2014-10-14T07:40:39-05:00 2013-12-31 050392605 MULLEN SCORPIO & CERILLI 67 CEDAR STREET PROVIDENCE RI 02903 990 2013-01-01 050501276 THE RHODE ISLAND FREE CLINIC INC RHOD 4012746347 655 BROAD STREET PROVIDENCE RI 02907 MARIE GHAZAL CHIEF EXECUTIVE OFFICER 4012746347 2014-10-01 1 ANTHONY W SCORPIO P01360145 4017513860 2013 2015-11-30 17:44:51Z MARIE GHAZAL 655 BROAD STREET PROVIDENCE RI 02907 946193 0 X RIFREECLINIC.ORG X 1998 RI PROVIDES HIGH-QUALITY MEDICAL CARE AND PREVENTATIVE HEALTH SERVICES TO RI ADULTS WHO DO NOT HAVE HEALTH INSURANCE OR CANNOT AFFORD TO PURCHASE THOSE SERVICES, AND TO SERVE AS AN EDUCATIONAL SITE FOR TRAINEES IN HEALTH CARE FIELDS. CARE IS PROVIDED BY VOLUNTEER PROFESSIONALS IN PARTNERSHIP WITH LEADING HOSPITALS, INSTITUTIONS OF HIGHER LEARNING, AND COMMUNITY AGENCIES, AND INCLUDES ACUTE AND CHRONIC MEDICAL CARE, PREVENTATIVE SERVICES, HOSPITAL CARE, HEALTH EDUCATION, AND PHARMACY SERVICES. 19 19 12 0 0 0 921634 928157 0 0 190 158 28327 17878 950151 946193 0 0 0 0 649378 539707 0 0 142866 398784 362052 1048162 901759 -98011 44434 1359456 1315160 125743 37013 1233713 1278147 X PROVIDES HIGH-QUALITY MEDICAL CARE AND PREVENTATIVE HEALTH SERVICES TO RHODE ISLAND ADULTS WHO DO NOT HAVE HEALTH INSURANCE OR CANNOT AFFORD TO PURCHASE THOSE SERVICES, AND TO SERVE AS AN EDUCATIONAL SITE FOR TRAINEES IN HEALTH CARE FIELDS. CARE IS PROVIDED BY VOLUNTEER PROFESSIONALS IN PARTNERSHIP WITH LEADING HOSPITALS, INSTITUTIONS OF HIGHER LEARNING, AND COMMUNITY AGENCIES, AND INCLUDES ACUTE AND CHRONIC MEDICAL CARE, PREVENTATIVE SERVICES, HOSPITAL CARE, HEALTH EDUCATION, AND A PHARMACY. 0 0 229433 CLINICAL - THE CLINIC IS A MEDICAL HOME FOR RHODE ISLAND'S UNINSURED WORKING POOR AND LOW-INCOME RESIDENTS. PATIENTS RECEIVE CARE FROM AN ACTIVE CORPS OF OVER 700 MEDICAL PROVIDERS AND VOLUNTEERS WORKING WITH MEDICAL, ACADEMIC, AND COMMUNITY PARTNERS THROUGHOUT RHODE ISLAND. FREE, COMPREHENSIVE PRIMARY CARE AND PREVENTION SERVICES ARE PROVIDED AT THE CLINIC'S STATE-OF-THE-ART FACILITY AT 655 BROAD STREET, PROVIDENCE. 129127 VOLUNTEER - OVER 700 DOCTORS, NURSES, PHARMACISTS, PSYCHOLOGISTS, PHYSICIAN ASSISTANTS, INTERPRETERS, SOCIAL WORKERS, MEDICAL TECHNICIANS, AND NON-MEDICAL VOLUNTEERS PROVIDED FREE CARE IN 2013. FUNDS FOR THIS PROGRAM SUPPORT THE RECRUITMENT, RETENTION, AND RECOGNITION OF OUR VOLUNTEERS. 81242 PHYSICIAN'S NETWORK - VOLUNTEER DOCTORS AND SPECIALISTS PROVIDE CARE TO ELIGIBLE PATIENTS IN THEIR OWN OFFICES THROUGHOUT RHODE ISLAND. THESE SERVICES ARE VALUED AT APPROXIMATELY $452,000. ADDITIONAL PATIENT CARE AND ANCILLARY SUPPORT INCLUDING LABORATORY, DIAGNOSTIC AND TESTING SERVICES ARE COORDINATED BY THE CLINIC THROUGH OUR NETWORK OF COMMUNITY PARTNERS. 