2017-11-13T15:38:24-06:00 2016-12-31 043037870 BOLLUS LYNCH LLP 89 SHREWSBURY STREET WORCESTER MA 01604 990 2016-01-01 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 2017-11-10 1 DAVID G EATON CPA P00545132 5087557107 2017-11-10 71.11.10.178 2017-11-10 12:52:13 ES P FD78FDF4D2A4075D44F1278AC2AD40027EF3B92A E98705733E5274E245650E19B086B31DD38DC4AB 2016 2017-02-10 21:41:12Z JANICE B YOST EDD 446 MAIN STREET 20TH FLOOR WORCESTER MA 01608 16569510 0 X HFCM.ORG X 1977 MA TO IMPROVE THE HEALTH STATUS OF THOSE WHO LIVE OR WORK IN CENTRAL MASSACHUSETTS. 14 14 8 0 95561 94561 18983 57867 0 0 5156493 2576115 202524 140243 5378000 2774225 2610862 2427556 0 0 700645 759295 0 0 0 905730 827177 4217237 4014028 1160763 -1239803 67770126 67332819 1060288 281060 66709838 67051759 TO IMPROVE THE HEALTH STATUS OF THOSE WHO LIVE OR WORK IN CENTRAL MASSACHUSETTS. 0 0 3081542 2427556 140243 TO PROVIDE FUNDING TO NON-PROFIT ORGANIZATIONS FOR THE PURPOSE OF IMPROVING THE HEALTH OF THOSE WHO LIVE AND WORK IN CENTRAL MASSACHUSETTS. 3081542 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 3 0 1 8 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 DEBORAH L PLUMMER PHD DIRECTOR 1.50 X 0 0 0 FRANCIS M SABA MHSA 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 JOHN P GUSHA DMD IMMEDIATE PAST 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 295193 0 22337 MICHELLE L EWING CONTROLLER 37.50 X 79488 0 24625 ELAINE C CINELLI VICE PRESIDENT OF PROGRAMS 37.50 X 132018 0 13032 506699 0 59994 2 0 1 0 0 57867 57867 552046 552046 15723793 95561 13795285 0 1928508 95561 2024069 95561 1928508 OTHER INCOME 900099 140243 140243 140243 2774225 140243 95561 2480554 2427556 2427556 295193 225099 70094 336988 229637 107351 20325 15499 4826 74019 55144 18875 32770 24413 8357 3057 3057 21250 21250 504361 504361 118721 118721 6127 3676 2451 77920 46752 31168 16587 9952 6635 23548 14129 9419 8045 4827 3218 OUTSIDE SERVICES 19683 11810 7873 OFFICE SUPPLIES 15849 9509 6340 OTHER EXPENSE 6380 150 6230 PUBLICATIONS AND SPECIA 5649 3389 2260 4014028 3081542 932486 0 170631 100453 187983 143760 6862 9032 257404 184697 79980 72707 34803978 34440649 32131517 32183101 336189 312575 52986 70542 67770126 67332819 100908 107143 906395 105120 52985 68797 1060288 281060 X 66709838 67051759 66709838 67051759 67770126 67332819 -1239803 1581724 0 X 0 1 X 1 0 66860403 3646956 2427556 1386610 159874 66533319 70411576 -153424 2610862 624178 162709 66860403 70492197 3488570 2593569 811358 164264 70411576 63665366 9850435 2228068 639078 156458 70492197 59783196 6962985 2229549 698240 153026 63665366 1.00000 0 0 257404 184697 72707 72707 INVESTMENT LIMITED PARTNERSHIPS 32183101 F 32183101 DEFERRED COMPENSATION PLAN 68797 68797 X 3851588 1581724 1581724 2269864 504361 504361 2774225 3509667 0 3509667 504361 504361 4014028 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. 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. THE FOUNDATION AND AFFILIATE ARE NO LONGER SUBJECT TO U.S. FEDERAL EXAMINATIONS BY TAX AUTHORITIES FOR YEARS BEFORE 2013. 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) 450000 BOOK REIMAGINE NORTH OF MAIN WORCESTER PUBLIC SCHOOLS 20 IRVING ST WORCESTER MA 01609 048001418 501(C)(3) 401050 BOOK WORCESTER HEARS ASCENTRIA COMMUNITY SERVICES (ACA) 14 EAST WORCESTER ST SUITE 300 WORCESTER MA 01604 043566243 501(C)(3) 456695 BOOK PARTNERSHIP FOR REFUGEE WELLNESS REGIONAL ENVIRONMENTAL COUNCIL CENTRAL MASS PO BOX 255 WORCSTER MA 01613 046364330 501(C)(3) 423235 BOOK WORCESTER REGIONAL FOOD HUB ADVOCATES INC 1881 WORCESTER RD FITCHBURG MA 01701 237451423 501(C)(3) 50435 BOOK WISER WOMEN WORCESTER HOUSING AUTHORITY 40 BELMONT STREET WORCESTER MA 01605 046004472 501(C)(3) 400480 BOOK A BETTER LIFE: HELPING FAMILES FIND THEIR WAY CAMPAIGN FOR A SAFE AND HEALTHY MASSACHUSETTS 35 MYRTLE STREET APT 1 BOSTON MA 02114 812127240 501(C)(3) 100000 BOOK SUPPORT FOR THE CAMPAIGN FOR A SAFE AND HEALTHY MASSACHUSETTS TOWN OF MILFORD CO MILFORD POLICE DEPARTMENT 52 MAIN STREET MILFORD MA 01757 501(C)(3) 5000 BOOK JUVENILE ADVOCACY GROUP (JAG), MILFORD FACING HISTORY AND OURSELVES 16 HURD ROAD BROOKLINE MA 02445 042761636 501(C)(3) 10000 BOOK FACING HISTORY AND OURSELVES CATHOLIC CHARITIES DIOCESE OF WORCESTER COUNTY 10 HAMMOND STREET WORCESTER MA 01610 042103979 501(C)(3) 5000 BOOK CATHOLIC CHARITIES DIOCESE OF WORCESTER COUNTY THE HEALTH FOUNDATION FUND INC 446 MAIN STREET 20TH FLOOR WORCESTER MA 01608 043521743 501(C)(3) 10000 BOOK THE GUSHA FAMILY ORAL HEALTH FUND 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. X 1 1 X X X 0 1 0 0 0 0 0 0 0 JANICE B YOST EDD PRESIDENT/ CEO 258900 0 13000 0 23293 0 8854 0 13483 0 317530 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 $13,293 TO THIS PLAN FOR THE CURRENT YEAR. THE CUMULATIVE BALANCE OF THE ACCRUED DEFERRED COMPENSATION AS OF YEAR-END IS $68,797. 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 THREE YEARS. 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, 2016 AND 2015 TOTALED $312,575 AND $336,189, 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 77920 STANDARD ACCOUNTING PROCEDURES THE HEALTH FOUNDATION FUND INC O 9526 STANDARD ACCOUNTING PROCEDURES THE HEALTH FOUNDATION FUND INC B 10000 STANDARD ACCOUNTING PROCEDURES