2012-11-14T08:19:57-06:00 2011-12-31 043037870 BOLLUS LYNCH LLP 89 SHREWSBURY STREET WORCESTER MA 01604 990 2011-01-01 042633274 THE HEALTH FOUNDATION OF CENTRAL MASSACHUSETTS INC HEAL 5084380009 446 MAIN STREET 20TH FLOOR WORCESTER MA 01608 JANICE B YOST EDD 5084380009 2012-11-13 1 DAVID EATON P00545132 5087557107 2012-11-13 2011 2016-02-24 21:20:13Z JANICE B YOST EDD 446 MAIN STREET 20TH FLOOR WORCESTER MA 01608 14976935 0 X HFCM.ORG X 1977 MA TO IMPROVE THE HEALTH STATUS OF THOSE WHO LIVE OR WORK IN CENTRAL MASSACHUSETTS. 13 13 5 0 0 0 0 0 0 0 1332502 3094299 142157 356019 1474659 3450318 1911087 2149125 0 0 537811 591945 0 0 0 532031 626117 2980929 3367187 -1506270 83131 62508004 60409777 783711 968353 61724293 59441424 TO IMPROVE THE HEALTH STATUS OF THOSE WHO LIVE OR WORK IN CENTRAL MASSACHUSETTS. 0 0 2634367 2149125 TO PROVIDE FUNDING TO NON-PROFIT ORGANIZATIONS FOR THE PURPOSE OF IMPROVING THE HEALTH AND WELFARE OF THOSE WHO LIVE AND WORK IN CENTRAL MASSACHUSETTS. 2634367 0 0 0 0 0 0 0 0 1 1 1 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1 7 0 5 1 0 0 0 0 0 0 0 0 0 0 X 13 13 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 MA X X THE FOUNDATION 5084380009 446 MAIN STREET 20TH FLOOR WORCESTER MA 01608 HENRY L FERGUSON III JD 1.50 X 0 0 0 LISA R FORTUNA MDMPH 1.50 X 0 0 0 JAY S HIMMELSTEINMDMPH 1.50 X 0 0 0 ROBIN B MCFEEDOMPH 1.50 X 0 0 0 MICHAEL J MUTCHLER MD 1.50 X 0 0 0 LUIS G PEREZ JD 1.50 X 0 0 0 BRIAN J PERRY 2.00 X 0 0 0 DEBORAH L PLUMMER PHD 1.50 X 0 0 0 ANN K TRIPP MBA 1.50 X 0 0 0 GEORGE ABRAHAMMDMPH 2.00 X 0 0 0 JOHN P GUSHA DMD 2.00 X 0 0 0 JEFFREY W HILLISJDMBA 2.50 X 0 0 0 LYNDA M YOUNG MD 2.00 X 0 0 0 JANICE B YOST EDD 37.50 X 208461 0 35148 ELAINE CINELLI 37.50 X 120807 0 11719 329268 0 46867 2 0 1 0 0 882425 882425 13738491 11526617 2211874 2211874 2211874 OTHER INCOME 900099 356019 356019 356019 3450318 356019 0 3094299 2149125 2149125 208461 143129 65332 260406 178795 81611 17447 11979 5468 73308 50333 22975 32323 22193 10130 2191 2191 19000 19000 5540 3125 2415 64066 38440 25626 14614 9274 5340 4019 2411 1608 6811 4087 2724 INVESTMENT FEES 468955 468955 OUTSIDE SERVICES 17879 9790 8089 OFFICE SUPPLIES 13290 7974 5316 PUBLICATIONS AND SPECIA 6737 3599 3138 3015 113 2902 3367187 2634367 732820 0 105232 98837 128556 178842 6460 5770 188702 170273 15848 18429 43356139 39412749 18316941 20127904 449127 427207 129701 140039 62508004 60409777 88833 87168 565177 741146 129701 140039 783711 968353 X 61724293 59441424 61724293 59441424 62508004 60409777 X 83131 -2366000 X 0 1 1 X 0 61935980 368941 2149125 219054 153546 59783196 56996509 7298261 1911087 298924 148779 61935980 49252271 10135553 1788998 463601 138716 56996509 