VOLUNTEER HEALTHCARE CLINIC INC: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- VOLUNTEER HEALTHCARE CLINIC INC (EIN 74-6082464)
- Tax period
- 2016-01-01 to 2016-12-31
- Filed
- 2017-05-11
- IRS object ID
- 201721319349303802
- Schema version
- 2016v3.0
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-05-11T11:57:54-07:00 | ReturnTs |
| Tax Period End | 2016-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Dunagan Jack LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3724 Jefferson Street Suite 307 | AddressLine1Txt |
| City | Austin | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 78731 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 746082464 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Volunteer Healthcare Clinic Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | VOLU | BusinessNameControlTxt |
| Phone | 5124596002 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4215 Medical Parkway | AddressLine1Txt |
| City | Austin | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 78756 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Elizabeth Ann Schlechter | PersonNm |
| Person Title | Treasurer | PersonTitleTxt |
| Signature | 2017-05-11 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Gary Joseph Jack | PreparerPersonNm |
| PTIN | P00184408 | PTIN |
| Phone | 5124208997 | PhoneNum |
| Self Employed | Yes (X) | SelfEmployedInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Marci Roe | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4215 Medical Parkway | AddressLine1Txt |
| City | Austin | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 78756 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $603,960 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| All Affiliates Included | false | AllAffiliatesIncludedInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.volclinic.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1966 | FormationYr |
| Legal Domicile State | TX | LegalDomicileStateCd |
| Activity Or Mission | Our mission is to improve the health of the uninsured and working poor by providing access to high quality health care and prevention education. Our vision is to help create and sustain a healthy community where all people have access to healthcare and personal well-being. | ActivityOrMissionDesc |
| Voting Members Governing Body | 17 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 17 | VotingMembersIndependentCnt |
| Total Employee | 16 | TotalEmployeeCnt |
| Total Volunteers | 512 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $406,835 | PYContributionsGrantsAmt |
| CY Contributions Grants | $541,304 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $27,384 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $29,109 | CYProgramServiceRevenueAmt |
| PY Investment Income | $24 | PYInvestmentIncomeAmt |
| CY Investment Income | $848 | CYInvestmentIncomeAmt |
| PY Other Revenue | $1,772 | PYOtherRevenueAmt |
| CY Other Revenue | $2,659 | CYOtherRevenueAmt |
| PY Total Revenue | $436,015 | PYTotalRevenueAmt |
| CY Total Revenue | $573,920 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| CY Salaries Comp Emp Bnft Paid | $317,796 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $64,098 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $442,080 | PYOtherExpensesAmt |
| CY Other Expenses | $159,583 | CYOtherExpensesAmt |
| PY Total Expenses | $442,080 | PYTotalExpensesAmt |
| CY Total Expenses | $477,379 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$6,065 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $96,541 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $867,456 | TotalAssetsBOYAmt |
| Total Assets EOY | $981,500 | TotalAssetsEOYAmt |
| Total Liabilities EOY | $0 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $867,456 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $981,500 | NetAssetsOrFundBalancesEOYAmt |
| Mission | Our mission is to improve the health of the uninsured and working poor by providing access to high quality health care and prevention education. Our vision is to help create and sustain a healthy community where all people, especially the indigent, have access to healthcare and personal well-being. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $362,814 | ExpenseAmt |
| Revenue | $29,109 | RevenueAmt |
| Desc | The Clinic provided walk-in clinics for adults and children seeking medical attention for primary, acute care needs and a chronic disease management clinic for patients with diabetes, hypertension, and endocrine disorders. The Clinic offered social service referrals, limited mental health services, and healthy lifestyle counseling as well. The Clinic also maintained an onsite pharmacy and lab. The Clinic offered care to people with no health insurance who are living at or below 200% of the U.S. Federal Poverty Level. | Desc |
| Total Program Service Expenses | $362,814 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (true) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (true) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | false | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (true) | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | false | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBondsInd |
| Escrow Account | false | EscrowAccountInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | false | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | false | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | false | BackupWthldComplianceInd |
| Employee | 16 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | false | Form990TFiledInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | Yes (true) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (true) | QuidProQuoContriDisclInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Form8282 Filed | 0 | Form8282FiledCnt |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Form8899 Filedind | false | Form8899Filedind |
| Form1098 C Filed | false | Form1098CFiledInd |
| DAF Excess Business Holdings | false | DAFExcessBusinessHoldingsInd |
| Taxable Distributions | false | TaxableDistributionsInd |
| Distribution To Donor | false | DistributionToDonorInd |
| Org Filed In Lieu Of Form1041 | false | OrgFiledInLieuOfForm1041Ind |
| Licensed More Than One State | false | LicensedMoreThanOneStateInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 17 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 17 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | false | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | false | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | false | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Marci Roe | PersonNm |
| Phone | 5124596002 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4215 Medical Parkway | AddressLine1Txt |
| City | Austin | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 78756 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|---|
| Allen Busch | |||||||
