2019-11-12T13:25:24-06:00 2018-12-31 043037870 BOLLUS LYNCH LLP 89 SHREWSBURY STREET WORCESTER MA 01604 990 2018-01-01 042633274 THE HEALTH FOUNDATION OF CENTRAL MASSACHUSETTS INC HEAL 5084380009 446 MAIN STREET 20TH FLOOR WORCESTER MA 01608 JANICE B YOST EDD PRESIDENT AND CEO 5084380009 2019-11-07 1 DAVID G EATON CPA P00545132 5087557107 2019-11-07 71.11.10.178 2019-11-07 13:26:46 ES P 954A65DB1995863A37271E4766999F33303993D7 954A65DB1995863A37271E4766999F33303993D7 2018 2020-01-14 16:20:31Z JANICE B YOST EDD 446 MAIN STREET 20TH FLOOR WORCESTER MA 01608 16154834 0 X HFCM.ORG X 1977 MA TO IMPROVE THE HEALTH STATUS OF THOSE WHO LIVE OR WORK IN CENTRAL MASSACHUSETTS. 11 11 5 0 14223 18323 0 0 0 0 2674628 4913834 289899 223819 2964527 5137653 2515119 2452443 0 0 817051 774877 0 0 0 967705 1042911 4299875 4270231 -1335348 867422 74982929 69576032 562693 693875 74420236 68882157 TO IMPROVE THE HEALTH STATUS OF THOSE WHO LIVE OR WORK IN CENTRAL MASSACHUSETTS. 0 0 3164824 2452443 223819 TO PROVIDE FUNDING TO NON-PROFIT ORGANIZATIONS FOR THE PURPOSE OF IMPROVING THE HEALTH OF THOSE WHO LIVE AND WORK IN CENTRAL MASSACHUSETTS. 3164824 0 0 0 0 0 0 0 0 1 1 1 0 0 1 1 0 1 0 0 1 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 0 0 1 5 0 1 5 1 1 1 0 0 0 0 0 0 0 0 0 X 11 11 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 MA X X THE HEALTH FOUNDATION OF CENTRAL MASSACHUSETTS INC 5084380009 446 MAIN STREET 20TH FLOOR WORCESTER MA 01608 FRANCIS M SABA MHSA CHAIR 2.00 X X 0 0 0 ANN K TRIPP MBA TREASURER 2.00 X X 0 0 0 JENNIFER J HYLTON PSYD DIRECTOR 1.50 X 0 0 0 JEAN G MCMURRAY DIRECTOR 1.50 X 0 0 0 GISELA VELEZ MD DIRECTOR 1.50 X 0 0 0 BARENT W WALSH PHD SECRETARY 2.00 X X 0 0 0 JUDGE TIMOTHY M BIBAUD DIRECTOR 1.50 X 0 0 0 ANTHONY EMERSON DBA DIRECTOR 1.50 X 0 0 0 RANDALL BECKER CPA MBA DIRECTOR 1.50 X 0 0 0 DENNIS M DIMITRI MD DIRECTOR 1.50 X 0 0 0 SEJAL M DAGA MD DIRECTOR 1.50 X 0 0 0 JANICE B YOST EDD PRESIDENT/ CEO 37.50 X 264513 0 24540 MICHELLE L EWING CONTROLLER 37.50 X 83618 0 23735 AMIE SHEI VICE PRESIDENT OF PROGRAMS 37.50 X 139900 0 26115 488031 0 74390 2 0 1 0 0 766510 766510 15150282 14223 11017181 0 4133101 14223 4147324 14223 4133101 OTHER INCOME 900099 223819 223819 223819 5137653 223819 14223 4899611 2452443 2452443 264513 203781 60732 365809 244902 120907 24034 18516 5518 80621 59888 20733 39900 30739 9161 5757 5757 21500 21500 706457 706457 7000 7000 18966 11380 7586 80141 48085 32056 13265 7959 5306 20714 12428 8286 8050 4830 3220 TAXES-OTHER 84033 84033 GRANT RELATED EXPENSES 46801 46801 OUTSIDE SERVICES 