTE FOR URBAN HEALTH INC 40 CLARKSON AVENUE BOX 1232 BROOKLYN NY 11203 113185372 501(C)(3) 520000 0 COMMUNITY GRANT PROGRAM BREAKING GROUND HOUSING DEVELOPMENT FUND CORPORATION 505 EIGHTH AVENUE 5TH FLOOR NEW YORK NY 10018 113048002 501(C)(3) 145000 0 COMMUNITY GRANT PROGRAM BROOKLYN BUREAU OF COMMUNITY SERVICE PO BOX 24630 BROOKLYN NY 11202 111630780 501(C)(3) 400000 0 COMMUNITY GRANT PROGRAM BROOKLYN COMMUNITIES COLLABORATIVE INC 4802 TENTH AVE BROOKLYN NY 11219 845090998 501(C)(3) 200000 0 COMMUNITY GRANT PROGRAM CABRINI IMMIGRANT SERVICES OF NYC INC 701 FORT WASHINGTON AVENUE NEW YORK NY 10040 455258656 501(C)(3) 250000 0 COMMUNITY GRANT PROGRAM CARE FOR THE HOMELESS 30 EAST 33RD STREET 5TH FLOOR NEW YORK NY 10016 133666994 501(C)(3) 240000 0 COMMUNITY GRANT PROGRAM CASITA MARIA INC 928 SIMPSON STREET BRONX NY 10459 131623994 501(C)(3) 340000 0 COMMUNITY GRANT PROGRAM CENTER FOR ALTERNATIVE SENTENCING & EMPLOYMENT SERVICES 151 LAWRENCE STREET BROOKLYN NY 11201 132668080 501(C)(3) 225000 0 COMMUNITY GRANT PROGRAM CENTER FOR EMPLOYMENT OPPORTUNITIES INC 50 BROADWAY SUITE 1604 NEW YORK NY 10004 133843322 501(C)(3) 350000 0 COMMUNITY GRANT PROGRAM CENTRAL NASSAU GUIDANCE AND COUNSELING SERVICES INC 950 S OYSTER BAY ROAD HICKSVILLE NY 11801 112438388 501(C)(3) 500000 0 COMMUNITY GRANT PROGRAM COMMUNILIFE INC 462 7TH AVENUE 3RD FLOOR NEW YORK NY 10018 133530299 501(C)(3) 440000 0 COMMUNITY GRANT PROGRAM COMMUNITY ACCESS INC 64 BEAVER STREET 109 NEW YORK NY 10004 237399839 501(C)(3) 165000 0 COMMUNITY GRANT PROGRAM COMMUNITY HEALTH CARE ASSOCIATION OF NEW YORK STATE 111 BROADWAY SUITE 1402 NEW YORK NY 10006 132690296 501(C)(3) 500000 0 COMMUNITY GRANT PROGRAM COMMUNITY HEALTH CENTER OF RICHMOND INC 439 PORT RICHMOND AVENUE STATEN ISLAND NY 10302 510567466 501(C)(3) 175000 0 COMMUNITY GRANT PROGRAM COMMUNITY HEALTH PROJECT INC 356 WEST 18TH STREET NEW YORK NY 10011 133409680 501(C)(3) 330000 0 COMMUNITY GRANT PROGRAM COMMUNITY HELP IN PARK SLOPE INC 200 4TH AVENUE BROOKLYN NY 11217 112449994 501(C)(3) 50000 0 COMMUNITY GRANT PROGRAM DR RICHARD IZQUIERDO HEALTH & SCIENCE CHARTER SCHOOL 800 HOME STREET BRONX NY 10456 271766995 501(C)(3) 400000 0 COMMUNITY GRANT PROGRAM EVERYDAY IS A MIRACLE INC 2068 MATTHEWS AVENUE SUITE 3 BRONX NY 10462 274262907 501(C)(3) 60000 0 COMMUNITY GRANT PROGRAM EXODUS TRANSITIONAL COMMUNITY INC 2271 3RD AVENUE NEW YORK NY 10035 311731465 