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Board of Trustees
Orientation Notebook
Compiled October 2014
TABLE OF CONTENTS
MISSION STATEMENT
STRATEGIC PLAN
BOARD INFORMATION
BOARD OF TRUSTEES & OFFICERS PROCEDURE MANUAL
BOARD ROSTER
BOARD COMMITTEE ASSIGNMENTS
BOARD SURVEYS
BOARD SELF-ASSESSMENT
BOARD AND EXECUTIVE DIRECTOR RESPONSIBILITIES
BOARD MEMBER DOCUMENTS
CONFIDENTIALITY AND NONDISCLOSURE FORM
CONFLICT OF INTEREST POLICY
BOARD MEMBER AGREEMENT FORM
DIRECTORS & OFFICERS INSURANCE POLICY DECLARATION PAGE
CORPORATE AND ORGANIZATIONAL DOCUMENTS
ARTICLES OF INCORPORATION
CONSTITUTION AND BY-LAWS
DOCUMENT RETENTION POLICY
WHISTLEBLOWER POLICY
FINANCIAL INFORMATION
IRS FORM 990 FOR MOST RECENT FISCAL YEAR
CURRENT FINANCIAL STATEMENT
CURRENT BUDGET
REFERENCES
SUMMARY OF PARLIAMENTARY PROCEDURES
ADDITIONAL RESOURCES
Board of Directors Orientation Notebook
Section 1:
MISSION STATEMENT
______________________________________________________________________
VISION STATEMENT
The conscience of society for quality and parity healthcare.
MISSION STATEMENT
To advance the art and science of medicine for people of African descent
through education, advocacy, and health policy to promote health and
wellness, eliminate health disparities, and sustain physician viability.
POSITIONAL STATEMENT
This national professional and scientific organization of physicians is
committed to:
1) preventing the diseases, disabilities, and adverse health conditions that
disproportionately or differentially impact persons of African descent and
underserved populations;
2) supporting efforts that improve the quality and availability of health care
to underserved populations; and
3) increasing the representation, preservation and contribution(s) of persons
of African descent in medicine. Towards these ends, the National Medical
Association provides education programs and opportunities for scholarly
exchange, conducts outreach efforts to promote improved public health, and
establishes national health policy agenda in support of physicians of African
descent and their patients.
(The Mission, Vision and Positioning Statements were adopted by the
Board of Trustees on October 16, 1999.)
8403 Colesville Road
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www.NMAnet.org
Board of Directors Orientation Notebook
Section 2:
STRATEGIC PLAN
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N M A S T R A T E G I C P L A N
"The conscience of equality and parity in health care"
2012 - 2015 STRATEGIC PLAN
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Table of Contents
Introduction ..................................................................................................................................... 2
Association History ................................................................................................................ 2
Strategic Planning Purpose and Process .............................................................................. 3
Vision, Mission and Values ................................................................................................... 3
Guiding Principles ................................................................................................................. 4
NMA Health Initiatives and Services ..................................................................................... 4
Strategic Issues ..................................................................................................................... 6
Strategic Objectives
CME/Education ........................................................................................................... 6
Physician Viability ....................................................................................................... 9
Leading Voice on Health Disparities ........................................................................... 9
Fiscal Accountability and Sustainability .................................................................... 12
Membership Reform .................................................................................................. 13
Convention Planning ................................................................................................. 13
Umbrella Programming ............................................................................................. 14
Partnerships and Collaborations ............................................................................... 14
Administrative Excellence ......................................................................................... 15
Critical Priorities 2012-2013 ................................................................................................ 17
Critical Priorities 2014 ......................................................................................................... 20
Critical Priorities 2015 ......................................................................................................... 20
Review and Evaluation Process .......................................................................................... 21
APPENDIX .......................................................................................................................... 22
SWOT Analysis
Strategic Planning Committee, NMA Senior Staff, Consultants
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Introduction
In its quest to become the “conscience and voice of society for quality and parity in healthcare,” the National Medical Association (NMA) is committed to advancing the art and science of medicine for individuals of African descent by sustaining physician viability, promoting health and wellness, and eliminating health disparities. To accomplish this mission, the Association adopted this Strategic Plan for 2012-2015 This plan outlines the NMA’s strategic issues, objectives, goals, actions that will be implemented over this planning period. Specific emphasis is placed on the 2012-2013 timeframe for operationalizing the strategic objectives. The NMA leadership serves as the champion advocating and representing the NMA agenda with substance and professionalism. History
The NMA is the nation's oldest and largest organization representing physicians of African descent and their patients. The NMA is a 501 (c) (3) national professional and scientific organization. The NMA was founded in 1895 during an era in the United States history when the majority of Black Americans were disenfranchised. The segregated policy of "separate but equal" dictated virtually every aspect of society. Under the backdrop of racial exclusivity, membership in America's professional organizations, including the American Medical Association (AMA), was restricted to whites only. The AMA determined medical policy for the country and played an influential role in broadening the expertise of physicians. When a group of Black doctors sought membership into the AMA, they were repeatedly denied admission. Subsequently, the NMA was created for Black doctors and health professionals who found it necessary to establish their own medical societies and hospitals. "Conceived in no spirit of racial exclusiveness, fostering no ethnic antagonisms, but born out of the exigency of the American environment..." the NMA extended equal rights and privileges to all physicians. Although the NMA has led the fight for better medical care and opportunities for all Americans, its primary focus targets health issues related to improving the health status and outcomes of African Americans and the medically underserved.
Strategic Planning Purpose and Process
The Strategic Plan is the guidepost for the NMA and will be used to direct its activities from 2012-2015. Additionally, this plan is intended to serve the following purposes:
� Communicate the Vision, Mission, Strategic Objectives and Goals of the NMA to its various stakeholders (internal and external)
� Set expectations for the overall organization (BOT, HOD, Staff) regarding their individual activities to support the NMA
� Support requests for funding from potential funders The 2006-2011 Strategic Plan was reviewed and updated over the course of several steps with the first being a strategic planning retreat convened in August 2012 by the Chair of the Board of Trustees (BOT). The additional steps in the planning process
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involved further discourse by the Strategic Planning Committee, final review by internal stakeholders then adoption by the House of Delegates. The strategic planning participants included representatives of representatives of the BOT who serve on the Strategic Planning Committee, Strategic Planning Committee, President of the NMA, NMA Senior Staff, House of Delegates, and Consultants.
Vision
The conscience of society for quality and parity in healthcare
Mission
To advance the art and science of medicine for people of African descent through education, advocacy, and health policy to sustain physician viability, promote health and wellness, and eliminate health disparities
Values
x Integrity To be truthful, respectful, honest, ethical, authentic and transparent
x Excellence
To provide the highest quality of service and work product
x Compassion To embrace others with empathy, kindness and concern
x Commitment
To perform the work of the Association with dedication, responsiveness, loyalty and a sense of purpose
x Empowerment
To educate others in ways that supports them in enhancing their practices, health and quality of life
x Accountability
To execute duties in a responsible, timely and effective manner
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Guiding Principles
The NMA guiding principles serve as the foundation for what and how NMA business is conducted as well as the standard for how stakeholders, patients, and supporters will be engaged. Everything the NMA does is guided by the principles that define our character and culture. These enduring qualities are the shared convictions of the NMA.
x Relevant Our integrity and viability rests on our ability to be a viable voice for the African American physician and population
x Fiscally Sound
We spend within our means and obtain sustainable and viable resources to sustain the organization
x Remain Competent and Abreast of Current Issues and Opportunities
Learning and development is a life-long journey – this is a continuum we strive to create and maintain including staying aware of today’s health topics and providing the highest caliber educational opportunities through CMEs
x Excellent Member Service
Commit to the highest levels of member service as defined by our members
x Accountability We strive to know our charge and fulfill according to expectations and with excellence
x Teamwork and Staff Development
It takes a team skilled, competent and actively engaged to execute the plan. The team includes NMA leadership, staff, consultants, community and other external partners.
x Collaborations/Partnerships
NMA will collaborate with partners with common goals and interest
x Celebrate and Promote Our Success We will reflect, appreciate and broadly communicate our achievements
x Activities Ensure all activities are outcome oriented
NMA Health Initiatives and Services
The NMA’s services, programs, and initiatives are reflective of the diverse interests of its members, as well as traditional and current health issues important to the African-
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American community. The Association has always advocated on behalf of people of African descent. In this capacity, NMA serves as the conscience of the medical profession. It is active in disseminating messages, as well as developing programs that address these issues.
As the nation's largest and only organization representing physicians of African descent, the NMA is committed to providing professional and public education on health issues significantly influencing the African-American community. Six geographic regions represent the national organization; these regions are further represented by 37 state and 75 local medical societies. Twenty-four scientific specialty sections are represented within the NMA structure with members who are available to provide specialty expertise for scientific review, evaluation, and validation of program proposals and efforts. Within each of the twenty-four sections, there is enormous capability and interest to support and conduct a variety of community disease prevention, education outreach, demonstration, physician education, and research programs.
The NMA in committed to keeping the African-American and broader community informed on the latest treatments, clinical trials, research results, and medications. In support of this commitment, the NMA has established the services, programs, and key health initiatives described in this section. Areas of Health Initiatives There are so many health related issues plaguing America today. With so many, some of which are shown in the list that follows, the NMA intentionally prioritized the following specific areas of interest to focus its attention. Those that are bolded are the highest priority for the NMA at this time:
x Cardiovascular Disease x Cancer x Diabetes x HIV x Obesity x Mental Health x Asthma x Immunizations x Hepatitis C x Clinical Trials x Homicide x Children’s Health x Environmental Health
The NMA will use an umbrella planning and project implementation approach to ensure as many of these areas of concern are addressed systematically and in a manner that will help to deter the challenges and result in positive impacts for minorities.
Comment [d1]: Staff needs to confirm the number of state and local societies
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NMA Services Primary services provided by the NMA include the following:
x Annual Convention and Scientific Assembly x Continuing Medical Education (CME) Program x National Colloquium on African American Health x The Journal of the National Medical Association (JNMA) x The National Medical Association News x Physician Locator Service x Student Scholarships x Research collaborations with the W. Montague Cobb NMA Health Institute x Walk-A-Mile With a Child x NMA Mentorship Workshop
Strategic Issues
A number of issues challenge the NMA, its members, and minority populations in the U.S. including:
� Remaining Relevant � Fiscal Sustainability � Health Policy Issues such as health disparities and inequality � Maintaining the workforce of physicians of color � Increasing and sustaining association membership � NMA branding and marketing to sustain position as leading voice for its members
and on health care disparities � Affordable Care Act
This plan is written to address these strategic issues. The Strategic Objectives shown below include: 1) Strategic Goal, 2) Operational Goals, and 3) Strategic Actions that drill down to the detail defining the specific tasks to be completed.
Strategic Objective: Continue as a primary source of CME
Strategic Goal – Maintain and develop programs that will keep members and communities abreast of current healthcare diagnoses, treatments and research of disease states Operational Goals
1. Ensure the continuation of the NMA to be the first source for maintaining clinical viability to sustain the Continuing Medical Education (CME) accreditation
2. Mentoring members via webinars concerning setting up practices, contracts, service delivery model, etc.
3. Convert paper journal to electronic Journal of the National Medical Association (JNMA)
4. Mentoring activities for medical students and undergraduate students to pursue a career in medicine
Comment [d2]: Staff needs to confirm if the NMA News, name of the Physician Locator Service and if one exists, name of the Student Scholarships exist and revive it
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Strategic Actions Operational Goal 1 - CME
oAssess and delineate the steps underway, specific requirements, resources and timeline needed to maintain CME accreditation oProviding on-line CME to members and non-members of the NMA
Responsibility: Educational Affairs Committee (Dr. Sadye Curry and Colin Syphax) Timeline: October 2012 Metric/Deliverable: Written assessment and specific CME strategy plan Provide a suggested cost to members and non members who take our on-line CME course Timeline: February 2013 Metric/Deliverable: Offer one -line CME activities to members and nonmember of
the NMA Timeline: July 2013 Metric/Deliverable: Offer a minimum of 4 on-line CME activities Timeline; 2014-2015 Metric/Deliverable: Offer a minimum of 5 on-line CME activities Timeline: 2014-2015 Metric/Deliverable: Offer a minimum of 6 on-line CME activities
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Operational Goal 2 - Mentoring o Conduct an assessment of mentoring needs and develop a plan to address the
results of the assessment Responsibility: Educational Affairs Committee (Dr. Sadye Curry and Colin
Syphax) Timeline: October 2012 Metric/Deliverable: Written assessment and specific mentoring plan Operational Goal 3 - Printed and On-line JNMA
o Update the member database o Create a hybrid printed JNMA with advertisements/sponsorships and on-line JNMA
Responsibility: Publications Committee (Dr. Chile Ahaghotu and Angelique Valladares) Timeline: February 2013 Metric/Deliverable: Contract for services to create the electronic and printed JNMA Timeline: July 2013 Metric/ Deliverable: Online JNMA Timeline: 2013-2014 Metric/Deliverable: Printed JNMA with advertisements/sponsorships Timeline: 2014-2015 Metric/Deliverable: Online JNMA is a revenue generating service Operational Goal 4 - Mentoring Activities for Medical Students and Undergraduates Strategic Actions
o Provide a mentoring activity once a year for either medical students or undergraduates
o Develop a plan to implement a NMA mentorship workshop Responsibility: Convention Committee (Dr. Bailey/Mr. Matthews) Timeline: Oct 2013 (first mentoring activity scheduled) Metric/Deliverable: Plan to implement a NMA mentorship workshop by July
2013 Timeline: 2014-2015 Metric/Deliverable: NMA Mentorship Workshop is a self-sustaining/revenue
generating product/service
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Strategic Objective: Ensure Physician Viability
Strategic Goal - Central to the sustainability and integrity of the NMA's presence is having a robust pool of medical doctors and professionals who are people of color. Develop support network for navigation of recent healthcare law changes to assist individual and group practices maintain viability. Operational Goals
1. Provide Accountable care operational goals 2. Peer review: identify specific physician liability/legal cases, review ability to provide legal
assistance Strategic Actions Operational Goal 1 - Accountable Care
o Develop an Accountable Care Act and Accountable Care Organization webinar and workshop for 2013 conference
o Determine the most appropriate means to communicate this information to NMA members o Develop a pool of experts for consultation o Assess cost/benefit to NMA, members and non-members
Responsibility: Educational Affairs Committee (Dr. Sadye Curry and Colin Syphax) and Health Policy Committee (Dr. LeNoir and B. Sogie Thomas) Timeline: February 2013 Metric/Deliverable: Training webinar and workshop for 2013 conference, communications
protocol, pool of content matter experts available for consultation, benefit cost assessment and fee schedule for webinar
Operational Goal 2 - Peer Review
o Define the process for gathering and assessing cases where NMA members have been impacted
o Ensure there is a committee in place to develop and conduct the peer review process Responsibility: Government and Compliance Committee Health Policy (Dr. J.D. Patterson and Monica Carter) Timeline: February 2013 Metric/Deliverable: Written assessment
Strategic Objective: Ensure that the NMA is the Leading Voice on Health Disparities
Strategic Goal - The NMA becomes recognized as the voice on health disparities and cultural competency
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Operational Goals 1. Content matter expert on diversity, health disparities and cultural competency 2. Become health literacy experts 3. Being present at strategic events and interacting with legislators (nationally and locally) 4. Create CMS advisory committee 5. Evaluate activities and effectiveness of AMA, CMS, CDC, HIH, FDA regarding inclusion
and cultural competency 6. Establish protocol and track who represents the NMA and how to ensure accountability and
messaging uniformity
Operational Goal 1 - Diversity and Cultural Competency Strategic Actions
o Develop Evaluate medical schools as to how they are handling diversity and cultural competency training
o Provide diversity-training program for medical schools, local societies at the NMA convention, via webinars, etc.
o Develop working relationship with Association of American Medical Colleges (AAMC) Responsibility: Educational Affairs Committee (Dr. Sadye Curry and Colin Syphax) Timeline: December 2013 Metric/Deliverable: Assessment and training program Timeline: 2013-2014 Metric/Deliverable: Provide at least one diversity training/cultural competency seminar for medical schools faculty to attend and one webinar Timeline: 2014-2015 Metric/Deliverable: Provide 2 diversity training and webinars that are revenue Generating Timeline: 2013-2015 Metric/Deliverable All consumer material written by the NMA will be in plain language Operational Goal 2 - Health Literacy Experts Strategic Actions
o Develop a patient education portal o Use mass media to communicate health empowerment o Develop health literacy program in plain language o Provide training to ensure staff provide information in plain language
Responsibility: Educational Affairs Committee (Dr. Sadye Curry and Darryl Matthews) Timeline: February 2013 Metric/Deliverable: Staff trained in plain language and plan for creating the patient education portal and materials
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Operational Goal 3 - Advocacy/Lobbying Strategic Actions
o A document on effective lobbying should be prepared and posted on the NMA website
o Identify where NMA needs to be to discuss health policy issues that impact physician viability or health disparities
o Create a template to document these activities monthly via NMA website and social media including highlights and photos
Responsibility: Health Policy Committee (Dr. LeNoir and Byron Sogie-Thomas, NMA President, President Elect, Immediate Past President, Chair of BOT, Speaker of the HOD, Executive Director) Timeline: October 2012 unless otherwise noted Metric/Deliverable: Advocacy Toolkit, and Template to document advocacy activities Operational Goal 4 - CMS Advisory Committee Strategic Actions
o Send a letter requesting a relationship be established with the Center for Medicaid and Medicare Services (CMS) and Food and Drug Administration(FDA)
Responsibility: BOT Chair and Darryl Matthews Timeline: October 2012
Metric/Deliverable: Invitation Letter Operational Goal 5 - Protocol for Representation Strategic Actions
o Develop a scorecard to assess how the American Medical Association, Center for Medicaid and Medicare Services, Center for Disease Control, HIH, FDA are addressing cultural competency and inclusion. Report to the BOT
Responsibility: Health Policy Committee (Dr. LeNoir and Byron Sogie-Thomas) Timeline: December 2013
Metric/Deliverable: Scorecard/Report Strategic Actions
o Develop a grid documenting where the leadership is present, purpose, outcomes, and information/materials used for messaging/branding the NMA
Responsibility: Governance and Compliance (Dr. J.D. Patterson and Monica Carter) Timeline: October 2012
Metric/Deliverable: Report Grid
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Strategic Objective: Ensure Fiscal Accountability and Sustainability
Strategic Goal - NMA will exclusively focus on implementing activities deemed relevant and ensure a sustainable future Operational Goals 1. Raise $800,000 in unrestricted funds by February 2013 2. Raise $2,000,000 to support NMA staffing and programming 3. Complete the 2010-2012 audits by March 2013
Operational Goal 1 - Raise $800,000 Unrestricted Funds Strategic Actions
o Specific plan for raising this amount o Increase the NMA corporate circle o Develop a written plan and host national and regional fundraisers, i.e. policy dinner
around the same time as the annual Congressional Black Caucus meetings Responsibility: Darryl Matthews Timeline: October 2012
Metric/Deliverable: Strategy Plan
Operational Goal 2 - Raise $2,000,000 Strategic Actions 1. Develop and maintain strategic fund development strategies/plan 2. Proactive planning to pursue PCORI and other funding sources 3. Develop and maintain health strategies plan and specify role for health strategist, health
economist and fund development consultants 4. Develop and maintain grant/funding grid report (detailing funding status) and contract
matrix (detailing contracts in hand, value/cost, contract period, contractor, scope of work, etc.)