21703 13022 8681 PUBLICATIONS AND SPECIA 5084 3050 2034 3440 3440 4270231 3164824 1105407 0 68936 115170 192967 238581 6751 6954 257404 226125 51993 31279 40502410 34835396 33776259 33981143 288607 264280 95006 103229 74982929 69576032 114675 113744 354757 476902 93261 103229 562693 693875 X 74420236 68882157 74420236 68882157 74982929 69576032 867422 -6405501 0 X 0 1 X 1 0 74148249 -2080633 2496564 631946 255433 68683673 66533319 10765544 2515119 431951 203544 74148249 66860403 3646956 2427556 1386610 159874 66533319 70411576 -153424 2610862 624178 162709 66860403 70492197 3488570 2593569 811358 164264 70411576 0 0 257404 226125 31279 31279 INVESTMENT LIMITED PARTNERSHIPS 33981143 F 33981143 DEFERRED COMPENSATION PLAN 103229 103229 X -2022224 -6405501 -6405501 4383277 754376 754376 5137653 3515855 0 3515855 754376 754376 4270231 PART X, LINE 2: THE HEALTH FOUNDATION OF CENTRAL MASSACHUSETTS, INC. QUALIFIES AS A TAX-EXEMPT ORGANIZATION UNDER SECTION 501(C)(4) OF THE INTERNAL REVENUE CODE (IRC). THE AFFILIATE IS EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE IRC. ACCORDINGLY, NO PROVISION FOR FEDERAL INCOME TAX IS REQUIRED,THOUGH IT WOULD BE SUBJECT TO TAX ON INCOME UNRELATED TO ITS TAX EXEMPT PURPOSE (UNLESS THAT INCOME IS OTHERWISE EXCLUDED BY THE IRC). MANAGEMENT ANNUALLY REVIEWS FOR UNCERTAIN TAX POSITIONS ALONG WITH ANY RELATED INTEREST AND PENALTIES AND BELIEVES THAT THE FOUNDATION AND THE AFFILIATE HAVE NO UNCERTAIN TAX POSITIONS THAT WOULD HAVE A MATERIAL ADVERSE EFFECT, INDIVIDUALLY OR IN THE AGGREGATE UPON THE COMBINED STATEMENTS OF FINANCIAL POSITION, OR THE RELATED COMBINED STATEMENTS OF ACTIVITIES, OR CASH FLOWS. BOTH THE FOUNDATION AND THE AFFILIATE FILE INCOME TAX RETURNS IN THE U.S. FEDERAL JURISDICTION. 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 FORM 990, SCHEDULE F, PAGE IV, QUESTION 1 THE FORM 926 WAS NOT ATTACHED, AS THE MONETARY TRANSACTIONS DO NOT MEET THE FILING REQUIREMENT THRESHOLD. 1 ATHOL AREA YMCA 545 MAIN STREET ATHOL MA 01331 022103727 501(C)(3) 68000 BOOK MEN'S RESIDENCE RENOVATION WORCESTER PUBLIC SCHOOLS 20 IRVING ST WORCESTER MA 01609 048001418 501(C)(3) 419631 BOOK WORCESTER HEARS NEADS WORLD CLASS SERVICE DOGS 305 REDEMPTION ROCK TRAIL PRINCETON MA 01541 237281887 501(C)(3) 60544 BOOK HANDICAP ACCESSIBLE VAN GENESIS CLUB INC 274 LINCOLN STREET WORCESTER MA 01605 042983234 501(C)(3) 50000 BOOK PSYCHIATRIC OUTREACH SERVICE AND TRAINING COLLABORATION CATHOLIC CHARITIES DIOCESE OF WORCESTER COUNTY 10 HAMMOND STREET WORCESTER MA 01610 042103979 501(C)(3) 75000 