PATIENT ASSISTANCE FOUNDATION: Form 990, tax year 2020

View the entire original 990 at ProPublica ↗

Organization
PATIENT ASSISTANCE FOUNDATION (EIN 94-2944137)
Tax period
2020-01-01 to 2020-12-31
Filed
2021-10-10
IRS object ID
202122839349300107
Schema version
2020v4.1
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 ReturnHeader

FieldValueIRS element (for citing)
Return2021-10-10T20:23:23-05:00ReturnTs
Tax Period End2020-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN390859910PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1BAKER TILLY US LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1135 MAIN STREET 9TH FLOORAddressLine1Txt
CitySAN FRANCISCOCityNm
State AbbreviationCAStateAbbreviationCd
ZIP94105ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2020-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN942944137EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1PATIENT ASSISTANCE FOUNDATIONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlPATIBusinessNameControlTxt
Phone4159233155PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line12100 WEBSTER STREET SUITE 100AddressLine1Txt
CitySAN FRANCISCOCityNm
State AbbreviationCAStateAbbreviationCd
ZIP94115ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonSCOTT PLYMALE LCSWPersonNm
Person TitleEXECUTIVE DIRECTORPersonTitleTxt
Phone4159233155PhoneNum
Signature2021-09-29SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstSCOTTPersonFirstNm
Person LastPLYMALE LCSWPersonLastNm
FieldValueIRS element (for citing)
SSNXXX-XX-XXXXSSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonJOUA LOPreparerPersonNm
PTINP01225144PTIN
Phone4157812500PhoneNum
Preparation2021-09-29PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer3TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2020TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1COMMUNITY HEALTH RESOURCE CENTERBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerSCOTT PLYMALEPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line12100 WEBSTER STREET SUITE 100AddressLine1Txt
CitySAN FRANCISCOCityNm
State AbbreviationCAStateAbbreviationCd
ZIP94115ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$1,059,444GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressCHRCSF.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1984FormationYr
Legal Domicile StateCALegalDomicileStateCd
Activity Or MissionTO PROVIDE AND PROMOTE INNOVATIVE HEALTH CARE AND HEALTH MAINTENANCE PROGRAMS TO THE GREATER BAY AREA AS WELL AS PATIENTS SERVED BY CPMC. CHRC PROVIDES COUNSELING, EDUCATION AND COORDINATION OF MULTIPLE PATIENT SERVICES TO SUPPLEMENT THE CARE AND SUPPORT PROVIDED BY PHYSICIANS.ActivityOrMissionDesc
Voting Members Governing Body14VotingMembersGoverningBodyCnt
Voting Members Independent14VotingMembersIndependentCnt
Total Employee14TotalEmployeeCnt
Total Volunteers14TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$323,723PYContributionsGrantsAmt
CY Contributions Grants$286,291CYContributionsGrantsAmt
PY Program Service Revenue$422,359PYProgramServiceRevenueAmt
CY Program Service Revenue$456,357CYProgramServiceRevenueAmt
PY Investment Income$33,315PYInvestmentIncomeAmt
CY Investment Income$66,089CYInvestmentIncomeAmt
PY Other Revenue$16,410PYOtherRevenueAmt
CY Other Revenue$19,064CYOtherRevenueAmt
PY Total Revenue$795,807PYTotalRevenueAmt
CY Total Revenue$827,801CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$802,257PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$946,291CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$51,142CYTotalFundraisingExpenseAmt
PY Other Expenses$361,810PYOtherExpensesAmt
CY Other Expenses$270,109CYOtherExpensesAmt
PY Total Expenses$1,164,067PYTotalExpensesAmt
CY Total Expenses$1,216,400CYTotalExpensesAmt
PY Revenues Less Expenses-$368,260PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$388,599CYRevenuesLessExpensesAmt
Total Assets BOY$3,237,934TotalAssetsBOYAmt
Total Assets EOY$3,141,067TotalAssetsEOYAmt
Total Liabilities BOY$73,583TotalLiabilitiesBOYAmt
Total Liabilities EOY$229,548TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$3,164,351NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$2,911,519NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTO PROVIDE AND PROMOTE INNOVATIVE HEALTH CARE AND HEALTH MAINTENANCE PROGRAMS TO THE GREATER BAY AREA AS WELL AS PATIENTS SERVED BY CPMC. CHRC PROVIDES COUNSELING, EDUCATION AND COORDINATION OF MULTIPLE PATIENT SERVICES TO SUPPLEMENT THE CARE AND SUPPORT PROVIDED BY PHYSICIANS.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$528,520ExpenseAmt
Revenue$453,494RevenueAmt
DescBEHAVIORAL/MENTAL HEALTH SERVICES AND NUTRITION COUNSELING -- THE ORGANIZATION HAS A TEAM OF LICENSED PROFESSIONALS OFFERING SUPPORT FOR INDIVIDUALS, GROUPS AND FAMILIES LOOKING FOR EMOTIONAL OR PRACTICAL GUIDANCE AND SUPPORT. LIKEWISE, THE ORGANIZATION HAS A TEAM OF REGISTERED DIETITIANS THAT PROVIDES NUTRITION COUNSELING SERVICES. THE ORGANIZATION'S NUTRITION SERVICES PROVIDE EDUCATION AND INSTRUCTION TO HELP SUPPORT ONE'S INDIVIDUAL VARIETY OF CONDITIONS, CONCERNS, GOALS AND LIFE STAGES.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$447,884ExpenseAmt
Revenue$2,310RevenueAmt
DescHEALTH EDUCATION -- THE ORGANIZATION OFFERS MONTHLY WELLNESS EVENTS THAT INCLUDE HEALTH SCREENINGS, COMMUNITY EDUCATION LECTURES AND EMPLOYEE WELLNESS PRESENTATIONS.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$84,794ExpenseAmt
Revenue$553RevenueAmt
