Attach to Form 990 or Form 990-EZ.
Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
| (i)Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
| Total | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .... | ||||||
| 2 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....... | ||||||
| 3 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 4 | Total. Add lines 1 through 3 | ||||||
| 5 | The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f).. | ||||||
| 6 | Public support. Subtract line 5 from line 4. | ||||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | ||||||
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | ||||||
| 9 | Net income from unrelated business activities, whether or not the business is regularly carried on.. | ||||||
| 10 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.).. | ||||||
| 11 | Total support Add lines 7 through 10. | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | 6,389,111 | 6,074,140 | 7,933,964 | 8,019,385 | 7,301,188 | 35,717,788 |
| 2 | Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose...... | 13,719,849 | 14,694,402 | 26,067,825 | 27,423,864 | 28,566,022 | 110,471,962 |
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513.. | 0 | |||||
| 4 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... | 0 | |||||
| 5 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | 0 | |||||
| 6 | Total. Add lines 1 through 5. | 20,108,960 | 20,768,542 | 34,001,789 | 35,443,249 | 35,867,210 | 146,189,750 |
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons... | 0 | |||||
| b | Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year. | 0 | |||||
| c | Add lines 7a and 7b.. | 0 | |||||
| 8 | Public support (Subtract line 7c from line 6.) | 146,189,750 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 20,108,960 | 20,768,542 | 34,001,789 | 35,443,249 | 35,867,210 | 146,189,750 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 94,308 | 97,988 | 118,767 | 1,218,377 | 241,643 | 1,771,083 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | 0 | |||||
| c | Add lines 10a and 10b. | 94,308 | 97,988 | 118,767 | 1,218,377 | 241,643 | 1,771,083 |
| 11 | Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on. | 0 | |||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) .. | 0 | |||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 20,203,268 | 20,866,530 | 34,120,556 | 36,661,626 | 36,108,853 | 147,960,833 |
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e | Discount claimed for blockage or other factors (explain in detail in Part VI): | |||||
| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). | 4 | ||||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | ||||
| 6 | Multiply line 5 by .035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| 7 | Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions) | |||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | ||
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
||
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | ||
| 4 Amounts paid to acquire exempt-use assets | ||
| 5 Qualified set-aside amounts (prior IRS approval required) | ||
| 6 Other distributions (describe in Part VI). See instructions | ||
| 7Total annual distributions. Add lines 1 through 6. | ||
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
||
| 9 Distributable amount for 2014 from Section C, line 6 | ||
