2018-10-29T10:18:18-05:00 2017-12-31 043037870 BOLLUS LYNCH LLP 89 SHREWSBURY STREET WORCESTER MA 01604 990 2017-01-01 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 2018-10-29 1 DAVID G EATON CPA P00545132 5087557107 2018-10-29 71.11.10.178 2018-10-29 10:53:51 ED P 954A65DB1995863A37271E4766999F33303993D7 82440DA47756E2518FCC1FC82E4A75CF45878D1B 2017 2019-02-21 02:37:17Z JANICE B YOST EDD 446 MAIN STREET 20TH FLOOR WORCESTER MA 01608 19989264 0 X HFCM.ORG X 1977 MA TO IMPROVE THE HEALTH STATUS OF THOSE WHO LIVE OR WORK IN CENTRAL MASSACHUSETTS. 14 14 6 0 153155 152155 57867 0 0 0 2576115 2674628 140243 289899 2774225 2964527 2427556 2515119 0 0 759295 817051 0 0 0 827177 967705 4014028 4299875 -1239803 -1335348 67332819 74982929 281060 562693 67051759 74420236 TO IMPROVE THE HEALTH STATUS OF THOSE WHO LIVE OR WORK IN CENTRAL MASSACHUSETTS. 0 0 3235375 2515119 289899 TO PROVIDE FUNDING TO NON-PROFIT ORGANIZATIONS FOR THE PURPOSE OF IMPROVING THE HEALTH OF THOSE WHO LIVE AND WORK IN CENTRAL MASSACHUSETTS. 3235375 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 0 0 0 0 0 0 1 1 0 0 1 7 0 1 6 1 1 1 0 0 0 0 0 0 0 X 14 14 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 SARIKA AGGARWAL MD DIRECTOR 1.50 X 0 0 0 DAVID N GRENIER DIRECTOR 1.50 X 0 0 0 JAY S HIMMELSTEIN MD MPH DIRECTOR 1.50 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 FRANCIS M SABA MHSA VICE CHAIR 2.00 X 0 0 0 MICHAEL J MUTCHLER MD CHAIR 2.00 X 0 0 0 ANN K TRIPP MBA TREASURER 2.00 X 0 0 0 JANICE B YOST EDD PRESIDENT/ CEO 37.50 X 274547 0 24229 MICHELLE L EWING CONTROLLER 37.50 X 81701 0 21979 AMIE SHEI VICE PRESIDENT OF PROGRAMS 37.50 X 136163 0 19100 492411 0 65308 2 0 1 0 0 638100 638100 18908110 153155 17024737 0 1883373 153155 2036528 153155 1883373 OTHER INCOME 900099 289899 289899 289899 2964527 289899 153155 2521473 2515119 2515119 274547 218908 55639 384380 274039 110341 20663 16039 4624 93033 72213 20820 44428 34485 9943 2308 2308 21500 21500 606795 606795 119617 119617 6433 3176 3257 79031 47419 31612 19710 12207 7503 20714 12428 8286 8062 4837 3225 TAXES-OTHER 43239 43239 OUTSIDE SERVICES 18857 10417 8440 OFFICE SUPPLIES 12228 7135 5093 PUBLICATIONS AND SPECIA 5524 3314 2210 3687 3639 48 4299875 3235375 1064500 0 100453 68936 143760 192967 9032 6751 257404 205411 72707 51993 34440649 40502410 32183101 33776259 312575 288607 70542 95006 67332819 74982929 107143 114675 105120 354757 68797 93261 281060 562693 X 67051759 74420236 67051759 74420236 67332819 74982929 -1335348 8703826 0 X 0 1 X 1 0 66533319 10765544 2515119 431951 203544 74148249 66860403 3646956 2427556 1386610 159874 66533319 70411576 -153424 2610862 624178 162709 66860403 70492197 3488570 2593569 811358 164264 70411576 63665366 9850435 2228068 639078 156458 70492197 1.00000 0 0 257404 205411 51993 51993 INVESTMENT LIMITED PARTNERSHIPS 33776259 F 33776259 DEFERRED COMPENSATION PLAN 93261 93261 X 11061558 8703826 8703826 2357732 606795 606795 2964527 3693080 0 3693080 606795 606795 4299875 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 1 MONTACHUSETT OPPORTUNITY COUNCIL 133 PRITCHARD ST FITCHBURG MA 01420 042401111 501(C)(3) 394734 BOOK REIMAGINE NORTH OF MAIN WORCESTER PUBLIC SCHOOLS 20 IRVING ST WORCESTER MA 01609 048001418 501(C)(3) 392517 BOOK WORCESTER HEARS ASCENTRIA COMMUNITY SERVICES (ACA) 14 EAST WORCESTER ST SUITE 300 WORCESTER MA 01604 043566243 501(C)(3) 40000 BOOK PARTNERSHIP FOR REFUGEE WELLNESS REGIONAL