2012-11-19T16:41:43-08:00 2012-06-30 Claridad & Crowe CPAs PO Box 907 Mill Valley CA 94942 990 2011-07-01 262593712 VOLUNTEERS IN MEDICINE - SAN FRANCISCO DBA CLINIC BY THE BAY VOLU 4154050222 4877 MISSION STREET SAN FRANCISCO CA 94112 JANET REILLY 2012-11-19 true JASMINE C CLARIDAD 4158883645 2011 2016-02-24 21:20:13Z 543370 false false X WWW.CLINICBYTHEBAY.ORG X 2008 CA TO ENGAGE VOLUNTEERS TO PROVIDE QUALITY HEALTH CARE IN A FREE CLINIC FOR THE WORKING UNINSURED. 14 13 6 147 0 467615 543304 0 40 66 11604 0 479259 543370 0 0 306974 339332 0 41442 134929 146764 441903 486096 37356 57274 184238 268533 12467 9488 171771 259045 TO UNDERSTAND AND SERVE, WITH DIGNITY AND RESPECT THE HEALTH AND WELLNESS NEEDS OF THE MEDICALLY UNDERSERVED IN THE SAN FRANCISCO BAY AREA. false false 419896 PROGRAMS INCLUDE - FREE PRIMARY AND PREVENTIVE HEALTH CARE SERVICES FOR LOW INCOME WORKING UNINSURED ADULTS. SERVICES INCLUDE: PRIMARY CARE CLINIC VISITS; COORDINATED REFERRALS FOR SPECIALTY, DIAGNOSTIC AND SURGICAL CARE; INDIVIDUAL AND GROUP HEALTH EDUCATION;COMMUNITY OUTREACH; AND PSYCHOSOCIAL ASSESSMENT AND REFERRALS.VOLUNTEER PROGRAM: CREATE AND SUPPORT MEANINGFUL, PROFESSIONAL OPPORTUNITIES FOR CIVIC ENGAGEMENT. RECRUITMENT, ORIENTATION, TRAINING AND ON-GOING RETENTION OF HEALTH CARE PROFESSIONALS (MD, NP, RN) AND COMMUNITY MEMBERS TO PROVIDE FREE HEALTH CARE AND HEALTH EDUCATION TO LOW INCOME UNINSURED ADULTS. 419896 true true false false false false false false false false true false false false true false true false false false false false false false true false false false false false false false false false false false false false false false true false false false false false false false false false false true 5 0 false 6 true false false false false false false false false false false false 0 false false false false false false false false false false false X 14 13 false false false false false false false true true false false false true true true true true true true false false false CA X ELIZA GIBSON 4154050207 4877 MISSION STREET SAN FRANCISCO CA 94112 CHARLIE WILSON MD 2.00 X 0 0 0 PAUL TUREK MD 2.00 X 0 0 0 VINEET SINGAL 2.00 X 0 0 0 KEN SHACHMUT 2.00 X 0 0 0 RITA SEMEL 2.00 X 0 0 0 SETH SCHOLAR 2.00 X 0 0 0 JOHN LEGNITTO 2.00 X 0 0 0 ANN LAZARUS 2.00 X 0 0 0 KAREN KAUFMAN 2.00 X 0 0 0 LYNN JIMENEZ 2.00 X 0 0 0 CHERYL BARTH 2.00 X X 0 0 0 SCOTT HAUGE 8.00 X X 0 0 0 JANET REILLY 8.00 X X 0 0 0 ELIZA GIBSON 40.00 X 95000 0 5702 95000 5702 0 false false false 0 77086 466218 543304 0 66 66 0 0 0 0 77086 0 0 0 0 543370 66 0 0 0 0 89987 79188 3599 7200 0 190879 171107 4334 15438 0 34779 30853 1043 2883 23687 21250 643 1794 0 0 2297 2297 0 0 0 16736 10075 311 6350 0 0 0 0 56244 50619 2813 2812 0 0 0 0 0 10752 9677 537 538 9668 6416 3252 SUPPLIES 9061 8649 206 206 SMALL EQUIPMENT 5322 4790 266 266 ANCILLARY SERVICES 390 390 ADMINISTRATIVE EXPENSES 36294 26882 5457 3955 0 486096 419896 24758 41442 139345 195313 0 0 10500 50940 0 0 0 0 0 38982 22903 26831 16079 0 0 0 0 7562 6201 184238 268533 12467 9488 12467 9488 X 124271 171830 47500 87215 171771 259045 184238 268533 X 57274 30000 X false true false X false