BOOK THE LEOMINSTER WOMEN'S PROGRAM COMMUNITY HEALTH CONNECTIONS 326 NICHOLS ROAD FITCHBURG MA 01420 043452697 501(C)(3) 100000 BOOK IMPROVING DENTAL CARE WORLD FARMERS 769 MAIN STREET BOX 112 LANCASTER MA 01523 273138588 501(C)(3) 99805 BOOK AFRICAN CORN MILLING HEYWOOD HOSPITAL 242 GREEN STREET GARDNER MA 01440 042103581 501(C)(3) 5000 BOOK MULTICULTURAL TASK FORCE THE SHINE INITIATIVE 9 LEOMINSTER CONNECTOR LEOMINSTER MA 01453 043537449 501(C)(3) 57000 BOOK APPLYING TECHNOLOGY TO PROMOTE MENTAL HEALTH EDUCATION COMMUNITY HEALTHLINK 72 JAQUES AVENUE WORCESTER MA 01610 042626179 501(C)(3) 65000 BOOK BEHAVIORAL HEALTH & SUBSTANCE USE DISORDER SOUTHBRIDGE PUBLIC SCHOOLS 25 COLE AVENUE SOUTHBRIDGE MA 01550 046001306 501(C)(3) 100000 BOOK BUILDING PBIS INTERNAL CAPACITY IN SOUTHBRIDGE PUBLIC SCHOOLS YWCA OF CENTRAL MASSACHUSETTS 1 SALEM SQUARE WORCESTER MA 01608 042105873 501(C)(3) 95000 BOOK CHILDCARE FACILITIES WORCESTER COUNTY FOOD BANK 474 BOSTON TURNPIKE SHREWSBURY MA 01545 043071457 501(C)(3) 573333 BOOK FOOD HUB QUABOAG VALLEY COMMUNITY DEVELOPMENT 23 WEST MAIN STREET 1 WARE MA 01082 043370097 501(C)(3) 37500 BOOK CLAYWORKS AND ARTWORKS PROJECT RIVERSIDE COMMUNITY CARE 206 MILFORD STREET UPTON MA 01568 043097170 501(C)(3) 100000 BOOK CAPACITY BUILDING AND INTEGRATION FOR CHILDREN'S BEHAVIORAL HEALTHCARE HABITAT FOR HUMANITY METRO WESTGREATER WORCESTER 640 LINCOLN STREET WORCESTER MA 01605 222583590 501(C)(3) 30000 BOOK HOME REPAIR TOOL TRUCK JERAMIAH'S INN 1059 MAIN STREET WORCESTER MA 01603 222567030 501(C)(3) 100000 BOOK JERAMIAH'S INN SOBER HOUSING EMPLOYMENT OPTIONS 82 BRIGHAM STREET MARLBOROUGH MA 01752 237089596 501(C)(3) 30000 BOOK CATERING OPTIONS/COOKING UP A CAREER FITCHBURG STATE UNIVERSITY 160 PEARL STREET FITCHBURG MA 01420 046002284 501(C)(3) 341950 BOOK SYNERGY INITIATIVE HEALTH CARE FOR ALL 1 FEDERAL STREET BOSTON MA 02110 043071598 501(C)(3) 35000 BOOK HEALTH CARE FOR ALL HEALTH FOUNDATION FUND 446 MAIN STREET 20TH FL WORCESTER MA 01608 043521743 501(C)(3) 9680 BOOK LIFE INSURANCE PART I, LINE 2: THE HEALTH FOUNDATION AND THE GRANTEE SIGN A CONTRACT OUTLINING THE DELIVERABLES, PAYMENT, AND REPORTING REQUIREMENTS FOR THE PROJECT. TYPICALLY, PROJECT PROCESS EVALUATION REPORTS ARE SUBMITTED TO THE FOUNDATION MIDWAY THROUGH THE CONTRACT YEAR. A PROJECT SUMMARY REPORT IS ALSO REQUIRED TO BE SUBMITTED TO THE FOUNDATION APPROXIMATELY TWO MONTHS AFTER THE CONTRACT END DATE, OUTLINING THE RESULTS AND EXPENSES. IN ADDITION, MULTI-YEAR GRANTEES ARE REQUIRED TO MEET WITH FOUNDATION STAFF ON A QUARTERLY BASIS