2011-03-29T18:30:16-05:00 2010-09-30 CBIZ KIRKLAND RUSS MURPHY & TAPP 13577 FEATHER SOUND DRIVE SUITE 400 CLEARWATER FL 33762 990 2009-10-01 237208280 ST PETERSBURG FREE CLINIC INC STPE 7278211200 863 THIRD AVENUE NORTH ST PETERSBURG FL 33701 JOHN NICELY 7278211200 2011-03-28 NATHAN SMITH 7275721400 2009 2016-02-24 21:20:13Z JOHN NICELY 863 3rd Avenue North St Petersburg FL 33701 4899819 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. 23 23 27 350 0 0 3639813 4610586 0 321 3519 146266 229159 3786400 4843264 145615 200615 0 972888 1044203 0 218773 2732604 3131621 3851107 4376439 -64707 466825 1906119 2395068 387952 381594 1518167 2013474 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 497710 58733 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 30 nurses who volunteer their time and services at the Free Clinic. 6,259 physician visits and 17,000 prescriptions were provided. Services also include health screenings, health education, limited number of work physicals, diabetic classes, over the counter medicine and medical equipment. 2050168 4878 Free Clinic Food Bank annually gathers 1,727,000 million pounds of donated and surplus food from distributors, retailers, wholesalers, growers, community groups, individuals, schools, churches, and businesses. The food is distributed to 50 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 40,000 meals last year. 969170 130667 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. 22,113 people were helped and 432,157 pounds of food were distributed through this program. Over $60,0000 in financial assistance was provided for assistance with water bills, transportation, and identification. Additionally, over $60,000 in financial assistance was provided for electric bills to those suffering from severe medical conditions. 7,310 children were served through assistance to families in need. 183872 3172 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. 63 women were provided shelter during the fiscal year with the average age being in the mid-forties. 298352 3165 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 9,615 nights of shelter were provided to 216 men. 34,804 evening meals were provided through the Beacon House Community Kitchen. 482224 6337 3999272 1 1 0 0 0 0 0 0 0 1 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 1 3 0 27 1 0 0 0 0 0 1 1 0 0 0 0 0 23 23 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 JIM THOMPSON jr 1.00 X 0 0 0 Beth Houghton 4.00 X 0 0 0 Cindy Rose 1.00 X 0 0 0 Al May 4.00 X X 0 0 0 Sandra Averitt 1.00 X 0 0 0 Marylou Bourdow 4.00 X X 0 0 0 Janice Buchanan 1.00 X 0 0 0 Jack Courtney 1.00 X 0 0 0 Leigha Epler 1.00 X 0 0 0 Catherine McGarry 3.00 X 0 0 0 Elise Minkoff 1.00 X 0 0 0 Jim Mortensen 1.00 X 0 0 0 John Nicely 2.00 X 0 0 0 Virginia Rowell 1.00 X 0 0 0 Bill Thomas 1.00 X 0 0 0 Sherwood White 2.00 X 0 0 0 Armetha Williams 1.00 X 0 0 0 MARY WYATT ALLEN 3.00 X 0 0 0 JAMES FLYNN 1.00 X 0 0 0 ROLAND METIVIER 1.00 X 0 0 0 NORM SMITH 1.00 X 0 0 0 Jane Egbert 55.00 X 75194 0 1480 Marie Viking 40.00 X 74183 0 6203 Clyde Davis 45.00 X 55898 0 311 205275 0 7994 0 0 0 0 0 832028 3778558 2592179 4610586 7375 7375 3856 -3856 -3856 -3856 281858 52699 229159 229159 4843264 0 0 232678 200615 200615 224187 178370 13668 32149 699645 552234 43814 103597 18494 15763 1331 1400 29042 29042 72835 57390 4994 10451 41971 35005 3482 3484 59729 33808 5833 20088 25459 14074 2536 8849 32718 25369 3043 4306 179383 153789 15402 10192 16221 16046 175 14418 9957 2802 1659 63049 55207 3921 3921 73306 56246 13590 3470 Donated Food Used/Distr 2525399 2525399 Program Supplies 57454 36191 7402 13861 BAD DEBT EXPENSE 36361 36361 Licenses and Fees 2067 1568 39 460 Staff Training and Cont 1708 877 176 655 2378 2322 56 4376439 3999272 158394 218773 48223 147562 330396 416246 484900 732595 40581 107358 28629 31926 2037044 1127663 923390 909381 50000 50000 1906119 2395068 146214 131166 237152 250428 4586 0 387952 381594 X 876672 1143971 546401 819503 95094 50000 1518167 2013474 1906119 2395068 X 0 1 1 X 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 641495 642662 -13276 319034 82344 869503 418040 308304 -17849 60000 7000 641495 0.00000 0.05750 0.94250 0 0 346687 346687 1366857 887679 479178 302328 239984 62344 21172 21172 909381 4843264 4376439 466825 28482 28482 495307 5287258 28482 293600 118056 440138 4847120 -3856 -3856 4843264 4673895 293600 3856 297456 4376439 0 4376439 Part V, Line 4: Description of Intended Use of Endowment Funds: PROVIDE A LONG-TERM PREDICTABLE STREAM OF FUNDING TO PROGRAMS SUPPORTED BY THE FREE CLINIC. Part XII, Line 2d - Other Adjustments: Elimination of Sister Margaret Freeman Foundation activity on FS: 118056. Part XII, Line 4b - Other Adjustments: Loss on Disposal of Assets recorded as expense on FS: -3856. Part XIII, Line 2d - Other Adjustments: Loss on Disposal of Assets Recorded as Expense on FS: 3856. Soup's On Fundraiser 52218 52218 6218 Battle of the Minds Fundraiser 229640 229640 46481 281858 281858 52699 52699 229159 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 200615 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 2592179 Estimated $1.50/lb 0 0 0 Method for Determining Number of Contributors: Part I, Column (b): Contributors donated approximately 1,728,119 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. There has been no change in the audit committee's role from the prior year. 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) Type II Supporting 0 1 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 Sister Margaret Freeman Foundation M Sister Margaret Freeman Foundation N