| 10 Line 8 amount divided by Line 9 amount | ||
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2014 |
(iii) Distributable Amount for 2014 |
|
|---|---|---|---|---|
|
1
Distributable amount for 2014 from Section C, line 6 |
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|
2
Underdistributions, if any, for years prior to 2014 (reasonable cause required--see instructions) |
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| 3 Excess distributions carryover, if any, to 2014: | ||||
| a From 2009.......X | ||||
| b From 2010.......X | ||||
| c From 2011.......X | ||||
| d From 2012.......X | ||||
| e From 2013....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2014 distributable amount | ||||
|
i
Carryover from 2009 not applied (see instructions) |
||||
| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | ||||
| 4Distributions for 2014 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2014 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from 4. | ||||
|
5
Remaining underdistributions for years prior to 2014, if any. Subtract lines 3g and 4a from line 2 (if amount greater than zero, see instructions) |
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|
6
Remaining underdistributions for 2014. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions) |
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|
7 Excess distributions carryover to 2015. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a From 2010.......X | ||||
| b From 2011.......X | ||||
| c From 2012.......X | ||||
| d From 2013....... | ||||
| e From 2014....... | ||||
| Facts And Circumstances Test |
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| Return Reference | Explanation |
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| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at| Return Reference | Explanation |
|---|---|
| FORM 990, PART III, LINE 2 | SIGNIFICANT PROGRAM SERVICES: On December 29, 2014, the Organization acquired the remaining 99.9% of membership interest of Holyoke HC, LLC (LLC) an entity that was organized in 2005 to acquire, rehabilitate, lease and sell real property for the purpose of commercial rental of interconnected mixed-use space offering primarily outpatient health care containing approximately 108,300 gross square feet and 85,000 net rentable square feet of space in the City of Holyoke, Massachusetts. The acquisition was accomplished by MHIC assigning its entire 99.99% interest in LLC to the Health Center, and no consideration was or will be transferred for the acquisition. |
| FORM 990, PART III, LINE 4B | PHARMACEUTICAL SERVICES: THE ON-SITE, STATE OF THE ART, COMMUNITY PHARMACY, FILLS APPROXIMATELY 4,000 PRESCRIPTIONS PER WEEK, IS OWNED AND OPERATED BY HOLYOKE HEALTH CENTER AND IS AN INTEGRAL PART OF ALL SERVICES OFFERED IN THE HOLYOKE HEALTH CENTER MEDICAL HOME. BOTH CLINICAL AND DISPENSING PHARMACY STAFF ARE ACTIVE IN HEALTH CENTER COMMITTEES THAT WORK TO CONTINUOUSLY IMPROVE HOLYOKE HEALTH CENTER'S QUALITY, PATIENT CENTERED PROGRAMMING. |
