2020-07-16T08:47:35-05:00 2019-06-30 390974031 WEGNER CPAS LLP 2921 LANDMARK PL STE 300 MADISON WI 537134236 990 2018-07-01 391370658 EPILEPSY FOUNDATION HEART OF WISCONSIN INC EPIL 6084425555 1310 MENDOTA ST NO 104 MADISON WI 53714 MICHAEL GOMOLL EXECUTIVE DIRECTOR 6084425555 2020-07-16 1 MIKE HABLEWITZ CPA P01259157 6082744020 66.222.124.178 2020-07-16 07:11:09 CD P E13E7DB5F4D638824F0D2C7B29E51EAEB0BA8C17 D3B6BAEB96C367CBE40ED6F3A4A6CFED3E2DFB98 2018 2021-01-29 14:40:06Z X MICHAEL GOMOLL 1310 MENDOTA ST NO 104 MADISON WI 53714 326786 0 X EPILEPSYWISCONSIN.ORG X 1980 WI THE EPILEPSY FOUNDATION HEART OF WISCONSIN LEADS THE FIGHT TO STOP SEIZURES, FIND A CURE AND OVERCOME CHALLENGES CREATED BY EPILEPSY. 13 13 11 20 0 0 282431 296246 5650 4061 1144 925 109865 9954 399090 311186 0 1200 0 0 200779 154086 0 0 58825 157645 211680 358424 366966 40666 -55780 206194 137842 26017 13445 180177 124397 X THE EPILEPSY FOUNDATION HEART OF WISCONSIN LEADS THE FIGHT TO STOP SEIZURES, FIND A CURE AND OVERCOME CHALLENGES CREATED BY EPILEPSY. 0 0 140668 1200 0 PUBLIC HEALTH EDUCATION - THE FOUNDATION CONDUCTED PUBLIC HEALTH EDUCATION, WHICH REACHED 1,350 SCHOOL-AGED CHILDREN. THE FOUNDATION CONDUCTED EMPLOYER TRAINING PROGRAMS FOR 147 PEOPLE. 120 SCHOOL NURSES RECEIVED AT LEAST ONE HOUR OF SEIZURE AWARENESS AND FIRST AID TRAINING AND 258 SCHOOL PERSONNEL RECEIVED 1 HOUR OF SEIZURE RECOGNITION AND FIRST AID TRAINING. DURING THE YEAR ENDED 6/30/19, 68 SENIOR DAY CARE STAFF RECEIVED SEIZURE RECOGNITION AND FIRST AID TRAINING. THE FOUNDATION CONDUCTED OTHER SEIZURE RECOGNITION AND FIRST AID PRESENTATIONS REACHING 2000 ADULTS. 20487 0 0 COMMUNITY SERVICES - THE FOUNDATION PARTICIPATED IN COUNTY DISABILITY COALITIONS, DEVELOPMENTAL DISABILITIES COUNCILS, STATEWIDE SURVIVAL COALITION AND UNITED WAY AGENCY EXECUTIVE GROUPS IN DANE COUNTY, ROCK COUNTY, GREEN COUNTY AND DODGE COUNTY WHICH BENEFIT PEOPLE AND FAMILIES WITH EPILEPSY OR THE DISABILITY COMMUNITY IN GENERAL. COMMUNITY SERVICE INCLUDES ADVOCACY ON BEHALF OF THE WIDER DISABILITY COMMUNITY AND THAT WORK IS ACCOMPLISHED THROUGH COLLABORATION WITH OTHER DISABILITY GROUPS AND HUMAN SERVICE PROVIDERS. 