65137195 4670933 -18023302 2239539 174170 118846 49252271 1.00000 0 0 188702 170273 18429 18429 INVESTMENT LIMITED PARTNERSHIPS 20127904 F 20127904 DEFERRED COMPENSATION PLAN 140039 140039 3450318 3367187 83131 -2366000 -2366000 -2282869 733933 -2366000 -2366000 3099933 350385 350385 3450318 3016802 0 3016802 350385 350385 3367187 1 MASS HOUSING & SHELTER ALLIANCE 25 KINGSTON STREET 3E BOSTON MA 02111 223068653 501(C)(3) 5000 BOOK HOME FOR GOOD:SOLUTIONS START HERE, HOMELESSNESS AMERICAN RED CROSS OF CENTRAL MA 2000 CENTURY DRIVE WORCESTER MA 016061256 530196605 501(C)(3) 10000 BOOK 2011 DISASTER RELIEF EFFORTS MASS LEAGUE OF COMMUNITY HEALTH CENTERS 40 COURT STREET 10TH FL BOSTON MA 02108 042507409 501(C)(3) 150000 BOOK CMOHI DENTAL RESIDENCY PROGRAM CHILDREN'S HOSPITAL BOSTON 300 LONGWOOD AVENUE BOSTON MA 02115 042774441 501(C)(3) 25000 BOOK CHILDREN'S MENTAL HEALTH CAMPAIGN ST PETER'S PARISH 929 MAIN STREET WORCESTER MA 01610 042130851 501(C)(3) 5000 BOOK "BABY AND ME" PROGRAM PERNET FAMILY HEALTH SERVICE 237 MILLBURY STREET WORCESTER MA 01610 042453851 501(C)(3) 5000 BOOK HEALTH SERVICES WORCESTER COUNTY FOOD BANK 474 BOSTON TURNPIKE SHREWSBURY MA 01545 043071457 501(C)(3) 259894 BOOK HUNGER-FREE AND HEALTHY WINCHENDON PUBLIC SCHOOLS 175 GROVE STREET WINCHENDON MA 014751162 046001370 501(C)(3) 247754 BOOK CHILDREN'S MENTAL HEALTH BOYS & GIRLS CLUB OF WEBSTER DUDLEY 55 OXFORD AVE DUDLEY MA 01571 042238069 501(C)(3) 50000 BOOK YOUTH DEVELOPMENT WORCESTER HOUSING AUTHORITY 40 BELMONT STREET WORCESTER MA 01605 046004472 501(C)(3) 155950 BOOK PUBLIC HOUSING RESIDENTS ACHIEVE SELF-SUFFICIENCY DISMAS HOUSE OF MASSACHUSETTS INC POB 3012530 RICHARDS ST JAMAICA PLAIN MA 02130 542075825 501(C)(3) 138413 BOOK PRISONER RE-ENTRY MILFORD REGIONAL MEDICAL CENTER 14 PROSPECT STREET MILFORD MA 01757 042103602 501(C)(3) 124500 BOOK ACCESS TO CARE/CREATING COMMUNITY HEALTH CENTER LUK INC 545 WESTMINSTER STREET FITCHBURG MA 01520 042483679 501(C)(3) 120000 BOOK YOUTH HOMELESSNESS HENRY LEE WILLIS COMMUNITY CENTER 119 FOREST STREET WORCESTER MA 01609 043124067 501(C)(3) 373641 BOOK PRISONER RE-ENTRY CITY OF WORCESTER-DIVISION OF PUBLIC HEALTH 25 MEADE STREET WORCESTER MA 016102715 046001418 501(C)(3) 25000 BOOK PUBLIC HEALTH REGIONALIZATION PROJECT AMENDMENT WORCESTER STATE FOUNDATION 486 CHANDLER STREET WORCESTER MA 016022597 223248067 501(C)(3) 73460 BOOK EXPAND AUDIOLOGY SERVICES EMPLOYMENT OPTIONS 82 BRIGHAM STREET MARLBOROUGH MA 01752 237089596 501(C)(3) 104200 BOOK MENTAL HEALTH FAMILY OPTIONS MANUAL AND TOOLKIT WENDALL P CLARK MEMORIAL YMCA 155 CENTRAL STREET WINCHENDON MA 014751162 042173363 501(C)(3) 50000 BOOK YOUTHFIT PROGRAM COMMUNITY HEALTH CONNECTIONS 275 