5. Report Progress Responsibility: Grants and Special Programs (Dr. Barry Harris, Cheryl Dukes, Darryl Matthews) Timeline: Quarterly at BOT, monthly to Committee Chairs, Effective October 2012 Metric/Deliverable: Grant/Funding Grid Reporting Awards and Grants Being Pursued, Fund Development Plan Contract matrix including specific detail, i.e., contracts in hand, value/cost, contract period (start/end), contractor, scope of work TimeLine: Continuing Metric/Deliverable: Secure non-pharmaceutical source of revenue for the Association to enhance fiscal health
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Operational Goal 3 - Complete 2010-2012 Audits Strategic Actions
o Complete the audits for fiscal years 2010-2012 and provide the final CPA statements to the BOT and leadership as requested
Responsibility: Dr. Gail Morgan and Darryl Matthews Timeline: March 2013
Metric/Deliverable: Completed audit reports
Strategic Objective: Undertake Membership Reform
Strategic Goal - The NMA appreciates its membership and will provide the leadership and benefits to ensure a desirable level of active and satisfied members. Operational Goals 1. Increase membership by 3,200 new members to reach the $800,000 financial goal (via
current membership drive offers) for unrestricted funds 2. Communicate NMA member benefits and value proposition 3. Promote allied health membership as dues paid NMA members
Strategic Actions
o Review BrightKey scope of work and hold them accountable to the targets o Review regular update of outcomes defined in the scope of work.
Responsibility: (Dr. Garfield Clunie, Darryl Matthews, C. Thomas) Timeline: October 2012 Metric/Deliverable: Membership Enhancement Plan/Increased Members
Strategic Objective: Ensure Fiscally Prudent Convention Planning
Strategic Goal – NMA conventions and other events shall be profitable beyond the measure of paying for event costs
Operational Goals - Profitable Conventions
Strategic Actions
o Develop and present a strategy plan to ensure all conventions pay for the expenses of the convention and increase the profit margin by a percentage to be determined in the plan
o Actively and immediately begin exploring joint conventions enterprises with National Dental Association
Responsibility: Darryl Matthews and Rutherford Timeline: October 2012 (and every 6 months) Metric/Deliverable: Strategy Plan
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Strategic Objective: Develop and/or Expand Umbrella Programming
Strategic Goal - The NMA will be strategic in pursuing/conducting programs that align with its mission and are appealing to a broad pool of funding opportunities. Operational Goals - Identify and pursue opportunities to maximize clinical research and umbrella programming by the NMA Strategic Actions
o Partner with large grant funders to conduct special projects including clinical research on these areas of interest Cardiovascular, Cancer, Diabetes, HIV, Obesity, Mental Health, Asthma, Immunization, Hepatitis C
o Use the Project Impact model as a means to conduct clinical research o Create partnerships to provide the resources to complete the research
Responsibility: Grants and Special Programs (Dr. Barry Harris, Cheryl Dukes, Darryl Matthews) Timeline: October 2012 and quarterly Metric/Deliverable: Program Plan
Strategic Objective: Continue to Establish and Refine Partnerships and Collaborations
Strategic Goal - Partnerships and collaborations should benefit the NMA and the leadership needs to be clearly aware of who these relationships are with and know the specific benefits the NMA will gain Operational Goals 1. Establish collaborations with Local Societies in national initiatives, pharmaceutical corporations,
other associations (National Podiatry, National Dental Associations) to share expertise, joint conventions, and other avenues of synergy
2. Establish formal relationships via Memorandum of Understanding with Office of Minority Health, CDC, CMS, FDA and other organizations
3. Physician of the Month 4. Promote allied health membership and non-allied members
Strategic Action
o Define the strategic approach (Strategy Plan) for creating and maintaining collaborations and partnerships
o Track status and outcomes (via grid) of these collaborations and partnerships and report to the BOT quarterly (report should at a minimum include the organization name, purpose for the interaction, outcomes, other matters to consider)
Responsibility: Health Policy Committee (Dr. LeNoir and Byron Sogie-Thomas
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Timeline: February 2013 with Quarterly Updates to the Board of Trustees Metric/Deliverable: Strategy Plan, Tracking Grid Report New partners and members
Strategic Objective: Continue to Ensure Administrative Excellence
Strategic Goal - The NMA will continue to be a viable organization with strong leadership, effective and efficient systems in place to ensure implementation of the strategic plan Operational Goals 1. Protect NMA intellectual property 2. Determine capacity of staff to complete strategic plan tasks 3. IT Enhancements 4. Move headquarters by December 2012 5. Effective tools in place to document contract and grant activities
Operational Goal 1 - Staff Capacity Strategic Action
o Vet strategic plan with NMA Staff, assess capacity to fulfill tasks , and present formal written recommendations to the Board of Trustees
Responsibility: Darryl Matthews Timeline: By September 30, 2012
Metric/Deliverable: Detailed assessment and formal written recommendations
Operational Goal 2 - Information Technology Strategic Action
o Develop a strategic IT plan including scope of work, proposed cost, potential options Responsibility: Finance Committee (Dr. Jeffrey Clark, Alex Johnson, Darryl Matthews) Timeline: October 2012
Metric/Deliverable: Written IT Plan
Operational Goal 3 - Intellectual Property Strategic Action
o Conduct assessment to determine what needs to be done to protect NMA intellectual property and present recommendations to Board of Trustees
Responsibility: Darryl Matthews Timeline: February 2013
Metric/Deliverable: Detailed assessment and formal written recommendations
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Operational Goal 4 - NMA Headquarters Strategic Actions
o Develop a proposal detailing options for NMA headquarters Responsibility: Finance Committee (Dr. Jeffrey Clark, Alex Johnson, Darryl Matthews) Timeline: December 2013
Metric/Deliverable: Written Business Plan
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Critical Priorities At a Glance
The following matrixes were created to centralize all of the critical priorities into the planning period 2012-2015. The information is categorized to align with the Strategic Objectives/Goals presented earlier in this plan. A specific timeline is also reflected in what follows as in the earlier sections of this plan.
Critical Priorities for 2012-13
Continue as a Primary Source of CME
Goal 1 – CME Accreditation
x Assessment of status of CME accreditation and CME Strategy Plan (October 2012) x Offer 1 online CME activity to members and non-members in (February 2013) x Offer a minimum of 4 online CME activities in (July 2013)
Goal 2 – Mentoring
x Written assessment and specific plan (October 2012) Goal 3 – Printed and Online JNMA
x Contract for services by (February 2013) x JNMA online (July 2013) x Printed JNMA (2013)
Goal 4 – Mentoring for Medical Students and Undergraduates
x Mentorship Workshop Plan (July 2013) x Mentoring Activity Scheduled (October 2013) x Mentorship Workshop in all 6 Regions by State and Local NMA Societies (2013)
Ensure Physician Viability Goal 1 – Accountable Care
x Plan for ACA/ACO webinar, workshop for 2013 conference, pool of experts for consultation (February 2013)
Goal 2 – Peer Review
x Written assessment/advisement as to when/how to get involved with NMA member cases (February 2013)
Ensure NMA Leading Voice on Health Disparities Goal 1 – Diversity and Cultural Competency
x Develop and conduct at least 1 revenue generating diversity training/cultural competency seminar and webinar for medical schools faculty (2013)
x All consumer material written in plain language (2013) Goal 2 – Health Literacy Experts
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x Staff trained in plain language and plan for creating the patient education portal and materials (February 2013)
Goal 3 – Advocacy/Lobbying
x Advocacy toolkit and template to document advocacy activities (October 2012) Goal 4 – CMS Advisory Committee
x Invitation Letter Submitted (October 2012) Goal 5 – Protocol for Representation
x Report Grid (October 2012) x Scorecard/Report (December 2013)
Ensure Fiscal Accountability and Sustainability Goal 1 – Raise $800,000 Unrestricted Funds (February 2013)
x Strategy plan (October 2012) Goal 2 – Raise $2,000,000 (additional revenue over conference)
x Fund development plan, grant/funding grid report, contract matrix (October 2012) x Report updates to Committee Chairs (Monthly), and Board of Trustees (Quarterly)
Goal 3 – 2010-2012 Financial Audits
x Complete 2010-2012 financial audits (March 2013) Undertake Membership Reform Goal – Membership Enhancement Plan/Increased Members (October 2012 and Continuous)
Ensure Fiscally Prudent Convention Planning
Goal – Profitable Conventions/Events x Strategy plan (October 2012 with 6 months updates to Board of Trustees)
Develop and/or Expand Umbrella Programming Goal – Develop Program Plan (October 2012 and report to Board of Trustees quarterly) Continue to Establish and Refine Partnerships and Collaborations Goal - Strategy plan and tracking/reporting grid (February 2013) Report to Board of Trustees (Quarterly)
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Continue to Ensure Administrative Excellence Goal 1 – Staff Capacity
x Detailed assessment/formal written recommendations to Board of Trustees (September 30, 2012)
Goal 2 – Information Technology
x Written IT Plan (October 2012) Goal 3 – Intellectual Property
x Detailed assessment/formal written recommendations to Board of Trustees (February 2013) Goal 4 – NMA Headquarters
x Written Business Plan (December 2013)
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Critical Priorities for 2014
Continue as a Primary Source of CME Goal 1 – CME Accreditation
x Offer a minimum of 5 online CME activities for members and non-members
Goal 3 – Printed and online JNMA x Printed JNMA 2013-2014 x JNMA is a revenue generating product/service
Goal 4 – Mentoring for Medical Students and Undergraduates
x Mentorship workshop is a revenue generating product/service Ensure NMA Leading Voice on Health Disparities Goal 1 – Diversity and Cultural Competency
x Develop and conduct at least 2 revenue generating diversity training/cultural competency seminar and webinar for medical schools faculty
x All consumer material written in plain language 2013
Critical Priorities for 2015
Continue as a Primary Source of CME
Goal 1 – CME Accreditation x Offer a minimum of 6 online CME activities for members and non-members
Goal 4 – Mentorship Workshop
x Mentorship workshop is a revenue generating product/service
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Strategic Plan Review and Evaluation Process
The annual review and evaluation process is extremely critical in providing NMA leadership with the support, guidance, and encouragement necessary to realize full implementation of the goals that have been set forth in this strategic plan. The Strategic Planning Team will meet quarterly with the Executive Director and representatives of senior management to review and discuss the progress in the implementation of the organization’s strategic goals. In addition, the Executive Director shall maintain and present the strategic plan dashboard to the full Board of Trustees as requested.
Implementation of strategic actions will be incorporated into the annual operational plan of all management departments, as well as councils, committees, and sections. The operational plans link the day-to-day operations of the Association to the strategic plan.
A “plan, do, check” attitude should be embraced with this strategic planning document, viewing it as a guide to be periodically revisited and updated versus a rigid roadmap to a fixed and unmovable target for success. The Strategic Planning Committee and NMA leadership believe the goals, and strategic actions put forth in this document are realistic. However, recognizing the dynamic environment that surrounds and influences the organization, a reshaping of some strategic actions to ensure the realities do not adversely influence implementation.
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APPENDIX A - 2012 SWOT ANALYSIS (Strengths, Weaknesses, Opportunities Threats)
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APPENDIX B - Strategic Planning Participants As mentioned earlier in this document, the NMA Strategic Planning Committee, Senior Staff and Consultants participated in a day long retreat to develop this plan. Their participation was a tremendous asset to the process and this finished product. The NMA acknowledges their contributions to complete the plan and the names of the participants are shown below.
Strategic Planning Committee Rahn Bailey, MD President Nashville, TN
Walter Faggett, MD Speaker, House of Delegates Washington, DC
Gregory Antoine, MD Board of Trustees, Region I Boston, MA
C. Freeman, MD Treasurer Nashville, TN
Cedric Bright, MD Immediate Past President Durham, NC
Gloria Frelix, MD Chair, Region III Durham, NC
Oliver Brooks, MD Secretary, House of Delegates Los Angeles, CA
Lonnie Joe, MD Vice Speaker, House of Delegates Detroit, MI
Virginia Caine, MD Chair, Region IV Indianapolis, IN
Michael LeNoir, MD President Elect Oakland, CA
Jeffrey Clark, MD Board of Trustees, Region IV Detroit, MI
Darryl Matthews NMA Executive Director Silver Springs, MD
Garfield Clunie, MD Board of Trustees, Region I New York, NY
Edith Mitchell Board of Trustees, Region II Philadelphia, PA
Elise Cook, MD CAFA Chair Houston, TX
Vivian Pinn, MD President, Past President’s Council Washington, DC
Joia Crear-Perry, MD Chair, Region V New Orleans, LA
George Saunders Secretary, Board of Trustees South Carolina
Sadye Curry, MD Board of Trustees, Region II Washington, DC
Ingrid Taylor Chair, Board of Trustees St Louis, MO
Lisa Green, MD Post Graduate Trustee Baltimore, MD
Rachel Villanueva, MD Chair, Region I New York, NY
24 | P a g e
Senior Staff Members
Colin Syphax, CME Byron Sogie-Thomas, Health Policy Patricia Norman, Conferences and Meetings Jackie Freeman, Contracts & Procurements LaSha Battley, Human Resources Administration Monica Carter Monique Lewis Department Representatives Alex Johnson - Finance Yolanda Fleming - Grants Cheryl Dukes - Grants Angelique Valladares - Publications Roslyn Douglas - External Communications Sharon Allison Ottey, MD
Consultants Sharon Ottey, MD NMA Health Strategist Joyce Rayzor NMA Grants Strategist Debra M Simmons Wilson Engaging Solutions, LLC Strategic Planning Consultant
Board of Directors Orientation Notebook
Section 3:
BOARD INFORMATION
1. Board of Trustees & Officers Procedure Manual 2. Board Roster 3. Board Committee Assignments 4. Ad Hoc Committee Roles 5. Committee List 6. Board Meeting Dates 7. Board Surveys a. Board Self-Assessment b. Board and Executive Director Responsibilities
Board of Trustees and Officers
Procedure Manual
As adopted by Board of Trustees, April 2003
National Medical Association
Board of Trustees & Officers Procedure Manual
Revised: September 2011
2
BOARD OF TRUSTEES & OFFICERS PROCEDURE MANUAL National Medical Association
This document serves as the official procedure manual of the National Medical Association, Inc. It contains explicit instructions for all established policies regarding performance of duties of the officers and members of the Board of Trustees. The amendment procedure to this manual is as follows.
a) Amendments to this document must be submitted in written form to the National Headquarters to the Office of the Board of Trustees and the Chairperson of the Board at least sixty (60) days prior to the Board meeting in which they are to be discussed.
b) All changes to this document require a majority approval vote by the Trustees.
c) No decision of the Executive Committee or Board of Trustees shall contradict the Procedure Manual except through the formal Amendment process.
Other responsibilities for officers may be obtained by referring to the NMA Constitution and Bylaws, Chapter V & VI.
First Submitted on April 11, 2003 Barry L. Harris II, M.D. Chair, Governance & Compliance Committee Postgraduate Physician Trustee National Medical Association
National Medical Association
Board of Trustees & Officers Procedure Manual
Revised: September 2011
3
BOARD OF TRUSTEES & OFFICERS PROCEDURE MANUAL National Medical Association
I. Chairman of the Board of Trustees A. Board Meetings
1. Shall convene, preside and adjourn all meetings of the Board of Trustees. 2. Shall only vote to break a tie. 3. Shall send written/ email notice of all Board meetings to Board members 30 days in
advance of the BOT meeting. 4. Shall notify BOT members of the deadline for BOT reports, generally two weeks prior
to the BOT meeting. 5. Shall ensure that accurate minutes, containing all decisions and transactions of all
meetings, are maintained. 6. Shall notify BOT members of submission date for reports. This date must be at least
two weeks prior to BOT meeting. Notification is preferred 30 days prior to BOT meeting.
7. Shall present a typed report detailing activities and updates regarding all current issues under his/her domain. This is to be submitted at least fourteen days prior to the BOT meeting electronically to National Office for dissemination.
8. Shall designate an acting Chair whenever he/she has to leave the meeting or will be unable to be reached for extended period of time. (Secretary of BOT)
9. Shall make committee assignments within 30 days of being elected. 10. Shall work with the Executive Director to design the agenda and logistics of the Board
meetings. 11. Must sign Confidentiality and Nondisclosure Agreement and Conflict of Interest
Statement at the first board meeting once elected in office. B. Executive Committee
1. Shall preside over and participate in all meetings of the Executive Committee (EC). 2. Shall call all meetings and provide notice of meetings at least 72 hours in advance,
except in emergency situations. 3. Shall present a report of activities at each Executive Committee meeting on all areas
that the Chairperson oversees. 4. Shall forward a copy of the report of activities to the National Office within 48 hours
before the Executive Committee meeting. 5. Shall present a type-written report of all Executive Committee decisions at the next
Board meeting and shall present a type-written annual report of the Executive Committee’s activities to the House of Delegates to be included as part of Chairperson's report.
6. Shall be the official liaison between the Executive Committee and the Office of Executive Director, and ensure that the Executive Director is addressing all directives from the Executive Committee.
C. General
1. Shall upon election represent the Board of Trustees at the meeting of the Auxiliary of National Medical Association (ANMA) immediately after the board meeting on the last day of the Convention.
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2. Shall upon election appoint/select/designate the Chair of the Finance Committee. 3. Shall meet with the Immediate-Past Chairperson immediately following the post-
convention Board meeting to discuss upcoming year and any pressing commitments.
4. Shall meet with the President and the Executive Director not later than 3 weeks after the national convention to become familiar with office operations.
5. Shall ensure BOT Committee Chairs and committee assignments are made by the end of the month of August.
6. Shall ensure that the National Office sends all pertinent materials to members of the Board and Executive Committee for their consideration in a timely manner, and to use electronic means as the preferred method.
7. Shall communicate at least weekly with the Executive Director to discuss office management.
8. Shall communicate regularly with the Executive Committee and/or Board Members as events occur.
9. Shall work closely with the Convention Committee throughout the year up through the Annual Convention.
10. Must maintain his/her own working email account, and answering machine/service. 11. Shall prepare a yearend report of the Board's activities for presentation to the House of
Delegates. 12. Shall preside with the President at the opening ceremony at the National Convention. 13. Shall update this document annually with any changes made by the House Delegates or
the Board for presentation at the House of Delegates to be included in his/her report in conjunction with Board of Trustee’s recommendations.
14. Shall supervise the Executive Director who oversees the day-to-day operations of the National Headquarters.
15. Shall, along with the President and Speaker of the HOD, conduct the evaluation of the Executive Director jointly every six months, utilizing the format adopted by the Association in conjunction with the Human Resources Department (Personnel Committee of the BOT).
16. Shall have emergency authority to sign contracts. 17. Shall present all contracts to the board by grid with dates of start and completion, costs
and description. Any newly executed contracts are to be presented to the board at the next board meeting.
18. Shall present a procedure manual to the incoming Board of Trustees. Shall work in conjunction with the Executive Director and other Board Committee Chairs to orient all new board members at the first Board meeting following the convention.