| FORM 990, PART III, LINE 4D | OTHER PROGRAM SERVICES: TO FURTHER ITS MISSION TO IMPROVE THE HEALTH OF ITS PATIENTS, HOLYOKE HEALTH CENTER OFFERS THE FOLLOWING OUTREACH AND NUTRITIONAL PROGRAMS: - FARM WORKERS' PROGRAM THE FARM WORKER'S PROGRAM IS A PROGRAM THAT PAYS FOR SOME PRIMARY HEALTH CARE SERVICES TO QUALIFIED MIGRANT AND SEASONAL FARM WORKERS AND THEIR DEPENDENTS. HOLYOKE HEALTH IS ONE OF THE PARTICIPATING COMMUNITY HEALTH CENTERS THAT PROVIDE PRIMARY CARE AND OUTREACH AND EDUCATION TO SEASONAL FARM WORKERS IN THE CONNECTICUT RIVER VALLEY. ITS PROGRAM FOCUSES ON FARM WORKERS IN HAMPSHIRE AND HAMPDEN COUNTIES. - FRUIT AND VEGETABLE PRESCRIPTION PROGRAM HOLYOKE HEALTH IS ONE OF A HANDFUL OF ORGANIZATIONS ACROSS THE COUNTRY THAT HAS BEEN AWARDED FUNDING TO PROVIDE THE FRUIT AND VEGETABLE PRESCRIPTION PROGRAM. THIS PROGRAM IS DEDICATED TO INCREASING A FAMILY MEMBER'S DIET BY ONE FRUIT AND ONE VEGETABLE EACH DAY. EACH YEAR HOLYOKE HEALTH ENROLLS THIRTY FAMILIES TO PARTICIPATE IN THIS PROGRAM AND THE PARTICIPATING PEDIATRICIAN GIVES A WRITTEN PRESCRIPTION FOR FRUITS AND VEGETABLES THAT WILL SUPPLY THE FAMILY FOR ONE MONTH THE FAMILY THEN REDEEMS THE PRESCRIPTION AT THE LOCAL FARMER'S MARKET AND THE FAMILY RECEIVES TOKENS FOR LOCALLY GROWN FRESH FRUITS AND VEGETABLES. THE PROGRAM LASTS THROUGHOUT THE MARKET SEASON ($28 WORTH OF PRODUCE EACH WEEK FOR A FAMILY OF FOUR). - HIV SUPPORT SERVICES AND CASE MANAGEMENT HOLYOKE HEALTH CENTER HAS A COMPREHENSIVE PROGRAM TO SUPPORT PATIENTS LIVING WITH HIV, INCLUDING PRIMARY MEDICAL CARE, INFECTIOUS DISEASE SPECIALISTS WITH EXPERIENCE IN HIV, AND CASE MANAGEMENT SUPPORT TO MEET THE NON-MEDICAL NEEDS OF ITS PATIENTS. THE PHARMACY PROVIDES CONSULTATION WITH A PHARMACIST EXPERIENCED IN HIV MEDICATIONS AND ASSISTANCE WITH ENROLLING IN THE HIV DRUG ASSISTANCE PROGRAM. ALSO AVAILABLE FOR PATIENTS WITH HIV ARE NUTRITION AND EYE CARE SERVICES. - LA LINDA MANITA LA LINDA MANITA OFFERS FREE GROUPS THAT PROVIDE PEER SUPPORT, BRINGS TOGETHER PARENTS, AND EDUCATES ABOUT CHILD DEVELOPMENT, PARENTING SKILLS, AND RESOURCES. THESE GROUPS ARE CONDUCTED IN ENGLISH AND SPANISH AND ARE SCHEDULED FOR AFTERNOON AND EARLY EVENING TIMES TO INCREASE ACCESS. LA LINDA MANITA'S GOAL IS TO PROVIDE CRUCIAL PARENTING INFORMATION AND TO REDUCE THE LEARNING DELAYS & BEHAVIORAL/DEVELOPMENTAL DISORDERS IN YOUNG CHILDREN THAT CAN OCCUR FREQUENTLY IN OUR COMMUNITY. THIS PROGRAM IS MEETING AN OVERALL NEED FOR SUPPORT AND EDUCATION FOR FAMILIES WITH YOUNG CHILDREN AND IS DOING SO AS A PART OF A CITY-WIDE EFFORT TO IMPROVE SCHOOL READINESS AS WELL AS PREVENTING LEARNING AND BEHAVIORAL ISSUES IN YOUNG CHILDREN. - LET'S MOVE HOLYOKE 5-2-1-0 THE LET'S MOVE HOLYOKE 5-2-1-0 IS COLLABORATIVE INITIATIVE THAT FOCUSES ON THE PROMOTION OF HEALTHY LIVING BY INTEGRATING THE 5-2-1-0 MESSAGE INTO THE COMMUNITY BY USING THE HEALTHY LIVING PLAN FOR CHILDREN AND FAMILY MEMBERS, AS A WAY TO SET GOALS FOR LIFESTYLE CHANGES. - 5 OR MORE FRUITS AND VEGETABLES EACH DAY - 2 HOURS OR LESS OF SCREEN TIME (TV, PHONE, COMPUTER) EACH DAY - 1 HOUR OF PHYSICAL ACTIVITY EACH DAY - 0 SUGAR SWEETENED DRINKS - PEER HEALTH ADVISORY BOARD THE PEER HEALTH ADVISORY BOARD IS A CO-ED PEER LEADERSHIP GROUP FOR 13-20 YEAR OLDS. THE GOAL OF THE BOARD IS TO CULTIVATE PEER LEADERS WHO ARE TRAINED IN EVIDENCE BASED CURRICULUM TO PREPARE THEM TO FOCUS ON COMMUNITY PROJECTS THAT BRING AWARENESS TO VIOLENCE PREVENTION PROGRAMS, DRUGS AND ALCOHOL PREVENTION, AND PREGNANCY PREVENTION. THE TEENS ATTEND AN INITIAL 8 SESSIONS OF CURRICULUM THAT FOCUS ON HIV/AIDS AND SEXUALLY TRANSMITTED INFECTION PREVENTION. THE FIRST SET OF TRAININGS HELP TO PREPARE THE TEENS TO BECOME MEMBERS