259174 TRAINING PROGRAM - STUDENTS RECEIVE TRAINING AND EXPERIENCE AT THE CLINIC THROUGH PARTNERSHIPS WITH LEADING ACADEMIC INSTITUITIONS LEADING TO CERTIFICATE AND LICENSURE IN THE HEALTH CARE FIELD.WELLNESS PROGRAM - HEALTHY LIVING CLASSES INCLUDING CHRONIC DISEASE MANAGEMENT, NUTRITION, FITNESS AND INDIVIDUAL COUNSELING PROMOTE SKILL DEVELOPMENT FOR SELF-MANAGEMENT AND PREVENTION OF CHRONIC DISEASES. 259174 698976 1 1 0 0 0 0 0 0 0 1 1 0 0 0 0 1 0 1 0 0 0 0 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 1 0 0 12 0 0 0 0 0 0 0 0 0 X 19 19 0 0 0 0 0 0 0 1 1 0 1 1 0 1 1 1 1 1 0 0 0 X X MARVIN RONNING 4012746347 655 BROAD STREET PROVIDENCE RI 02907 MARIE GHAZAL CHIEF EXECUTIVE OFFICER 40.00 X X 155734 0 17373 VALERIE M LITTLEFIELD PMP PRESIDENT UNTIL 11/18/13 1.00 X X 0 0 0 MARK GIM PRESIDENT AS OF 11/18/13 1.00 X X 0 0 0 DAYLE JOSEPH EDD RN SECRETARY UNTIL 11/18/13 1.00 X X 0 0 0 THOMAS N FORSYTHE TREASURER UNTIL 11/18/13 1.00 X X 0 0 0 CAROLINE TROISE MD BOARD MEMBER/MEDICAL DIRECTOR 1.00 X 0 0 0 JEFFREY CHASE-LUBITZ ESQ VICE PRESIDENT AS OF 11/18/13 1.00 X X 0 0 0 ANDREW W DAVIS ESQ BOARD MEMBER 1.00 X 0 0 0 WILLIAM FITZGERALD SECRETARY AS OF 11/18/13 1.00 X X 0 0 0 KATHLEEN HITTNER MD BOARD MEMBER 1.00 X 0 0 0 GEORGE GREER BOARD MEMBER 1.00 X 0 0 0 RONALD P JORDAN BOARD MEMBER JAN 2013 1.00 X 0 0 0 MARK WAGGONER BOARD MEMBER 1.00 X 0 0 0 MIRIAM WEIZENBAUM BOARD MEMBER 1.00 X 0 0 0 REVEREND J ALLEN WILLIAMS DMIN BOARD MEMBER 1.00 X 0 0 0 DOMENIC DELMONICO TREASURER AS OF NOV 18, 2013 2.00 X X 0 0 0 NANCY GAGLIANO MD BOARD MEMBER 0.00 X 0 0 0 JERRY FINGERUT MD BOARD MEMBER NOV- DEC 2013 0.00 X 0 0 0 JUDY DIAZ BOARD MEMBER 0.00 X 0 0 0 HERBERT RAKATANSKY MD FACG BOARD MEMBER 0.00 X 0 0 0 155734 0 17373 1 0 1 0 0 928157 928157 158 158 OTHER INCOME 621300 17878 17878 17878 946193 17878 0 158 X 173104 112516 17311 43277 286752 266151 7163 13438 36009 32058 798 3153 43842 35579 1950 6313 1000 1000 9000 7298 402 1300 94693 56145 2472 36076 86452 70178 4035 12239 846 319 421 106 13416 869 5158 7389 5995 5995 33654 27290 1501 4863 9536 7754 401 1381 VISTA 25267 21088 986 3193 SUPPLIES 19618 16091 2151 1376 MEDICATIONS AND MEDICAL 9600 9579 21 TELEPHONE 8922 6813 597 1512 44053 29248 7555 7250 901759 698976 59917 142866 323583 483094 301100 126041 4618 3411 12935 1033485 340395 726744 693090 1359456 1315160 41087 37013 84656 125743 37013 X 1002879 1074602 230834 203545 1233713 1278147 1359456 