2013-01-31T13:37:55-06:00 2012-09-30 273605969 CBIZ KIRKLAND RUSS MURPHY & TAPP 13577 FEATHER SOUND DRIVE SUITE 400 CLEARWATER FL 33762 990 2011-10-01 237208280 ST PETERSBURG FREE CLINIC INC STPE 7278211200 863 THIRD AVENUE NORTH ST PETERSBURG FL 33701 ELISE MINKOFF 7278211200 2013-01-31 CHRIS CORNEROLI P01258051 7275721400 2011 2016-02-25 16:41:14Z BETH A HOUGHTON 863 THIRD AVENUE NORTH ST PETERSBURG FL 33701 5622978 0 X WWW.STPETERSBURGFREECLINIC.ORG X 1970 FL PROVIDE TEMPORARY ASSISTANCE FOR FAMILIES AND INDIVIDUALS IN NEED OF THE BASICS OF FOOD, SHELTER, HEALTH CARE, LIMITED FINANCIAL ASSISTANCE, AND REFERRAL INFORMATION. 16 16 39 4033 0 0 3752938 5295379 0 0 -1990 -4320 211962 258088 3962910 5549147 201785 199098 0 0 1034432 1150416 0 0 241506 3018122 3956964 4254339 5306478 -291429 242669 2100571 2375551 370399 397150 1730172 1978401 X FREE CLINIC'S MISSION IS TO PROVIDE TEMPORARY ASSISTANCE WITH HEALTH CARE, FOOD, AND SHELTER TO PEOPLE WHO ARE NOT ELIGIBLE FOR OTHER ASSISTANC PROGRAMS AND THOSE FACING EMERGENCY SITUATIONS SUCH AS JOB LOSS. 0 0 558902 61790 THE FREE CLINIC HEALTH CENTER IS A WALK-IN CLINIC FOR ADULTS (AGES 18-64) WITHOUT PRIVATE INSURANCE, MEDICARE, MEDICAID, AND FOR THOSE WHO DO NOT QUALIFY BY LOW INCOME FOR COUNTY HEALTH CARE. A GRANT FUNDED ADVANCED REGISTERED NURSE PRACTITIONER TREATS PATIENTS ALONG WITH 36 LICENSED DOCTORS AND 35 NURSES WHO VOLUNTEER THEIR TIME AND SERVICES AT THE FREE CLINIC. 7,800 PHYSICIAN VISITS AND 11,000 PRESCRIPTIONS WERE PROVIDED. SERVICES ALSO INCLUDE HEALTH SCREENINGS, HEALTH EDUCATION, LIMITED NUMBER OF WORK PHYSICALS, DIABETIC CLASSES, OVER THE COUNTER MEDICINE AND MEDICAL EQUIPMENT. 2811250 0 FREE CLINIC FOOD BANK ANNUALLY GATHERS 2,014,000 POUNDS OF DONATED AND SURPLUS FOOD FROM DISTRIBUTORS, RETAILERS, WHOLESALERS, GROWERS, COMMUNITY GROUPS, INDIVIDUALS, SCHOOLS, CHURCHES, AND BUSINESSES. THE FOOD IS DISTRIBUTED TO 62 PARTNER AGENCIES THROUGHOUT THE COMMUNITY WHICH INCLUDES FOOD PANTRIES, SOUP KITCHENS AND DAY-CARE GROUPS FOR CHILDREN AND THE ELDERLY. THE FOOD IS ALSO SUPPLIED TO THREE FREE CLINIC PROGRAMS INCLUDING WE HELP SERVICES (FOOD IS GIVEN DIRECTLY TO INDIVIDUALS AND FAMILIES IN NEED), THE WOMEN'S RESIDENCE (A SHELTER FOR SINGLE HOMELESS WOMEN), AND BEACON HOUSE (A MEN'S SHELTER AND COMMUNITY KITCHEN) WHICH PROVIDED 53,400 MEALS LAST YEAR. 1030085 132119 FREE CLINIC WE HELP SERVICES OFFERS INDIVIDUALS AND FAMILIES IN NEED WITH A VARIETY OF RESOURCES, EMERGENCY FOOD FROM THE ONSITE FOOD PANTRY, PERSONAL HYGIENE ITEMS, LIMITED FINANCIAL ASSISTANCE