19. Shall present a grid of the previous year's decisions at the first meeting following the convention to be assembled by Board Executive Liaison.
20. Shall give all outgoing officers certificates of appreciation at the end of their term at the annual convention.
21. Shall have no more than two Scroll of Merit awards. The recipients are to be reported to the Board at the April quarterly meeting.
22. Shall have primary responsibility for the implementation of resolutions passed by the House of Delegates that affect the BOT.
23. Shall present to House of Delegates an attendance/participation calendar of the BOT as a part of year-end report.
24. Shall report inactive trustees to Judicial Committee for consideration of replacement.
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25. Shall perform other functions as may be deemed by the Board of Trustees and House of Delegates that may be required to implement the Constitution and its Bylaws and to fulfill directives of the HOD.
26. Shall give all past officers’ certificates of appreciation as they leave office. Customarily to be done in the morning prior to the election of new board officers.
II. Secretary A. Board Meetings
1. Must attend all meetings of the Board of Trustees. 2. Shall provide all members of the BOT a proposed agenda at least two weeks prior to
each meeting. 3. Shall verify that a quorum has been attained at each BOT Meeting. 4. Shall ensure accurate minutes of the BOT meetings are completed and distributed
within 60 days after the adjournment of the BOT Meeting. 5. Shall keep up with motions made during the BOT meeting and be the source of
reiteration of motions that may be unclear. 6. Must ensure a grid of action items passed and unfinished business at BOT meeting is
disseminated by staff within 14 days after BOT meeting. 7. Shall act as Vice-Chairperson of the BOT and Executive Committee, if the
Chairperson of the Board of Trustees has to be away for an extended period of time. 8. Must sign Confidentiality and Nondisclosure Agreement and Conflict of Interest
Statement at first board meeting once elected in office. B. Executive Committee
1. Shall act as Vice-Chairperson of the Executive Committee, if the Chairperson of the Board of Trustees has to be away for an extended period of time.
2. Shall serve as Secretary of the Executive Committee. As such, shall record and distribute for review and approval all minutes of Executive Committee meetings/conference calls.
3. Shall ensure that accurate minutes of the Executive Committee meeting are provided to the Board of Trustees.
C. General
1. Work in conjunction with chairman to ensure proper referral of action items to be approved by the House of Delegates.
2. Shall ensure that a written report is given to the House of Delegates at each Annual Convention, documenting the actions of the Board with respect to the resolutions and recommendations from the previous year.
III. President
A. House of Delegates Councils 1. Shall appoint all HOD Council Chairpersons and members, and present those
appointments to the HOD at the convention. Any appointments not filled at the convention must be filled and presented at the October Board meeting.
2. Shall replace all non-functioning Council chairs and members and present those appointments to the BOT following replacement.
3. Shall appoint the Chairpersons of all Ad hoc HOD Committees as terms expire or vacancies occur. These must be reported to the BOT in his/her report.
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4. Shall review the responsibilities of each council chairperson before their appointment.
5. Shall communicate with all council chairpersons at least monthly to discuss the progress of that council's tasks.
6. Shall report on councils’ progress at each BOT meeting. Any pressing development should be reported at the Executive Committee meeting following such event.
7. Shall inform all council chairpersons of any pertinent decisions relative to their council made by the HOD, BOT, or EC.
B. Executive Committee
1. Shall participate in all Executive Committee meetings. 2. Shall have a vote on the Executive Committee. 3. Shall report to the Executive Committee on progress of the Councils and all other
areas that the President oversees. 4. Shall submit a report of presidential activities within 48 hours before routinely
scheduled Executive Committee meetings. 5. Shall relay decisions of the Executive Committee regarding a particular council to
that council's chairperson. C. Board of Trustees
1. Is a voting member of the Board of Trustees. 2. Must attend all Board meetings and submit a typewritten report detailing their
activities since the last Board meeting. This is to be submitted electronically at least 14 days prior to the board meeting to National Office for dissemination.
3. Must sign Confidentiality and Nondisclosure Agreement and Conflict of Interest Statement at first board meeting once elected in office.
D. General
1. Shall give an inaugural address at his/her installation ceremony. 2. Shall preside along with the Chairman of BOT at the formal opening awards ceremony
of the NMA Convention. 3. Shall give a farewell speech at the President’s Installation at the subsequent
Convention. 4. Shall deliver an annual address to the opening session of the House of Delegates. 5. Shall meet with the Special Assistant to the President immediately following
installation at the National Convention. 6. Shall upon election, represent the NMA at the meeting of the ANMA immediately
after the board meeting on the last day of the convention. 7. Shall meet with the Chairperson and the Executive Director not later than 3 weeks
after the national convention to become familiar with office operations. 8. Shall along with the Chairman and Speaker of the HOD conduct the evaluation of the
Executive Director jointly every six months. The format is to be drafted by the Personnel Committee of the BOT.
9. Shall attend meetings where NMA representation is needed. Expenses are covered based upon funds available as specified by Finance Office or at the expense of the President or sponsor if it exceeds the approved budget.
10. Shall have no more than two Scroll of Merit awards. These are to be reported to the Board meeting held in conjunction with the Interim House of Delegates meeting.
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11. Must maintain his/her own working email account, and answering machine/service. 12. Shall inform the President-Elect of his/her responsibilities for the following year. 13. Shall personally or have a designee attend all medical school commencement exercises
to which they are invited.
IV. Immediate Past President A. Board of Trustees Meetings
1. Must attend all meetings of the Board of Trustees. 2. Is a voting member of the Board of Trustees. 3. Shall present a typed report detailing his/her activities and any action items to the
Board of Trustees. This is to be submitted at least two weeks prior to board meeting electronically to National Office for dissemination.
4. Must sign Confidentiality and Nondisclosure Agreement and Conflict of Interest Statement at first board meeting once elected in office.
B. General
1. Shall serve as a resource for current president. 2. Provide contacts and information that might be beneficial to the President so that
he/she may serve the organization at their maximum potential.
V. President-Elect A. Board of Trustees Meetings
1. Must attend all meetings of the Board of Trustees. 2. Is non-voting member of the Board of Trustees. 3. Shall present a typed written report detailing his/her activities and presenting any
action items to the Board of Trustees. This is to be submitted electronically at least two weeks prior to the board meeting to the National Office for dissemination.
4. Shall use their yearlong term as President-Elect to develop an Executive Strategic Agenda to be implemented during their term as President. This Agenda is to be presented to BOT by the April Meeting.
5. Must sign Confidentiality and Nondisclosure Agreement and Conflict of Interest Statement at first board meeting once elected in office.
B. Executive Committee
1. Shall serve as a non-voting member of the Executive Committee. 2. Shall attend all meetings of the Executive Committee without voting privileges.
C. General
1. Shall prepare to fill the Presidential appointments, including National Council Chairpersons, at the National Convention upon or before becoming President.
2. Shall learn from the President the roles and responsibilities of the Presidency. 3. Shall coordinate travel and NMA representation at external conferences events with
the National President and Chair of the BOT.
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VI. Treasurer A. Board of Trustees Meetings
1. Is a non-voting member of the Board. 2. Must attend all Board meetings. 3. Shall report to the BOT detailing the present financial condition of the organization,
including: a) year to date income statement detailing all expenditures and received revenues, b) all accounts payable and accounts receivable, c) current bank balance, and d) an account of all national debts.
4. The report is to be submitted electronically at least two weeks prior to the board meeting to the National Office for dissemination.
5. Shall present a proposed budget for the next calendar year, January 1 to December 31 to the BOT at the April meeting for approval.
6. Shall present a final fiscal year report at April Board meeting for the previous year. 7. Shall review bank statements of previous years and report on management of
accounts to the Board. 8. Shall provide a detailed and graphic report outlining the performance of the
investment accounts to the Committee on Administrative and Financial Affairs (CAFA) and to the Finance Committee of the Board of Trustees.
9. Must sign Confidentiality and Nondisclosure Agreement and Conflict of Interest Statement at first board meeting once elected in office.
B. Executive Committee
1. Shall serve as a non-voting member of the Executive Committee and attend all meetings. C. General
1. Shall be custodian of the accounts of the Association as written in the Constitution and Bylaws Chapter V., Section 4.
2. Shall present a financial report to the House of Delegates listing all financial activity since the start of the new fiscal year and presenting a listing of all accounts receivable and accounts payable.
3. Shall notify Section Chairs immediately, in writing of any section overdrafts. VII. Speaker of the House A. Board Meetings
1. May attend all meetings of the Board of Trustees. 2. May participate ex-officio and with the right to vote, at all sessions of the BOT and EC. 3. Shall present a typed report detailing his/her activities and presenting any action items to
the Board of Trustees. This is to be submitted electronically at least two weeks prior to the Board meeting to National Office for dissemination.
4. Must sign Confidentiality and Nondisclosure Agreement and Conflict of Interest Statement at first board meeting once elected in office.
B. Executive Committee
1. Shall participate, ex-officio and with the right to vote, on Executive Committee. 2. Shall be the voice of the House of Delegates to the Executive Committee.
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3. Shall make sure that the directives given by the HOD are followed. C. General
1. Shall have primary responsibility for the implementation of programs administered by Councils of the House of Delegates.
2. Shall complete the following so that the House of Delegates may adjourn: a. Verify and announce the elections results
b. Ensure verification and announcement of the itemized tally of constitutional amendments and resolutions; and,
c. Affix his/her signature to the minutes of the HOD. 3. Shall along with the Chairman and President evaluate the Executive Director every six
months. The format is to be drafted by the Personnel Committee of the BOT. VIII. Vice Speaker of the House A. Board Meetings
1. May attend all meetings of the Board of Trustees. 2. May participate, ex-officio and without the right to vote, in the open sessions of the
Board of Trustees and on the Executive Committee. 3. Shall present a typed report detailing his/her activities and presenting any
recommendations for action by the Board of Trustees. This is to be submitted at least two weeks prior to the board meeting electronically to National Office.
B. General 1. Must sign Confidentiality and Nondisclosure Agreement and Conflict of Interest
Statement at the first board meeting once elected in office.
IX. Secretary of the House A. Board Meetings
1. May attend all meetings of the Board of Trustees. 2. He/She may participate, ex-officio and without the right to vote, in the open sessions of
the Board of Trustees and on the Executive Committee. 3. Shall present a typed report detailing their activities and presenting any
recommendations for action by the Board of Trustees. This is to be submitted at least two weeks prior to board meeting electronically to National Office for dissemination.
B. General
1. Shall chair the Implementation Committee. 2. Must sign Confidentiality and Nondisclosure Agreement and Conflict of Interest
Statement at first board meeting once elected in office. X. Executive Director A. Board Meetings
1. Shall attend all meetings of the Board of Trustees. 2. May participate, ex-officio and without the right vote, in the open sessions of the BOT. 3. Shall present a typed report detailing their activities and presenting any
recommendations for action by the Board of Trustees. This is to be submitted electronically at least two weeks prior to the BOT meeting for dissemination.
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Revised: September 2011
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4. Shall insure that four (4) forms are present on the day of election of BOT officers and distributed to all Board members:
a. Committee assignment request form, b. Board committee descriptions and their responsibilities, c. Confidentiality Agreement Forms, and d. Conflict of Interest Statements. 5. Shall ensure that senior staff is present throughout the Board meetings. 6. Shall ensure that all contracts are presented to the BOT by grid with dates of start and
completion, costs and description. Any newly executed contracts are to be presented to the BOT at the very next meeting.
7. Shall ensure all grants are presented to the BOT via a grid. It should indicate the dates, granting organization, principle investigator, amount of the grant and deliverables.
8. Shall ensure that all development funding is presented to the BOT by grid with at least the following information: donor, revenue solicited, revenue received, date received, purpose of contribution, confirmation documentation of receipt and the total amount of funding. This should be depicted separately for convention funding and other funding.
B. Executive Committee
1. Shall participate, ex-officio and without the right to vote, in the open sessions on the Executive Committee.
2. Shall make sure that the directives given by the House of Delegates are carried out and followed.
C. General
1. Must annually sign confidentiality agreement statement at first board meeting. 2. Shall assign a full time staff person to work with the President throughout their term of
office and will assign a backup staff person to assist the Office of the President when the Special Assistant is away from the office.
3. Shall make the Chair of the Board aware of all contracts prior to execution. 4. Shall work with the Treasurer regarding the checks for signage. Where applicable, after
the Treasurer signs the checks, the Chairperson will sign the checks and send them to the National office.
XII. Regional Chairs A. Board of Trustees Meetings
1. Must attend all meetings of the Board of Trustees. 2. Is non-voting member of the Board of Trustees. 3. Shall present a typed report detailing their activities and presenting any
recommendations for action by the BOT. This is to be submitted electronically at least two weeks prior to board meeting to National Office for dissemination.
4. Shall participate on at least two BOT committees. B. General
1. Shall be a resource to constituents of the region to disseminate information in the interim of the House of Delegates.
2. Must sign Confidentiality and Nondisclosure Agreement and Conflict of Interest Statement at first board meeting once elected in office.
This version supersedes all versions prior to October 2014
BOARD OF TRUSTEES
2014-2015 ROSTER [Private Address List – For Internal Use Only]
OFFICERS
Garfield A. Clunie, M.D. 10 West 135th Street, 17F
3rd Year-1st Term Expires 2015
Chairman/Region I Trustee (212) 241-5681 Office
New York, NY 10037 (212) 348-7438 Office Fax
(917) 370-7565 Cell Office:
(917) 370-7565 Home 5 East 98th Street
New York, NY 10037
Assistant: Tara Jefferson- (212) 241-5681 Email:GClunieMD@gmail.com NMA Assistant: Carla Welborn (202) 347-1895 cwelborn@nmanet.org
Preferred Mailing & Use for Overnight Deliveries: Home Practice: Maternal-Fetal Medicine Lawrence L. Sanders, Jr., M.D. President-Elect 2488 Manor Walk (404) 756-1321 Office Decatur, GA 30030 (404) 378-3780 Home (404) 202-4178 Cell
Preferred Mailing & Use for Overnight Deliveries: Home Email: lsanders@msm.edu Practice: Internal Medicine Assistant: Ronna Branch (404) 752-1717 Rbranch@msm.edu Michael A. LeNoir, M.D.
2014-2015 President 2488 Manor Walk (404) 756-1321 Office Decatur, GA 30030 (404) 378-3480 Home (404) 202-4178 Cell Office: Email:lsanders@msm.edu 720 Westview Drive Atlanta, GA 30310 Practice: Internal Medicine Assistant: NMA Assistant: Carla Welborn (202) 347-1895 cwelborn@nmanet.org
Preferred Mailing & Use for Overnight Deliveries: Home
Michael A. LeNoir, M.D. 2013-2014 Immediate Past President 2940 Summit Street, #1 (510) 834-4897 Office Oakland, CA 94609-3410 (510) 291-2903 Office Fax (510) 220-1169 Cell (510) 339-1062 Home E-Mail: drlenoir@drlenoir.com
Practice: Allergy & Immunology
Assistant: Carla Welborn (202) 347-1895
cwelborn@nmanet.org Rahn K. Bailey, M.D.
2014-2015 Immediate Past President Meharry Medical College
(615) 327-6606 Office 2940 Summit Street, #1 (510) 834-4897 Office Oakland, CA 94609-3410 (510) 291-2903 Office Fax (510) 220-1169 Cell (510) 339-1062 Home E-Mail: drlenoir@drlenoir.com Practice: Allergy & Immunology
NMA Assistant: Carla Welborn (202) 347-1895 cwelborn@nmanet.org
This version supersedes all versions prior to October 2014
Traci C. Burgess, M.D., MPH 3rd Year - 1st Term Secretary P.O. Box 2049 Expires 2014 (201) 291-6324 Office Teaneck, N.J. 07666-1449 ( 201 291-6170 Office (201) 291-6318 Office Fax The Center for Maternal Fetal Medicine at the Valley Hospital
(201) 390-8067 Cell E-mail: tburgessmd@gmail.com 15 Essex Road
Paramus, NJ 07652 Preferred Mailing: Home Practice: Maternal-Fetal Medicine,
OB/GYN & Use for Overnight Deliveries: Please call first
Edith P. Mitchell, M.D. 2nd Year - 1st Term President – Elect 301 Freedom Ct. Expires 2015 (215) 955-4652 Office
Newton Square, PA 19073 (215) 955-1961 Office Phone 2 (215) 503-4103 Fax
Office:
O
(215) 503-4103 Office Facsimile (215) 460-9454 Cell
(215) 610-356-3014 Home (215) 610-359-1110
Office: Email: Edith.mitchell@jefferson.edu Kimmel Cancer Ctr of Thomas Jefferson University 233 South 10th Street, Suite 502 Philadelphia, PA 19107-5541 Preferred Mailing and Use for Overnight Deliveries: Practice: Medical Oncology Either of the above.
Lonnie Joe, Jr., M.D. 2014-2015 Speaker, House of Delegates 31551 West Stonewood Court Expires 2015 (248) 557-5227 Office Farmington Hills, MI 48334 (248) 557-6920 Office 2
Office: 22255 Greenfield #280 Southfield, Michigan 48075
(248) 557-1732 Office Fax (248) 730-2525 Cell
Assistant: Sebrina West (248) 557-5227 Email: lonjoe@aol.com NMA HOD Liaison: Jackie Freeman (202) 347-1895 Practice: Internal Medicine Preferred Mailing Address & Use for Overnight Deliveries: Office
Oliver T. Brooks, M.D.