501(C)(3) 500000 0 COMMUNITY GRANT PROGRAM FEDERATION OF ORGANIZATION FOR THE NYS MENTALLY DISABLED 1 FARMINGDALE ROAD/ROUTE 109 WEST BABYLON NY 11704 131837418 501(C)(3) 60000 0 COMMUNITY GRANT PROGRAM FEEDING WESTCHESTER INC 200 CLEARBROOK ROAD ELMSFORD NY 10523 133507988 501(C)(3) 100000 0 COMMUNITY GRANT PROGRAM FOR THE BETTER INC 1866 E 51ST STREET BROOKLYN NY 11234 852956154 501(C)(3) 25000 0 COMMUNITY GRANT PROGRAM FOUNTAIN HOUSE INC 425 W 47TH STREET NEW YORK NY 10036 133055988 501(C)(3) 500000 0 COMMUNITY GRANT PROGRAM FUND FOR THE CITY OF NEW YORK INC 121 AVENUE OF THE AMERICAS 6TH FLOOR NEW YORK NY 10013 132612524 501(C)(3) 205000 0 COMMUNITY GRANT PROGRAM GOTHAM FOOD PANTRY 888C 8TH AVENUE NEW YORK NY 10019 853425480 501(C)(3) 250000 0 COMMUNITY GRANT PROGRAM GREEN & HEALTHY HOMES INITIATIVE INC 2714 HUDSON STREET BALTIMORE MD 21224 521786577 501(C)(3) 200000 0 COMMUNITY GRANT PROGRAM GREEN BRONX MACHINE INTERNATIONAL 3935 BLACKSTONE AVE 12G BRONX NY 10471 453303493 501(C)(3) 60000 0 COMMUNITY GRANT PROGRAM GREENWICH HOUSE INC 27 BARROW STREET NEW YORK NY 10014 135562204 501(C)(3) 100000 0 COMMUNITY GRANT PROGRAM HARLEM GROWN INC 127 W 127TH STREET SUITE 418 NEW YORK NY 10027 274250636 501(C)(3) 180000 0 COMMUNITY GRANT PROGRAM HARLEM PRIDE CORPORATION 42 MACOMBS PLACE NEW YORK NY 10039 272191962 501(C)(3) 35000 0 COMMUNITY GRANT PROGRAM HEAVEN BOUND CHURCH OF GOD IN CHRIST PO BOX 925 MIDDLETOWN NY 10940 352345774 501(C)(3) 30000 0 COMMUNITY GRANT PROGRAM HOUR CHILDREN INC 36-11 12TH STREET LONG ISLAND CITY NY 11106 133647412 501(C)(3) 350000 0 COMMUNITY GRANT PROGRAM HUDSON LINK FOR HIGHER EDUCATION IN PRISON INC PO BOX 862 OSSINING NY 10562 134132348 501(C)(3) 500000 0 COMMUNITY GRANT PROGRAM HUNTS POINT ALLIANCE FOR CHILDREN 1231 LAFAYETTE AVENUE SB BRONX NY 10474 208503907 501(C)(3) 150000 0 COMMUNITY GRANT PROGRAM INDEPENDENCE CARE SYSTEM INC 25 ELM PLACE 5TH FLOOR BROOKLYN NY 11201 133964284 501(C)(3) 465000 0 COMMUNITY GRANT PROGRAM INSTITUTE FOR COMMUNITY EQUITY AND SHARING INC 13 GREENE AVENUE BROOKLYN NY 11238 830909234 501(C)(3) 90000 0 COMMUNITY GRANT PROGRAM INTERBOROUGH DEVELOPMENTAL AND CONSULTATION CENTER INC 1623 KINGS HIGHWAY BROOKLYN NY 11229 237358415 501(C)(3) 340000 0 COMMUNITY GRANT PROGRAM JEWISH CHILDCARE ASSOCIATION OF NEW YORK 858 EAST 29 STREET BROOKLYN NY 11210 131624060 501(C)(3) 500000 0 COMMUNITY GRANT PROGRAM JULIA DYCKMAN