2016-11-14T11:33:49-06:00 2015-12-31 043037870 BOLLUS LYNCH LLP 89 SHREWSBURY STREET WORCESTER MA 01604 990 2015-01-01 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 2016-11-10 1 DAVID G EATON CPA P00545132 5087557107 2016-11-10 2015 2017-02-10 21:41:12Z JANICE B YOST EDD 446 MAIN STREET 20TH FLOOR WORCESTER MA 01608 20583316 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 0 14322 0 18983 0 0 6150710 5156493 61582 202524 6212292 5378000 2593569 2610862 0 0 689654 700645 0 0 0 721783 905730 4005006 4217237 2207286 1160763 71502913 67770126 1235613 1060288 70267300 66709838 TO IMPROVE THE HEALTH STATUS OF THOSE WHO LIVE OR WORK IN CENTRAL MASSACHUSETTS. 0 0 3226678 2610862 TO PROVIDE FUNDING TO NON-PROFIT ORGANIZATIONS FOR THE PURPOSE OF IMPROVING THE HEALTH OF THOSE WHO LIVE AND WORK IN CENTRAL MASSACHUSETTS. 3226678 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 1 0 1 4 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 X 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 DIRECTOR 1.50 X 0 0 0 JOHN P GUSHA DMD CHAIR 2.00 X 0 0 0 MICHAEL J MUTCHLER MD VICE CHAIR 2.00 X 0 0 0 ANN K TRIPP MBA TREASURER 2.00 X 0 0 0 LYNDA M YOUNG MD SECRETARY 2.00 X 0 0 0 LUIS G PEREZ JD EXECUTIVE COMMITTEE 2.00 X 0 0 0 JANICE B YOST EDD PRESIDENT/ CEO 37.50 X 253737 0 21303 ELAINE C CINELLI VICE PRESIDENT OF PROGRAMS 37.50 X 132634 0 12190 386371 0 33493 2 0 1 0 0 18983 18983 614688 614688 19747121 15205316 4541805 4541805 4541805 OTHER INCOME 900099 202524 202524 202524 5378000 202524 0 5156493 2610862 2610862 253736 197482 56254 322848 220740 102108 20503 15957 4546 67389 52449 14940 36169 27690 8479 3742 3742 21000 21000 584864 584864 123481 123481 5979 3587 2392 76811 46087 30724 15049 9029 6020 13177 7906 5271 8016 4810 3206 OUTSIDE SERVICES 31679 19007 12672 OFFICE SUPPLIES 12578 7547 5031 PUBLICATIONS AND SPECIA 5597 3358 2239 OTHER EXPENSE 3757 167 3590 4217237 3226678 990559 0 102285 170631 36680 187983 7538 6862 241654 161674 10459 79980 46719123 34803978 24227104 32131517 359454 336189 40270 52986 71502913 67770126 110941 100908 1084402 906395 40270 52985 1235613 1060288 X 70267300 66709838 70267300 66709838 71502913 67770126 X 1160763 -4718226 1 X 0 1 X 1 0 70411576 -153424 2610862 624178 162709 66860403 70492197 3488570 2593569 811358 164264 70411576 63665366 9850435 2228068 639078 156458 70492197 59783196 6962985 2229549 698240 153026 63665366 61935980 368941 2149125 219054 153546 59783196 1.00000 0 0 241654 161674 79980 79980 INVESTMENT LIMITED PARTNERSHIPS 32131517 F 32131517 DEFERRED COMPENSATION PLAN 52985 52985 X 74910 -4718226 -4718226 4793136 584864 584864 5378000 3632373 0 3632373 584864 584864 4217237 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 2012. 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 1 PERNET FAMILY HEALTH SERVICE 237 MILLBURY ST WORCESTER MA 01610 042453851 501(C)(3) 10000 BOOK PERNET FAMILY HEALTH SERVICE COMMUNITY LEGAL AID 405 MAIN ST 4TH FLOOR WORCESTER MA 01608 042446242 501(C)(3) 2500 BOOK COMMUNITY LEGAL AID THE CASA PROJECT 100 GROVE ST SUITE 403 WORCESTER MA 01605 042711865 501(C)(3) 2500 BOOK THE CASA PROJECT MONTACHUSETT OPPURTUNITY COUNCIL 133 PRITCHARD ST FITCHBURG MA 01420 042401111 501(C)(3) 