Term Expires 2014
Vice President, House of Delegates
4104 Country Club Drive (Home) (323) 357-6693 Office Lakewood, CA 90712-3832 (323) 564-1631 Office Fax
(562) 421-1747 Home (562) 421-1747 Home Fax Email: OliBro@aol.com
Watts Health Care Corp 10300 Compton Avenue Los Angeles, CA 90712
Practice: Pediatrics
Preferred Mailing Address & Use for Overnight Deliveries: Home
This version supersedes all versions prior to October 2014
Rachel Villanueva, M.D. 151 E. 31st Street, Apt 29-K
Term 2014-2015 Secretary, House of Delegates (212) 725-6060 Office
New York, NY 10016 (212) 725-6065 Office Fax Office Address: 110 East 40th Street, Suite 801
(212) 889-7626 Home
New York, N.Y. 10016 (917) 270-8516 Cell E-Mail: Rachevill@gmail.com
Preferred Mailing & Uses for Overnight Deliveries: Home
Assistant: Wilma (212) 252-0111 Practice: OB/GYN
C. Freeman, M.D., M.B.A 20 Ironsides Street, Unit 1 Marina del Rey, CA 90292-5956 Office: 1414 S.Grand Ave. #410 Los Angeles, CA 90015
3rd Year-1st Term Expires 2015
Treasurer (310) 512-7760 Office (310) 512-7760 Fax (310) 823-7275 Home (310) 383-0990 Cell
Preferred Mailing & Uses for Overnight Deliveries: Home
E-mail: cfreemanmdmba@hotmail.com
Practice: Geriatrics/ Psychiatry
Leon McDougle, M.D., MPH CAFA Chair Associate Professor of Family Medicine (614) 688-649 Office Associate Dean for Diversity and Cultural Affairs (614) 688-6491 Fax Chief Diversity Officer Lead Physician-Research, OSU Family Medicine at CarePoint East OSU Family Medicine at CarePoint East 543 Taylor Avenue 2nd Floor Columbus, Ohio 43203 Email:Leon.McDougle@osumc.edu
Practice: Family Medicine
Executive Director -Vacant
This version supersedes all versions prior to October 2014
TRUSTEES
Garfield A. Clunie, M.D. 140 West 124th Street, PH-11
2nd Year-1st Term Expires 2015
Region I Trustee and Chairman (212) 241-5681 Office
New York, NY 10027 (212) 348-7438 Office Fax (917) 370-7565 Cell
E-Mail : GClunieMD@gmail.com
Practice: Maternal-Fetal Medicine
Assistant: Tara Jefferson- (212) 241-5681
P. Grace Harrell, M.D. 1st Year Region I - Trustee 4 Canal Park Term Expires 2015 (617) 596-5685 Office Cambridge, MA 02141 Office: MGH Anesthesia Email: pharrell@partners.org Jackson 4 Practice: Anesthesiology
Boston, MA 02114 Preferred Mailing & Uses for Overnight Deliveries: Office
Wesley B. Carter, M.D. 1st Year - 1st Term Region II – Trustee 1407 Wentbridge Rd. Expires 2015 (804) 338-3014 Cell Richmond, VA 23227 Philadelphia, PA 19107-5541
Email: WBCNAC72@aol.com
Preferred Mailing & Use for Overnight Deliveries: Practice: Child-General Psychiatry
Jackson L. Davis III, M.D. 1st Year-1st Term* Region II-Trustee 1213 Jamaica Street, NE (202)388-6000 Office Washington, DC 20011 (202)388-6001 Facsimile Office: (202)529-0034 Home
Assistant: Debbie Tooson-Harris (317) 221-2301 (202)550-7067 Cell 4121 Minnesota Ave. NE Washington, DC 20018 Email: jacksonldavis3@verizon.net Preferred Mailing & Use for Overnight Deliveries: Home Practice: Urology John E. Arradondo, M.D. 1st Year – 1st Term Region III – Trustee 128 Dekewood Dr. 3rd Year - 1st Term Corporate Trustee Expires 2014 (201) 291-6324 Office ( 201 291-6170 Office (201) 291-6318 Office Fax (201) 390-8067 Cell
E-mail: tburgessmd@gmail.com
Preferred Mailing: Home
Expires 2016 (615) 594-2586 Office Old Hickory, TN 37138-2163 (615) 847-1154 Office Fax Email: jeamd@comcast.net Preferred Mailing & Use for Overnight Deliveries: Office Practice: Anesthesia/ Critical Care
This version supersedes all versions prior to October 2014
Albert W. Morris, Jr., M.D. 2nd Year – 2nd Term Region III – Trustee 3236 Winddrift Circle Practice: Maternal-etal Medicine, OB/GYN
& Use for Overnight Deliveries: Please call first
128 Dekewood Drive
Expires 2015 (901)550-5834 Cell Email:dralmorris@aol.com 594-2586 Office
Memphis, TN 38125 2013-14 Chairman 3236 Winddrift Circle Memphis, TN 38125 (901)550-5834 Cell
Email:dralmorris@aol.com Practice: Radiolog
Email:dralmorris@aol.com Preferred Mailing & Use for Overnight Deliveries: Home Practice: Radiology
Virginia A. Caine, M.D. 2nd Year-1st Term Expires 2015
Region IV- Trustee 8902 Riverbend Ct. (317) 221-2301 Office Indianapolis, IN 46250 (317) 841-9104 Home
(317) 753-3988 Cell Email:vcaine@comcast.net
Jeffrey Clark, M.D. CClCC_________________________________________________________________________________________________________Jeffrey K. Clark, M.D.
2nd Year-1st Term 1835 Lakeview Court Term Expires 2015 Bloomfield Hills, MI 48304 Preferred Mailing & Use for Overnight Deliveries: Home
Assistant: Gilda (313) 745-2332
Region IV – Trustee 1835 Lakeview Court Bloomfield Hills, MI 48304
(313) 745-2332 Office Bloomfield Hills, MI 48304 (313) 745-8907 Office Fax
(248)594-1847 Home (248) 594-1849 Home Fax (248) 933-3179 cell
Email: jkc82mda@aol.com
Practice: Anesthesia/ Critical Care Preferred Mailing & Use for Overnight Deliveries: Home
Henry M. Evans Jr., M.D. 2nd Year 1st Term Region V –Trustee 4301 Elysian Fields Expires 2015 (504) 284-3866 Office New Orleans, LA 70122 Preferred Mailing & Use for Overnight Deliveries: Home
Email: laavemedical@bellsouth.net Practice: Family Practice
________________________________________________________________________________________
This version supersedes all versions prior to October 2014
Elise D. Cook, M.D. 2nd Year 1st Term Region V – Trustee Associate Professor Term Expires 2016 (713)-563-1474 Office UT M.D. Anderson Cancer Center (713) 404-0639 Pager Department of Clinical Cancer Prevention Unit 1360 (713) 468-6224 Home Houston, TX 77230-1439 (281) 468-6224 Cell P.O. Box 301439 (713) 563-5746 Fax Houston, TX 77230-1439 Home: E-mail: elise_cook@yahoo.com 3909 Fernwood Dr. Houston, TX 77021 Practice: Cancer Prevention
Preferred Mailing & Use for Overnight Deliveries: Home
Gail N. Morgan, M.D. 5253 South Graham Street Seattle, WA 98118
2nd Year-1st Term Term Expires 2015
Region VI- Trustee (206) 223-6851 ext. 57238 Office (206) 344-7959 Fax (206) 860-1063 Home
Office: Virginia Mason Medical Center 1100 Ninth Ave. Seattle, WA 98118
(206) 300-0777 Cell (206) 540-5650 Pager Email: gnmorganmd@comcast.net
Preferred Mailing & Use for Overnight Deliveries: Home Practice: Diagnostics/Radiology
Warren James Strudwick Jr., M.D. 2nd Year – 1st Term Region VI – Trustee 5852 McAndrew Dr. Expires 2016 (510) 922-1614 Office Oakland, CA 94611 (510) 290-9995 Cell (510) 339-0339 Home Office:
5900 Hollis St. Suite K Email: wstrud@mac.com Emeryville, CA 94608 Preferred Mailing & Overnight Deliveries: Office Practice: Orthopedic Surgery, Sports Medicine
Traci C. Burgess, M.D., MPH 1st Year – 2nd Term Corporate Trustee P.O. Box 2049 Expires 2014 (201) 291-6324 Office Teaneck, N.J. 07666-1449 ( 201 291-6170 Office (201) 291-6318 Office Fax The Center for Maternal Fetal Medicine at the Valley Hospital
(201) 390-8067 Cell E-mail: tburgessmd@gmail.com 15 Essex Road
Paramus, NJ 07652 Preferred Mailing: Home Practice: Maternal-Fetal Medicine, OB/GYN & Use for Overnight Deliveries: Please call first
This version supersedes all versions prior to October 2014
Michael G. Knight, M.D. 2nd Year 1st Term Postgraduate Trustee 435 E. 70th St., Apt. 33-E Expires 2015 (917) 444-0749 Office New York, NY 10021
Preferred Mailing/Overnight: Home HH::Deliveries: Office
53
o
Email: knightmg@gmail.com
Topaz Sampson 2nd Year 1st Term Student Trustee 65 Vine St. #2 Expires 2015 (347) 526-4482 Cell Dayton, OH 45409
Email: president@snma.org Practice: MSIII
This version supersedes all versions prior to October 2014
REGIONAL CHAIRPERSONS
Camille A. Clare, M.D., MPH Region I - Chairperson 1376 Midland Ave., # 402 (212) 423-6796 Office Bronxville, NY 10708 (212) 423-8121 Fax (917) 449-3033 Cell Office:
Metropolitan Hospital 1901 First Ave. Email: camille_clare@hotmail.com New York, NY 10029 Practice: Obstetrics/Gynecology
Preferred Mailing & Use for Overnight Deliveries: Home Assistant:
Lornel G. Tompkins, M.D. Region II - Chairperson 3200 Waterton Drive (804) 788-0556 Office Midlothian, VA 23113-2148
(804) 640-9811Home (804) 320-1457 Fax
(804) 640-9811 Cell Email: 1drt@msn.com Office:
Practice: Pulmonology Preferred Mailing & Uses for Overnight Deliveries: Home
Gloria D. Frelix, M.D., M.H.A Region III - Chairperson 301 S. Dogwood Trail (252) 619-6090 Cell Elizabeth City, NC 27909 (252) 331-1044 Home
E-mail: gfrelix@yahoo.com Preferred Mailing & Uses for Overnight Deliveries: Home Practice: Radiation Oncologist
Adrienne Ray, M.D. Region IV- Chairperson 6912 South Shore#2 S
(312) 670-2530 Office Chicago, Illinois 60649 (708) 488-0072 Office #2
(773) 363-3668 Home (773) 791-4843 Cell (312) 250-5315 Pager
Assistant: Office:
625
Email: ARay_md@yahoo.com
625 N. Michigan Ave. Ste: 210 Practice: Obstetrics/Gynecology Chicago, Illinois 60611 Preferred Mailing & Uses for Overnight Deliveries: Home
This version supersedes all versions prior to October 2014
Joia Crear-Perry, M.D. Region V - Chairperson 58 Fontainebleau Drive (504) 361-3003 Office
New Orleans, LA 70125-3445 (504) 813-4450 Cell
(504) 218-7074 Home Office: (504) 365-1127 Office Fax
4747 Earhardt Blvd., Suite J E-mails: jadelemd@aol.com N.O., LA 70125 Region5nma@gmail.com Assistant: Shani Hunter (504) 361-3003
Practice: Obstetrics/Gynecology Preferred Mailing & Uses for Overnight Deliveries: Home
Richard Allen Williams, M.D. Region VI- Chairperson 3425 Clairton Place (818) 907-65790 Office Encino, CA 91436 (818) 907-6750 Home (818) 907- 0510 Home Fax (310) 991-8027 Cell
Preferred Mailing & Uses for Overnight Deliveries: Home
E-mail: mhinst@aol.com
Practice: Cardiology
Melvin Gravely Parliamentarian Office: (614) 901-3369
Fax: (614) 342-6242 Fax: (614) 342-6242
(504) 813-4450 Cell
3195 Genevieve Drive Columbus, Ohio 43219-3088
Fax: (614) 342-6242 (504) 218-7074 Home
Columbus, Ohio 43219-3088
Emails: mel@thegravelygroup.com / melvin.gravely76@gmail.com
1
NATIONAL MEDICAL ASSOCIATION BOARD OF TRUSTEES COMMITTEES
ROLES AND RESPONSIBILITIES (Updated September 2011)
Role of the Committee Member A Board of Trustees (BOT) Committee Member must adequately review and be prepared to discuss specific recommendations brought before the committee inclusive of minutes and/or reports presented at previous meetings. The Committee Member should be able to clearly communicate ideas and work cooperatively with the Committee Chair to complete the steps necessary for the Committee to accomplish its given task. Responsibilities of Committee Members
1. Attend meetings and conference calls on time and work within the defined agenda. 2. Review materials given to committee members relating to agenda items. 3. Be prepared to fully participate in committee deliberations and activities. 4. Maintain a record of and complete assignments, and be prepared to discuss and report on
their status.
Role of Committee Chairs Strong leadership is the cornerstone of success in chairing a committee. The BOT Committee Chair must clearly communicate goals and objectives to committee members and association staff. Committee meetings should adhere to a specific agenda that will guide the committee through all of the steps necessary to accomplish its given task.
Responsibilities of the Committee Chairs
1. Develop the committee’s yearly goals and objectives with committee members at the first meeting. This should be developed with review of the previous year’s minutes, action items and strategic agenda as it pertains to the specific committee. 2. Ensure that all members understand their individual roles and responsibilities, as well as that of the committee. 3. Schedule meetings/conference calls for the upcoming year. This information should be provided to the BOT Liaison. 4. Attend all meetings and conference calls. 5. Develop an agenda for each meeting. 6. Keep a timely meeting in accordance with the agenda. 7. Ensure that adequate minutes are recorded for each meeting/conference call. 8. Ensure committee members receive all pertinent information regarding an issue. 9. Lead pertinent and directed discussion, and include all committee members in deliberations and decisions. 10. Maintain a record of relevant information. Keep track of assignments and their status. 11. Evaluate and communicate committee efforts. The Chair has responsibility for keeping committee members, Association leadership and the membership abreast of the committee activities.
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STANDING COMMITTEES
Role of Standing Committees Standing committees coordinate, and cooperate with each other to fulfill the NMA's mission. There are two (2) standing leadership committees (Executive and NMA/ANMA Liaison) and seven (7) standing committees of the Board of Trustees that conduct the business of the Association in between the meetings of the House of Delegates.
Executive
NMA/ANMA Liaison
Convention
Educational Affairs
Financial Affairs
Grants and Special Projects
Governance and Compliance
Health Policy
Membership
Publications
_________________________________________________________________________________
LEADERSHIP COMMITTEES CHARGES
Executive Committee
The Executive Committee, between Board of Trustees meetings, carries out the policies and the mission as defined by the House of Delegates and effects timely actions for maximal effectiveness and optimum efficiency in the conduct of NMA affairs. The Committee oversees the management of the National Office and has final responsibility for financial integrity and fiscal health of the organization, in accordance with the mandate of the Constitution and By-Laws of the National Medical Association. _________________________________________________________________________________
NMA/ANMA Liaison Committee
The NMA/ANMA Liaison Committee facilitates cooperation between the two organizations, and makes recommendations in the coordination of programs and activities of mutual interest and shared benefit between the NMA and Auxiliary to the National Medical Association (ANMA). _________________________________________________________________________________
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BOT COMMITTEE CHARGES Convention Committee The Convention Committee recommends and assists in the coordination of activities and plenary for the annual NMA Convention. The Committee facilitates meaningful cooperation between the Association and ANMA in activities of mutual interest and shared benefit. The Committee also promotes activities through which medical students may enhance their organizational skills and embrace the goals and objectives for which the Association stands.
Educational Affairs Committee The Educational Affairs Committee monitors, in conjunction with the Director of Continuing Medical Education (CME) and the Chairperson for the Council on Educational Affairs, all the national, regional and local meetings. The Committee develops and maintains guidelines for speakers and participants, and makes recommendations for guidelines of participation by other medical groups in scientific forums in which CME is given by the NMA.
Financial Affairs Committee The Financial Affairs Committee provides policy guidance to the Board on matters related to expenditures of any entity of the Association. Assists the Treasurer to develop and recommend an appropriate budget for the organization. This committee is assigned the responsibility for recommending a resource development plan, which will assure the availability of adequate financial and related resources essential to the conduct of the various programs and functions approved by the House of Delegates (HOD). In considering the financial needs of the organization, the Committee recommends dues and fees to the Board of Trustees for action by the HOD. The Committee is responsible for personnel issues, including but not limited to policy, severance pay, benefits, vacation, and sick leave.
Health Policy Committee The Health Policy Committee identifies, researches, and formulates health policy positions that reflect the perspective of African American and minority physicians who are engaged in the practice of medicine or medical education. Issues to be addressed include: (1) access to medical education and/or medical practice opportunities; (2) financing mechanism for medical services; (3) legislative initiatives to facilitate the delivery of quality medical services to all segments of the national population; (4) professional standards, licensure, recertification, and disciplinary procedures; (5) minority physician development and related health care personnel; (6) medical research significant to America’s seniors; and (7) oversight and assistance in the development of materials for legislative hearings and public information.
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The Committee should evaluate resolutions from the HOD that will be used in public statements regarding the NMA’s position in health-related areas and other areas pertinent to the welfare of its membership. The Committee serves as a resource to the Board providing information necessary for resolving issues. The committee should act on pertinent recommendations adopted at the Annual Convention and report to the Board of Trustees. The Committee should work in conjunction with the Council on Medical Legislation (CML) and CME, and to conduct regional meetings with them.
Grants and Special Projects (R& D) Committee The Grants and Special Projects (R&D) Committee develops guidelines for and reviews and monitors all proposals relative to activities that are to be sponsored by the Association or any of its organizational elements, (i.e., Scientific Sections, Regions, Councils, Special Committees and Task Forces) and that seek funding by grant contract or endorsement, regardless of the source.
Governance and Compliance Committee The Governance and Compliance Committee recommends and develops policy that governs the roles, responsibilities and performance of Board of Trustees members and National Officers of the Association. It provides rules for compliance to the standards, policies and principles of the NMA. The committee shall be responsible for new Board member orientation, Board self-evaluation and educational programs for the Trustees. The Committee will also promote membership development for future Board participation. _________________________________________________________________________________________________
Membership Committee
The Membership Committee shall pursue methods toward increasing membership in the NMA. Strategies will be reviewed and implemented in reference to student, fellow, and resident membership, as well as retention and reclamation of old memberships. The Committee will work closely with assigned staff from the National Office in an effort to develop and maintain efficient and effective mechanisms for the membership process. The Committee shall make recommendations on mechanisms whereby the membership will have full access to the benefits offered by our Association (i.e., auto leasing, insurance programs, merchandise discounts, travel discounts, hotel discounts, member loans, equipment leasing). The committee, prior to presentation to the Board of Trustees, shall review recommendations regarding membership in the organization. _________________________________________________________________________________
Publications Committee The Publication Committee shall be directly responsible to the Board of Trustees and is responsible for recommending and working with the Publisher. It shall evaluate the contents and editorial policies of the JNMA regularly and make recommendations to the BOT. It shall determine and approve the amount and content of all advertising appearing in the Journal, shall supervise matters dealing with pagination and finances, and may summon consultants, subject to approval of the Chairman of the Board and when deemed necessary. Any expenses of such meetings should be defrayed from the Journal.
NATIONAL MEDICAL ASSOCIATION BOARD OF TRUSTEES AD HOC COMMITTEES
AND TASK FORCES ROLES AND RESPONSIBILITIES
(Updated September 2011)
Audit Committee
In compliance with the Sarbanes-Oxley Act of 2002, the Audit Committee, working as an independent arm of the BOT, provides oversight of the audit. The Committee may establish, prior to the Audit, the anticipated scope of the audit, the general extent of the audit planned, and the major risks to be addressed. After the Audit, the external auditors will meet with the committee to present the audited financial statements, discuss any limitations placed on the scope or nature of the testing performed, outline deficiencies in internal controls, and relay recommendations for addressing outcome. Other tasks should also include:
Ensure that annual staff performance evaluations are completed.
Review yearly the performance of the external auditors and determine, whether the contract with the current firm should be renewed, or if bids should be taken to find a new auditor.
Responsible for understanding and monitoring the internal controls in place within the organization; and work with the Executive Director in reference to other matters. Policies should be reviewed and an understanding of how risks are assessed should be developed.