false X 190825 342806 467615 543304 1544550 0 0 190825 342806 467615 543304 1544550 250955 1293595 3 304 40 66 413 0 976 324 1300 1546263 X 0.00000 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 22170 17859 4311 16812 5044 11768 16079 ACCRUED VACATION 9488 9488 543370 486096 57274 57274 980017 438862 85000 523862 456155 87215 87215 543370 924958 438862 438862 486096 486096 Part XII, Line 4b Part XII, Line 4b: Other revenue amounts included on 990 but not included in F/S INC IN CURRENT YEAR TEMP REST REV $87215 false BELIEVE IT! 2012 77086 77086 77086 77086 SCOTT HAUGE-CAL Insurance BOARD DIRECTOR 2354 INSURANCE PREMIUMS PD false NON-CASH CONTRIBUTIONS OF SERVICES & GOODS Volunteers in Medicine - San Francisco d.b.a. Clinic by the Bay is committed to creating meaningful opportunities for civic engagement and as such, donated professional services and goods are core to our operations. During fiscal year 2011-2012, volunteer physicians, nurse practitioners, nurses, receptionists, interpreters and other dedicated community members donated 8,250 hours to provide free health care to low-income working uninsured adults. These hours are valued at $320,004. Additionally, needed ancillary services (lab and radiology) were donated, valued at $77,488, as well as over-the-counter medications ($3,157) and medical and administrative supplies ($1,975.) The other largest of donated services and goods is in the area of fundraising, including event space and service, food and drink, as well as donated items for a silent auction for our annual spring fundraiser ($15,730.) The total of in-kind services and goods for fiscal year 2011 - 2012 is $438,862. NON-CASH ASSISTANCE TO INDIVIDUALS VOLUNTEERS IN MEDICINE-SAN FRANCISCO dba CLINIC BY THE BAY PROVIDES PRIMARY CARE MEDICAL SERVICES FOR UNINSURED ADULTS.THE ELIGIBILITY CRITERIA FOR PRIMARY CARE MEDICAL SERVICES ARE - PATIENTS MUST BE 18 YEARS OR OLDER, LIVE IN ONE OF OUR NEARBY ZIP CODES (94112,94134,94014,94015), HAVE NO INSURANCE, AND HAVE INCOME AT OR BELOW 250% OF THE FEDERAL POVERTY LEVEL. ASSISTANCE INCLUDES PRIMARY CARE OFFICE VISITS, DIAGNOSTIC AND ANCILLARY SERVICES (RADIOLOGY AND LAB). FOR THE YEAR ENDED JUNE 30, 2012, ASSISTANCE TO 839 RECIPIENTS WAS PROVIDED WITH A FAIR MARKET VALUE OF $334,706. FMV IS BASED ON MEDICARE 4 & 5 RATES PLUS COSTS OF LAB AND RADIOLOGY SERVICES. Form 990, Part VI, Line 19 Form 990, Part VI, Line 19: Other Organization Documents Publicly Available TAX RETURNS AND ANNUAL FINANCIAL STATEMENTS ARE AVAILABLE UPON WRITTEN REQUEST. Form 990, Part VI, Line 12c Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts ALL MEMBERS OF THE GOVERNING BOARD ARE REQUIRED TO REFRAIN FROM ENGAGING IN TRANSACTIONS THAT PRESENT A CONFLICT OF INTEREST TO THE ORGANIZATION, AND MUST (AT LEAST ANNUALLY), PROVIDE A WRITTEN STATEMENT TO THE BOARD THAT NO SUCH CONFLICTS EXIST. Form 990, Part VI, Line 11 Form 990, Part VI, Line 11: Form 990 Review Process THE ORGANIZATION ENGAGED A CPA FIRM TO PREPARE THE TAX RETURNS, WHICH IS CLOSELY REVIEWED BY THE EXECUTIVE DIRECTOR. AN ELECTRONIC VERSION IS SUBMITTED TO ALL BOARD MEMBERS FOR COMMENT BEFORE FILING.