MONTGOMERY AREA COMMUNITY WELLNESS COALITION: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- MONTGOMERY AREA COMMUNITY WELLNESS COALITION (EIN 30-0092712)
- Tax period
- 2013-10-01 to 2014-09-30
- Filed
- 2015-01-30
- IRS object ID
- 201510309349301011
- Schema version
- 2013v4.0
- 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 | 2015-01-30T10:01:13-06:00 | ReturnTs |
| Tax Period End | 2014-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 454084437 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WARREN AVERETT LLC | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3815 INTERSTATE CT | AddressLine1 |
| City | MONTGOMERY | City |
| State | AL | State |
| ZIP Code | 36109 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 300092712 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MONTGOMERY AREA COMMUNITY WELLNESS COALITION | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | MONT | BusinessNameControlTxt |
| Phone | 3342936504 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3060 MOBILE HIGHWAY | AddressLine1 |
| City | MONTGOMERY | City |
| State | AL | State |
| ZIP Code | 36108 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | CYNTHIA BISBEE | PersonNm |
| Person Title | EXECUTIVE DIRECTOR | PersonTitleTxt |
| Phone | 3342936504 | PhoneNum |
| Signature | 2015-01-21 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | TATIA W KNIGHT CPA | PreparerPersonNm |
| PTIN | P00848736 | PTIN |
| Phone | 3342712200 | PhoneNum |
| Preparation | 2015-01-21 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | CYNTHIA BISBEE | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3060 MOBILE HIGHWAY | AddressLine1 |
| City | MONTGOMERY | City |
| State | AL | State |
| ZIP Code | 36108 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $578,775 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | N/A | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2002 | FormationYr |
| Legal Domicile State | AL | LegalDomicileStateCd |
| Activity Or Mission | TO INCREASE ACCESS TO AND APPROPRIATE UTILIZATION OF HEALTH CARE BY UNDER/UNINSURED INDIVIDUALS IN THE RIVER REGION. | ActivityOrMissionDesc |
| Voting Members Governing Body | 16 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 16 | VotingMembersIndependentCnt |
| Total Employee | 6 | TotalEmployeeCnt |
| Total Volunteers | 21 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $569,095 | PYContributionsGrantsAmt |
| CY Contributions Grants | $561,276 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $7,250 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $16,065 | CYProgramServiceRevenueAmt |
| PY Investment Income | $789 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,052 | CYInvestmentIncomeAmt |
| PY Other Revenue | $1,591 | PYOtherRevenueAmt |
| CY Other Revenue | $382 | CYOtherRevenueAmt |
| PY Total Revenue | $578,725 | PYTotalRevenueAmt |
| CY Total Revenue | $578,775 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $188,621 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $214,741 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $323,768 | PYOtherExpensesAmt |
| CY Other Expenses | $349,809 | CYOtherExpensesAmt |
| PY Total Expenses | $512,389 | PYTotalExpensesAmt |
| CY Total Expenses | $564,550 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $66,336 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $14,225 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $422,854 | TotalAssetsBOYAmt |
| Total Assets EOY | $425,840 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $51,755 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $40,516 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $371,099 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $385,324 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO IMPROVE HEALTH CARE ACCESS FOR ALL | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $510,462 | ExpenseAmt |
| Revenue | $16,065 | RevenueAmt |
| Desc | PLANS, COORDINATES AND PROVIDES COMMUNITY HEALTH SERVICES TARGETING PERSONS WITH CHRONIC DISEASES AND LITTLE OR NO HEALTH INSURANCE, THROUGH THREE PRIMARY FOCUS AREAS: (1) THE BOARD MEETS ON A REGULAR BASIS AND MEMBERS WORK TOGETHER TO PLAN AND COORDINATE SERVICES TO THE TARGET POPULATION PROVIDED THROUGH THE "SAFETY NET" PROVIDERS AND TO HELP REDUCE THE COST OF HEALTH CARE TO THE COMMUNITY; (2) PROVIDE WELLNESS CASE MANAGEMENT SERVICES TO THE TARGET POPULATION, INCLUDING LINKAGE TO A MEDICAL HOME FOR AFFORDABLE PRIMARY CARE SERVICES, ACCESS TO FREE MEDICATIONS AND OTHER COMMUNITY RESOURCES, AND CHRONIC DISEASE SELF-MANAGEMENT EDUCATION TO ASSIST MEMBERS OF THE TARGET POPULATION TO MANAGE CHRONIC DISEASES SUCH AS DIABETES, HEART DISEASE, ASTHMA, AND OBESITY; AND (3) PROVIDE CONTINUING EDUCATION OPPORTUNITIES FOR HEALTH CARE PROFESSIONALS TO LEARN ABOUT PREVENTION AND MANAGEMENT OF CHRONIC DISEASES AND TO EARN CONTINUING EDUCATION CREDITS. | Desc |
| Total Program Service Expenses | $510,462 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | 0 | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | Yes (1) | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 6 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 6 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 16 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 16 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CYNTHIA BISBEE | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3342936504 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3060 MOBILE HIGHWAY | AddressLine1 |