Report directly to the full Board of Trustees at least once a year. The Board should then review and approve the committee's charter for the coming year
Health Information Technology (HIT) Task Force The Health Information Technology (HIT) Task Force will advise the Board of Trustees on all matters relating to HIT adoption and implementation. It will also help NMA members prepare for HIT adoption pursuant to the HITECH Act. It will also serve to facilitate collaboration between the BOT and the wider NMA membership on all HIT issues. Finally, the Task Force will help to maintain collaborations and alliances between NMA and outside groups, regarding HIT adoption. ____________________________________________________________________________________ Strategic Agenda Planning Task Force The overall charge of the task group is to assist the Chair and Executive Director in reviewing and updating the NMA Strategic Plan 2006-2011 (Five-Year Strategic Plan) and developing the 2012-2017 Strategic Plan. The Committee assists the Chair in reviewing and ensuring that action items presented to the Board of Trustees for consideration address the NMA’s Annual Strategic Plan and operational objectives. The composition of the Strategic Plan Work Group includes the National Leadership, Senior Staff, Chairs of all Standing Committees of the Board of Trustees, Ad Hoc Committees, and Work Groups. Specific Objectives:
1. Complete previous year’s documents before October Board Meeting. 2. Finalize the Strategic Agenda for the upcoming operational year. 3. Monitor the indicators identified on the Strategic Agenda
Revised September 2011
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4. Prepare a report card and related documents for presentation to the BOT and HOD at the Annual meeting.
NATIONAL MEDICAL ASSOCIATION BOARD OF TRUSTEES 2014-2015 Standing and Ad hoc Committees
(with Staff Liaison)
The President, Chair of the Board, and Executive Director are Ex Officio of all committees Updated 9/30/14
Executive Committee (C. Welborn)
NMA/ANMA Liaison Committee (C. Welborn)
Convention (Y. Fleming)
Convention, cont’d (Y. Fleming)
Garfield A. Clunie, M.D. – Chair gcluniemd@gmail.com (917) 370-7565 Lawrence Sanders, M.D. lsanders@msm.edu (404) 202-4178 Michael A. LeNoir, M.D. michael.lenoir@gmail.com (510) 220-1169 Lonnie Joe, Jr., M.D. lonjoe@aol.com (248) 730-2525 Traci C. Burgess, M.D., MPH tburgessmd@gmail.com (201) 390-8067 C. Freeman, M.D., MBA cfreemanmdmba@hotmail.com (310) 383_0990 Gail N. Morgan, M.D. gnmorganmd@comcast.net (206) 300-0777 Jeffery Clark, M.D. jkc82mda@aol.com (248) 933-3179 Edith P. Mitchell, M.D. edith.mitchell@jefferson.edu (215) 955-4652 Executive Director –TBD
Garfield A. Clunie, M.D. – Chair gcluniemd@gmail.com (917) 370-7565 Lawrence Sanders, M.D. – Chair lsanders@msm.edu (404) 202-4178 Lonnie Joe, Jr., M.D. lonjoe@aol.com (248) 730-2525 Michael A. LeNoir, M.D. michael.lenoir@gmail.com (510) 220-1169 Edith P. Mitchell, M.D. edith.mitchell@jefferson.edu (215) 955-4652 ANMA Velva Clark, RN, BS velvasclark@comcast.net Helen Kinard Scott, DPA hkinard@aol.com Charlotte Henderson, Ed.D chucki4@aol.com Sonya Scott speede1212@aol.com Regina Wheat-Gbadouwey rwheat456@yahoo.com Mae S. Walton msw213@aol.com
Lawrence Sanders, M.D. – Chair lsanders@msm.edu (404) 202-4178 Lonnie Joe, Jr., M.D. lonjoe@aol.com (248) 730-2525 Michael A. LeNoir, M.D. michael.lenoir@gmail.com (510) 220-1169 C. Freeman, M.D., MBA cfreemanmdmba@hotmail.com (310) 383_0990 P. Grace Harrell, M.D., MPH pharrell@partners.org (617) 596-5685 Jeffery Clark, M.D. jkc82mda@aol.com (248) 933-3179 Oliver T. Brooks, M.D. olibro@aol.com (310) 901-5179 Elise D. Cook, M.D. elise_cook@yahoo.com (281) 468-6224 Joia Crear-Perry, M.D. jadelemd@aol.com (504) 813-4450 Camille A. Clare, M.D., MPH camille_clare@hotmail.com (917) 449-3033 Michael G. Knight, M.D. knightmg@gmail.com (917) 444-0749
ANMA Velva Clark, RN, BS velvasclark@comcast.net Helen Kinard Scott, DPA hkinard@aol.com Charlotte Henderson, PhD chucki4@aol.com Sarita Cathcart-McLarin scathcart@msn.com Sharon Melvin, RN, MPH smelvin14@gmail.com Sabrina Williams sabrinawilliams57@icloud.com Judge Morris Overstreet morrisoverstreet@yahoo.com
NATIONAL MEDICAL ASSOCIATION BOARD OF TRUSTEES 2014-2015 Standing and Ad hoc Committees
(with Staff Liaison)
The President, Chair of the Board, and Executive Director are Ex Officio of all committees Updated 9/30/14
Educational Affairs (C. Syphax/F. Charlouis)
Financial Affairs (A. Johnson)
Governance and Compliance (L. Battley)
Grants and Special Programs (Y. Fleming)
Edith P. Mitchell, M.D. – Chair edith.mitchell@jefferson.edu (215) 955-4652 P. Grace Harrell, M.D., MPH pharrell@partners.org (617) 596-5685 Jackson L. Davis, III.M.D. jacksonldavis3@verizon.net
(202)-550-7067 Albert W. Morris, Jr. MD dralmorris@aol.com (901)550-5834 Elise D. Cook, M.D. elise_cook@yahoo.com (281) 468-6224 Henry M. Evans, Jr., M.D. laavemedical@bellsouth.net (504) 284-3866 Gail N. Morgan, M.D. gnmorganmd@comcast.net (206) 300-0777 John E. Arradondo, M.D., MPH jeamd@comcast.net (615) 594-2586
Jeffery Clark, M.D. – Chair jkc82mda@aol.com (248) 933-3179 Rachel Villanueva, M.D. rachevill@gmail.com (917) 270-8516 C. Freeman, M.D., MBA cfreemanmdmba@hotmail.com (310) 383-0990 Traci C. Burgess, M.D., MPH tburgessmd@gmail.com (201) 390-8067 John E. Arradondo, M.D., MPH jeamd@comcast.net (615) 594-2586 Warren J. Strudwick, Jr., M.D. wstrud@mac.com (510) 290-9995 Elise D. Cook, M.D. elise_cook@yahoo.com (281) 468-6224 Wesley B. Carter, M.D. WBCNAC72@aol.com (804) 338-3015 Leon McDougle leon.mcdougle@osumc.edu (614) 596-2305
Gail N. Morgan, M.D. – Chair gnmorganmd@comcast.net (206) 300-0777 Lonnie Joe, Jr., M.D. lonjoe@aol.com (248) 730-2525 Wesley B. Carter, M.D. WBCNAC72@aol.com (804) 338-3015 Albert W. Morris, Jr. MD dralmorris@aol.com (901) 550-5834 Richard A. Williams, M.D. mhinst@aol.com (310) 991-8027 Warren J. Strudwick, Jr., M.D. wstrud@mac.com (510) 290-9995 Adrienne Ray, M.D. aray_md@yahoo.com (773) 791-4843 Lornel, Thompkins, M.D. 1drt@msn.com (804) 640-9811 John E. Arradondo, M.D., MPH jeamd@comcast.net (615) 594-2586
Virginia A. Caine, M.D. – Chair vcaine@hhcorp.org (317) 753-3988 Richard A. Williams, M.D. mhinst@aol.com (310) 991-8027 Topaz Sampson, B.S. President@snma.org topaz.sampson@gmail.com (347) 526-4482 Gloria D. Frelix, M.D., MHA gfrelix@yahoo.com (252) 619-6090 Michael A. LeNoir, M.D. michael.lenoir@gmail.com (510) 220-1169 Adrienne Ray, M.D. aray_md@yahoo.com (773) 791-4843 Lornel, Thompkins, M.D. 1drt@msn.com (804) 640-9811 Michael G. Knight, M.D. knightmg@gmail.com (917) 444-0749
NATIONAL MEDICAL ASSOCIATION BOARD OF TRUSTEES 2014-2015 Standing and Ad hoc Committees
(with Staff Liaison)
The President, Chair of the Board, and Executive Director are Ex Officio of all committees Updated 9/30/14
Health Policy (C. Syphax/F. Charlouis)
Membership (Y. Fleming)
Membership, cont’d (Y. Fleming)
Publications (A. Valladares)
Edith P. Mitchell, M.D. – Chair edith.mitchell@jefferson.edu (215) 955-4652 Traci C. Burgess, M.D. , MPH tburgessmd@gmail.com (201) 390-8067 Wesley B. Carter, M.D. WBCNAC72@aol.com (804) 338-3015 Richard A. Williams, M.D. mhinst@aol.com (310) 991-8027 Michael A. LeNoir, M.D. michael.lenoir@gmail.com (510) 220-1169 Virginia A. Caine, M.D. vcaine@hhcorp.org (317) 753-3988 Adrienne Ray, M.D. aray_md@yahoo.com (773) 791-4843 Lornell Thompkins, M.D. 1drt@msn.com (804) 640-9811 Henry M. Evans, Jr., M.D. laavemedical@bellsouth.net (504) 284-3866 ANMA Sharon Melvin, RN, MPH smelvin14@gmail.com Judge Morris Overstreet morrisoverstreet@yahoo.com
Joia Crear-Perry, M.D. – Chair jadelemd@aol.com (504) 813-4450 Oliver T. Brooks, M.D. olibro@aol.com (310) 901-5179 C. Freeman, M.D., MBA cfreemanmdmba@hotmail.com (310) 383_0990 Jackson L. Davis, III.M.D. jacksonldavis3@verizon.net (202)-550-7067 Jeffery Clark, M.D. jkc82mda@aol.com (248) 933-3179 Michael G. Knight, M.D. knightmg@gmail.com (917) 444-0749 Topaz Sampson, B.S. President@snma.org topaz.sampson@gmail.com (347) 526-4482 Rachel Villanueva, M.D. rachevill@gmail.com 917-270-8516 Camille A. Clare, M.D., MPH camille_clare@hotmail.com (917) 449-3033 Gloria D. Frelix, M.D., MHA gfrelix@yahoo.com (252) 619-6090
ANMA Velva Clark, RN, BS velvasclark@comcast.net Helen Kinard Scott, DPA hkinard@aol.com Charlotte Henderson, Ed.D. chucki4@aol.com Regina Wheat-Gbadouwey rwheat456@yahoo.com Sonya Scott speede1212@aol.com Ruth V. Creary, Ph.D. rvcreary@gmail.com
William Lawson, M.D. PhD Chair & Editor-in-Chief of the JNMA eblawson@howard.edu (202) 865-6615 Michael A. LeNoir, M.D. michael.lenoir@gmail.com (510) 220-1169 Jackson L. Davis, III.M.D. jacksonldavis3@verizon.net (202)-550-7067
NATIONAL MEDICAL ASSOCIATION BOARD OF TRUSTEES 2014-2015 Standing and Ad hoc Committees
(with Staff Liaison)
The President, Chair of the Board, and Executive Director are Ex Officio of all committees Updated 9/30/14
Audit (Ad hoc) (A. Johnson)
Gloria D. Frelix, M.D., MHA – Chair gfrelix@yahoo.com (252) 619-6090 Virginia A. Caine, M.D. vcaine@hhcorp.org (317) 753-3988 Henry M. Evans, Jr., M.D. laavemedical@bellsouth.net (504) 284-3866 Camille A. Clare, M.D., MPH camille_clare@hotmail.com (917) 449-3033
2014-2015 STANDING COMMITTEE
MONTHLY MEETINGS
Executive Committee- 1st Tuesday
Health Policy Committee- 2nd
Monday
Educational Affairs Committee- 2nd
Tuesday
Membership Committee- 2nd
Wednesday
Publications Committee- 2nd
Thursday
Convention Committee- 3rd
Wednesday
Grants & Special Programs Committee- 3rd
Wednesday
Financial Affairs Committee- 3rd
Monday
Governance and Compliance Committee- 4th
Tuesday
* The Staff Liaison will work with the Committee Chair to prepare and disseminate
the agenda, minutes and related meeting materials, and to disseminate conference call
information.
* All Committee Chairs have the option to change their respective meeting day, as
long as it does not conflict with any other committee. Committee Chairs may also call
meetings as often as deemed necessary.
Board of Directors Orientation Notebook
Section 4:
BOARD DOCUMENTS
1. Confidentiality and Nondisclosure Form 2. Conflict of Interest Policy 3. Board Members Agreement Form 4. Directors & Officers Insurance Policy Declaration Page
NATIONAL MEDICAL ASSOCIATION
CONFIDENTIALITY AND NONDISCLOSURE AGREEMENT
This Confidentiality Agreement (“Agreement”) dated this _____ day of
_____________, is entered into by and between the National Medical Association, a New
Jersey not-for-profit association with its principal place of business at 8403 Colesville
Road, Suite 820, Silver Spring, Maryland (Montgomery County). (the “NMA”), and
____________________ (“Trustee”) (hereinafter referred to as the “Parties”).
RECITALS
WHEREAS, Trustee is a newly appointed member of the NMA Board of Trustees
(the “NMA Board”) who owes the NMA the fiduciary duties of care and loyalty; and
WHEREAS, Trustee and the NMA contemplate that in the course of performing
Trustee’s duties as a member of the NMA Board, Trustee will have access to privileged
and confidential information; and
WHEREAS, the Parties desire to set forth their understanding regarding Trustee’s
duty to keep confidential all information relating to the NMA and its business, operations
and personnel.
NOW, THEREFORE, in consideration of the above premises, the Parties agree as
follows:
1. Confidential Information. For purposes of this Agreement, “Confidential
Information” means all proprietary and confidential information of the NMA, whether
printed, written, oral, electronic or on software, disclosed by the NMA or acquired or
learned by Trustee in connection with the performance of Trustee’s duties, including but
not limited to: (i) financial information or other financial data, (ii) fundraising and grant
information, (iii) personnel information, (iv) business procedures, systems, operations,
plans, premises and processes, (v) service information (vi) member information, and (vii)
intellectual property rights.
The term “Confidential Information” shall not include any information which the
Trustee can demonstrate:
(a) is lawfully received free of restriction from another source having the right
to so furnish such information; or
(b) has become generally available to the public without breach of this
Agreement by the Trustee; or
2
(c) which prior to the time or disclosure to the Trustee was rightfully in the
possession of the Trustee free of restriction as evidenced by
documentation in the Trustees’ possession.
2. Obligation of Confidentiality. The Parties agree that all Confidential
Information shall be kept confidential by the Trustee and, without the prior
written consent of the NMA, the Trustee shall not (i) distribute or disclose any
of the Confidential Information in any manner, (ii) permit any third party
access to the Confidential Information, or (iii) use the Confidential
Information for any purpose other than as stated herein or agreed in writing by
the NMA.
3. Ownership of Information. Trustee acknowledges and agrees that any
Confidential Information provided to Trustee, in whatever form, is the sole
property of the NMA. As such, nothing contained in this Agreement shall be
construed as granting or conferring upon Trustee any rights by license or
otherwise, express or implied, to any information, property or rights of the
NMA, including but not limited to, the Confidential Information.
4. Disclosures Required by Law or Court Order. In the event that Trustee
receives a request to disclose all or any part of the NMA’s Confidential
Information under the terms of a valid and effective subpoena or order issued
by a court of competent jurisdiction or by a governmental body, Trustee
agrees to immediately notify the NMA of the existence, terms and
circumstances surrounding such a request so that the NMA may seek an
appropriate protective order, or waive compliance by Trustee with the
appropriate provisions of this Agreement. If Trustee is compelled to disclose
any of the NMA’s Confidential Information, Trustee shall disclose only that
portion thereof which Trustee is compelled to disclose and Trustee shall use
his/her best efforts to obtain an order or other reliable assurance that
confidential treatment will be accorded to the Confidential Information so
disclosed.
5. Return of Confidential Information. If Trustees ceases to be a member of the
NMA Board, then all documents, records, materials and similar repositories of
information, including any and all copies thereof containing Confidential
Information relating to the NMA then in the possession of Trustee, prepared
by or obtained from the NMA, shall be promptly surrendered and delivered to
the NMA. Likewise, Trustee shall certify in writing the destruction of all
notes, analyses and other information prepared or extracted by Trustee from
the Confidential Information.
3
6. Injunctive Relief. Trustee agrees that any threatened or existing violation of
this Agreement would cause the NMA irreparable harm for which it would not
have adequate remedy at law, and that the NMA shall be entitled to seek
immediate injunctive relief prohibiting such violation in addition to any other
rights or remedies which the NMA may have at law of in equity.
7. No Waiver of Rights. It is understood and agreed that no failure or delay by
the NMA in exercising any right, power or privilege hereunder shall operate
as a waiver thereof, not shall any single or partial exercise thereof preclude
any other or further exercise thereof or the exercise or any right, power or
privilege hereunder.
8. Indemnification Expenses. Trustee agrees to indemnify the NMA for any and
all losses, liabilities, obligations, damages, penalties, judgments, suits, costs,
expenses or disbursements of any kind (including without limitation,
attorneys’ fees and expenses) arising out of, or incurred by the NMA, as the
result of a violation, breach or non-performance by Trustee of any of the terms
of this Agreement.
9. Entire Agreement. This Agreement sets forth the entire agreement and
understanding of the Parties concerning the subject matter hereof, and no
representation, promise, inducement or statement of intention not set forth in
this Agreement has been made by or on behalf of either Party hereto.
10. Severability Survival. If any provision of this Agreement is held to be illegal,
invalid or unenforceable, such provision shall be fully severable and this
Agreement shall be construed as if the illegal, invalid or unenforceable
provision had never been a part of this Agreement and remaining provisions
of this Agreement shall be given full force and effect. The restrictions and
obligations of this Agreement shall survive any expiration, termination or
cancellation of this Agreement and any relationship of the Parties and shall
continue to bind the parties and their successors, heirs and permitted assigns
in perpetuity.
11. Governing Law. This Agreement shall be governed by and construed in
accordance with the laws of the Montgomery County, Maryland, without
giving effect to its principles of conflict of laws. The parties hereto consent to
the jurisdiction of the courts of the Montgomery County, Maryland in all
matters pertaining to this Agreement.
12. Counterparts. This Agreement may be executed in counterparts, each of
which will be considered one and the same Agreement and will become
effective when such counterparts have been signed and delivered by each of
the Parties to the other Party, it being understood that the Parties need not sign
the same counterpart.
4
IN WITNESS WHEREOF, the Parties have caused this Agreement to be signed
as of the date first above written.
NATIONAL MEDICAL ASSOCIATION
By: ______________________________
Name:
Title:
__________________________________
TRUSTEE
National Medical Association Conflict of Interest Statement
for Officers, Trustees, Committee Members, Staff Members, and Consultants
No National Medical Association (hereinafter referred to as the “NMA”) Officer,
Trustee, Committee member or Staff shall derive any personal profit or gain, directly or
indirectly, by reason of his or her participation with the NMA. Each NMA Officer,
Trustee, Committee member, Staff or Consultant shall disclose to the NMA any personal
interest which he or she may have in any matter pending before the NMA, and shall
refrain from participation in any decision on such matter.