FOR WATER BILLS, LIMITED TRANSPORTATION ASSISTANCE, AND COMMUNITY REFERRAL GUIDANCE AND DIRECTION. APPROXIMATELY 50,000 PEOPLE WERE HELPED AND 517,344 POUNDS OF FOOD WERE DISTRIBUTED THROUGH THIS PROGRAM. OVER $97,000 IN FINANCIAL ASSISTANCE WAS PROVIDED FOR ASSISTANCE WITH WATER BILLS, TRANSPORTATION, AND IDENTIFICATION. ADDITIONALLY, OVER $41,000 IN FINANCIAL ASSISTANCE WAS PROVIDED FOR ELECTRIC BILLS TO THOSE SUFFERING FROM SEVERE MEDICAL CONDITIONS. 7,500 CHILDREN WERE ALSO PROVIDED FOOD THROUGH THIS PROGRAM. 194857 3291 THE FREE CLINIC WOMEN'S RESIDENCE PROVIDES A SAFE PLACE FOR SINGLE HOMELESS WOMEN TO STAY WHILE THEY ARE WORKING, SAVING, AND PLANNING FOR INDEPENDENT LIVING. UP TO 20 WOMEN MAY STAY AT ANY ONE TIME. THE WOMEN ARE SUPPORTED THROUGH REFERRAL AND INFORMATION PROGRAMS SUCH AS EDUCATION ABOUT BUDGETING, GOAL SETTING, JOB SEEKING, AND SELF-ESTEEM. WOMEN MAY STAY UP TO SIX MONTHS, WITH AN AVERAGE STAY OF FOUR MONTHS. 70 WOMEN WERE PROVIDED SHELTER DURING THE FISCAL YEAR WITH THE AVERAGE AGE BEING IN THE MID-FORTIES. 341146 1898 THE FREE CLINIC BEACON HOUSE IS A TEMPORARY AND TRANSITIONAL SHELTER OFFERING 30 BEDS, A SAFE PLACE TO STAY, AND JOB AND HOUSING INFORMATION FOR SINGLE, HOMELESS MEN. DINNER IS SERVED SIX NIGHTS A WEEK TO ANYONE IN THE COMMUNITY WHO IS HUNGRY. RESIDENTS WORK WITH STAFF TO SET GOALS, SAVE MONEY, AND WORK TOWARD INDEPENDENT LIVING. REFERRAL INFORMATION, CLOTHING, AND PERSONAL HYGIENE ITEMS ARE PROVIDED. DURING THE LAST FISCAL YEAR, APPROXIMATELY 7,800 NIGHTS OF SHELTER WERE PROVIDED TO 90 MEN. 32,000 EVENING MEALS WERE PROVIDED THROUGH THE BEACON HOUSE COMMUNITY KITCHEN. 536003 5189 4936240 1 1 0 0 0 0 0 0 0 1 1 0 0 0 0 1 0 1 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 1 9 0 1 39 1 0 0 0 0 0 1 1 0 0 0 0 X 16 16 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 FL X THE ORGANIZATION 7278211200 863 THIRD AVENUE NORTH ST PETERSBURG FL 33701 SANDRA AVERITT PHD 1.00 X 0 0 0 MARYLOU BOURDOW 8.00 X X 0 0 0 ELISE MINKOFF 4.00 X X 0 0 0 JOHN NICELY 2.00 X X 0 0 0 MARY WYATT ALLEN 2.00 X 0 0 0 TIM COOP 2.00 X X 0 0 0 LYNDETTE AGUIRRE 4.00 X 0 0 0 GLENN MCKELVEY 1.00 X 0 0 0 DAVE HOSICK 1.00 X 0 0 0 GINNY ROWELL 1.00 X 0 0 0 SHERWOOD WHITE 1.00 X 0 0 0 ED AMEEN 1.00 X 0 0 0 WAYNE HOOVER 8.00 X 0 0 0 SARAH M LUCAS 1.00 X 0 0 0 RICK MALCHON JR 2.00 X 0 0 0 KATHY MATTHEWS 1.00 X 0 0 0 BETH HOUGHTON 40.00 X 3570 0 0 3570 0 0 0 0 0 0 0 40130 5255249 3422976 5295379 3018 3018 7338 -7338 -7338 -7338 324581 66493 258088 258088 5549147 0 0 253768 199098 199098 59575 46610 