| City | MONTGOMERY | City |
| State | AL | State |
| ZIP Code | 36108 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd |
|---|---|---|---|---|---|---|
| BEN KELLEY | ||||||
| IMMEDIATE PAST CHAIRPERSON | 1.00 | Yes (X) | $0 | $0 | $0 | |
| HEATHER JOHNSON | ||||||
| CHAIRPERSON | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| ALICE TOLES | ||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| MICHAEL BRIDDELL | ||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| HENRY PARKER | ||||||
| CHAIRPERSON-ELECT | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| CHARLENE ROBERSON | ||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| NANCY HOGAN | ||||||
| SECRETARY | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| MARY WEIDLER | ||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| ASHLEY LOUGH | ||||||
| TREASURER | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| KARA WATTS | ||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| LOU IALACCI | ||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| BERNELL MAPP | ||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| BOB ORRISON | ||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| WANDA SIMS | ||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| SUSAN DOUGLASS | ||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| VICTORIA JONES | ||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| JANET MCQUEEN | ||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| CYNTHIA BISBEE | ||||||
| EXECUTIVE DIRECTOR | 22.00 | $47,640 | $0 | $0 | Yes (X) | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $47,640 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $0 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | 0 | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp
Contractor Name ContractorName
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HEALTH SERVICES INC | BusinessNameLine1 |
Contractor Address ContractorAddress
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 70365 | AddressLine1 |
| City | MONTGOMERY | City |
| State | AL | State |
| ZIP Code | 36107 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Services | WELLNESS CASE MGMT | ServicesDesc |
| Compensation | $264,000 | CompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 1 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $6,542 | GovernmentGrantsAmt |
| All Other Contributions | $554,734 | AllOtherContributionsAmt |
| Noncash Contributions | $7,106 | NoncashContributionsAmt |
| Total Contributions | $561,276 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| CDI CONFERENCE REVENUE | 624100 | $6,878 | $6,878 |
| CM CONFERENCE REVENUE | 624100 | $5,610 | $5,610 |
| SPRING HEALTH SEMINAR | 624100 | $3,577 | $3,577 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $16,065 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,052 | TotalRevenueColumnAmt |
| Exclusion | $1,052 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | OTHER INCOME | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $382 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $382 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $382 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $578,775 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $16,447 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,052 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $54,216 | TotalAmt |
| Program Services | $41,308 | ProgramServicesAmt |
| Management And General | $12,908 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $138,235 | TotalAmt |
| Program Services | $119,483 | ProgramServicesAmt |
| Management And General | $18,752 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,115 | TotalAmt |
| Program Services | $9,562 | ProgramServicesAmt |
| Management And General | $1,553 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,175 | TotalAmt |
| Program Services | $9,478 | ProgramServicesAmt |
| Management And General | $1,697 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,250 | TotalAmt |
| Program Services | $8,318 | ProgramServicesAmt |
| Management And General | $932 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,580 | TotalAmt |
| Program Services | $16,703 | ProgramServicesAmt |
| Management And General | $1,877 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,975 | TotalAmt |
| Program Services | $6,379 | ProgramServicesAmt |
| Management And General | $1,596 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,787 | TotalAmt |
| Program Services | $2,918 | ProgramServicesAmt |
| Management And General | $869 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $655 | TotalAmt |
| Program Services | $506 | ProgramServicesAmt |
| Management And General | $149 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,273 | TotalAmt |
| Program Services | $3,121 | ProgramServicesAmt |
| Management And General | $1,152 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| ADVOCATES | $229,500 | $229,500 | |
| CONTRACTED SERVICES | $69,753 | $58,597 | $11,156 |
| MISCELLANEOUS | $2,972 | $1,648 | $1,324 |
| STAFF DEVELOPMENT | $1,835 | $1,835 | $0 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,229 | TotalAmt |
| Program Services | $1,106 | ProgramServicesAmt |
| Management And General | $123 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $564,550 | TotalAmt |