Any Officer, Trustee, Committee member, Staff or Consultant, who is also an officer,
trustee, director, committee member, employee or relative of a NMA donor, grantor,
supplier, vendor or other person or entity with which the NMA conducts business, shall
immediately inform the NMA or his or her affiliation with such person or entity. Further,
in connection with any Committee or Board of Trustee action specifically directed to any
such person or entity, he or she shall not participate in the decision affecting such person
or entity and the decision with respect to such person or entity must be made and/or
ratified by the full Board of Trustees.
All Officers, Trustees, Committee members, Staff and Consultants shall refrain from
obtaining any list of NMA members or personal or private solicitation purposes, at any
time during the term of their affiliation with the NMA.
At this time, I am or have served as an Officer, Trustee, Director, Committee member,
employee/or I am a relative of the following NMA donor, grantor, supplier, vendor or
other person or entity with which the NMA has conducted business within the past 5
years.
Now this is to certify that, except as described below:
1) I am not now, nor at any time during the past 5 years have been a participant,
directly or indirectly, in any arrangement, agreement, investment, or other
activity with any donor, grantor, supplier, vendor or other person or entity
doing business with the NMA, which has resulted or could result in personal
benefit to me;
2) I am not now, nor at any time during the past 5 years have been a director or
indirect recipient of any salary payments or loans or gifts of any kind, or any
National Medical Association
Conflict of Interest Statement
2
free service or discounts or other fees from or on behalf of any person or
entity engaged in any transaction with the NMA; or
3) I have not obtained any list of NMA members for personal or private
solicitation purposes at any time during the term of my affiliation with the
NMA.
Any exceptions to 1, 2 or 3 above are stated below, or attached hereto, with a full
description of the transaction(s) and of the interest, whether direct or indirect, which I
have (or have had during the past 5 years) in the persons or entities having
transactions with the NMA.
Date: ______________ Signature: ________________________________
Printed: ________________________________
1
NATIONAL MEDICAL ASSOCIATION
Board Member Agreement Form
Board duties
I will:
Attend Board meetings by phone or in person, as required in our policies and procedures. I will
be responsible for reviewing the NMA Board of Trustees & Officers Procedure Manual.
Review the agenda and supporting materials prior to Board and committee meetings.
Serve on committees and take on special assignments as needed.
Personally contribute to the National Medical Association (NMA)
Remain informed about NMA’s mission, services, and policies and promote the NMA
Provide support and advice to the Executive Director and staff in my role as volunteer, but avoid
interfering in management activities.
Support the organization by representing the organization in the community and with funders.
Support the board’s decisions and align with our leadership in executing board directives
Board member code of conduct I understand that the board has the duty to govern the corporate affairs of the NMA and is the body
legally responsible for the governance of the organization. As a board member, I therefore have the
duties of care, loyalty, and obedience to the organization.
The duty of care is the duty to monitor the organization’s activities, see that its mission is being
accomplished, and guard its financial resources. The duty of care relates to the expectation that
board members act not only in good faith, but with due care, including exercising reasonable
inquiry, acting as an ordinarily prudent person in such a position would.
The duty of loyalty requires that the board member must always act for the benefit of the
organization, and not for their own benefit or interest. It includes the duty to avoid conflicts of
interest, not take personal advantage of corporate opportunities, and to appropriately maintain
the confidentiality of private corporate affairs
The duty of obedience is to comply with the law and in carry out the purposes of the
organization in accordance with its mission as stated in the organizational documents.
As a board member I agree to:
Act with honesty and integrity
Support in a positive manner all actions taken by the board of directors even when I am in a
minority position on such actions. I recognize that decisions of the board can be made only by a
majority vote at a board meeting and I respect the majority decisions of the board, while
2
retaining the right to seek changes through ethical and constructive channels, and in accordance
with the board’s procedures and policies.
Act as an board member, Officer, and member of a committee of the Board, acting within his/her
realm of designated authority
Participate in (1) the strategic planning, (2) board self-evaluation programs, and (3) board
development workshops, seminars, and other educational events that enhance my skills as a
board member.
Keep confidential information confidential.
Exercise my authority as a board member only when acting in a meeting with the full board or
when appointed by the board.
I will act within my designated authority as a board member, Officer, or committee member of
the Board according to our policies and procedures, and in adherence to the corporate
formalities required of a non-for-profit organization.
Work with and respect the opinions of my peers who serve this board, and leave my personal
prejudices out of all board discussions.
Always act for the good of the organization, represent it in a positive and supportive manner,
and protect the interests of all people served by the organization at all times.
Observe the parliamentary procedures and display courteous conduct in all board and
committee meetings.
Refrain from intruding on administrative issues that are the responsibility of management,
except to monitor the results of the organization.
Accept my responsibility for providing oversight of the financial condition of the organization.
Avoid acting in a way that represents a conflict of interest between my position as a board
member and my personal or professional life, even if those actions appear to provide a benefit
for the organization. This includes using my position for the advantage of my friends and
business associates. If such a conflict does arise, I will declare that conflict before the board and
refrain from voting on matters in which I have conflict.
Abide by this commitment and the board’s operating procedures as well as the organization’s
Constitution and By-Laws and adopted written policies and procedures.
___________________________________________ ___________________________
Signature Date
Board of Directors Orientation Notebook
Section 5:
CORPORATE AND ORGANIZATIONAL DOCUMENTS
1. Articles of Incorporation 2. Constitution and Bylaws 3. Whistleblower Policy
NATIONAL MEDICAL ASSOCIATION POLICY AND PROCEDURES
Chapter: Program Development
Key Words: guidelines, policy, procedures, manual
SUBJECT: WHISTLE-BLOWER POLICY NO: NMA- PAGE 1 OF 6 DATE: JULY 22, 2010
REFERENCE: SUPERSEDES:
I. PURPOSE
Purpose of the Whistleblower Policy
The National Medical Association’s (NMA) Board of the Directors hereby adopts the following employee
Whistle-Blower policy for reporting instances of wrongdoing within the organization. Wrongdoing includes,
but is not limited to, illegal or unethical acts and violations of the organization’s Standards of Ethics or other
NMA’s policies or procedures. Such policies and procedures would include accounting, internal accounting
controls, or auditing matters.
II. BACKGROUND
A. OVERVIEW
NMA’s Standard of Ethics requires its directors, officers, and employees to observe high standards of
business and personal ethics in the conduct of their duties and responsibilities. Employees and
representatives of NMA are expected to practice honesty and integrity in fulfilling their responsibilities and
to comply with all applicable laws and regulations. Furthermore, the NMA is committed to fostering and
maintaining an environment where employees can report wrongdoing or suspected wrongdoing without fear
of retaliation.
B. DEFINITIONS
Good Faith. Good faith is evident when a report is made without malice or consideration of personal
benefit and the employee has a reasonable basis to believe the report is true. However, a report does not
have to be proven to be true to be made in good faith. Good faith is lacking when the disclosure is
known to be malicious, false, or frivolous. Disclosures lacking good faith will be treated as serious
disciplinary offenses.
Wrongdoing. Examples of wrongdoing include, but are not limited to: fraud, including financial fraud
and accounting fraud; violations of laws and regulations; violations of NMA policies; unethical behavior
or practices; endangerment to public health or safety; and negligence of duty.
Adverse Employment Action. Examples of adverse employment action include, but are not limited to,
discharge, demotion, suspension, transfer to a lesser position, denial of promotions, denial of benefits,
threats, harassment, or any other manner of discrimination with respect to an employee’s terms or
NATIONAL MEDICAL ASSOCIATION POLICY AND PROCEDURES
Chapter: Program Development
Key Words: guidelines, policy, procedures, manual
SUBJECT: WHISTLE-BLOWER POLICY NO: NMA- PAGE 2 OF 6 DATE: JULY 22, 2010
conditions of employment. Employees who engage in any such prohibited conduct in violation of this
policy will be subject to discipline, up to and including termination.
Compliance Officer: The Compliance Officer is responsible for investigating and resolving all reported
complaints and allegations concerning violations of this Policy and, at his or her discretion, shall advise
the Executive Director, Chairman Board of Trustees and/or the Governance and Compliance Committee.
The Compliance Officer has direct access to the Audit Committee and is required to report to the Audit
Committee at least annually on compliance activity. NMA’s Compliance Officer will be appointed by
Governance and Compliance Committee.
III. SCOPE
This policy applies to all NMA Directors, Officers, and employees.
IV. POLICY
National Medical Association prides itself on adherence to federal, state, local laws and regulations, and
maintains the highest standard for business ethics. As such, any employee who has a reasonable belief that
the National Medical Association or any of its employees has committed any violation of federal, state, or
local law or regulation, including any financial wrongdoing, is strongly encouraged to immediately report
the violation in writing to the Director of Human Resources or your immediate supervisor. In cases where
the employee has a reasonable belief that a complaint would include any of these individuals, the complaint
may be taken directly to the Executive Director of the National Medical Association. If the Executive
Director is believed to be involved in the matter being reported, such that a report of a matter would be
ineffective, the employee may make a report to the Chairman, NMA Board of Trustees.
In no circumstance shall supervisors perform investigations or take any other follow-up steps on their own.
The investigation will be conducted by the Association. Appropriate remedial and corrective action will be
taken if warranted, which may include referring the matter to the relevant law enforcement entity. Any
good faith report of wrongdoing will be held in confidence to the extent that the needs of the investigation
permit. It is National Medical Association’s policy that there will be no retaliation taken against the
reporting employee. Retaliation for a good faith report is, in itself, a violation of National Medical
Association policy and may result in disciplinary action up to and including termination. However, filing a
clearly frivolous report not made in good faith will not insulate an employee from appropriate personnel
action up to and including termination.
Note that financial wrongdoing may include, but is not limited to:
questionable accounting practices;
fraud or deliberate error in financial statements or recordkeeping;
NATIONAL MEDICAL ASSOCIATION POLICY AND PROCEDURES
Chapter: Program Development
Key Words: guidelines, policy, procedures, manual
SUBJECT: WHISTLE-BLOWER POLICY NO: NMA- PAGE 3 OF 6 DATE: JULY 22, 2010
failure to adhere to internal accounting controls;
misrepresentations to company officers or the accounting department (including deviation from full
reporting of financial conditions).
Employees are reminded of the importance of keeping financial matters confidential. Employees with
questions concerning the confidentiality or appropriateness of disclosure of particular information should
contact Human Resources.
V. PROCEDURES
A. Staff Roles and Responsibilities
It is the responsibility of employees to comply with the policy and to report violations or suspected
violations in accordance with this Whistleblower Policy
B. Confidentiality and Anonymity
Every effort will be made to protect the complainant’s identity except (1) to the extent necessary to conduct
a complete and fair investigation, or (2) as required by law. A complainant may make an anonymous report.
Employees are encouraged, however, to put their names on reports of wrongdoing because appropriate
follow-up questions and investigation may not be possible unless the source of the information is identified.
Concerns expressed anonymously will be investigated, but consideration will be given to:
The seriousness of the issue raised;
The credibility of the concern; and
The likelihood of confirming the allegation from attributable sources
C. Steps
Report the wrongdoing to management to include: Director of Human Resources, your immediate
supervisor, Executive Director, Chairman, Board of Trustees.
Employee will complete Whistle-Blower Disclosure Statement.
Employee will be contacted by NMA’s Compliance Officer appointed by Governance and
Compliance Committee.
D. Evaluation
The Compliance Officer will notify the reporting employee and acknowledge receipt of the reported
violation or suspected violation to the reporting employee within seven business days. All reports will be
promptly investigated and appropriate corrective action will be taken if warranted by the investigation. The
Compliance Officer will forward all complaints regarding corporate accounting practices, internal controls,
NATIONAL MEDICAL ASSOCIATION POLICY AND PROCEDURES
Chapter: Program Development
Key Words: guidelines, policy, procedures, manual
SUBJECT: WHISTLE-BLOWER POLICY NO: NMA- PAGE 4 OF 6 DATE: JULY 22, 2010
or auditing to the Audit Committee and will work with the Committee until the matter is resolved. During
the investigation process, the identity of the employee disclosing the information will be kept confidential to
the greatest extent possible and will be revealed only on a need-to-know basis or as required by law or court
order.
VI. QUESTIONS / INFORMATION
For further information regarding this policy and procedure please contact the Director Human Resources.
VII. ATTACHMENTS (Appendices referenced in document)
E. Appendix #1: National Medical Association Whistle-Blower Disclosure Statement
VIII. SUNSET DATE
Pursuant to the NMA guidelines, this policy shall be reviewed for continuance by May 01, XXXX.
IX. APPROVED
________________________ ________
Name Date
NMA Executive Director
________________________ ________
Name Date
Chair, NMA Board of Trustees
National Medical Association Whistle-Blower Disclosure Statement
NATIONAL MEDICAL ASSOCIATION POLICY AND PROCEDURES
Chapter: Program Development
Key Words: guidelines, policy, procedures, manual
SUBJECT: WHISTLE-BLOWER POLICY NO: NMA- PAGE 5 OF 6 DATE: JULY 22, 2010
Personal Information:
Name: ____________________________ Email Address: _______________ Work Extension: _________
Are you requesting confidentiality? ________
Incident Information:
Date(s): __________________
Name of suspected employee(s):
______________________ ______________________ ______________________
______________________ ______________________ ______________________
Witness (es):
______________________ ______________________ ______________________
______________________ ______________________ ______________________
Do you have any evidence supporting the allegation? Yes / No
If yes, please describe:
Please describe any physical evidence left with the Management:
Description of the alleged violation (please be as specific as possible and attach additional sheets as necessary):
NATIONAL MEDICAL ASSOCIATION POLICY AND PROCEDURES
Chapter: Program Development
Key Words: guidelines, policy, procedures, manual
SUBJECT: WHISTLE-BLOWER POLICY NO: NMA- PAGE 6 OF 6 DATE: JULY 22, 2010
Certification:
I have read and understand the National Medical Association’s Whistle-Blower Policy. I represent that the facts outlined
above are true and accurate to the best of my knowledge.
_____________________________ ____________
Signature Date
This disclosure statement has been received by NMA’s Management Staff on the date noted below, and I am in custody of
any evidence noted above.
_____________________________ ____________
NMA Management Staff Date
Board of Directors Orientation Notebook
Section 6:
FINANCIAL INFORMATION 1. IRS Form 990 for Most Recent Fiscal Year 2. 2014 Budget 3. Budget at a Glance
CORPORATE AND ORGANIZATIONAL DOCUMENTS
FINANCIAL INFORMATION 1. IRS Form 990 for Most Recent Fiscal Year 2. Current Financial Statement 3. Current Budget
REFERENCES 1. Summary of Parliamentary Procedures 2. Additional Resources
DR
AFT
Checkifself-employed
OMB No. 1545-0047
Department of the TreasuryInternal Revenue Service
Check ifapplicable:
AddresschangeNamechangeInitialreturn
Termin-atedAmendedreturn Gross receipts $
Applica-tionpending
Are all subordinates included?
332001 10-29-13
| Do not enter Social Security numbers on this form as it may be made public.
Beginning of Current Year
Paid
Preparer
Use Only
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations)
Open to Public Inspection| Information about Form 990 and its instructions is at
A For the 2013 calendar year, or tax year beginning and ending
B C D Employer identification number
E
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H(b)
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F Yes No
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Website: |
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For Paperwork Reduction Act Notice, see the separate instructions.
(or P.O. box if mail is not delivered to street address) Room/suite
)501(c)(3) 501(c) ( (insert no.) 4947(a)(1) or 527
|Corporation Trust Association OtherForm of organization: Year of formation: State of legal domicile:
|
|
Net
Ass
ets
orFu
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Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is
true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Signature of officer Date
Type or print name and title
Date PTINPrint/Type preparer's name Preparer's signature
Firm's name Firm's EIN
Firm's address
Phone no.
Form
Name of organization
Doing Business As
Number and street Telephone number
City or town, state or province, country, and ZIP or foreign postal code
Is this a group return
for subordinates?Name and address of principal officer: ~~
If "No," attach a list. (see instructions)
Group exemption number |
Tax-exempt status:
Briefly describe the organization's mission or most significant activities:
Check this box if the organization discontinued its operations or disposed of more than 25% of its net assets.
Number of voting members of the governing body (Part VI, line 1a)
Number of independent voting members of the governing body (Part VI, line 1b)
Total number of individuals employed in calendar year 2013 (Part V, line 2a)
~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~
Total number of volunteers (estimate if necessary)
Total unrelated business revenue from Part VIII, column (C), line 12
Net unrelated business taxable income from Form 990-T, line 34
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~
����������������������
Contributions and grants (Part VIII, line 1h) ~~~~~~~~~~~~~~~~~~~~~
Program service revenue (Part VIII, line 2g) ~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~Investment income (Part VIII, column (A), lines 3, 4, and 7d)
Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) ~~~~~~~~
Total revenue - add lines 8 through 11 (must equal Part VIII, column (A), line 12) ���
Grants and similar amounts paid (Part IX, column (A), lines 1-3)
Benefits paid to or for members (Part IX, column (A), line 4)
Salaries, other compensation, employee benefits (Part IX, column (A), lines 5-10)
~~~~~~~~~~~
~~~~~~~~~~~~~
~~~
Professional fundraising fees (Part IX, column (A), line 11e)
Total fundraising expenses (Part IX, column (D), line 25)
~~~~~~~~~~~~~~
Other expenses (Part IX, column (A), lines 11a-11d, 11f-24e)
Total expenses. Add lines 13-17 (must equal Part IX, column (A), line 25)
Revenue less expenses. Subtract line 18 from line 12
~~~~~~~~~~~~~
~~~~~~~
����������������
Total assets (Part X, line 16)
Total liabilities (Part X, line 26)
Net assets or fund balances. Subtract line 21 from line 20
~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~
��������������
May the IRS discuss this return with the preparer shown above? (see instructions) ���������������������
LHA Form (2013)
www.irs.gov/form990.
Part I Summary
Signature BlockPart II
990
Return of Organization Exempt From Income Tax990 2013
§
==
999
NATIONAL MEDICAL ASSOCIATION53-6010805
8403 COLESVILLE ROAD 920 (202) 347-18954,803,949.
SILVER SPRING, MD 20910GARFIELD A. CLUNIE, MD X
SAME AS C ABOVEX
WWW.NMANET.ORGX 1895 NJ
TO PROMOTE THE SCIENCE OF ARTAND MEDICINE.
23211421
49,014.0.
2,567,331. 2,665,478.2,657,025. 1,967,582.
70,461. 62,521.167,718. 82,720.
5,462,535. 4,778,301.0. 0.0. 0.
1,371,065. 922,811.0. 0.
219,969.5,071,966. 4,687,285.6,443,031. 5,610,096.-980,496. -831,795.
4,981,718. 4,063,534.2,619,768. 1,933,649.2,361,950. 2,129,885.
GARFIELD A. CLUNIE, MD, CHAIRMAN
YONG ZHANG, CPA P01249785MCGLADREY LLP 42-07143251861 INTERNATIONAL DRIVE, SUITE 400MCLEAN, VA 22102 703-336-6400
X
DR
AFT
Code: Expenses $ including grants of $ Revenue $
Code: Expenses $ including grants of $ Revenue $
Code: Expenses $ including grants of $ Revenue $
Expenses $ including grants of $ Revenue $
33200210-29-13
1
2
3
4
Yes No
Yes No
4a
4b
4c
4d
4e
Form 990 (2013) Page
Check if Schedule O contains a response or note to any line in this Part III ����������������������������
Briefly describe the organization's mission:
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ?