ANDRUS MEMORIAL INC 1156 N BROADWAY YONKERS NY 10701 132793295 501(C)(3) 210134 0 COMMUNITY GRANT PROGRAM LITTLE SISTERS ON THE ASSUMPTION FAMILY HEALTH SERVICES INC 333 EAST 115TH STREET NEW YORK NY 10029 132867881 501(C)(3) 125000 0 COMMUNITY GRANT PROGRAM MAKE THE ROAD NEW YORK 301 GROVE STREET BROOKLYN NY 11237 113344389 501(C)(3) 115000 0 COMMUNITY GRANT PROGRAM METROPOLITAN CENTER FOR MENTAL HEALTH INC 160 W 86TH STREET NEW YORK NY 10024 131978365 501(C)(3) 120000 0 COMMUNITY GRANT PROGRAM MIDTOWN SOUTH COMMUNITY COUNCIL 331 W 38TH STREET 5 NEW YORK NY 10018 270138480 501(C)(3) 25000 0 COMMUNITY GRANT PROGRAM MYSON INC 712 EAST 217TH STREET BRONX NY 10467 834504327 501(C)(3) 18000 0 COMMUNITY GRANT PROGRAM NATIONAL BLACK LEADERSHIP COMMISSION ON AIDS NBLCA 215 WEST 125TH STREET SUITE 2 NEW YORK NY 10027 134148824 501(C)(3) 215000 0 COMMUNITY GRANT PROGRAM NAZARETH HOUSING INC 519 E 11TH STREET NEW YORK NY 10009 133176952 501(C)(3) 100000 0 COMMUNITY GRANT PROGRAM NEW ALTERNATIVES FOR CHILDREN INC 37 WEST 26TH STREET NEW YORK NY 10010 133149298 501(C)(3) 650000 0 COMMUNITY GRANT PROGRAM NEW YORK COMMON PANTRY INC 8 EAST 109TH STREET NEW YORK NY 10029 133127972 501(C)(3) 400000 0 COMMUNITY GRANT PROGRAM NEW YORK PSYCHOTHERAPY AND COUNSELING CENTER 176-20 148TH AVENUE JAMAICA NY 11434 112320614 501(C)(3) 225000 0 COMMUNITY GRANT PROGRAM NEW YORK SCHOOL-BASED HEALTH FOUNDATION PO BOX 8324 ALBANY NY 12208 271484759 501(C)(3) 400000 0 COMMUNITY GRANT PROGRAM NYSARC INC NYC CHAPTER 83 MAIDEN LANE NEW YORK NY 10038 135678837 501(C)(3) 250000 0 COMMUNITY GRANT PROGRAM OPEN DOOR FAMILY LIFE CENTER INC 999 GREENE AVENUE BROOKLYN NY 11221 201056519 501(C)(3) 15000 0 COMMUNITY GRANT PROGRAM OUTREACH DEVELOPMENT CORPORATION 11711 MYRTLE AVENUE RICHMOND HILL NY 11418 112518262 501(C)(3) 95000 0 COMMUNITY GRANT PROGRAM PARENT-CHILD RELATIONSHIP ASSOCIATION 909 58TH STREET BROOKLYN NY 11219 831900689 501(C)(3) 35292 0 COMMUNITY GRANT PROGRAM PATH TO JOBS 64 WEST 35TH STREET 2ND FLOOR NEW YORK NY 10001 611722430 501(C)(3) 315000 0 COMMUNITY GRANT PROGRAM PROVIDENCE HOUSE INC 703 LEXINGTON AVENUE BROOKLYN NY 11221 112594653 501(C)(3) 270000 0 COMMUNITY GRANT PROGRAM QUEENS COMMUNITY HOUSE INC 92-17 165 STREET JAMAICA NY 11433 112375583 501(C)(3) 100000 0 COMMUNITY GRANT PROGRAM QUEENS ECONOMIC DEVELOPMENT CORPORATION 120-55 QUEENS BLVD SUITE 309 KEW GARDENS NY 11424 