17980 0 0 CLIENT SERVICES - THE FOUNDATION SERVED 3,400 DIRECT CLIENTS DURING THE YEAR ENDED 6/30/19. DURING THE YEAR, THE FOUNDATION SPONSORED 10 EDUCATIONAL DINNER MEETINGS THROUGHOUT THE SERVICE AREA WHICH WERE ATTENDED BY 325 CLIENTS. THE FOUNDATION SERVED 1,500 CLIENTS THROUGH SUPPORT GROUPS DURING THE YEAR. IN SEPTEMBER AND OCTOBER, 2018, THE FOUNDATION CONDUCTED STUDIO E, A SIX-WEEK ART THERAPY PROGRAM, FOR 14 ADULTS WITH EPILEPSY. THE FOUNDATION CONDUCTED A WEEK-LONG RESIDENTIAL SUMMER CAMP FOR KIDS AND HAD 18 CHILDREN FROM OUR SERVICE AREA ATTEND, AN ADULT RETREAT WITH 48 ATTENDEES FROM OUR AREA, AND A DAY OF PROGRAMMING FOR BROTHERS AND SISTERS OF KIDS WITH DISABILITIES, WITH 20 IN ATTENDANCE. 88 PARENTS ATTENDED 3 PARENT AND CAREGIVER EDUCATION PROGRAMS AND 80 FAMILIES PARTICIPATED IN FAMILIAS UNIDOS CON NINOS CON NECESSIDADES ESPECIALIES INCLUDING MONTHLY SUPPORT GROUP MEETINGS. 10713 0 4061 EDUCATION AND TRAINING - DURING THE YEAR ENDED 6/30/19, THE FOUNDATION CONDUCTED THE ADVANCES IN EPILEPSY TREATMENT CONFERENCE ON THE CAMPUS OF THE MARSHFIELD CLINIC ATTENDED BY 90 PEOPLE. IN MARCH OF 2019 TWO STAFF ATTENDED A CDC SKILL BUILDING TRAINING CONFERENCE IN BOULDER CO (REMOTELY). 10713 0 4061 189848 1 1 0 0 0 0 0 0 0 0 1 0 0 0 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 0 0 1 6 0 11 1 0 0 0 0 0 1 1 0 0 0 0 0 0 X 13 13 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 WI X ALEX MOSKOFF 6083472830 1273 SCENIC RIDGE DR VERONA WI 53593 JOSEPH JARES MD CHAIR 1.00 X X 0 0 0 JULIE MARIE VICE CHAIR 1.00 X X 0 0 0 CAROL MANCL SECRETARY 1.00 X X 0 0 0 JIM FERK TREASURER 1.00 X X 0 0 0 TOM MCCARRIER BOARD LIASON 1.00 X 0 0 0 PATRICK MARCELL DIRECTOR 1.00 X 0 0 0 STUART WALTONEN PHD DIRECTOR 1.00 X 0 0 0 LESLIE SULLIVAN DIRECTOR 1.00 X 0 0 0 SALLY KLAPPER-RANDA DIRECTOR 1.00 X 0 0 0 MARTY MULLEN DIRECTOR 1.00 X 0 0 0 JENNIFER BENISHEK DIRECTOR 1.00 X 0 0 0 SHELLEEN SCHMOLL DIRECTOR 1.00 X 0 0 0 LUANNE MALSIN DIRECTOR 1.00 X 0 0 0 DENNIS PERKINS EXECUTIVE DIRECTOR (THRU APRIL) 40.00 X 43350 0 0 MICHAEL GOMOLL EXECUTIVE DIRECTOR (BEG APRIL) 40.00 X 35856 0 0 79206 0 0 0 0 0 0 0 54105 88747 102029 51365 2160 296246 EDUCATION CONFERENCE 616000 4061 4061 4061 925 925 21693 88747 15600 6093 6093 3861 3861 3861 311186 4061 0 10879 1200 1200 29636 14818 7409 7409 113441 56721 28360 28360 10 5 2 3 10999 5500 2750 2749 7577 7577 11900 11900 601 601 17702 5806 9498 2398 689 689 22907 11453 5727 5727 9896 5703 2097 2096 44155 44155 27 13 7 7 5426 2713 1356 1357 7912 3956 1978 1978 BAD DEBT EXPENSE 45391 45391 DUES AND SUBSCRIPTIONS 13369 12283 543 543 NEWSLETTER/PUBLICATIONS 2938 2938 21190 9995 5598 5597 366966 189848 118293 58825 45076 7490 90725 91629 59563 23203 1188 1188 1029 9097 127581 122346 8613 5235 206194 137842 26017 13445 26017 13445 X 180177 124397 180177 124397 206194 137842 -55780 0 X 0 0 0 X 267918 294348 257500 282431 296246 1398443 267918 294348 257500 282431 296246 1398443 5876 1392567 120 148 259 826 925 2278 9070 1000 10070 1410791 29615 0.98710 0.99100 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: MISCELLANEOUS INCOME - 2015 AMOUNT: $ 9,070. 