DescHEALTH SCREENINGS -- THE ORGANIZATION PROVIDES BOTH GRANT-FUNDED AND CONTRACTED HEALTH SCREENING SERVICES AT EMPLOYEE HEALTH AFFAIRS, WELLNESS EVENTS, SCHOOLS AND COMMUNITY CENTERS. THE HEALTH SCREENING SERVICES, WHICH INCLUDE CHOLESTEROL, BLOOD GLUCOSE, BLOOD PRESSURE, BODY MASS INDEX, BONE DENSITY AND MEMORY SCREENS, ARE CONDUCTED BY REGISTERED NURSES.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$1,061,198TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi EndowmentsYes (1)DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other SecYes (1)ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related Entity0RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document10IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee14EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members14GoverningBodyVotingMembersCnt
Independent Voting Member14IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldCAStatesWhereCopyOfReturnIsFldCd
Other WebsiteYes (X)OtherWebsiteInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1HALL TAI & ASSOCIATESBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone4155645183PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11156 CLEMENT STREETAddressLine1Txt
CitySAN FRANCISCOCityNm
State AbbreviationCAStateAbbreviationCd
ZIP94118ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (15 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
MARILYN KUTZSCHER MD
PRESIDENT2.00Yes (X)Yes (X)$0$0$0
FRANK HUANG
TREASURER - SECRETARY2.00Yes (X)Yes (X)$0$0$0
ARI BARON MD
DIRECTOR2.00Yes (X)$0$0$0
PETER CALLANDER
DIRECTOR2.00Yes (X)$0$0$0
SHELLY GORDON MD
DIRECTOR - ADVISORY BOARD2.00Yes (X)$0$0$0
BARRY BARON MD
DIRECTOR2.00Yes (X)$0$0$0
JOAN DEHOVITZ BRAUN
DIRECTOR2.00Yes (X)$0$0$0
HOLLY HOLTER MD
DIRECTOR2.00Yes (X)$0$0$0
NAVEEN SRIVATSA
DIRECTOR2.00Yes (X)$0$0$0
DAVID TONG MD
DIRECTOR2.00Yes (X)$0$0$0
RUSSELL WOO MD
DIRECTOR2.00Yes (X)$0$0$0
BROCK BERNSTEN MD
DIRECTOR - ADVISORY BOARD2.00Yes (X)$0$0$0
CHARLES SELLMAN
DIRECTOR2.00Yes (X)$0$0$0
MARCY NATHAN
DIRECTOR2.00Yes (X)$0$0$0
SCOTT PLYMALE LCSW
EXECUTIVE DIRECTOR40.00Yes (X)$144,355$0$7,800
FieldValueIRS element (for citing)
Total Reportable Comp From Org$144,355TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$7,800TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K1IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
All Other Contributions$286,291AllOtherContributionsAmt
Total Contributions$286,291TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescPROGRAMDesc
Business900099BusinessCd
Total Revenue Column$456,357TotalRevenueColumnAmt
Related Or Exempt Func Income$456,357RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$456,357TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$28,674TotalRevenueColumnAmt
Exclusion$28,674ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$12,000RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$0RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$12,000RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$12,000TotalRevenueColumnAmt
Exclusion$12,000ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$269,058SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$231,643SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$37,415SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$37,415TotalRevenueColumnAmt
Exclusion$37,415ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescOTHER INCOMEDesc
Business900099BusinessCd
Total Revenue Column$7,064TotalRevenueColumnAmt
Exclusion$7,064ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$7,064OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$827,801TotalRevenueColumnAmt
Related Or Exempt Func Income$456,357RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$85,153ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$152,155TotalAmt
Program Services$152,155ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$602,949TotalAmt
Program Services$531,829ProgramServicesAmt
Management And General$35,409ManagementAndGeneralAmt
Fundraising$35,711FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$19,788TotalAmt
Program Services$17,923ProgramServicesAmt
Management And General$929ManagementAndGeneralAmt
Fundraising$936FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$104,205TotalAmt
Program Services$94,358ProgramServicesAmt
Management And General$4,896ManagementAndGeneralAmt
Fundraising$4,951FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$67,194TotalAmt
Program Services$60,855ProgramServicesAmt
Management And General$3,155ManagementAndGeneralAmt
Fundraising$3,184FundraisingAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$47,195TotalAmt
Management And General$47,195ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$23,413TotalAmt
Program Services$20,888ProgramServicesAmt
Management And General$2,525ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$495TotalAmt
Program Services$473ProgramServicesAmt
Management And General$11ManagementAndGeneralAmt
Fundraising$11FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$19,388TotalAmt
Program Services$10,203ProgramServicesAmt
Management And General$4,280ManagementAndGeneralAmt
Fundraising$4,905FundraisingAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$6,925TotalAmt
Program Services$6,608ProgramServicesAmt
Management And General$158ManagementAndGeneralAmt
Fundraising$159FundraisingAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$148,393TotalAmt
Program Services$141,593ProgramServicesAmt
Management And General$3,389ManagementAndGeneralAmt
Fundraising$3,411FundraisingAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$7,939TotalAmt
Program Services$7,573ProgramServicesAmt
Management And General$182ManagementAndGeneralAmt
Fundraising$184FundraisingAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$6,612TotalAmt
Program Services$4,879ProgramServicesAmt
Management And General$1,615ManagementAndGeneralAmt
Fundraising$118FundraisingAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
EQUIPMENT RENTAL, MAINT$11,250$10,729$258$263
STAFF DEVELOPMENT$1,249$1,132$58$59
MISCELLANEOUS-$2,750-$2,750