If "Yes," describe these new services on Schedule O.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization cease conducting, or make significant changes in how it conducts, any program services?
If "Yes," describe these changes on Schedule O.
~~~~~~
Describe the organization's program service accomplishments for each of its three largest program services, as measured by expenses.
Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and
revenue, if any, for each program service reported.
( ) ( ) ( )
( ) ( ) ( )
( ) ( ) ( )
Other program services (Describe in Schedule O.)
( ) ( )
Total program service expenses |
Form (2013)
2Statement of Program Service AccomplishmentsPart III
990
NATIONAL MEDICAL ASSOCIATION 53-6010805
X
TO ADVANCE THE ART AND SCIENCE OF MEDICINE FOR PEOPLE OF AFRICANDESCENT THROUGH EDUCATION, ADVOCACY, AND HEALTH POLICY TO PROMOTEHEALTH AND WELLNESS, ELIMINATE HEALTH DISPARITIES, AND SUSTAINPHYSICIAN VIABILITY.
X
X
1,253,992. 670,017.GRANTS AND SPECIAL PROGRAMS - PROGRAMS DESIGNED TO IMPROVE THE STATUSOF HEALTHCARE FOR UNDERSERVED POPULATIONS.
1,028,680. 1,207,087.ANNUAL SCIENTIFIC ASSEMBLY AND CONTINUING MEDICAL EDUCATION - ANNUALSCIENTIFIC ASSEMBLY OF TWENTY FIVE MEDICAL SPECIALTY SECTIONS PROVIDESAN EDUCATIONAL FORUM FOR MEMBERS AND NON-MEMBERS TO DISCUSS CURRENTMEDICAL SCIENCE AND ISSUES AFFECTING UNDERSERVED POPULATIONS.
69,514. 90,478.PUBLICATIONS - MONTHLY JOURNAL PROVIDES MEMBERS AND SUBSCRIBERS WITHUP-TO-DATE INFORMATION ABOUT MEDICINE AND ISSUES AFFECTING UNDERSERVEDPOPULATIONS.
617,697.2,969,883.
2
DR
AFT
33200310-29-13
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a
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11c
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11e
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12b
13
14a
14b
15
16
17
18
19
20a
20b
a
b
a
b
If "Yes," complete Schedule ASchedule B, Schedule of Contributors
If "Yes," complete Schedule C, Part I
If "Yes," complete Schedule C, Part II
If "Yes," complete Schedule C, Part III
If "Yes," complete Schedule D, Part I
If "Yes," complete Schedule D, Part IIIf "Yes," complete
Schedule D, Part III
If "Yes," complete Schedule D, Part IV
If "Yes," complete Schedule D, Part V
If "Yes," complete Schedule D,Part VI
If "Yes," complete Schedule D, Part VII
If "Yes," complete Schedule D, Part VIII
If "Yes," complete Schedule D, Part IXIf "Yes," complete Schedule D, Part X
If "Yes," complete Schedule D, Part XIf "Yes," complete
Schedule D, Parts XI and XII
If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optionalIf "Yes," complete Schedule E
If "Yes," complete Schedule F, Parts I and IV
If "Yes," complete Schedule F, Parts II and IV
If "Yes," complete Schedule F, Parts III and IV
If "Yes," complete Schedule G, Part I
If "Yes," complete Schedule G, Part IIIf "Yes,"
complete Schedule G, Part IIIIf "Yes," complete Schedule H
Form 990 (2013) Page
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Is the organization required to complete ?
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for
public office?
~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization engage in lobbying activities, or have a section 501(h) election in effect
during the tax year?
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or
similar amounts as defined in Revenue Procedure 98-19?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to
provide advice on the distribution or investment of amounts in such funds or accounts?
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures?
Did the organization maintain collections of works of art, historical treasures, or other similar assets?
~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization report an amount in Part X, line 21, for escrow or custodial account liability; serve as a custodian for
amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services?
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent
endowments, or quasi-endowments?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~
If the organization's answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X
as applicable.
Did the organization report an amount for land, buildings, and equipment in Part X, line 10?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization report an amount for investments - other securities in Part X, line 12 that is 5% or more of its total
assets reported in Part X, line 16?
Did the organization report an amount for investments - program related in Part X, line 13 that is 5% or more of its total
assets reported in Part X, line 16?
~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in
Part X, line 16?
Did the organization report an amount for other liabilities in Part X, line 25?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~
Did the organization's separate or consolidated financial statements for the tax year include a footnote that addresses
the organization's liability for uncertain tax positions under FIN 48 (ASC 740)?
Did the organization obtain separate, independent audited financial statements for the tax year?
~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Was the organization included in consolidated, independent audited financial statements for the tax year?
~~~~~
Is the organization a school described in section 170(b)(1)(A)(ii)?
Did the organization maintain an office, employees, or agents outside of the United States?
~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business,
investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000
or more? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any
foreign organization?
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to
or for foreign individuals?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX,
column (A), lines 6 and 11e? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines
1c and 8a? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a?
Did the organization operate one or more hospital facilities?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return? ����������
Form (2013)
3Part IV Checklist of Required Schedules
990
NATIONAL MEDICAL ASSOCIATION 53-6010805
XX
X
X
X
X
X
X
X
X
X
X
X
XX
X
X
XXX
X
X
X
X
X
XX
3
DR
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33200410-29-13
Yes No
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
21
22
23
24a
24b
24c
24d
25a
25b
26
27
28a
28b
28c
29
30
31
32
33
34
35a
35b
36
37
38
a
b
c
d
a
b
Section 501(c)(3) and 501(c)(4) organizations.
a
b
c
a
b
Section 501(c)(3) organizations.
Note.
(continued)
If "Yes," complete Schedule I, Parts I and II
If "Yes," complete Schedule I, Parts I and III
If "Yes," completeSchedule J
If "Yes," answer lines 24b through 24d and completeSchedule K. If "No", go to line 25a
If "Yes," complete Schedule L, Part I
If "Yes," completeSchedule L, Part I
If "Yes," complete Schedule L, Part III
If "Yes," complete Schedule L, Part IVIf "Yes," complete Schedule L, Part IV
If "Yes," complete Schedule L, Part IVIf "Yes," complete Schedule M
If "Yes," complete Schedule M
If "Yes," complete Schedule N, Part IIf "Yes," complete
Schedule N, Part II
If "Yes," complete Schedule R, Part IIf "Yes," complete Schedule R, Part II, III, or IV, and
Part V, line 1
If "Yes," complete Schedule R, Part V, line 2
If "Yes," complete Schedule R, Part V, line 2
If "Yes," complete Schedule R, Part VI
Form 990 (2013) Page
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or
government on Part IX, column (A), line 1? ~~~~~~~~~~~~~~~~~~
Did the organization report more than $5,000 of grants or other assistance to individuals in the United States on Part IX,
column (A), line 2? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5 about compensation of the organization's current
and former officers, directors, trustees, key employees, and highest compensated employees?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the
last day of the year, that was issued after December 31, 2002?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?
Did the organization maintain an escrow account other than a refunding escrow at any time during the year to defease
any tax-exempt bonds?
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?
~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~
Did the organization engage in an excess benefit transaction with a
disqualified person during the year?
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and
that the transaction has not been reported on any of the organization's prior Forms 990 or 990-EZ?
~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization report any amount on Part X, line 5, 6, or 22 for receivables from or payables to any current or
former officers, directors, trustees, key employees, highest compensated employees, or disqualified persons? If so,
complete Schedule L, Part II ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial
contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member
of any of these persons? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV
instructions for applicable filing thresholds, conditions, and exceptions):
A current or former officer, director, trustee, or key employee? ~~~~~~~~~~~
A family member of a current or former officer, director, trustee, or key employee?
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer,
director, trustee, or direct or indirect owner?
~~
~~~~~~~~~~~~~~~~~~~~~
Did the organization receive more than $25,000 in non-cash contributions?
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation
contributions?
~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization liquidate, terminate, or dissolve and cease operations?
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations
sections 301.7701-2 and 301.7701-3?
Was the organization related to any tax-exempt or taxable entity?
~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
If "Yes" to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity
within the meaning of section 512(b)(13)?
~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~
Did the organization make any transfers to an exempt non-charitable related organization?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization conduct more than 5% of its activities through an entity that is not a related organization
and that is treated as a partnership for federal income tax purposes? ~~~~~~~~
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19?
All Form 990 filers are required to complete Schedule O �������������������������������
Form (2013)
4Part IV Checklist of Required Schedules
990
NATIONAL MEDICAL ASSOCIATION 53-6010805
X
X
X
X
X
X
X
X
XX
XX
X
X
X
X
XX
X
X
X
4
DR
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33200510-29-13
Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting organizations.
Yes No
1
2
3
4
5
6
7
a
b
c
1a
1b
1c
a
b
2a
Note.
2b
3a
3b
4a
5a
5b
5c
6a
6b
7a
7b
7c
7e
7f
7g
7h
8
9a
9b
a
b
a
b
a
b
c
a
b
Organizations that may receive deductible contributions under section 170(c).
a
b
c
d
e
f
g
h
7d
8
9
10
11
12
13
14
Sponsoring organizations maintaining donor advised funds.
a
b
Section 501(c)(7) organizations.
a
b
10a
10b
Section 501(c)(12) organizations.
a
b
11a
11b
a
b
Section 4947(a)(1) non-exempt charitable trusts. 12a
12b
Section 501(c)(29) qualified nonprofit health insurance issuers.
Note.
a
b
c
a
b
13a
13b
13c
14a
14b
e-file
If "No," to line 3b, provide an explanation in Schedule O
If "No," provide an explanation in Schedule O
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?
Did the supporting
organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year?
Form (2013)
Form 990 (2013) Page
Check if Schedule O contains a response or note to any line in this Part V ���������������������������
Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable ~~~~~~~~~~~
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable ~~~~~~~~~~
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming
(gambling) winnings to prize winners? �������������������������������������������
Enter the number of employees reported on Form W-3, Transmittal of Wage and Tax Statements,
filed for the calendar year ending with or within the year covered by this return ~~~~~~~~~~
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
If the sum of lines 1a and 2a is greater than 250, you may be required to (see instructions)
~~~~~~~~~~
~~~~~~~~~~~
Did the organization have unrelated business gross income of $1,000 or more during the year?
If "Yes," has it filed a Form 990-T for this year?
~~~~~~~~~~~~~~
~~~~~~~~~~
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a
financial account in a foreign country (such as a bank account, securities account, or other financial account)?~~~~~~~
If "Yes," enter the name of the foreign country:
See instructions for filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
~~~~~~~~~~~~
~~~~~~~~~
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit
any contributions that were not tax deductible as charitable contributions?
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts
were not tax deductible?
~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
If "Yes," did the organization notify the donor of the value of the goods or services provided?
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required
to file Form 8282?
~~~~~~~~~~~~~~~
����������������������������������������������������
If "Yes," indicate the number of Forms 8282 filed during the year
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?
~~~~~~~~~~~~~~~~
~~~~~~~
~~~~~~~~~Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?
~
Did the organization make any taxable distributions under section 4966?
Did the organization make a distribution to a donor, donor advisor, or related person?
~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~
Enter:
Initiation fees and capital contributions included on Part VIII, line 12
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
~~~~~~~~~~~~~~~
~~~~~~
Enter:
Gross income from members or shareholders
Gross income from other sources (Do not net amounts due or paid to other sources against
amounts due or received from them.)
~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Is the organization filing Form 990 in lieu of Form 1041?
If "Yes," enter the amount of tax-exempt interest received or accrued during the year ������
Is the organization licensed to issue qualified health plans in more than one state?
See the instructions for additional information the organization must report on Schedule O.
~~~~~~~~~~~~~~~~~~~~~
Enter the amount of reserves the organization is required to maintain by the states in which the
organization is licensed to issue qualified health plans
Enter the amount of reserves on hand
~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization receive any payments for indoor tanning services during the tax year?
If "Yes," has it filed a Form 720 to report these payments?
~~~~~~~~~~~~~~~~
����������
5Part V Statements Regarding Other IRS Filings and Tax Compliance
990
J
NATIONAL MEDICAL ASSOCIATION 53-6010805
1340
X
14X
XX
X
XX
X
X
X
XX
X
5
DR
AFT
332006 10-29-13
Yes No
1a
1b
1
2
3
4
5
6
7
8
9
a
b
2
3
4
5
6
7a
7b
8a
8b
9
a
b
a
b
Yes No
10
11
a
b
10a
10b
11a
12a
12b
12c
13
14
15a
15b
16a
16b
a
b
12a
b
c
13
14
15
a
b
16a
b
17
18
19
20
For each "Yes" response to lines 2 through 7b below, and for a "No" responseto line 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
If "Yes," provide the names and addresses in Schedule O(This Section B requests information about policies not required by the Internal Revenue Code.)
If "No," go to line 13
If "Yes," describein Schedule O how this was done
(explain in Schedule O)
If there are material differences in voting rights among members of the governing body, or if the governing
body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts?
Form (2013)
Form 990 (2013) Page
Check if Schedule O contains a response or note to any line in this Part VI ���������������������������
Enter the number of voting members of the governing body at the end of the tax year
Enter the number of voting members included in line 1a, above, who are independent
~~~~~~
~~~~~~
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other
officer, director, trustee, or key employee? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization delegate control over management duties customarily performed by or under the direct supervision
of officers, directors, or trustees, or key employees to a management company or other person? ~~~~~~~~~~~~~~
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed?
Did the organization become aware during the year of a significant diversion of the organization's assets?
Did the organization have members or stockholders?
~~~~~
~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or
more members of the governing body?
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or
persons other than the governing body?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
The governing body?
Each committee with authority to act on behalf of the governing body?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the
organization's mailing address? �����������������
Did the organization have local chapters, branches, or affiliates?
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates,
and branches to ensure their operations are consistent with the organization's exempt purposes?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form?
Describe in Schedule O the process, if any, used by the organization to review this Form 990.
Did the organization have a written conflict of interest policy? ~~~~~~~~~~~~~~~~~~~~
~~~~~~
Did the organization regularly and consistently monitor and enforce compliance with the policy?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization have a written whistleblower policy?
Did the organization have a written document retention and destruction policy?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~
Did the process for determining compensation of the following persons include a review and approval by independent
persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
The organization's CEO, Executive Director, or top management official
Other officers or key employees of the organization
If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).
~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a
taxable entity during the year? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation
in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization's
exempt status with respect to such arrangements? ������������������������������������
List the states with which a copy of this Form 990 is required to be filed
Section 6104 requires an organization to make its Forms 1023 (or 1024 if applicable), 990, and 990-T (Section 501(c)(3)s only) available
for public inspection. Indicate how you made these available. Check all that apply.
Own website Another's website Upon request Other
Describe in Schedule O whether (and if so, how), the organization made its governing documents, conflict of interest policy, and financial
statements available to the public during the tax year.
State the name, physical address, and telephone number of the person who possesses the books and records of the organization: |
6Part VI Governance, Management, and Disclosure
Section A. Governing Body and Management
Section B. Policies
Section C. Disclosure
990
J
NATIONAL MEDICAL ASSOCIATION 53-6010805
X
23
21
X
XXX
X
X
X
XX
X
X
XX
XX
XXX
XX
X
NJ
X
JUAN G. GONZALEZ, CPA - (202) 347-18958403 COLESVILLE ROAD, NO. 920, SILVER SPRING, MD 20910
6
DR
AFT
Indi
vidu
al tr
uste
e or
dire
ctor
Inst
itutio
nal t
rust
ee
Offi
cer
Key
empl
oyee
Hig
hest
com
pens
ated
empl
oyee
Form
er
(do not check more than onebox, unless person is both anofficer and a director/trustee)
332007 10-29-13
current
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a
current
current
former
former directors or trustees
(A) (B) (C) (D) (E) (F)
Form 990 (2013) Page
Check if Schedule O contains a response or note to any line in this Part VII ���������������������������
Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization's tax year.
¥ List all of the organization's officers, directors, trustees (whether individuals or organizations), regardless of amount of compensation.Enter -0- in columns (D), (E), and (F) if no compensation was paid.
¥ List all of the organization's key employees, if any. See instructions for definition of "key employee."¥ List the organization's five highest compensated employees (other than an officer, director, trustee, or key employee) who received report-
able compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the organization and any related organizations.
¥ List all of the organization's officers, key employees, and highest compensated employees who received more than $100,000 ofreportable compensation from the organization and any related organizations.
¥ List all of the organization's that received, in the capacity as a former director or trustee of the organization,more than $10,000 of reportable compensation from the organization and any related organizations.
List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest compensated employees; and former such persons.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
PositionName and Title Average hours per
week (list any
hours forrelated
organizationsbelowline)
Reportablecompensation
from the
organization(W-2/1099-MISC)
Reportablecompensationfrom related
organizations(W-2/1099-MISC)
Estimatedamount of
othercompensation
from theorganizationand related
organizations
Form (2013)
7Part VII Compensation of Officers, Directors, Trustees, Key Employees, Highest Compensated
Employees, and Independent Contractors
990
NATIONAL MEDICAL ASSOCIATION 53-6010805
(1) ALBERT W. MORRIS, JR., M.D. 15.00CHAIRMAN X X 0. 0. 0.(2) MICHAEL A. LENOIR, M.D. 40.00PRESIDENT X X 25,000. 0. 0.(3) RAHN K. BAILEY, M.D. 40.00IMMEDIATE PAST PRESIDENT X X 62,682. 0. 0.(4) JOHN E. ARRADONDO, M.D., MPH 10.00SECRETARY & REGION III TRUSTEE X X 0. 0. 0.(5) LAWRENCE SANDERS, MD 10.00PRESIDENT-ELECT X X 0. 0. 0.(6) WALTER L. FAGGETT, M.D. 30.00SPEAKER, HOUSE OF DELEGATE X 0. 0. 0.(7) LONNIE JOE, JR. M.D. 10.00VICE SPEAKER, HOUSE OF DEL X 0. 0. 0.(8) OLIVER T. BROOKS, M.D. 10.00SECRETARY, HOUSE OF DELEGATES X 0. 0. 0.(9) C. FREEMAN, M.D., M.B.A 10.00TREASURER X X 0. 0. 0.(10) ERICKA C. GRIFFIN, M.D. 2.00CAFA CHAIR X 0. 0. 0.(11) GARFIELD A. CLUNIE, M.D. 2.00REGION I - TRUSTEE X 0. 0. 0.(12) P. GRACE HARRELL, M.D. 2.00REGION I - TRUSTEE X 0. 0. 0.(13) EDITH P. MITCHELL, M.D. 2.00REGION II - TRUSTEE X 0. 0. 0.(14) JACKSON L. DAVIS III, M.D. 2.00REGION II - TRUSTEE X 0. 0. 0.(15) VIRGINIA A. CAINE, M.D. 2.00REGION IV - TRUSTEE X 0. 0. 0.(16) JEFFREY K. CLARK, M.D. 2.00REGION IV - TRUSTEE X 0. 0. 0.(17) HENRY M. EVANS, JR., M.D. 2.00REGION V - TRUSTEE X 0. 0. 0.