1315160 44434 0 X X 0 1 X 1 0 X 1186667 942805 970559 921634 928157 4949822 1186667 942805 970559 921634 928157 4949822 4949822 3457 522 372 190 158 4699 53220 13204 7543 28327 17878 120172 5074693 0.97540 0.97260 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 119607 16425 0 136032 119607 16425 136032 106841 12766 119607 105647 1194 106841 93089 12558 105647 98220 -5131 93089 0.18000 0.82000 0 1 1 848840 168127 680713 180100 167723 12377 4545 4545 0 693090 X 2706314 14727 1743696 1698 1760121 946193 0 946193 2645455 1743696 1743696 901759 0 901759 PART X, LINE 2: THE ORGANIZATION IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE ORGANIZATION EVALUATES THEIR UNCERTAIN TAX POSITION USING GUIDANCE FOR CONTINGENCIES AS CONTAINED IN US GENERALLY ACCEPTED ACCOUNTING PRINCIPLES. THE ORGANIZATION WAS NOT AWARE OF ANY UNCERTAIN TAX POSITIONS. PART XI, LINE 2D - OTHER ADJUSTMENTS: INVESTMENT INCOME - RHODE ISLAND CARES FOUNDATON 1,698. X 0 0 0 0 0 0 0 0 0 MARIE GHAZAL CHIEF EXECUTIVE OFFICER 155734 0 0 0 0 0 0 0 17373 0 173107 0 0 0 FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS REVIEWED AND APPROVED BY THE BOARD TREASURER ON BEHALF OF THE BOARD OF DIRECTORS. THE BOARD TREASURER REPORTS THE REVIEW TO THE BOARD OF DIRECTORS AT THE NEXT SCHEDULED MEETING. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION'S CONFLICT OF INTEREST POLICY REQUIRES THAT ALL BOARD OF DIRECTOR MEMBERS AND STAFF MUST REVIEW AND SIGN THE POLICY. A SIGNED COPY OF THE CONFLICT OF INTEREST POLICY IS KEPT ON FILE AND REVIEWED EACH YEAR. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST AND ON GUIDESTAR'S WEBSITE. FORM 990, PART IX, LINE 11G DEVELOPMENT & GRANT CONSULTANTS: PROGRAM SERVICE EXPENSES 10,750. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 33,606. TOTAL EXPENSES 44,356. VOLUNTEER SERVICES - CONSULTANT: PROGRAM SERVICE EXPENSES 13,642. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 13,642. NURSE AND NURSE PRACTITIONER: PROGRAM SERVICE EXPENSES 19,424. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 19,424. BOOKKEEPING SERVICES: PROGRAM SERVICE EXPENSES 12,329. MANAGEMENT AND GENERAL EXPENSES 2,472. FUNDRAISING EXPENSES 2,470. TOTAL EXPENSES 17,271. FORM 990, PART XII, LINE 2C: THE FINANCE COMMITTEE IS RESPONSIBLE FOR OVERSIGHT OF THE AUDIT AND THE SELECTION OF THE INDEPENDENT AUDITORS RHODE ISLAND CARES FOUNDATION 655 BROAD STREET PROVIDENCE RI 02907 432107840 TO SUPPORT THE RHODE ISLAND FREE CLINIC A TAX-EXEMPT ORGANIZATION RI 501(C)(3) LINE 11B, II 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0