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$1,216,400TotalAmt
Program Services$1,061,198ProgramServicesAmt
Management And General$104,060ManagementAndGeneralAmt
Fundraising$51,142FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
EOY$210,624EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$49,801BOYAmt
EOY$31,342EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$1,638,933BOYAmt
EOY$1,301,632EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$28,877BOYAmt
EOY$44,300EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$14,006BOYAmt
EOY$11,045EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$82,115LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$68,892LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$21,162BOYAmt
EOY$13,223EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$1,478,941BOYAmt
EOY$1,522,687EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$6,214BOYAmt
EOY$6,214EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$3,237,934BOYAmt
EOY$3,141,067EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$73,583BOYAmt
EOY$105,265EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$124,283EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$73,583BOYAmt
EOY$229,548EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,525,418BOYAmt
EOY$1,609,887EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,638,933BOYAmt
EOY$1,301,632EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$3,164,351BOYAmt
EOY$2,911,519EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$3,237,934BOYAmt
EOY$3,141,067EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$388,599ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$135,767NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS Audited0FSAuditedInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Public Organization170Yes (X)PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$393,141CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$389,771CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$365,307CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$323,723CurrentTaxYearMinus1YearAmt
Current Tax Year$286,291CurrentTaxYearAmt
Total$1,758,233TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$393,141CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$389,771CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$365,307CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$323,723CurrentTaxYearMinus1YearAmt
Current Tax Year$286,291CurrentTaxYearAmt
Total$1,758,233TotalAmt
FieldValueIRS element (for citing)
Substantial Contributors Tot$229,935SubstantialContributorsTotAmt
Public Support Total170$1,528,298PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$28,829CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$23,659CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$41,094CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$46,724CurrentTaxYearMinus1YearAmt
Current Tax Year$40,674CurrentTaxYearAmt
Total$180,980TotalAmt

Other Income170 OtherIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$13,543CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$16,989CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,242CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$210CurrentTaxYearMinus1YearAmt
Current Tax Year$7,064CurrentTaxYearAmt
Total$39,048TotalAmt
FieldValueIRS element (for citing)
Total Support$1,978,261TotalSupportAmt
Gross Receipts Rltd Activities$1,849,299GrossReceiptsRltdActivitiesAmt
Public Support CY1700.77250PublicSupportCY170Pct
Public Support PY1700.84070PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME:FormAndLineReferenceDesc
ExplanationOTHER INCOME - 2016 AMOUNT: $ 13,543. 2017 AMOUNT: $ 16,989. 2018 AMOUNT: $ 1,242. 2019 AMOUNT: $ 210. 2020 AMOUNT: $ 7,064.ExplanationTxt