TO ASSESS PROJECT PROGRESS. THE ACTIVATION FUND GRANTEES ARE REQUIRED TO MEET WITH THE FOUNDATION STAFF ONCE DURING THE GRANT CONTRACT. X 1 1 X X X 0 1 0 0 0 0 0 0 0 JANICE B YOST EDD PRESIDENT/ CEO 232112 0 0 0 32401 0 9343 0 15197 0 289053 0 0 0 AMIE SHEI VICE PRESIDENT OF PROGRAMS 139900 0 0 0 0 0 5786 0 20329 0 166015 0 0 0 PART I, LINE 1A THE FOUNDATION PAYS FOR HEALTH CLUB MEMBERSHIP FOR THE PRESIDENT. PART I, LINE 4B THERE IS A DEFERRED COMPENSATION PLAN IN ACCORDANCE WITH IRC SECTION 457(B) FOR THE PRESIDENT. THE ORGANIZATION ACCRUED $14,033 TO THIS PLAN FOR THE CURRENT YEAR. THE CUMULATIVE BALANCE OF THE ACCRUED DEFERRED COMPENSATION AS OF YEAR-END IS $103,229. JEAN MCMURRAY BOARD MEMBER 573333 THE BOARD MEMBER IS THE EXECUTIVE DIRECTOR OF THE WORCESTER COUNTY FOOD BANK. THE AMOUNT OF THIS TRANSACTION IS A GRANT TO WORCESTER COUNTY FOOD BANK. 0 FORM 990, PART VI, SECTION B, LINE 11B THE HEALTH FOUNDATION STAFF EMAILS THE DOCUMENTS TO THE BOARD FOR REVIEW, QUESTIONS, AND COMMENTS. THE 990 IS THEN FILED AFTER THE BOARD HAS REVIEWED IT. FORM 990, PART VI, SECTION B, LINE 12C ANNUAL DISCLOSURE BY STAFF AND DIRECTORS, WITH A REVIEW OF THE POLICY EVERY YEAR. FORM 990, PART VI, SECTION B, LINE 15 NO OFFICER OR DIRECTOR RECEIVES COMPENSATION EXCEPT FOR THE PRESIDENT/CEO. THE EXECUTIVE COMMITTEE REVIEWS SALARY DATA COMPILED BY THE "COUNCIL ON FOUNDATIONS" IN SETTING AND RECOMMENDING TO THE FULL BOARD FOR APPROVAL THE PRESIDENT/CEO'S SALARY AND BENEFITS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION PROVIDES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS UPON REQUEST. THE ORGANIZATION'S GOVERNING DOCUMENTS ARE ALSO AVAILABLE ON THE WEBSITE OF THE COMMONWEALTH OF MASSACHUSETTS. FORM 990, PART X, LINE 13 DURING 2008, THE FOUNDATION LOANED $492,000 TO AN INTERMEDIARY FOR A PROGRAM-RELATED INVESTMENT. THE FUND IS TO BE USED FOR ACQUIRING AND DEVELOPING AFFORDABLE HOUSING FOR THE ADULT CHRONICALLY HOMELESS IN THE WORCESTER AREA. THE FUND IS ADMINISTERED BY AN INTERMEDIARY. THE BALANCE IN THIS FUND AT DECEMBER 31, 2018 AND 2017 TOTALED $264,279 AND $288,607, RESPECTIVELY. THE HEALTH FOUNDATION FUND INC 446 MAIN STREET 20TH FL WORCESTER MA 01608 043521743 TO SUPPORT THE PURPOSE AND MISSION OF ITS MEMBER, THE HEALTH FOUNDATION. MA 501(C)(3) LINE 7 N/A 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 THE HEALTH FOUNDATION FUND INC N 80141 STANDARD ACCOUNTING PROCEDURES THE HEALTH FOUNDATION FUND INC O 8671 STANDARD ACCOUNTING PROCEDURES THE HEALTH FOUNDATION FUND INC B 9680 STANDARD ACCOUNTING PROCEDURES