2016-11-02T14:14:38-07:00 2016-06-30 990 2015-07-01 134228071 Community Health Free Clinic COMM 3193630416 947 14th Avenue SE Cedar Rapids IA 52401 Kevin Crist Treasurer 3193630416 2016-11-03 2015 2017-02-10 21:41:12Z Kevin Crist 947 14th Avenue SE Cedar Rapids IA 52401 1327229 0 X WWW.COMMUNITYHFC.ORG X 2002 IA TO ALLEVIATE HUMAN PAIN AND SUFFERING BY PROVIDING ACCESS TO AND THE DELIVERY OF COMPASSIONATE HEALTHCARE. 12 12 24 220 0 0 1448299 1259752 0 0 30520 24862 -2429 17112 1476390 1301726 0 0 0 0 335955 326849 0 0 89095 1038910 922755 1374865 1249604 101525 52122 3421489 3432081 32793 18407 3388696 3413674 TO ALLEVIATE HUMAN PAIN AND SUFFERING BY PROVIDING ACCESS TO AND THE DELIVERY OF COMPASSIONATE HEALTHCARE. 0 0 989350 0 0 PROVIDED FREE HEALTH CARE SERVICES, INCLUDING MEDICAL, DENTAL AND VISION FOR ANY UNDER-SERVED OR UNINSURED INDIVIDUAL IN NEED OF HEALTH CARE. APPROXIMATELY 150 NEW PATIENTS WERE SEEN PER MONTH. THE TOTAL OF NEW AND EXISTING INDIVIDUALS SERVED DURING THE YEAR WAS 4,761 WITH OVER 15,000 SERVICES PROVIDED. THE COMMUNITY HEALTH FREE CLINIC PROUDLY SERVICES INDIVIDUALS ALL OVER THE EAST CENTRAL IOWA AREA. 0 0 0 989350 1 1 0 0 0 0 0 0 0 1 1 0 0 1 0 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 3 0 24 1 0 0 0 0 0 0 0 0 0 0 X 12 12 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 CO FL IL MN MO NJ NY WA WI X MELISSA DOYLE 3192211585 715 10TH AVENUE SE CEDAR RAPIDS IA 52401 TAMI MITCHELL PRESIDENT 1 0 X X 0 0 0 SISTER SUSAN O'CONNOR SECRETARY 1 0 X X 0 0 0 MARK MARZ DDS VICE-PRESIDENT 1 0 X X 0 0 0 KEVIN CRIST TREASURER 1 0 X X 0 0 0 CATHY GULLICKSON DIRECTOR 1 0 X 0 0 0 GREG HAYES MD DIRECTOR 1 0 X 0 0 0 REED JAKSICH DIRECTOR 1 0 X 0 0 0 DAVID MORTON DIRECTOR 1 0 X 0 0 0 MICHAEL HALL DIRECTOR 1 0 X 0 0 0 AIMEE MEARDON-ORRIS DIRECTOR-RESIGNED JANUARY 2016 1 0 X 0 0 0 RO FOEGE DIRECTOR 1 0 X 0 0 0 KAY JACKSON DIRECTOR 1 0 X 0 0 0 SANDRA MCINTOSH DIRECTOR 1 0 X 0 0 0 DARLENE SCHMIDT CEO 55 0 X 65348 0 0 65348 0 0 0 0 0 0 0 285576 0 24530 0 35000 914646 525017 1259752 0 22378 0 0 22378 0 0 0 0 0 0 0 0 19234 0 0 0 19234 0 19234 0 0 19234 24856 0 22372 0 2484 0 2484 0 0 2484 1009 24530 3131 -2122 0 -2122 0 1301726 0 0 41974 0 0 0 0 0 0 0 0 69348 27739 24272 17337 0 0 0 0 234323 147197 54626 32500 0 0 0 0 0 0 0 0 23178 13383 5983 3812 0 0 0 0 0 0 0 0 12300 0 12300 0 0 0 0 0 0 0 4026 0 4026 0 0 0 0 0 6135 0 0 6135 40660 19630 16654 4376 55323 31869 14374 9080 0 0 0 0 29467 16975 7656 4836 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48009 27657 12473 7879 13822 0 13822 0 DONATED GOODS 514983 514983 0 0 MEDICATIONS 73581 73581 0 0 MEDICAL SERVICES 122128 122128 0 0 REGISTRATION FEES 2897 1669 753 475 -576 -7461 4220 2665 1249604 989350 171159 89095 