4186 8779 946191 740283 66488 139420 15001 13547 1454 49763 40273 4553 4937 79886 60483 4939 14464 31525 26555 2486 2484 48353 31475 5454 11424 31318 21862 5073 4383 36322 27364 3945 5013 171311 147296 13661 10354 23324 22246 646 432 13276 9957 1660 1659 60116 55288 2414 2414 80294 69791 6968 3535 DONATED FOOD USED/DISTR 3385210 3385210 PROGRAM SUPPLIES 57482 34355 3854 19273 LICENSES AND FEES 11349 1360 541 9448 STAFF TRAINING AND CONT 5554 3187 500 1867 1530 1364 166 5306478 4936240 128732 241506 32956 59076 358363 543683 423309 435348 149247 110218 45146 82912 54017 50613 2122641 1078940 987533 1043701 50000 50000 2100571 2375551 106695 120170 263704 276980 370399 397150 X 896948 1336116 783224 424685 50000 217600 1730172 1978401 2100571 2375551 X 242669 5560 X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 846072 381275 -26124 558938 642285 869503 277211 -13276 287366 846072 641495 642662 -13276 319034 82344 869503 418040 308304 -17849 60000 7000 641495 0.00000 0.34000 0.66000 0 0 346687 346687 1416043 860284 555759 359911 218656 141255 1043701 5549147 5306478 242669 5560 5560 248229 6070469 5560 285150 223275 513985 5556484 -7337 -7337 5549147 5599202 285150 7574 292724 5306478 0 5306478 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: PROVIDE A LONG-TERM PREDICTABLE STREAM OF FUNDING TO PROGRAMS SUPPORTED BY THE FREE CLINIC. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE FREE CLINIC FOLLOWS ACCOUNTING STANDARDS CODIFICATION TOPIC 740, "INCOME TAXES" ("ASC 740"). A COMPONENT OF THIS STANDARD PRESCRIBES A RECOGNITION AND MEASUREMENT THRESHOLD OF TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. FOR THOSE BENEFITS TO BE RECOGNIZED, A TAX POSITION MUST BE MORE-LIKELY-THAN-NOT TO BE SUSTAINED UPON EXAMINATION BY TAXING AUTHORITIES. THE FREE CLINIC'S POLICY IS TO RECOGNIZE INTEREST AND PENALTIES ASSOCIATED WITH TAX POSITIONS UNDER THIS STANDARD AS A COMPONENT OF TAX EXPENSE, AND NONE WERE RECOGNIZED SINCE THERE WAS NO MATERIAL IMPACT OF THE APPLICATION OF THIS STANDARD FOR THE YEARS ENDED SEPTEMBER 30, 2012 AND 2011. THE FREE CLINIC'S INFORMATION RETURNS ARE OPEN TO IRS EXAMINATION FOR THE 2008 TAX YEAR ENDED SEPTEMBER 30, 2009, AND ALL SUBSEQUENT YEARS. PART XII, LINE 2D - OTHER ADJUSTMENTS: ELIMINATION OF SISTER MARGARET FREEMAN FOUNDATION ACTIVITY ON FS 134,672. ELIMINATION OF SISTER MARGARET FREEMAN FOUNDATION UNREALIZED GAIN/LOSS 88,603. PART XII, LINE 4B - OTHER ADJUSTMENTS: LOSS ON DISPOSAL OF ASSETS RECORDED AS EXPENSE ON FS -7,337. PART XIII, LINE 2D - OTHER ADJUSTMENTS: LOSS