350000 BOOK REIMAGINE NORTH OF MAIN WORCESTER PUBLIC SCHOOLS 120 IRVING ST WORCESTER MA 01609 048001418 501(C)(3) 165000 BOOK WORCESTER HEARS ASCENTRIA COMMUNITY SERVICES (ACA) 14 EAST WORCESTER ST SUITE 300 WORCESTER MA 01604 043566243 501(C)(3) 170722 BOOK PARTNERSHIP FOR REFUGEE WELLNESS REGIONAL ENVIRONMENTAL COUNCIL CENTRAL MASS PO BOX 255 WORCSTER MA 01613 046364330 501(C)(3) 161650 BOOK WORCESTER REGIONAL FOOD HUB GAAMHA INC 208 COLEMAN ST GARDNER MA 01440 042437107 501(C)(3) 39499 BOOK COMMUNITY BASED DAY SERVICES EMPLOYMENT OPTIONS 82 BRINGHAM STREET MALBOROUGH MA 01752 237089596 501(C)(3) 78000 BOOK CATERING OPTIOINS SOCIAL ENTERPRISE HMEA 8 FORGE PARK EAST FRANKLIN MA 02038 042300014 501(C)(3) 56700 BOOK STUDENTS FOR HIGHER: RISING UP FOR AUTISM WORCESTER COMMUNITY HOUSING RESOURCES 11 PLEASANT ST SUITE 300 WORCESTER MA 01609 222719744 501(C)(3) 85000 BOOK STORE-FRONT RENEWAL PROJECT CMWIB (CITY OF WORCESTER) CITY HALL ROOM 206 455 MAIN ST WORCESTER MA 01608 046001418 501(C)(3) 84800 BOOK CAREER CENTER 2.0 MASS ED CO 484 MAIN ST SUITE 500 WORCESTER MA 01608 237055676 501(C)(3) 73700 BOOK ON OUR WAY - EDUCATION FOR A BRIGHT TOMORROW COMMUNITY HARVEST PROJECT 37 WHEEKER ROAD NORTH GRAFTON MA 01536 043424018 501(C)(3) 100000 BOOK ORCHARD HIGH DENSITY GROWING PROJECT WORKING FOR WORCESTER (SCHAB) 330 MERRIMAC STREET NEWBURYPORT MA 01950 300707429 501(C)(3) 29114 BOOK EXPANDING CAPACITY AND REACH INITIATIVE LATIN AMERICAN HEALTH ALLIANCE 27 VERNON ST WORCESTER MA 01610 205359235 501(C)(3) 89203 BOOK CAFE REYES CATERING NEW VUE COMMUNITIES (TWIN CITIES CDC) 470 MAIN ST FITCHBURG MA 01420 042690210 501(C)(3) 50000 BOOK HOUSING STABILITY PROJECT ADVOCATES INC 1881 WORCESTER RD FITCHBURG MA 01701 237451423 501(C)(3) 123771 BOOK WORCESTER INITIATIVE FOR SUPPORTED RE-ENTRY WORCESTER HOUSING AUTHORITY 40 BELMONT STREET WORCESTER MA 01605 046004472 501(C)(3) 604657 BOOK A BETTER LIFE: HELPING FAMILES FIND THEIR WAY CENTRAL MASS REGIONAL PLANNING COMMISSION 2 WASHINGTON SQUARE 2ND FLOOR WORCESTER MA 01604 042318872 501(C)(3) 25000 BOOK CENTRAL MASS DATA COMMON- PHASE 2 HEALTH LAW ADVOCATES 1 FEDERAL STREET BOSTON MA 02110 043298116 501(C)(3) 104130 BOOK SPECIAL INITIATIVE TO PROTECT CONSUMERS' RIGHTS TO COVEREAGE UNDER HEALTH REFORM THE JANE FUND OF CENTRAL MASSACHUSETTS PO BOX 562 HOLDEN MA 01520 911811542 501(C)(3) 5000 BOOK JANE FUND OF CENTRAL MASSACHUSETTS ST JOHN'S CHURCH 44 TEMPLE ST WORCESTER MA 01604 042106729 501(C)(3) 102500 BOOK ST. JOHN'S CHURCH FOOD FOR THE POOR PROGRAM 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 0 0 0 0 0 0 0 0 JANICE B YOST EDD PRESIDENT/ CEO 217768 0 13000 0 22969 0 8638 0 12665 0 275040 0 0 0 PART I, LINE 1A THE FOUNDATION PAYS FOR HEALTH CLUB MEMBERSHIP FOR THE PRESIDENT. FORM 990, PART VI, SECTION B, LINE 11 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 XI, LINE 9: ROUNDING 1. 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, 2015 AND 2014 TOTALED $336,189 AND $359,454, 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 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 THE HEALTH FOUNDATION FUND INC N 76811 STANDARD ACCOUNTING PROCEDURES THE HEALTH FOUNDATION FUND INC O 8251 STANDARD ACCOUNTING PROCEDURES