112436149 501(C)(3) 85000 0 COMMUNITY GRANT PROGRAM RAUSCHENBUSCH METRO MINISTRIES INC 401 W 40TH STREET NEW YORK NY 10018 133859713 501(C)(3) 75000 0 COMMUNITY GRANT PROGRAM RESEARCH FOUNDATION OF THE CITY UNIVERSITY OF NEW YORK 230 WEST 41ST STREET NEW YORK NY 10036 020733394 501(C)(3) 460000 0 COMMUNITY GRANT PROGRAM RONALD MCDONALD HOUSE NEW YORK 405 EAST 73RD STREET NEW YORK NY 10021 132933654 501(C)(3) 150000 0 COMMUNITY GRANT PROGRAM SAFE HORIZON INC 2 LAFAYETTE STREET 3RD FLOOR NEW YORK NY 10007 132946970 501(C)(3) 200000 0 COMMUNITY GRANT PROGRAM SERVICES FOR THE UNDERSERVED INC 463 7TH AVENUE 17TH FLOOR NEW YORK NY 10018 911918247 501(C)(3) 250000 0 COMMUNITY GRANT PROGRAM SHARE FOR LIFE FOUNDATION INC 301 SAINT NICHOLAS AVENUE SUITE 25 NEW YORK NY 10027 571145113 501(C)(3) 30000 0 COMMUNITY GRANT PROGRAM SHELTERING ARMS CHILDREN AND FAMILY SERVICES INC 25 BROADWAY 18TH FLOOR NEW YORK NY 10004 133709095 501(C)(3) 355000 0 COMMUNITY GRANT PROGRAM SOUTH ASIAN COUNCIL FOR SOCIAL SERVICES 14306 45 AVENUE FLUSHING NY 11355 113632920 501(C)(3) 200000 0 COMMUNITY GRANT PROGRAM ST BARNABAS HOSPITAL 4422 THIRD AVENUE BRONX NY 10457 131740122 501(C)(3) 150000 0 COMMUNITY GRANT PROGRAM ST JOHN BREAD AND LIFE PROGRAM INC 795 LEXINGTON AVENUE BROOKLYN NY 11221 113174514 501(C)(3) 240000 0 COMMUNITY GRANT PROGRAM STANLEY M ISAACS NEIGHBORHOOD CENTER INC 415 EAST 93RD STREET NEW YORK NY 10128 132572034 501(C)(3) 100000 0 COMMUNITY GRANT PROGRAM THE CHILD CENTER OF NY INC 118-35 QUEENS BLVD 6TH FLOOR FOREST HILLS NY 11375 111733454 501(C)(3) 150000 0 COMMUNITY GRANT PROGRAM THE RED DOOR PLACE INC 201 WEST 13TH STREET NEW YORK NY 10011 841859955 501(C)(3) 50000 0 COMMUNITY GRANT PROGRAM THE RIVER FUND NEW YORK INC 89-11 LEFFERTS BLVD RICHMOND HILL NY 11418 113450363 501(C)(3) 240000 0 COMMUNITY GRANT PROGRAM THE SALVATION ARMY 440 WEST NYACK ROAD WEST NYACK NY 10994 222406433 501(C)(3) 250000 0 COMMUNITY GRANT PROGRAM TRINITY HUMAN SERVICES CORPORATION 153A JOHNSON AVENUE BROOKLYN NY 11206 133171439 501(C)(3) 24000 0 COMMUNITY GRANT PROGRAM UTOPIA RESEARCH CENTER GREATER NY INC 576 E 165TH STREET BRONX NY 10456 833737500 501(C)(3) 150000 0 COMMUNITY GRANT PROGRAM VIOLENCE INTERVENTION PROGRAM INC PO BOX 1161 NEW YORK NY 10035 133540337 501(C)(3) 225000 0 COMMUNITY GRANT PROGRAM VISITING NURSE SERVICE OF NEW YORK 107 EAST 70TH STREET NEW YORK NY 10021 133189926 501(C)(3) 