242929 163534 359170 532159 252898 242081 0 0 0 0 0 0 0 0 291364 308179 18895 6236 2030322 707128 1327805 1323194 22372 0 0 0 0 0 0 0 906056 856698 3421489 3432081 32793 18407 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32793 18407 X 2663258 2737792 427348 357292 298090 318590 3388696 3413674 3421489 3432081 52122 -27138 -6 0 0 0 X 0 1 X 1 0 X 2943234 2856182 2462172 1448299 1259752 10969639 2943234 2856182 2462172 1448299 1259752 10969639 80607 10889032 14305 26722 21551 18117 41612 122307 39070 3183 1009 43262 11135208 0.97789 0.98642 X Schedule A, Part II, Line 10 GROSS RECEIPTS FROM FUNDRAISING EVENTS $1,009 FYE 6/30/16, $3,183 FYE 6/30/15 AND $39,070 FYE 6/30/14. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 682540 20500 -6944 0 12684 4026 679386 714455 500 -14590 0 12631 5194 682540 643514 500 86748 0 12145 4162 714455 633854 550 75182 0 61783 4289 643514 387335 247581 2179 0 0 3241 633854 0.5311 0.4689 0 1 0 0 31040 31040 0 1730677 478556 1252121 0 0 0 0 0 268605 228572 40033 0 0 0 0 1323194 BENEFICIAL INTEREST IN ASSETS HELD BY COMMUNITY FOUNDATION 679386 CASH SURRENDER VALUE OF LIFE INSURANCE 21665 LONG-TERM CERTIFICATES OF DEPOSIT 155647 856698 0 0 X 2957936 -27138 1684243 0 3131 1660236 1297700 4026 0 4026 1301726 2932958 1684249 0 0 3131 1687380 1245578 4026 0 4026 1249604 Schedule D, Part V, Line 4 CHFC INTENDS TO USE THE EARNINGS FROM THE ENDOWMENT FUNDS FOR LONG-TERM FINANCIAL SUPPORT OF THE CLINIC. Schedule D, Part X, Line 2 THE ORGANIZATION HAS DETERMINED THAT IT WAS NOT REQUIRED TO RECORD A LIABILITY RELATED TO UNCERTAIN TAX POSITIONS. Schedule D, Part XI, Line 2d FUNDRAISING EVENT EXPENSE ($3,131) Schedule D, Part XII, Line 2d FUNDRAISING EVENT EXPENSES ($3,131) COLOR RUN-5K 25539 24530 1009 0 0 0 0 0 3131 0 0 25539 24530 1009 0 0 0 0 0 3131 3131 -2122 X 336345 514983 FMV X COMPUTER EQUIPMENT 1 10034 FMV 0 0 1 0 Schedule M, Part I, Line 20 COLUMN B - IS AN ESTIMATED QUANTITY OF MEDICINES DONATED. Schedule M, Part I, Lines 25-28 COLUMN B - IS THE NUMBER OF DONORS. Form 990, Part VI, Section B, Line 11b THE FEDERAL FORM 990 IS PREPARED BY THE DIRECTOR OF FINANCE AND THEN REVIEWED BY AN INDEPENDENT PUBLIC ACCOUNTING FIRM AS WELL AS THE COMMUNITY HEALTH FREE CLINIC'S(CHFC) BOARD TREASURER; ANY NECESSARY CHANGES ARE THEN MADE TO THE RETURN. THE FEDERAL FORM 990 IS THEN MARKED DRAFT UNTIL APPROVED BY CHFC'S BOARD OF DIRECTORS. THE DRAFT DOCUMENT IS SENT TO ALL BOARD MEMBERS BY ELECTRONIC MAIL FOR THEIR REVIEW AND COMMENT. COMMENTS BY THE BOARD MEMBERS, IF ANY, WILL BE ADDRESSED BY THE DIRECTOR OF FINANCE AND TREASURER BEFORE THE FEDERAL FORM 990 IS FILED WITH THE IRS. Form 990, Part VI, Section B, Line 12c UPON FIRST BEING ELECTED TO THE BOARD OF