2013-11-12T16:35:19-06:00 2013-06-30 410746749 CLIFTONLARSONALLEN LLP 600 3RD AVE SE STE 300 CEDAR RAPIDS IA 52401 990 2012-07-01 134228071 COMMUNITY HEALTH FREE CLINIC COMM 3193630416 947 14TH AVENUE SE CEDAR RAPIDS IA 52401 PATRICIA BARNES 3193630416 2013-11-11 1 DAVID LITTLE P01480921 3193632697 2012 2016-03-07 17:11:31Z PATRICIA BARNES 947 14TH AVENUE SE CEDAR RAPIDS IA 52401 2891572 0 X WWW.COMMUNITYHFC.ORG X 2002 IA TO PROVIDE HEALTH CARE TO THE UNINSURED AND UNDER-SERVED OF EAST CENTRAL IOWA THROUGH MODEL COMMUNITY PARTNERSHIPS. 12 12 45 450 0 0 2943234 2856182 0 0 31784 35390 0 0 2975018 2891572 0 0 0 0 532872 582976 19050 0 135077 2277426 2408588 2829348 2991564 145670 -99992 3287951 3239405 33513 38010 3254438 3201395 TO PROVIDE HEALTH CARE TO THE UNINSURED AND UNDER-SERVED OF EAST CENTRAL IOWA THROUGH MODEL COMMUNITY PARTNERSHIPS. 0 0 2682692 PROVIDED FREE HEALTH CARE SERVICES, INCLUDING MEDICAL, DENTAL AND VISION FOR ANY UNDER-SERVED OR UNINSURED INDIVIDUAL IN NEED OF HEALTH CARE. APPROXIMATELY 400 NEW PATIENTS WERE SEEN PER MONTH. THE AVERAGE TOTAL OF NEW AND EXISTING INDIVIDUALS SERVICED DURING THE YEAR WAS 27,073. COMMUNITY HEALTH FREE CLINIC PROUDLY SERVICES INDIVIDUALS ALL OVER THE EAST CENTRAL IOWA AREA. 2682692 1 1 0 0 0 0 0 0 0 1 1 0 0 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 5 0 45 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 AZ CO FL MN NJ NY NC MO WA WI IL X SUSAN RUSSELL DIRECTOR OF FINANCE 3192211585 715 10TH AVE SE CEDAR RAPIDS IA 52401 AMY JOHNSON BOYLE 1.00 X 0 0 0 JAMES FLYNN JR MD 1.00 X 0 0 0 GREG HAYES MD 1.00 X 0 0 0 MARK MARZ DDS 1.00 X 0 0 0 SISTER SUSAN O'CONNOR 1.00 X 0 0 0 MICHAEL SUNDALL 1.00 X 0 0 0 BRANDT WORLEY 1.00 X 0 0 0 KEVIN CRIST 1.00 X 0 0 0 REX ENO 1.00 X X 0 0 0 DAVID MULLER MD 1.00 X X 0 0 0 MICHELLE NIERMAN 1.00 X X 0 0 0 PATRICIA BARNES 1.00 X X 0 0 0 DARLENE SCHMIDT 55.00 X 62520 0 0 62520 0 0 0 0 0 0 0 281484 7000 29894 2537804 1984033 2856182 26722 26722 8668 0 8668 8668 8668 0 7000 0 0 2891572 0 0 35390 63444 25378 22205 15861 478295 354037 57827 66431 41237 29166 6122 5949 14350 14350 4289 4289 14706 14706 80180 44902 29125 6153 96209 67382 14213 14614 55030 38541 8130 8359 14626 14626 DONATED GOODS 1984033 1984033 MEDICATIONS 139919 139919 0 0 MEDICAL SERVICES 42529 42529 0 0 REGISTRATION FEES 1837 1287 271 279 -39120 -44482 2637 2725 2991564 2682692 173795 135077 69933 139886 552492 315757 208877 209005 235049 292027 4187 3707 2005556 580359 1480226 1425197 737187 853826 3287951 3239405 33513 38010 33513 38010 X 2622863 2553648 335035 350657 296540 297090 3254438 3201395 3287951 3239405 -99992 46949 0 X X 0 1 X 1 0 X 1882342 3050743 3167212 2943234 2856182 13899713 1882342 3050743 3167212 2943234 2856182 13899713 20256 13879457 17140 15285 14056 14305 26722 87508 13987221 0.99230 0.98790 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 633854 550 75182 61783 4289 643514 387335 