| Chair | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| Jose Garcia | |||||||
| Vice Chair | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| Curtis Burch Jr | |||||||
| Secretary | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| Elizabeth Ann Schlechter | |||||||
| Treasurer | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| Tom McHorse | |||||||
| Med Director | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| Jim Arnold Jr | |||||||
| Director | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| Peggy Barrett | |||||||
| Director | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| Berenice Craig | |||||||
| Director | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| Richard Harris | |||||||
| Director | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| Tom Hassell | |||||||
| Director | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| Larry Lay | |||||||
| Director | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| Sheldon Markowitz | |||||||
| Director | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| Ranjit Nayak | |||||||
| Director | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| Davika Reid | |||||||
| Director | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| Lynda Shanblum | |||||||
| Director | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| Aurora Trahan | |||||||
| Director | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| Rick Windham | |||||||
| Director | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| Marci Roe | |||||||
| Exec Director | 40.00 | 0.00 | Yes (X) | $69,916 | $0 | $2,098 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $69,916 | TotalReportableCompFromOrgAmt |
| Total Other Compensation | $2,098 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | false | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $157,556 | FundraisingAmt |
| Government Grants | $100,391 | GovernmentGrantsAmt |
| All Other Contributions | $283,357 | AllOtherContributionsAmt |
| Total Contributions | $541,304 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Patient fees | Desc |
| Total Revenue Column | $29,109 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $29,109 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $29,109 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $848 | TotalRevenueColumnAmt |
| Exclusion | $848 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $30,040 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $157,556 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $30,040 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Other revenues | Desc |
| Total Revenue Column | $2,659 | TotalRevenueColumnAmt |
| Exclusion | $2,659 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $2,659 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $573,920 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $29,109 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $3,507 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $72,014 | TotalAmt |
| Program Services | $56,170 | ProgramServicesAmt |
| Management And General | $3,960 | ManagementAndGeneralAmt |
| Fundraising | $11,884 | FundraisingAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $223,347 | TotalAmt |
| Program Services | $174,211 | ProgramServicesAmt |
| Management And General | $12,284 | ManagementAndGeneralAmt |
| Fundraising | $36,852 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,435 | TotalAmt |
| Program Services | $17,499 | ProgramServicesAmt |
| Management And General | $1,234 | ManagementAndGeneralAmt |
| Fundraising | $3,702 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,523 | TotalAmt |
| Management And General | $6,523 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,920 | TotalAmt |
| Management And General | $5,920 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,505 | TotalAmt |
| Program Services | $12,911 | ProgramServicesAmt |
| Management And General | $797 | ManagementAndGeneralAmt |
| Fundraising | $797 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,585 | TotalAmt |
| Program Services | $18,321 | ProgramServicesAmt |
| Management And General | $1,132 | ManagementAndGeneralAmt |
| Fundraising | $1,132 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,332 | TotalAmt |
| Program Services | $4,850 | ProgramServicesAmt |
| Management And General | $5,482 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| Medicines | $36,996 | $36,996 | ||
| Miscellaneous | $30,664 | $20,974 | $4,466 | $5,224 |
| Personnel leasing fees | $12,663 | $9,307 | $697 | $2,659 |
| Medical supplies | $6,328 | $6,328 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,067 | TotalAmt |
| Program Services | $5,247 | ProgramServicesAmt |
| Management And General | $7,972 | ManagementAndGeneralAmt |
| Fundraising | $1,848 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $477,379 | TotalAmt |
| Program Services | $362,814 | ProgramServicesAmt |
| Management And General | $50,467 | ManagementAndGeneralAmt |
| Fundraising | $64,098 | FundraisingAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Joint Costs | Yes (X) | JointCostsInd |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $103,177 | BOYAmt |
| EOY | $169,977 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $160,184 | BOYAmt |
| EOY | $960 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $587,445 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $256,137 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $344,562 | BOYAmt |
| EOY | $331,308 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $151,519 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $259,533 | BOYAmt |
| EOY | $327,736 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $867,456 | BOYAmt |
| EOY | $981,500 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $734,405 | BOYAmt |
| EOY | $854,728 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $73,286 | BOYAmt |
| EOY | $65,007 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $59,765 | BOYAmt |
| EOY | $61,765 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $867,456 | BOYAmt |
| EOY | $981,500 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $867,456 | BOYAmt |
| EOY | $981,500 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $96,541 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $17,503 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Cash | Yes (X) | MethodOfAccountingCashInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $155,788 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $393,670 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $441,386 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $406,835 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $541,304 | CurrentTaxYearAmt |
| Total | $1,938,983 | TotalAmt |