200000 0 COMMUNITY GRANT PROGRAM VISITING NURSE SERVICES IN WESTCHESTER INC 1311 MAMARONECK AVENUE WHITE PLAINS NY 10605 132601443 501(C)(3) 45000 0 COMMUNITY GRANT PROGRAM WEST SIDE CENTER FOR COMMUNITY LIFE INC 263 WEST 86TH STREET NEW YORK NY 10024 710908184 501(C)(3) 100000 0 COMMUNITY GRANT PROGRAM YMCA OF YONKERS INC 17 RIVERDALE AVENUE YONKERS NY 10701 131740520 501(C)(3) 50000 0 COMMUNITY GRANT PROGRAM YOUTH BRIDGE NEW YORK 520 EIGHTH AVENUE SUITE 1400 NEW YORK NY 10018 133937355 501(C)(3) 230000 0 COMMUNITY GRANT PROGRAM YOUTH JUSTICE NETWORK INC 63 W 125TH STREET 4TH FLOOR NEW YORK NY 10027 133576756 501(C)(3) 100000 0 COMMUNITY GRANT PROGRAM YWCA OF YONKERS INC 87 SOUTH BROADWAY YONKERS NY 10701 131740521 501(C)(3) 380000 0 COMMUNITY GRANT PROGRAM 88 0 PART I, LINE 2: AFFINITY LEGACY IS CARRYING ON THE LEGACY UPON WHICH AFFINITY HEALTH PLAN WAS FOUNDED TO IMPROVE THE HEALTH AND WELL-BEING OF PEOPLE IN THE COMMUNITIES WE SERVE. THE ORGANIZATION CREATED THE COMMUNITY GRANT PROGRAM TO PROVIDE GRANTS TO ELIGIBLE ORGANIZATIONS THAT PROVIDE SERVICES TO PEOPLE WITHIN AFFINITY'S 10 COUNTY SERVICE AREA. THE GRANT MONITORING PROCESS BEGINS WITH ORGANIZATIONS EXPRESSING INTEREST VIA A LETTER OF INTENT (LOI). ORGANIZATIONS THAT PASSED THE LOI GATING STEP ARE REQUIRED TO SUBMIT A FULL APPLICATION, DETAILING THE PROJECT FOR WHICH THEY ARE REQUESTING FUNDING. APPLICATIONS ARE REVIEWED BY THE COMMUNITY WORKGROUP AND THE EXECUTIVE DIRECTOR AND ASSESSED AGAINST THE BOARD-ESTABLISHED FUNDING CRITERIA I.E., THE ORGANIZATIONS HAS TO: - BE REGISTERED AS A TAX-EXEMPT ORGANIZATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE, OR PROVIDE DOCUMENTATION OF CURRENT FISCAL SPONSORSHIP. - HAVE PURPOSES CONSISTENT WITH AFFINITY'S MISSION "TO IMPROVE THE HEALTH AND WELL-BEING OF THE COMMUNITIES WE SERVE." - OPERATE PROGRAMS WITHIN AFFINITY'S 10-COUNTY SERVICE AREA BRONX, KINGS, NASSAU, NEW YORK, ORANGE, QUEENS, RICHMOND, ROCKLAND, SUFFOLK, AND WESTCHESTER. - NOT HAVE RECEIVED FUNDING FROM ANY OTHER COMPONENT OF THE AFFINITY CHARITABLE ASSET DISTRIBUTION. ADDITIONALLY, GRANT PROJECTS HAVE TO BE FOCUSED ON ONE OF FOUR FUNDING PRIORITIES: MENTAL HEALTH, FOOD INSECURITY, FORMERLY INCARCERATED INDIVIDUALS AND CONSUMER HEALTH EDUCATION AND WORKFORCE ADVANCEMENT. LASTLY, PROJECTS ARE EVALUATED FOR THEIR POTENTIAL COMMUNITY IMPACT. DECISIONS ON WHICH GRANTEE / PROJECTS TO FUND ARE MADE