NICHOLS ROAD FITCHBURG MA 01420 043452697 501(C)(3) 99000 BOOK PHARMACY PROGRAM DEVELOPMENT QUINSIGAMOND COMMUNITY COLLEGE 670 BOYLSTON STREET WORCESTER MA 01606 042897624 501(C)(3) 48000 BOOK HEALTHCARE CAREER LADDER EXPANSION PROJECT HENRY LEE WILLIS COMMUNITY CENTER 119 FOREST STREET WORCESTER MA 01609 043124067 501(C)(3) 50000 BOOK IMPROVE THE HEALTH OF BLACK MEN/MOSAIC CULTURAL COMPLEX CAPACITY BUILDING 21 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: THE HEALTH FOUNDATION AND THE GRANTEE SIGN A CONTRACT OUTLINING THE DELIVERABLES, PAYMENT, AND REPORTING REQUIREMENTS FOR THE PROJECT. TYPICALLY, PROJECT PROCESS EVALUATION REPORTS ARE SUBMITTED TO THE FOUNDATION MIDWAY THROUGH THE CONTRACT YEAR. A PROJECT SUMMARY REPORT IS ALSO REQUIRED TO BE SUBMITTED TO THE FOUNDATION APPROXIMATELY TWO MONTHS AFTER THE CONTRACT END DATE, OUTLINING THE RESULTS AND EXPENSES. IN ADDITION, MULTI-YEAR GRANTEES ARE REQUIRED TO MEET WITH FOUNDATION STAFF ON A QUARTERLY BASIS TO ASSESS PROJECT PROGRESS. X 1 1 X X X 0 0 0 0 0 0 0 0 0 JANICE B YOST EDD 198461 0 10000 0 0 0 18928 0 16220 0 243609 0 18200 0 PART I, LINE 1A THE FOUNDATION PAYS FOR HEALTH CLUB MEMBERSHIP FOR THE PRESIDENT. FORM 990, PART VI, SECTION B, LINE 11 THE ORGANIZATION'S FORM 990 IS REVIEWED BY THE BOARD AND IS FILED UPON RECEIVING BOARD MEMBER APPROVAL. FORM 990, PART VI, SECTION B, LINE 12C ANNUAL DISCLOSURE BY STAFF AND DIRECTORS, WITH A REVIEW OF THE POLICY EVERY THREE YEARS. FORM 990, PART VI, SECTION B, LINE 15 THE PRESIDENT'S SALARY IS APPROVED BY THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION PROVIDES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS UPON REQUEST. THE ORGANIZATION'S GOVERNING DOCUMENTS ARE ALSO AVAILABLE ON THE WEBSITE OF THE COMMONWEALTH OF MASSACHUSETTS. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -2,366,000. FORM 990, PART XII, LINE 2C THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. FORM 990, PART X, LINE 13 DURING 2008, THE FOUNDATION LOANED $492,000 TO AN INTERMEDIARY FOR A PROGRAM-RELATED INVESTMENT. THE FUND IS TO BE USED FOR ACQUIRING AND DEVELOPING AFFORDABLE HOUSING FOR THE ADULT CHRONICALLY HOMELESS IN THE WORCESTER AREA. THE FUND IS ADMINISTERED BY AN INTERMEDIARY. THE BALANCE IN THIS FUND AT DECEMBER 31, 2011 AND 2010 TOTALED $427,207 AND $449,127, RESPECTIVELY. THE HEALTH FOUNDATION FUND INC 446 MAIN STREET 20TH FL WORCESTER MA 01608 043521743 TO SUPPORT THE PURPOSE AND MISSION OF ITS MEMBER, THE HEALTH FOUNDATION. MA 501(C)(3) LINE 7 N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 THE HEALTH FOUNDATION FUND INC M 64066 STANDARD ACCOUNTING PROCEDURES THE HEALTH FOUNDATION FUND INC N 15902 STANDARD ACCOUNTING PROCEDURES