ON DISPOSAL OF ASSETS RECORDED AS EXPENSE ON FS 7,338. ELIMINATION OF SISTER MARGARET FREEMAN FOUNDATION ACTIVITY ON FS 71. EXPENSES NETTED AGAINST REVENUE 165. SOUP'S ON FUNDRAISER 68926 68926 4982 BATTLE OF THE MINDS FUNDRAISER 255655 255655 61511 324581 324581 66493 66493 258088 1 SPECIFIC ASSISTANCE TO INDIVIDUALS IN NEED OF FOOD, MEDICAL CARE, SHELTER, LIMITED FINANCIAL ASSISTANCE, AND REFERRAL INFORMATION, THROUGH PROGRAMS SUCH AS BEACON HOUSE, WE HELP SERVICES, AND WOMEN'S RESIDENCE 15000 199098 0 BOOK PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: THE VARIOUS PROGRAMS, SUCH AS BEACON HOUSE, WE HELP SERVICES, AND WOMEN'S RESIDENCE PROVIDE ASSISTANCE TO INDIVIDUALS IN THE FOLLOWING WAYS: - DIRECT MEDICINE - THE CLINIC PURCHASES AND DISTRIBUTES MEDICINE DIRECTLY TO PATIENTS. - UTILITIES - THE CLINIC PAYS UTILITY BILLS ON BEHALF OF INDIVIDUALS. - DIRECT ASSISTANCE - THE CLINIC PROVIDES FOOD (MOSTLY DONATED) ON BEHALF OF INDIVIDUALS. - TRANSPORTATION - THE CLINIC PURCHASES BUS PASSES ON BEHALF OF INDIVIDUALS. - ID SERVICES - THE CLINIC HELPS INDIVIDUALS WITH OBTAINING DRIVER LICENSES AND BIRTH CERTIFICATES. - DIABETIC SUPPLIES - THE CLINIC PROVIDES DIABETIC TESTING SUPPLIES. ALL APPLICANTS ARE INTERVIEWED AND SCREENED TO DETERMINE THEIR SPECIFIC NEEDS. ALL ASSISTANCE IS PAID FOR DIRECTLY BY THE CLINIC, AND NO MONEY GOES DIRECTLY TO INDIVIDUALS. X 3422976 ESTIMATED $1.70/LB 0 0 0 METHOD FOR DETERMINING NUMBER OF CONTRIBUTORS: PART I, COLUMN (B): CONTRIBUTORS DONATED APPROXIMATELY 2,014,000 POUNDS OF FOOD DURING THE YEAR. FORM 990, PART VI, SECTION B, LINE 11 THE EXECUTIVE DIRECTOR REVIEWS THE FORM 990, AND PRESENTS THE EXACT IRS FILING COPY OF THE FORM 990 FOR EACH VOTING BOARD MEMBER'S REVIEW, BEFORE IT IS FILED. FORM 990, PART VI, SECTION B, LINE 12C THE EXECUTIVE DIRECTOR MONITORS FOR ANY CONFLICT OF INTEREST AMONG EMPLOYEES, AND INVOLVES THE CHAIRPERSON OR BOARD AS NECESSARY. FORM 990, PART VI, SECTION B, LINE 15A THE BOARD'S EXECUTIVE COMMITTEE DETERMINES THE EXECUTIVE DIRECTOR'S SALARY BASED ON THEIR KNOWLEDGE OF SALARIES AT COMPARABLE ORGANIZATIONS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, POLICIES, AND AUDITED FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. PLEASE CALL 727-823-7866 TO MAKE A REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 5,560. SISTER MARGARET FREEMAN FOUNDATION 863 3RD AVENUE NORTH ST PETERSBURG FL 33701 311470427 PROVIDE FUNDS FOR THE ST. PETERSBURG FREE CLINIC FL 501(C)(3) 11A - TYPE 1 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0