OF THE ADVISORY BOARD. AFTER BECOMING MEMBERS, THE TEENS CONTINUE A RIGOROUS SCHEDULE OF TRAINING SESSIONS. THESE SESSIONS NOT ONLY TEACH THE TEENS ABOUT PREGNANCY AND INFECTION PREVENTION, BUT THEY EQUIP THEM WITH THE SKILLS TO COMMUNICATE WITHOUT VIOLENCE AND TO BECOME EDUCATIONAL PEER LEADERS IN THE COMMUNITY. - WOMEN'S HEALTH PROGRAM HOLYOKE HEALTH HAS A WOMEN'S HEALTH PROGRAM THAT FOCUSES ON CERVICAL CANCER AND BREAST CANCER SCREENING, DIAGNOSTICS, AND CASE MANAGEMENT. THE ORGANIZATION HAS ESTABLISHED A TEAM OF PROVIDERS, NURSE CASE MANAGERS, AND MEDICAL ASSISTANTS WHO USE THE LATEST TECHNOLOGY TO TRACK THE PATIENTS TO MAKE SURE THAT THEY HAVE GOTTEN A PAP TEST OR SCREENING MAMMOGRAM. THE STAFF COMMUNICATES ALL RESULTS AND SCHEDULED APPOINTMENTS WITH THE PATIENTS' PRIMARY CARE PROVIDER AND WILL WORK CLOSELY WITH ANY PATIENTS WHO RECEIVE ABNORMAL CERVICAL OR BREAST SCREENING RESULTS. THE CASE MANAGER AND MEDICAL ASSISTANT WORK DIRECTLY WITH THE PATIENTS TO SCHEDULE ANY FOLLOW UP APPOINTMENTS, SECURE PAYMENT FOR THE PROCEDURES, AND PROVIDE SUPPORTIVE REFERRALS. |
| FORM 990, PART VI, SECTION A, LINE 2 | BUSINESS RELATIONSHIPS: JAY BREINES, MICHAEL GERMANI AND BENJAMIN CARTAGENA ALL HAVE A BUSINESS RELATIONSHIP. |
| FORM 990, PART VI, SECTION B, LINE 11B | PROCESS TO REVIEW THE FORM 990: THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION. THE BOARD OF DIRECTORS DIRECTED THE CFO TO PRESENT THE 990 FILING (IN DRAFT FORM) TO THE EXECUTIVE/FINANCE COMMITTEE FOR REVIEW. ONCE THE REVIEW HAS BEEN COMPLETED, THE COMMITTEE RECOMMENDS TO THE BOARD OF DIRECTORS THAT THE 990 FILING BE APPROVED BY THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 12C PROCESS FOR MONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICY: THE HOLYOKE HEALTH CENTER INC. REQUIRES NEW EMPLOYEES AND NEWLY APPOINTED MEMBERS OF THE BOARD OF DIRECTORS TO REVIEW AND SIGN THE HOLYOKE HEALTH CENTER INC. CONFLICT OF INTEREST POLICY. THEREAFTER, THE POLICY IS REVIEWED AND SIGNED ANNUALLY BY THE EMPLOYEES AND APPOINTED MEMBERS OF THE BOARD OF DIRECTORS. THE ORGANIZATION'S LEADERS AND BOARD OF DIRECTOR WILL REVIEW ANY RELATIONSHIPS CAREFULLY TO ENSURE THE HEALTH CENTERS' MISSION AND COMMUNITY SERVED IS NOT HARMED BY ANY CONTRACTUAL RELATIONSHIP. DISCIPLINARY ACTIONS CAN RESULT FOR THOSE FAILING TO COMPLY TO THE ORGANIZATION'S CONFLICT OF INTEREST POLICY. |
| FORM 990, PART VI, SECTION B, LINE 15A | REVIEW OF CEO COMPENSATION: THE BOARD OF DIRECTORS ESTABLISHED A SPECIAL COMPENSATION COMMITTEE COMPOSED OF THREE BOARD OF DIRECTOR MEMBERS TO CONDUCT A REVIEW OF THE COMPENSATION PACKAGE FOR THE CEO. DURING THE REVIEW, THIS COMMITTEE CONTACTED THE MASSACHUSETTS LEAGUE OF COMMUNITY HEALTH CENTERS FOR COMPENSATION INFORMATION REGARDING COMPARABLE POSITIONS AND COMPARABLE RESPONSIBILITIES. BASED UPON THAT REVIEW, THE COMMITTEE MADE ITS RECOMMENDATION TO THE BOARD OF DIRECTORS, WHICH WAS ACCEPTED BY THE BOARD. |
| FORM 990, PART VI, SECTION C, LINE 19 | GOVERNING DOCUMENTS AVAILABLE TO THE PUBLIC: THE HOLYOKE HEALTH CENTER INC.'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, FINANCIAL STATEMENTS, AND ANNUAL INFORMATION RETURNS (FORM 990 SERIES) ARE AVAILABLE TO THE PUBLIC DURING REGULAR BUSINESS HOURS AT THE CENTER'S ADMINISTRATIVE OFFICES AT 230 MAPLE STREET, HOLYOKE, MA 01040-6260. |
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