2021-03-16T11:48:50-07:00 2020-06-30 990 2019-07-01 134228071 COMMUNITY HEALTH FREE CLINIC COMM 3193630416 947 14th Avenue SE Cedar Rapids IA 52401 Laura Wirth Treasurer 3193630416 2021-05-15 2019 2022-09-23 18:48:47Z Laura Wirth 947 14th Ave SE Cedar Rapids IA 52401 5110555 0 X WWW.COMMUNITYHFC.ORG X 2002 IA TO ALLEVIATE HUMAN PAIN AND SUFFERING BY PROVIDING ACCESS TO AND THE DELIVERY OF COMPASSIONATE HEALTHCARE. 15 15 23 293 0 0 4234957 5054445 0 0 40822 51336 0 0 4275779 5105781 0 0 0 0 356335 341391 0 0 62492 4055934 4696750 4412269 5038141 -136490 67640 4215512 4244214 16007 12732 4199505 4231482 TO ALLEVIATE HUMAN PAIN AND SUFFERING BY PROVIDING ACCESS TO AND THE DELIVERY OF COMPASSIONATE HEALTHCARE. 0 0 4808459 0 Provided Free Health Care Services, including medical, dental and vision care for underserved and uninsured individuals in need of health care. Approximately 180 new patients were seen per month. The total of new and existing individuals served during the year was 9,525 with over 18,110 services provided. The Community Health Free Clinic served individuals all over the East Central Iowa area. 0 0 0 4808459 1 1 0 0 0 0 0 0 0 1 1 0 0 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 2 0 0 23 1 0 0 0 0 0 0 0 0 0 0 0 0 X 15 15 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 CO FL IL MN MO NJ NV NY WA WI X MARTY MILLER 3192002540 715 10TH AVENUE SE CEDAR RAPIDS IA 52401 DARLENE SCHMIDT CEO 55.0 0 X 76804 0 0 BEN HOOVER President 1.0 X X 0 0 0 KAY JACKSON SECRETARY 1.0 0 X X 0 0 0 LAURA WIRTH TREASURER 1.0 0 X X 0 0 0 MICHAEL HALL DIRECTOR 1.0 0 X 0 0 0 RO FOEGE DIRECTOR 1.0 0 X 0 0 0 SANDRA MCINTOSH DIRECTOR 1.0 0 X 0 0 0 JERRY TIEDT DIRECTOR 1.0 0 X 0 0 0 JOHN BANKS DIRECTOR 1.0 0 X 0 0 0 DARLENE DAVERMANN-REID Vice President 1.0 0 X X 0 0 0 GREG DEWOLF DIRECTOR 1.0 0 X 0 0 0 JEANETTE WERLING DIRECTOR 1.0 0 X 0 0 0 Heather Smith Friedman Director 1.0 0 X 0 0 0 Sue Lowder Director 1.0 0 X 0 0 0 Dennis Naughton Director 1.0 0 X 0 0 0 Kevin Techau Director 1.0 0 X 0 0 0 76804 0 0 0 0 0 0 0 262620 0 0 0 24789 4767036 4260744 5054445 0 35169 0 0 35169 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5941 15000 894 3880 5047 11120 16167 0 0 16167 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5105781 0 0 51336 0 0 0 0 0 0 0 0 77939 58454 15588 3897 0 0 0 0 242427 143674 64197 34556 0 0 0 0 0 0 0 0 21025 13265 5236 2524 0 0 0 0 0 0 0 0 15329 0 15329 0 0 0 0 0 0 0 5992 0 5992 0 0 0 0 0 3204 0 0 3204 38358 21033 14570 2755 38190 24095 9511 4584 0 0 0 0 30111 18998 7499 3614 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 61299 38675 15266 7358 14002 0 14002 0 Donated Goods 4259849 4259849 0 0 Medications 121047 121047 0 0 Medical Services 106926 106926 0 0 Change in Inventory -4765 -4765 0 0 7208 7208 0 0 5038141 4808459 167190 62492 201792 278096 288080 234235 224273 219024 0 0 0 0 0 0 0 0 942131 946896 7777 8959 2070811 880476 1232927 1190335 0 0 0 0 0 0 0 0 1318532 1366669 4215512 4244214 16007 12732 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16007 12732 X 3565772 3611821 633733 619661 4199505 4231482 4215512 4244214 67640 -35655 -8 0 0 X 0 1 1 0 X 1259752 1481608 3761434 4234957 5054446 15792197 1259752 1481608 3761434 4234957 5054446 15792197 0 15792197 41612 64077 29054 38643 35169 208555 0 0 0 0 0 0 1009 0 0 0 0 1009 16001761 0 0.98690 0.98419 X Schedule A, Part II, Line 10 Gross receipts from Fundraising Event $1,009 FYE 6/30/2016 Sched A Part II Line 10 Gain on Sale of Capital assets 16,167 (Sale of Land lot gain $11,120 /Sale of Stock $5.047) FYE 6/30/2020 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1081358 10000 -3598 0 13814 5992 1067954 1010118 40435 49560 0 12935 5820 1081358 749717 222211 55823 0 12611 5022 1010118 679386 4166 70450 0 0 4285 749717 682540 20500 -6944 0 12684 4026 679386 0.673 0.327 0.0 1 0 0 27160 27160 0 1825101 676306 1148795 0 0 0 0 0 218550 204170 14380 0 0 0 0 1190335 Beneficial Interest in Assets Held by Community Foundation 1067954 Cash Surrender Value of Life Insurance 25282 Long term Certificates of Deposit 273433 1366669 0 0 X 6327327 -35652 1263190 0 0 1227538 5099789 5992 0 5992 5105781 6295346 1263197 0 0 0 1263197 5032149 5992 0 5992 5038141 Schedule D, Part V, Line 4 CHFC Intends to use the earnings from the endowment funds for long term financial support of the clinic. Schedule D, Part X, Line 2 The organization is exempt from income taxes under section 501(c)(3) or the IRS tax code and a similar section of the IA Income tax law, which provides income tax exemption for corporations organized and operated exclusively for religious, charitable or educational purposes. The IRS has not classified the organization as a private foundation. The organization files information returns i the US Federal jurisdiction and follows the standard for evaluating uncertain tax positions. The organization has determined that it was not required to record a liablility related to uncertain tax postions. X 1 894 FMV X 240 4259849 FMV 0 0 1 0 Schedule M, Part I, Line 9 Sched M Part ! Line 9 is the # of donors in this category. Schedule M, Part I, Line 20 Schedule M Part 1 Line 20 is an estimate of the number of donors in this category. Form 990, Part VI, Section B, Line 11b The Federal Form 990 is prepared by the clinics Director of Finance and reviewed by the Board treasurer and a volunteer. The Federal form 990 is then marked draft and sent to the CHFC Board Members for review and approval (after any discussion or comments or necessary changes). The document is sent via email and all approvals are documented via email/ZOOM due to COVID. After all comments are addressed the Federal Form 990 is filed. Form 990, Part VI, Section B, Line 12c Upon first being elected to the Board of Directors, Appointed to a Board Committee or Elected as an Officer to the CHFC, The Board Member, Board Committee Member or Officer is required to complete the conflict of interest disclosures statement and submit the statement to the Board President. If the Board President has concerns about any statement, he/she shall submit the statement to the executive committee of the CHFC Board of Directors. Each statemtent shall be resubmitted with any necessary changes each year or as any additional conflicts or interest arise. Statements are retained by the executive director in CHFC offices. Form 990, Part VI, Section B, Line 15 In July of each year, the CEO/Clinic executive director drafts a list of annual goals & objectives and provides it to the President of the Board of Directors. The Board reviews the goals and objectives at the annual beginning of the fiscal year meeting in July. Any modifications suggested are incorparated as appropriate and the benchmark for the fiscal year is finalized in June (End of fiscal year). CEO provides the President of the BOD with a document that details his/her performance against annual goals & objectives against the annual goals approved the prior July. After a review with the CEO/Director the President of teh BOD assigns the performance review and overall grade of (A) fails to meet expectations, B Meets expectations or C exceeds expectations. During June and July the president of the BOD reviews comparable salaries and wage changes for the local area for the coming year and determines specific salary changes are appropriate based on performance for the year and budgetary constraints (normally stated as a %increase). The Board President seeks concurrence of the Executive Committee (independent of the CEO0 for the overall grade and suggested increase. The CEO/Directors overall grade and salary increase are voted on by the BOD. The specifics of the salary increase are not documented in the board meeting minutes to provide confidentiality. The Presidents communication with teh treasurer are sufficient documentation. Salary changes become effective the first day of the fiscal year . No other compensated individual meets the IRS definition of officer or key employee. Form 990, Part VI, Section C, Line 19 CHFC makes its governing documents, conflict of interest policy and financial statements available to the public upon request via both hard copy and/or electronic format.