Tax Rev Levied Orgnztnl Bnft170 TaxRevLeviedOrgnztnlBnft170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Govt Furn Srvc Fclts Vl170 GovtFurnSrvcFcltsVl170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $155,788 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $393,670 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $441,386 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $406,835 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $541,304 | CurrentTaxYearAmt |
| Total | $1,938,983 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $584,097 | SubstantialContributorsTotAmt |
| Public Support Total170 | $1,354,886 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $5,500 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $25 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $18 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $24 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $848 | CurrentTaxYearAmt |
| Total | $6,415 | TotalAmt |
Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $232 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $724 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,870 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,772 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,659 | CurrentTaxYearAmt |
| Total | $8,257 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $1,953,655 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $165,213 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.69350 | PublicSupportCY170Pct |
| Public Support PY170 | 0.67700 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $259,533 | BeginningYearBalanceAmt |
| Contributions | $52,700 | ContributionsAmt |
| Investment Earnings Or Losses | $17,503 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $329,736 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $208,395 | BeginningYearBalanceAmt |
| Contributions | $68,263 | ContributionsAmt |
| Investment Earnings Or Losses | -$17,125 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $259,533 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $154,926 | BeginningYearBalanceAmt |
| Contributions | $47,293 | ContributionsAmt |
| Investment Earnings Or Losses | $6,176 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $208,395 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $130,808 | BeginningYearBalanceAmt |
| Contributions | $12,306 | ContributionsAmt |
| Investment Earnings Or Losses | $11,812 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $154,926 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $81,692 | BeginningYearBalanceAmt |
| Contributions | $43,625 | ContributionsAmt |
| Investment Earnings Or Losses | $5,491 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $130,808 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.78300 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.18700 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.03000 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | Yes (true) | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | false | EndowmentsHeldRelatedOrgInd |
| Related Org List Sch R | false | RelatedOrgListSchRInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $50,000 | OtherCostOrOtherBasisAmt |
| Book Value | $50,000 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $481,571 | OtherCostOrOtherBasisAmt |
| Depreciation | $215,812 | DepreciationAmt |
| Book Value | $265,759 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $20,022 | OtherCostOrOtherBasisAmt |
| Depreciation | $14,170 | DepreciationAmt |
| Book Value | $5,852 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $35,852 | OtherCostOrOtherBasisAmt |
| Depreciation | $26,155 | DepreciationAmt |
| Book Value | $9,697 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $331,308 | TotalBookValueLandBuildingsAmt |
| Total Book Value Securities | $151,519 | TotalBookValueSecuritiesAmt |
Other Assets Org OtherAssetsOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Beneficial interest in fund held at ACF | Desc |
| Book Value | $327,736 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $327,736 | TotalBookValueOtherAssetsAmt |
| Total Rev Etc Audited Fincl Stmt | $591,423 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | $17,503 | OtherRevenueAmt |
| Revenue Not Reported | $17,503 | RevenueNotReportedAmt |
| Revenue Subtotal | $573,920 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $573,920 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $477,379 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $477,379 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $477,379 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part V, Line 4: Intended uses of the endowment fund. | To provide general support to the Organization. |
| Part XI, Line 2d: Other revenue amounts included in F/S but not included on form 990 | Change in value of beneficial interest $17503 |
Schedule G IRS990ScheduleG
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agrmt Prof Fundraising Acty | false | AgrmtProfFundraisingActyInd |
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | 50th Anniversay | Event1Nm |
| Gross Receipts Event1 | $187,596 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $157,556 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $30,040 | GrossRevenueEvent1Amt |
| Rent Facility Costs Event1 | $6,154 | RentFacilityCostsEvent1Amt |
| Food And Beverage Event1 | $19,237 | FoodAndBeverageEvent1Amt |
| Other Direct Expenses Event1 | $4,649 | OtherDirectExpensesEvent1Amt |
| Gross Receipts Total | $187,596 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $157,556 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $30,040 | GrossRevenueTotalEventsAmt |
| Rent Fclty Costs Total Events | $6,154 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $19,237 | FoodAndBeverageTotalEventsAmt |
| Oth Direct Expnss Total Events | $4,649 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $30,040 | DirectExpenseSummaryEventsAmt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Line 11b: Form 990 Review Process | The Clinic's CPA prepares a draft of the return. The Executive Director and Treasurer review the draft before it is filed. |
| Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees | The Clinic has a personnel committee, which is a sub-committee of the Board of Directors, comprised of 5 directors, which includes the Treasurer. This committee oversaw the hiring of the Executive Director and reviews compensation changes for new and existing staff members. When determining a new leased employee's salary, efforts are made to bench mark against other similar positions in similar organizations. This might take the form of speaking with other non-profit leaders within the community, reviewing on-line salary reporting sites/or reviewing available compensation reports. Other factors, such as experience and knowledge, are also taken into consideration. |
| Form 990, Part VI, Line 19: Other Organization Documents Publicly Available | Certain other documents available upon request. |
| Other Changes In Net Assets Or Fund Balances - Other Increases | Change in value of beneficial interest = $17503 |
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