ENVIRONMENTAL COUNCIL CENTRAL MASS PO BOX 255 WORCSTER MA 01613 046364330 501(C)(3) 500075 BOOK WORCESTER REGIONAL FOOD HUB ADVOCATES INC 1881 WORCESTER RD FITCHBURG MA 01701 237451423 501(C)(3) 57365 BOOK WISER WOMEN WORCESTER HOUSING AUTHORITY 40 BELMONT STREET WORCESTER MA 01605 046004472 501(C)(3) 305000 BOOK A BETTER LIFE: HELPING FAMILES FIND THEIR WAY WORCESTER STATE FOUNDATION 486 CHANDLER STREET WORCESTER MA 01602 223248067 501(C)(3) 40000 BOOK WIPLE IN THE COMMUNITY (LATINO EDUCATION INSTITUTE) HEYWOOD HOSPITAL 242 GREEN STREET GARDNER MA 01440 042103581 501(C)(3) 100476 BOOK COMMUNITY OF MENTAL HEALTH CENTER AT THE QUABBIN RETREAT GVNA HEALTHCARE 34 PEARLY LANE GARDNER MA 01440 042104246 501(C)(3) 2500 BOOK GVNA HEALTHCARE COMMUNITY HEALTHLINK 72 JAQUES AVENUE WORCESTER MA 01610 042626179 501(C)(3) 5000 BOOK COMMUNITY HEALTHLINK,WORCESTER YOUTH & FAMILY SERVICES BOYS & GIRLS CLUB OF WORCESTER 65 TAINTER STREET WORCESTER MA 01610 042105851 501(C)(3) 5000 BOOK PLUMLEY VILLAGE CLUBHOUSE YWCA OF CENTERAL MASSACHUSETTS 1 SALEM SQUARE WORCESTER MA 01608 042105873 501(C)(3) 2500 BOOK YWCA OF CENTRAL MA WORCESTER COUNTY FOOD BANK 474 BOSTON TURNPIKE SHREWSBURY MA 01545 043071457 501(C)(3) 2500 BOOK WORCESTER COUNTY FOOD BANK VETERANS INC 69 GROVE STREET WORCESTER MA 01605 043098024 501(C)(3) 55800 BOOK CLINICAL STABILIZATION SERVICES BILLING AND CREDENTIALING ARMS WITH ETHICS 9480 BYRON AVENUE SURFSIDE FL 33154 463738235 501(C)(3) 55500 BOOK WORCESTER GUN VIOLENCE REDUCTION PROJECT THE CASA PROJECT INC 100 GROVE STREET SUITE 403 WORCESTER MA 016052608 042711865 501(C)(3) 45600 BOOK TRAINING ROOM RENOVATION HMEA 8 FORGE PARK EAST FRANKLIN MA 02038 042300014 501(C)(3) 65000 BOOK AUTISM, ADVANTAGE AT WORK ABBY'S HOUSE 52 HIGH STREET WORCESTER MA 01609 042648411 501(C)(3) 75000 BOOK ABBY'S HOUSE THRIFT SHOP WORCESTER COMMUNITY ACTION COUNCIL INC 484 MAIN STREET 2ND FLOOR WORCESTER MA 01608 042382160 501(C)(3) 62000 BOOK BANK ON WORCESTER COUNTY MONTACHUSETT INTERFAITH HOSPITALITY NETWORK 758 MAIN STREET LEOMINSTER MA 01453 030387748 501(C)(3) 20000 BOOK HOMELESS SHELTER GOVERNED BY TRAUMA INFORMED PRACTICES THE BARTON CENTER FOR DIABETES EDUCATION 30 ENNIS ROAD PO BOX 356 NORTH OXFORD MA 015370356 222701822 501(C)(3) 67000 BOOK TECHNOLOGY UPDATE FOR THE TRANSMISSION AND RECORDING OF BLOOD GLUCOSE DATA GAAMHA INC 208 COLEMAN STREET GARDNER MA 01440 042437107 501(C)(3) 98275 BOOK WOMEN'S SUPPORTIVE HOUSING - SUBSTANCE USE DISORDERS 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 250985 0 0 0 23562 0 9032 0 15197 0 298776 0 0 0 AMIE SHEI VICE PRESIDENT OF PROGRAMS 136163 0 0 0 0 0 434 0 18666 0 155263 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 $13,559 TO THIS PLAN FOR THE CURRENT YEAR. THE CUMULATIVE BALANCE OF THE ACCRUED DEFERRED COMPENSATION AS OF YEAR-END IS $93,261. 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, 2017 AND 2016 TOTALED $288,607 AND $312,575, RESPECTIVELY. FORM 990, SCHEDULE F, PAGE 4, QUESTION 1 THE FORM 926 INFORMATION WAS REPORTED ON A K-1 FROM MESIROW FINANCIAL PRIVATE EQUITY PARTNERSHIP FUND IV, L.P. THIS K-1 REPORTED UBIT INCOME AND WE HAVE INCLUDED THE FORM 926 ATTACHMENTS WITH THE PAPER FILED FORM 990-T. 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 79031 STANDARD ACCOUNTING PROCEDURES THE HEALTH FOUNDATION FUND INC O 8963 STANDARD ACCOUNTING PROCEDURES THE HEALTH FOUNDATION FUND INC B 13000 STANDARD ACCOUNTING PROCEDURES