| Program Services | $510,462 | ProgramServicesAmt |
| Management And General | $54,088 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $122,007 | BOYAmt |
| EOY | $146,114 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $180,717 | BOYAmt |
| EOY | $206,375 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $108,902 | BOYAmt |
| EOY | $57,021 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,197 | BOYAmt |
| EOY | $12,396 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $15,502 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $11,568 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,031 | BOYAmt |
| EOY | $3,934 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $422,854 | BOYAmt |
| EOY | $425,840 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $51,755 | BOYAmt |
| EOY | $37,298 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $3,218 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $51,755 | BOYAmt |
| EOY | $40,516 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $371,099 | BOYAmt |
| EOY | $385,324 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $371,099 | BOYAmt |
| EOY | $385,324 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $422,854 | BOYAmt |
| EOY | $425,840 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $14,225 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | 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 (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | 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 | $579,602 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $453,370 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $517,194 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $569,096 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $561,276 | CurrentTaxYearAmt |
| Total | $2,680,538 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $579,602 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $453,370 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $517,194 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $569,096 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $561,276 | CurrentTaxYearAmt |
| Total | $2,680,538 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $2,680,538 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $989 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $966 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,064 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $789 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,052 | CurrentTaxYearAmt |
| Total | $4,860 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,638 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $4,703 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,990 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,591 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $382 | CurrentTaxYearAmt |
| Total | $10,304 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $2,695,702 | TotalSupportAmt |
| Public Support CY170 | 0.99440 | PublicSupportCY170Pct |
| Public Support PY170 | 0.99570 | 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
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $15,502 | OtherCostOrOtherBasisAmt |
| Depreciation | $11,568 | DepreciationAmt |
| Book Value | $3,934 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $3,934 | TotalBookValueLandBuildingsAmt |
| Total Rev Etc Audited Fincl Stmt | $594,515 | TotalRevEtcAuditedFinclStmtAmt |
| Donated Services And Use Fclts | $15,740 | DonatedServicesAndUseFcltsAmt |
| Revenue Not Reported | $15,740 | RevenueNotReportedAmt |
| Revenue Subtotal | $578,775 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $578,775 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $580,290 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $15,740 | DonatedServicesUseFcltsAmt |
| Expenses Not Reported | $15,740 | ExpensesNotReportedAmt |
| Expenses Subtotal | $564,550 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $564,550 | TotalExpensesPerForm990Amt |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HEALTH SERVICES INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | BOARD MEMBER BERNELL MAPP IS THE EXECUTIVE DIRECTOR OF HEALTH SERVICES | RelationshipDescriptionTxt |
| Transaction | $264,000 | TransactionAmt |
| Transaction | CONTRACT SERVICES FOR WELLNESS CASE MANAGEMENT AND WELLNESS EXAMS | TransactionDesc |
| Sharing Of Revenues | 0 | SharingOfRevenuesInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | THE CPA SITTING ON THE BOARD OF DIRECTORS REVIEWS THE 990. THE RETURN IS PROVIDED TO THE FULL BOARD FOR REVIEW AND COMMENT BEFORE FILING WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | ANY CONFLICTS OF INTEREST ARE DISCUSSED AND REVIEWED BY THE BOARD. |
| FORM 990, PART VI, SECTION B, LINE 15 | ON AN ANNUAL OR AS NEEDED BASIS, THE EXECUTIVE COMMITTEE SHALL MAKE RECOMMENDATIONS TO THE BOARD ON THE APPRAISAL AND CONTRACT/COMPENSATION AMOUNT OF THE EXECUTIVE DIRECTOR. A REVIEW OF COMPENSATION (CONTRACT AMOUNT) CAN INCLUDE REFERENCE BASED EXECUTIVE COMPENSATION DATA OF COMPARABLE NON-PROFIT AGENCIES AND OTHER COMPENSATION DATA THAT MAY BE RELEVANT. FOR KEY EMPLOYEES, AN ANNUAL EVALUATION IS CONDUCTED TO DETERMINE ANY SALARY INCREASES. |
| FORM 990, PART VI, SECTION C, LINE 19 | DOCUMENTS ARE AVAILABLE UPON REQUEST |
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