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,638,933BeginningYearBalanceAmt
Other Expenditures$337,301OtherExpendituresAmt
End Year Balance$1,301,632EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,912,779BeginningYearBalanceAmt
Contributions$257,939ContributionsAmt
Other Expenditures$531,785OtherExpendituresAmt
End Year Balance$1,638,933EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$2,207,609BeginningYearBalanceAmt
Contributions$284,670ContributionsAmt
Other Expenditures$579,500OtherExpendituresAmt
End Year Balance$1,912,779EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$2,440,683BeginningYearBalanceAmt
Contributions$328,926ContributionsAmt
Other Expenditures$562,000OtherExpendituresAmt
End Year Balance$2,207,609EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$2,656,802BeginningYearBalanceAmt
Contributions$357,781ContributionsAmt
Other Expenditures$573,900OtherExpendituresAmt
End Year Balance$2,440,683EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.00000BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY0.00000PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY1.00000TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org0EndowmentsHeldRelatedOrgInd

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$60,016OtherCostOrOtherBasisAmt
Depreciation$46,793DepreciationAmt
Book Value$13,223BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$22,099OtherCostOrOtherBasisAmt
Depreciation$22,099DepreciationAmt
Book Value$0BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$13,223TotalBookValueLandBuildingsAmt

Other Securities OtherSecuritiesGrp

FieldValueIRS element (for citing)
DescINVESTMENTS - MARKETABLE SECURITIESDesc
Book Value$1,522,687BookValueAmt
Method ValuationFMethodValuationCd
FieldValueIRS element (for citing)
Total Book Value Securities$1,522,687TotalBookValueSecuritiesAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescPPP LOAN PAYABLEDesc
Amt$124,283Amt
FieldValueIRS element (for citing)
Total Liability$124,283TotalLiabilityAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART V, LINE 4:FormAndLineReferenceDesc
ExplanationTEMPORARILY RESTRICTED NET ASSET IS USED TO ACCOUNT FOR RESOURCES THAT ARE RESTRICTED BY THE DONOR FOR USE FOR PARTICULAR PURPOSE OR IN A PARTICULAR FUTURE PERIOD. WHEN A RESTRICTION EXPIRES, TEMPORARILY RESTRICED NET ASSETS ARE RECLASSIFIED TO UNRESTRICTED NET ASSETS AND REPORTED IN THE STATEMENT OF ACTIVITIES AS "NET ASSETS RELEASED FROM RESTRICTIONS.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp

FieldValueIRS element (for citing)
PersonSCOTT PLYMALE LCSWPersonNm
TitleEXECUTIVE DIRECTORTitleTxt
Base Compensation Filing Org$144,355BaseCompensationFilingOrgAmt
Compensation Based On Rltd Orgs$0CompensationBasedOnRltdOrgsAmt
Bonus Filing Organization$0BonusFilingOrganizationAmount
Bonus Related Organizations$0BonusRelatedOrganizationsAmt
Other Compensation Filing Org$0OtherCompensationFilingOrgAmt
Other Compensation Rltd Orgs$0OtherCompensationRltdOrgsAmt
Deferred Compensation Flng Org$7,800DeferredCompensationFlngOrgAmt
Deferred Comp Rltd Orgs$0DeferredCompRltdOrgsAmt
Nontaxable Benefits Filing Org$0NontaxableBenefitsFilingOrgAmt
Nontaxable Benefits Rltd Orgs$0NontaxableBenefitsRltdOrgsAmt
Total Compensation Filing Org$152,155TotalCompensationFilingOrgAmt
Total Compensation Rltd Orgs$0TotalCompensationRltdOrgsAmt
Comp Report Prior990 Filing Org$0CompReportPrior990FilingOrgAmt
Comp Report Prior990 Rltd Orgs$0CompReportPrior990RltdOrgsAmt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11BELECTRONIC COPY OF 990 IS DISTRIBUTED TO EACH BOARD MEMBER FOR REVIEW PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12CTHE CONFLICT OF INTEREST IS REVIEWED BY EACH OFFICER, DIRECTOR, OR KEY EMPLOYEE AT THE BEGINNING OF EACH MEETING.
FORM 990, PART VI, SECTION B, LINE 15THE EXECUTIVE DIRECTOR'S COMPENSATION IS APPROVED BY THE BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION C, LINE 19DOCUMENTS ARE AVAILABLE UPON REQUEST.

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