2017 AMOUNT: $ 1,000. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 127581 122346 5235 5235 CHOCOLATE DECADENCE 21311 17049 4262 1470 LEMONADE FOR LIVY 20732 16586 4146 6 64665 51732 12933 1522 617 495 2195 5999 106708 85367 21341 1522 617 1965 2195 5999 12298 9043 FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 WAS PREPARED BY THE OUTSIDE ACCOUNTANTS AND REVIEWED BY THE AUDIT COMMITTEE AND THE BOARD CHAIR. THE ENTIRE BOARD RECEIVED A COPY OF THE FORM 990 PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION'S CONFLICT OF INTEREST POLICY STATES THAT NO MEMBER OF THE BOARD OF DIRECTORS OR THEIR IMMEDIATE FAMILY MAY ENGAGE IN BUSINESS TRANSACTIONS WITH THE EPILEPSY FOUNDATION HEART OF WISCONSIN FOR PROFIT, THAT PAID MEMBERS OF THE EPILEPSY FOUNDATION HEART OF WISCONSIN'S STAFF MAY NOT SERVE ON THE BOARD OF DIRECTORS, AND THAT MEMBERS OF THE BOARD OF DIRECTORS RECEIVE NO COMPENSATION, EXCEPT FOR REIMBURSEMENT OF EXPENSES INCURRED ON BOARD OF DIRECTOR BUSINESS. THE POLICY IS ANNUALLY REVIEWED AT THE FIRST MEETING OF THE YEAR IF A CONFLICT OF INTEREST ARISES, THE CONFLICTED BOARD MEMBER IS ASKED TO RESIGN FROM HIS/HER POSITION. FORM 990, PART VI, SECTION B, LINE 15A IN DETERMINING THE COMPENSATION OF THE EXECUTIVE DIRECTOR, THE ORGANIZATION PARTICIPATES IN A UNITED WAY WAGE AND BENEFITS SURVEY OF DANE COUNTY NONPROFIT ORGANIZATIONS. IT ALSO USES OTHER COMPARATIVE DATA THAT MAY BE AVAILABLE THROUGH THE NATIONAL OFFICE OR THE ASSOCIATION OF FUNDRAISING PROFESSIONALS. THE GOVERNANCE COMMITTEE CONDUCTS THIS REVIEW ANNUALLY AND RECOMMENDS TO THE BOARD OF DIRECTORS CHANGES OR INCREASES TO THE EXECUTIVE DIRECTOR'S COMPENSATION. THE GOVERNANCE COMMITTEE MEMBERS DECIDE ON AN EVALUATION FORM AND CONTACT INDIVIDUAL BOARD MEMBERS TO COLLECT EVERYONE'S EVALUATION. THESE ARE COMPILED INTO AN EVALUATION DOCUMENT FOR PRESENTATION TO THE EXECUTIVE DIRECTOR AND INCLUSION INTO HIS EMPLOYMENT FILE. THE BOARD'S RECOMMENDATION FOR SALARY ADJUSTMENTS IS MADE IN THIS DOCUMENT AND AGREED TO BY THE EXECUTIVE DIRECTOR AT A REGULARLY SCHEDULED BOARD MEETING. THE BOARD MAY GO INTO EXECUTIVE SESSION BRIEFLY TO MAKE ANY NECESSARY DELIBERATIONS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.