DIRECTORS, APPOINTED TO A BOARD COMMITTEE OR ELECTED AS AN OFFICER OF CHFC, THE BOARD MEMBER, BOARD COMMITTEE MEMBER OR OFFICER IS REQUIRED TO COMPLETE THE CONFLICT OF INTEREST DISCLOSURE STATEMENT AND SUBMIT THE STATEMENT TO THE BOARD PRESIDENT. IF THE BOARD PRESIDENT HAS CONCERNS ABOUT ANY STATEMENT, HE/SHE SHALL SUBMIT THE STATEMENT TO THE EXECUTIVE COMMITTEE OF THE CHFC BOARD OF DIRECTORS. EACH STATEMENT SHALL BE RESUBMITTED WITH ANY NECESSARY CHANGES EACH YEAR OR AS ANY ADDITIONAL CONFLICTS OR INTEREST ARISE. STATEMENTS ARE RETAINED BY THE EXECUTIVE DIRECTOR IN CHFC'S OFFICE. Form 990, Part VI, Section B, Line 15 IN JULY OF EACH YEAR, THE CEO/CLINIC EXECUTIVE DIRECTOR (CED) DRAFTS A LIST OF ANNUAL GOALS & OBJECTIVES AND PROVIDES IT TO THE PRESIDENT OF THE BOARD OF DIRECTORS(BOD). THE BOD REVIEWS THE GOALS & OBJECTIVES AT THE ANNUAL BEGINNING OF THE FISCAL YEAR MEETING IN JULY. ANY MODIFICATIONS SUGGESTED ARE INCORPORATED AS APPROPRIATE AND THE BENCHMARK FOR THE FISCAL YEAR IS FINALIZED IN JUNE (END OF FISCAL YEAR). CEO/CED PROVIDES THE PRESIDENT OF THE BOD WITH A DOCUMENT THAT DETAILS HIS/HER PERFORMANCE AGAINST THE ANNUAL GOALS & OBJECTIVES APPROVED IN THE PRIOR JULY. AFTER A FACE-TO-FACE REVIEW WITH THE CEO/CED, THE PRESIDENT OF THE BOD ASSIGNS THE PERFORMANCE REVIEW AN OVERALL GRADE OF (A) FAILS TO MEET EXPECTATIONS;(B) MEETS EXPECTATIONS OR (C) EXCEEDS EXPECTATIONS. DURING JUNE AND JULY THE PRESIDENT OF THE BOD CALLS UPON ONE OR MORE BUSINESSES IN THE AREA TO LEARN WHAT COMPARABLE SALARY AND WAGE CHANGES ARE BEING CONSIDERED IN THE AREA FOR THE NEXT FISCAL YEAR AND DETERMINES THE SPECIFIC SALARY CHANGES APPROPRIATE FOR CHFC BASED UPON THE CEO/CED'S PERFORMANCE, PROGRESS OF THE ORGANIZATION AND BUDGETARY CONSTRAINTS (NORMALLY STATED AS X% TO Y% INCREASE). THE BOARD PRESIDENT SEEKS CONCURRENCE OF THE EXECUTIVE COMMITTEE (WITHOUT THE INVOLVEMENT OF THE CEO/CED) FOR THE OVERALL GRADE AND SUGGESTED SALARY INCREASE. THE CEO/CED'S OVERALL GRADE AND SALARY INCREASE ARE VOTED ON BY THE BOD. THE SPECIFICS OF THE SALARY INCREASE ARE NOT DOCUMENTED IN THE BOARD MEETING MINUTES TO PROVIDE THE CEO/CED WITH CONFIDENTIALITY. THE PRESIDENT'S COMMUNICATION WITH THE EXECUTIVE COMMITTEE AND THE FOLLOW-UP COMMUNICATION WITH THE TREASURER ARE SUFFICIENT DOCUMENTATION. SALARY CHANGES BECOME EFFECTIVE THE FIRST DAY OF THE FISCAL YEAR. FORM 990, PART VI, SECTION B, LINE 15B - THERE IS NO PROCESS FOR DETERMINING COMPENSATION OF THE CHFC'S OTHER OFFICERS OR KEY EMPLOYEES AS CHFC DOES NOT HAVE ANY OTHER EMPLOYEES THAT MEET THE DEFINITION OF EITHER POSITION. Form 990, Part VI, Section C, Line 19 CHFC MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST EITHER BY HARD COPY OR ELECTRONIC FORMAT.