AFTER A COMPREHENSIVE REVIEW AND DISCUSSION. THE PACKET OF THE RECOMMENDED PROJECTS ARE THEN PRESENTED TO THE BOARD FOR FINAL APPROVAL. GRANTEE / PROJECT MONITORING IS PERFORMED IN SEVERAL WAYS. GRANTEES ARE REQUIRED TO SUBMIT INTERIM REPORTS AND FINAL REPORTS (INCLUDING BUDGETS) ON THEIR FUNDED PROJECTS. ALSO, GRANTEES MEET REGULARLY WITH THE EXECUTIVE DIRECTOR VIA ZOOM TO DISCUSS PROGRESS. X X X 0 0 0 0 0 0 0 1 0 CLARA MERCEDES HANSEN EXECUTIVE DIRECTOR 315000 0 30000 0 0 0 31250 0 62170 0 438420 0 0 0 RACHEL AMALFITANO CFO/CONSULTANT 180600 0 0 0 0 0 0 0 0 0 180600 0 0 0 AMY KNAPP TRUSTEE, THRU OCTOBER 2022 11000 0 0 0 0 0 0 0 0 0 11000 0 0 0 PART I, LINE 7 AN INDIVIDUAL INCLUDED IN SCHEDULE J, PART II RECEIVED A DISCRETIONARY BONUS DURING CALENDAR YEAR 2023, WHICH WAS INCLUDED IN COLUMN B(II) HEREIN AND IN THEIR 2023 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES FORM 990, PART VI, SECTION A, LINE 4 AFFINITY AMENDED ITS CERTIFICATE OF INCORPORATION ON JULY 10, 2023. THE CERTIFICATE WAS AMENDED TO REMOVE REFERENCE TO THE MEMBERS OF THE CORPORATION AND TO REMOVE THE CORPORATE MEMBERSHIP. FORM 990, PART VI, SECTION B, LINE 11B AFFINITY HAS ITS FORM 990 PREPARED BY AN OUTSIDE ACCOUNTING FIRM AND HAS ESTABLISHED THE FOLLOWING REVIEW PROCESS TO ENSURE THAT THE INFORMATION REPORTED IS COMPLETE AND ACCURATE. WHEN THE FORM 990 HAS BEEN PREPARED, REVIEWED BY MANAGEMENT AND IS READY TO BE FILED WITH THE INTERNAL REVENUE SERVICE, IT IS ELECTRONICALLY SENT TO THE BOARD FOR APPROVAL. ONCE THE BOARD HAS APPROVED THE RETURN IT IS FILED WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C LOYALTY TO AFFINITY'S MISSION REQUIRES THAT BOARD MEMBERS, OFFICERS, AND KEY PERSONS AFFIRM THEIR DUTY TO ACT IN WAYS THAT PROMOTE THE MISSION OF AFFINITY AND TO ABIDE BY THE CONFLICT OF INTEREST AND STANDARDS OF CONDUCT POLICY. EACH BOARD AND COMMITTEE MEMBER, OFFICER, AND KEY PERSON WILL PRIOR TO HIS OR HER INITIAL ELECTION OR APPOINTMENT, AS APPLICABLE, AND ANNUALLY THEREAFTER SIGN A STATEMENT THAT AFFIRMS THAT SUCH PERSON: I) HAS RECEIVED A COPY OF THE CONFLICT OF INTEREST AND STANDARDS OF CONDUCT POLICY, II) HAS READ AND UNDERSTANDS THE POLICY; III) HAS AGREED TO COMPLY WITH IT; AND IV) UNDERSTANDS THAT AFFINITY IS A CHARITABLE CORPORATION AND THAT, IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION, MUST ENGAGE PRIMARILY IN ACTIVITIES THAT ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. AFTER DISCLOSURE OF A SPECIFIC ACTUAL OR POTENTIAL CONFLICT OF INTEREST AND ALL MATERIAL FACTS AND, AFTER ANY DISCUSSION BETWEEN THE BOARD AND THE INTERESTED PERSON, THE INTERESTED PERSON MUST LEAVE THE BOARD MEETING WHILE A DETERMINATION OF CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON. THE REMAINING BOARD MEMBERS WILL DECIDE IF A CONFLICT OF INTEREST EXISTS. IF NO CONFLICT OF INTEREST EXISTS, THE INTERESTED PERSON MAY RETURN TO PARTICIPATE IN DISCUSSIONS AND VOTING ON THE MATTER. NO INTERESTED PERSON MAY ATTEMPT TO INFLUENCE THE DELIBERATION OR VOTING ON THE MATTER GIVING RISE TO A CONFLICT OF INTEREST. AN INTERESTED PERSON MAY MAKE A PRESENTATION OR OTHERWISE PARTICIPATE AT THE BOARD MEETING. AFTER SUCH PRESENTATION, HOWEVER, THE PERSON SHALL LEAVE THE MEETING DURING THE DISCUSSION OF AND VOTE ON THE PROPOSED POLICY, TRANSACTION, OR ARRANGEMENT. FORM 990, PART VI, SECTION B, LINE 15 THE PROCESS FOR DETERMINING COMPENSATION FOR EXECUTIVE DIRECTOR AND CFO INCLUDED REVIEW AND APPROVAL BY A COMPENSATION COMMITTEE (THE "COMMITTEE") COMPRISED OF INDEPENDENT DIRECTORS CHARGED WITH THIS RESPONSIBILITY, CONSIDERATION OF COMPARABILITY DATA AND CONTEMPORANEOUS SUBSTANTIATION AND DOCUMENTATION OF THE DELIBERATION AND DECISION. THIS PROCESS IS DONE ON AN ANNUAL BASIS AND WAS LAST UNDERTAKEN IN 2023. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS FORM 990 AVAILABLE FOR PUBLIC INSPECTION AS REQUIRED UNDER SECTION 6104 OF THE INTERNAL REVENUE CODE. THE RETURN IS ALSO POSTED ON GUIDESTAR.ORG AND OTHER SIMILAR TYPES OF WEBSITES. THE ORGANIZATION'S FINANCIAL STATEMENTS, CONFLICT OF INTEREST POLICY, ARTICLES OF INCORPORATION AND BYLAWS ARE AVAILABLE UPON WRITTEN REQUEST. FORM 990, PART VII, LINE 3 THROUGH 12: THE BOARD TRUSTEES WERE COMPENSATED DURING THE YEAR FOR SERVICES PROVIDED TO THE BOARD, NOT AS INDEPENDENT CONTRACTORS. FORM 990, PART XII, LINE 2C: THE ORGANIZATION HAS A COMMITTEE THAT ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF THE ORGANIZATION'S FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS DID NOT CHANGE FROM THE PRIOR YEAR. AHP ENTERPRISES INC 2885 DILL PLACE BRONX NY 10465 473885217 MGMT SERVICES DE AFFINITY HEALTH SERVICES HOLDINGS INC C 0 AFFINITY HEALTH SERVICES HOLDINGS INC 2885 DILL PLACE BRONX NY 10465 473909849 HOLDING CORPORATION DE N/A C 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0