247581 2179 3241 633854 301409 28948 54125 2853 387335 239667 34491 30009 2758 301409 313438 1198 -72630 2339 239667 0.53830 0.46170 0.00000 1 0 1761717 347289 1414428 243839 233070 10769 1425197 BENEFICIAL INTEREST IN ASSETS HELD BY COMMUNITY FOUNDATION 643514 ASSETS HELD FOR SALE 3000 LONG TERM CERTIFICATES OF DEPOSIT 207312 853826 X 6439786 46949 3505554 3552503 2887283 4289 4289 2891572 6492829 3505554 3505554 2987275 4289 4289 2991564 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: CHFC INTENDS TO USE THE EARNINGS FROM THE ENDOWMENT FUNDS FOR LONG TERM FINANCIAL SUPPORT OF THE CLINIC. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: THE ORGANIZATION HAS DETERMINED THAT IT WAS NOT REQUIRED TO RECORD A LIABILITY RELATED TO UNCERTAIN TAX POSITIONS. X 1001827 1984033 FMV 0 0 1 0 METHOD FOR DETERMINING NUMBER OF CONTRIBUTORS: PART I, COLUMN (B): LINE 20 IS AN ESTIMATED QUANTITY OF MEDICINES DONATED. FORM 990, PART VI, SECTION B, LINE 11 AFTER THE INDEPENDENT PUBLIC ACCOUNTING FIRM PREPARES A DRAFT OF THE FEDERAL FORM 990, THE DIRECTOR OF FINANCE AND TREASURER REVIEW THE DRAFT AND IF NECESSARY MAKE ANY CHANGES. THE FEDERAL FORM 990 IS THEM MARKED DRAFT UNTIL APPROVED BY THE COMMUNITY HEALTH FREE CLIENT (CHCF) 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 OF INTEREST ARISE. STATEMENTS ARE RETAINED BY THE EXECUTIVE DIRECTOR IN CHFC'S OFFICE. FORM 990, PART VI, SECTION B, LINE 15A IN JULY OF EACH YEAR, THE CEO/CLINIC EXECUTIVE DIRECTOR DRAFTS A LIST OF ANNUAL GOALS & OBJECTIVES AND PROVIDES IT TO THE PRESIDENT OF THE BOARD. THE BOARD OF DIRECTORS REVIEWS THE GOALS AND OBJECTIVES AT THE ANNUAL BEGINNING OF 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/CLINIC EXECUTIVE DIRECTOR PROVIDES THE PRESIDENT OF THE BOARD WITH A DOCUMENT THAT DETAILS HIS/HER PERFORMANCE AGAINST THE ANNUAL GOALS AND OBJECTIVES APPROVED IN THE PRIOR JULY. AFTER A FACE-TO-FACE REVIEW WITH THE CEO/CLINIC EXECUTIVE DIRECTOR, THE PRESIDENT OF THE BOARD 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 BOARD 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/CLINIC EXECUTIVE DIRECTOR'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/CLINIC EXECUTIVE DIRECTOR) FOR THE OVERALL GRADE AND SUGGESTED SALARY INCREASE. THE CEO/CLINIC EXECUTIVE DIRECTOR'S OVERALL GRADE AND SALARY INCREASE ARE VOTED ON BY THE BOARD OF DIRECTORS. THE SPECIFICS OF THE SALARY INCREASE ARE NOT DOCUMENTED IN BOARD MEETING MINUTES TO PROVIDE THE CEO/CLINIC EXECUTIVE DIRECTOR 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 FISCAL DAY OF THE YEAR. THIS PROCESS WAS LAST COMPLETED JULY OF 2012. FORM 990, PART VI, SECTION B, LINE 15B: THERE IS NOT A PROCESS FOR DETERMINING COMPENSATION OF THE CHFC'S OTHER OFFICERS OR KEY EMPLOYEES BECAUSE 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. AUDIT OVERSIGHT COMMITTEE FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED FROM PRIOR YEAR.