7
DR
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Form
er
Indi
vidu
al tr
uste
e or
dire
ctor
Inst
itutio
nal t
rust
ee
Offi
cer
Hig
hest
com
pens
ated
empl
oyee
Key
empl
oyee
(do not check more than onebox, unless person is both anofficer and a director/trustee)
33200810-29-13
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
(B) (C)(A) (D) (E) (F)
1b
c
d
Sub-total
Total from continuation sheets to Part VII, Section A
Total (add lines 1b and 1c)
2
Yes No
3
4
5
former
3
4
5
Section B. Independent Contractors
1
(A) (B) (C)
2
(continued)
If "Yes," complete Schedule J for such individual
If "Yes," complete Schedule J for such individual
If "Yes," complete Schedule J for such person
Page Form 990 (2013)
PositionAverage hours per
week(list any
hours forrelated
organizationsbelowline)
Name and title Reportablecompensation
from the
organization(W-2/1099-MISC)
Reportablecompensationfrom related
organizations(W-2/1099-MISC)
Estimatedamount of
othercompensation
from theorganizationand related
organizations
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ |
~~~~~~~~~~ |
������������������������ |
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable
compensation from the organization |
Did the organization list any officer, director, or trustee, key employee, or highest compensated employee on
line 1a? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization
and related organizations greater than $150,000? ~~~~~~~~~~~~~
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services
rendered to the organization? ������������������������
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from
the organization. Report compensation for the calendar year ending with or within the organization's tax year.
Name and business address Description of services Compensation
Total number of independent contractors (including but not limited to those listed above) who received more than
$100,000 of compensation from the organization |
Form (2013)
8Part VII
990
NATIONAL MEDICAL ASSOCIATION 53-6010805
(18) ELISE D. COOK, M.D. 2.00REGION V - TRUSTEE X 0. 0. 0.(19) GAIL MORGAN, M.D. 2.00REGION VI - TRUSTEE X 0. 0. 0.(20) WARREN JAMES STRUDWICK JR., M.D 2.00REGION VI - TRUSTEE X 0. 0. 0.(21) TRACI C. BURGESS, M.D., MPH 2.00CORPORATE TRUSTEE X 0. 0. 0.(22) MICHAEL G. KNIGHT, M.D. 2.00POSTGRADUATE TRUSTEE X 0. 0. 0.(23) TOPAZ SAMPSON 2.00STUDENT TRUSTEE X 0. 0. 0.(24) DARRYL R. MATTHEWS SR. 40.00EXECUTIVE DIRECTOR X 199,155. 0. 9,957.
286,837. 0. 9,957.0. 0. 0.
286,837. 0. 9,957.
1
X
X
X
SHARON D. ALLISON OTTEY, M.D.10111 MLK HIGHWAY, STE 117, BOWIE, MD 20720 CONSULTING 217,687.KAMA'AINA KIDS156 CHAMAKUA DRIVE, KAILUA, HI 96734
CHILDREN'S PRORGAM FOR ANNUALCONVENTION 137,628.
2
8
DR
AFT
Noncash contributions included in lines 1a-1f: $
33200910-29-13
Total revenue.
(A) (B) (C) (D)
1 a
b
c
d
e
f
g
h
1
1
1
1
1
1
a
b
c
d
e
f
Co
ntr
ibu
tio
ns
, G
ifts
, G
ran
tsa
nd
Oth
er
Sim
ila
r A
mo
un
ts
Total.
Business Code
a
b
c
d
e
f
g
2
Pro
gra
m S
erv
ice
Re
ven
ue
Total.
3
4
5
6 a
b
c
d
a
b
c
d
7
a
b
c
8
a
b
9 a
b
c
a
b
10 a
b
c
a
b
Business Code
11 a
b
c
d
e Total.
Oth
er
Re
ven
ue
12
Revenue excludedfrom tax under
sections512 - 514
All other contributions, gifts, grants, and
similar amounts not included above
See instructions.
Form (2013)
Page Form 990 (2013)
Check if Schedule O contains a response or note to any line in this Part VIII �������������������������
Total revenue Related orexempt function
revenue
Unrelatedbusinessrevenue
Federated campaigns
Membership dues
~~~~~~
~~~~~~~~
Fundraising events
Related organizations
~~~~~~~~
~~~~~~
Government grants (contributions)
~~
Add lines 1a-1f ����������������� |
All other program service revenue ~~~~~
Add lines 2a-2f ����������������� |
Investment income (including dividends, interest, and
other similar amounts)
Income from investment of tax-exempt bond proceeds
~~~~~~~~~~~~~~~~~ |
|
Royalties ����������������������� |
(i) Real (ii) Personal
Gross rents
Less: rental expenses
Rental income or (loss)
Net rental income or (loss)
~~~~~~~
~~~
~~
�������������� |
Gross amount from sales of
assets other than inventory
(i) Securities (ii) Other
Less: cost or other basis
and sales expenses
Gain or (loss)
~~~
~~~~~~~
Net gain or (loss) ������������������� |
Gross income from fundraising events (not
including $ of
contributions reported on line 1c). See
Part IV, line 18 ~~~~~~~~~~~~~
Less: direct expenses~~~~~~~~~~
Net income or (loss) from fundraising events ����� |
Gross income from gaming activities. See
Part IV, line 19 ~~~~~~~~~~~~~
Less: direct expenses
Net income or (loss) from gaming activities
~~~~~~~~~
������ |
Gross sales of inventory, less returns
and allowances ~~~~~~~~~~~~~
Less: cost of goods sold
Net income or (loss) from sales of inventory
~~~~~~~~
������ |
Miscellaneous Revenue
All other revenue ~~~~~~~~~~~~~
Add lines 11a-11d ~~~~~~~~~~~~~~~ |
|�������������
9Part VIII Statement of Revenue
990
NATIONAL MEDICAL ASSOCIATION 53-6010805
160,486.
2,504,992.
2,665,478.
CONVENTION & EXHIBITS 541900 1,207,087. 935,787. 271,300.MEMBERSHIP DUES 900099 670,017. 670,017.PUBLICATIONS 541800 90,478. 49,014. 41,464.
1,967,582.
35,011. 35,011.
7,000.0.
7,000.7,000. 7,000.
53,158.
25,648.27,510.
27,510. 27,510.
OTHER INCOME 900099 75,720. 75,720.
75,720.4,778,301. 1,605,804. 49,014. 458,005.
9
DR
AFT
Check here if following SOP 98-2 (ASC 958-720)
332010 10-29-13
Total functional expenses.
Joint costs.
(A) (B) (C) (D)
1
2
3
4
5
6
7
8
9
10
11
a
b
c
d
e
f
g
12
13
14
15
16
17
18
19
20
21
22
23
24
a
b
c
d
e
25
26
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).
Grants and other assistance to governments and
organizations in the United States. See Part IV, line 21
Compensation not included above, to disqualified
persons (as defined under section 4958(f)(1)) and
persons described in section 4958(c)(3)(B)
Pension plan accruals and contributions (include
section 401(k) and 403(b) employer contributions)
Professional fundraising services. See Part IV, line 17
(If line 11g amount exceeds 10% of line 25,
column (A) amount, list line 11g expenses on Sch O.)
Other expenses. Itemize expenses not covered above. (List miscellaneous expenses in line 24e. If line24e amount exceeds 10% of line 25, column (A)amount, list line 24e expenses on Schedule O.)
Add lines 1 through 24e
Complete this line only if the organization
reported in column (B) joint costs from a combined
educational campaign and fundraising solicitation.
Form 990 (2013) Page
Check if Schedule O contains a response or note to any line in this Part IX ��������������������������
Total expenses Program serviceexpenses
Management andgeneral expenses
Fundraisingexpenses
Grants and other assistance to individuals in
the United States. See Part IV, line 22 ~~~
Grants and other assistance to governments,
organizations, and individuals outside the
United States. See Part IV, lines 15 and 16 ~
Benefits paid to or for members ~~~~~~~
Compensation of current officers, directors,
trustees, and key employees ~~~~~~~~
~~~
Other salaries and wages ~~~~~~~~~~
Other employee benefits ~~~~~~~~~~
Payroll taxes ~~~~~~~~~~~~~~~~
Fees for services (non-employees):
Management
Legal
Accounting
Lobbying
~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~
Investment management fees
Other.
~~~~~~~~
Advertising and promotion
Office expenses
Information technology
Royalties
~~~~~~~~~
~~~~~~~~~~~~~~~
~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~
Occupancy ~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~Travel
Payments of travel or entertainment expenses
for any federal, state, or local public officials
Conferences, conventions, and meetings ~~
Interest
Payments to affiliates
~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~
Depreciation, depletion, and amortization
Insurance
~~
~~~~~~~~~~~~~~~~~
~~
All other expenses
|
Form (2013)
Do not include amounts reported on lines 6b,7b, 8b, 9b, and 10b of Part VIII.
10Part IX Statement of Functional Expenses
990
NATIONAL MEDICAL ASSOCIATION 53-6010805
X
296,794. 38,480. 255,121. 3,193.
510,174. 67,807. 436,688. 5,679.
55,637. 1,994. 53,643.60,206. 5,689. 53,144. 1,373.
117,568. 40,634. 76,905. 29.38,282. 1,113. 37,169.
239,252. 4,000. 235,252.
11,104. 11,104.
1,360,956. 921,087. 299,412. 140,457.55,345. 38,884. 10,560. 5,901.
141,921. 39,765. 99,042. 3,114.124,986. 38,445. 86,541.
457,020. 49,608. 407,412.587,233. 502,433. 70,038. 14,762.
601,618. 524,247. 53,257. 24,114.30,721. 30,721.
16,234. 16,234.14,894. 14,894.
AUDIO/VISUAL 263,419. 223,567. 29,458. 10,394.CONTRACTUAL/COMMISSIONS 206,811. 204,763. 2,048.PRINTING/MAILING/DUPLIC 170,214. 135,470. 28,590. 6,154.PENALTIES/FINES/LATE FE 48,180. 45,000. 3,180.
201,527. 86,897. 109,831. 4,799.5,610,096. 2,969,883. 2,420,244. 219,969.
10
DR
AFT
33201110-29-13
(A) (B)
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
1
2
3
4
5
6
7
8
9
10c
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
a
b
10a
10b
As
se
ts
Total assets.
Lia
bil
itie
s
Total liabilities.
Organizations that follow SFAS 117 (ASC 958), check here and
complete lines 27 through 29, and lines 33 and 34.
27
28
29
Organizations that do not follow SFAS 117 (ASC 958), check here
and complete lines 30 through 34.
30
31
32
33
34
Ne
t A
ss
ets
or
Fu
nd
Ba
lan
ce
s
Form 990 (2013) Page
Check if Schedule O contains a response or note to any line in this Part X �����������������������������
Beginning of year End of year
Cash - non-interest-bearing
Savings and temporary cash investments
Pledges and grants receivable, net
~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~
Accounts receivable, net ~~~~~~~~~~~~~~~~~~~~~~~~~~
Loans and other receivables from current and former officers, directors,
trustees, key employees, and highest compensated employees. Complete
Part II of Schedule L ~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Loans and other receivables from other disqualified persons (as defined under
section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing
employers and sponsoring organizations of section 501(c)(9) voluntary
employees' beneficiary organizations (see instr). Complete Part II of Sch L ~~
Notes and loans receivable, net
Inventories for sale or use
Prepaid expenses and deferred charges
~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~
Land, buildings, and equipment: cost or other
basis. Complete Part VI of Schedule D
Less: accumulated depreciation
~~~
~~~~~~
Investments - publicly traded securities
Investments - other securities. See Part IV, line 11
Investments - program-related. See Part IV, line 11
Intangible assets
~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~
~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Other assets. See Part IV, line 11 ~~~~~~~~~~~~~~~~~~~~~~
Add lines 1 through 15 (must equal line 34) ����������
Accounts payable and accrued expenses
Grants payable
Deferred revenue
~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Tax-exempt bond liabilities
Escrow or custodial account liability. Complete Part IV of Schedule D
~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~
Loans and other payables to current and former officers, directors, trustees,
key employees, highest compensated employees, and disqualified persons.
Complete Part II of Schedule L ~~~~~~~~~~~~~~~~~~~~~~~
Secured mortgages and notes payable to unrelated third parties ~~~~~~
Unsecured notes and loans payable to unrelated third parties ~~~~~~~~
Other liabilities (including federal income tax, payables to related third
parties, and other liabilities not included on lines 17-24). Complete Part X of
Schedule D ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Add lines 17 through 25 ������������������
|
Unrestricted net assets
Temporarily restricted net assets
Permanently restricted net assets
~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~
|
Capital stock or trust principal, or current funds
Paid-in or capital surplus, or land, building, or equipment fund
Retained earnings, endowment, accumulated income, or other funds
~~~~~~~~~~~~~~~
~~~~~~~~
~~~~
Total net assets or fund balances ~~~~~~~~~~~~~~~~~~~~~~
Total liabilities and net assets/fund balances ����������������
Form (2013)
11Balance SheetPart X
990
NATIONAL MEDICAL ASSOCIATION 53-6010805
3,590. 500.2,191,234. 1,074,734.
132,781. 82,042.87,333. 77,103.
109,386. 127,299.
600,214.552,341. 45,059. 47,873.
2,281,787. 2,568,799.
130,548. 85,184.4,981,718. 4,063,534.1,295,488. 768,534.
461,711. 266,640.
500,000. 500,000.
362,569. 398,475.2,619,768. 1,933,649.
X
245,431. 29,331.2,116,519. 2,100,554.
2,361,950. 2,129,885.4,981,718. 4,063,534.
11
DR
AFT
33201210-29-13
1
2
3
4
5
6
7
8
9
10
1
2
3
4
5
6
7
8
9
10
Yes No
1
2
3
a
b
c
2a
2b
2c
a
b
3a
3b
Form 990 (2013) Page
Check if Schedule O contains a response or note to any line in this Part XI ���������������������������
Total revenue (must equal Part VIII, column (A), line 12)
Total expenses (must equal Part IX, column (A), line 25)
Revenue less expenses. Subtract line 2 from line 1
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A))
~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~
Net unrealized gains (losses) on investments
Donated services and use of facilities
Investment expenses
Prior period adjustments
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Other changes in net assets or fund balances (explain in Schedule O)
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33,
column (B))
~~~~~~~~~~~~~~~~~~~
�����������������������������������������������
Check if Schedule O contains a response or note to any line in this Part XII ���������������������������
Accounting method used to prepare the Form 990: Cash Accrual Other
If the organization changed its method of accounting from a prior year or checked "Other," explain in Schedule O.
Were the organization's financial statements compiled or reviewed by an independent accountant? ~~~~~~~~~~~~
If "Yes," check a box below to indicate whether the financial statements for the year were compiled or reviewed on a
separate basis, consolidated basis, or both:
Separate basis Consolidated basis Both consolidated and separate basis
Were the organization's financial statements audited by an independent accountant? ~~~~~~~~~~~~~~~~~~~
If "Yes," check a box below to indicate whether the financial statements for the year were audited on a separate basis,
consolidated basis, or both:
Separate basis Consolidated basis Both consolidated and separate basis
If "Yes" to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit,
review, or compilation of its financial statements and selection of an independent accountant?~~~~~~~~~~~~~~~
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit
Act and OMB Circular A-133? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit
or audits, explain why in Schedule O and describe any steps taken to undergo such audits ����������������
Form (2013)
12Part XI Reconciliation of Net Assets
Part XII Financial Statements and Reporting
990
NATIONAL MEDICAL ASSOCIATION 53-6010805
4,778,301.5,610,096.-831,795.2,361,950.249,291.
350,439.0.
2,129,885.
X
X
X
X
12
DR
AFT
OMB No. 1545-0047
Department of the TreasuryInternal Revenue Service
33202109-25-13
Information about Schedule A (Form 990 or 990-EZ) and its instructions is at
(iii)
(see instructions)
(iv)(i)
(v)
(i)
(vi)
(i)
(i) (ii) (vii)
(Form 990 or 990-EZ)Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.| Attach to Form 990 or Form 990-EZ.
|
Open to PublicInspection
Name of the organization Employer identification number
1
2
3
4
5
6
7
8
9
10
11
section 170(b)(1)(A)(i).
section 170(b)(1)(A)(ii).
section 170(b)(1)(A)(iii).
section 170(b)(1)(A)(iii).
section 170(b)(1)(A)(iv).
section 170(b)(1)(A)(v).
section 170(b)(1)(A)(vi).
section 170(b)(1)(A)(vi).
section 509(a)(2).
section 509(a)(4).
section 509(a)(3).
a b c d
e
f
g
h
(i)
(ii)
(iii)
Yes No
11g(i)
11g(ii)
11g(iii)
Yes No Yes No Yes No
Total
For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.
Schedule A (Form 990 or 990-EZ) 2013
Type of organization (described on lines 1-9 above or IRC section
)
Is the organizationin col. listed in yourgoverning document?
Did you notify theorganization in col.
of your support?
Is theorganization in col.
organized in theU.S.?
Name of supportedorganization
EIN Amount of monetarysupport
(All organizations must complete this part.) See instructions.
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
A church, convention of churches, or association of churches described in
A school described in (Attach Schedule E.)
A hospital or a cooperative hospital service organization described in
A medical research organization operated in conjunction with a hospital described in Enter the hospital's name,
city, and state:
An organization operated for the benefit of a college or university owned or operated by a governmental unit described in
(Complete Part II.)
A federal, state, or local government or governmental unit described in
An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in
(Complete Part II.)
A community trust described in (Complete Part II.)
An organization that normally receives: (1) more than 33 1/3% of its support from contributions, membership fees, and gross receipts from
activities related to its exempt functions - subject to certain exceptions, and (2) no more than 33 1/3% of its support from gross investment
income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975.
See (Complete Part III.)
An organization organized and operated exclusively to test for public safety. See
An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or
more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See Check the box that
describes the type of supporting organization and complete lines 11e through 11h.
Type I Type II Type III - Functionally integrated Type III - Non-functionally integrated
By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than
foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).
If the organization received a written determination from the IRS that it is a Type I, Type II, or Type III
supporting organization, check this box
Since August 17, 2006, has the organization accepted any gift or contribution from any of the following persons?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
A person who directly or indirectly controls, either alone or together with persons described in (ii) and (iii) below,
the governing body of the supported organization?
A family member of a person described in (i) above?
A 35% controlled entity of a person described in (i) or (ii) above?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~
Provide the following information about the supported organization(s).
LHA
www.irs.gov/form990.
SCHEDULE A
Part I Reason for Public Charity Status
Public Charity Status and Public Support 2013
NATIONAL MEDICAL ASSOCIATION 53-6010805
X
13
DR
AFT
Subtract line 5 from line 4.
33202209-25-13
Calendar year (or fiscal year beginning in)
Calendar year (or fiscal year beginning in) |
2
(a) (b) (c) (d) (e) (f)
1
2
3
4
5
Total.
6 Public support.
(a) (b) (c) (d) (e) (f)
7
8
9
10
11
12
13
Total support.
12
First five years.
stop here
14
15
14
15
16
17
18
a
b
a
b
33 1/3% support test - 2013.
stop here.
33 1/3% support test - 2012.
stop here.
10% -facts-and-circumstances test - 2013.
stop here.
10% -facts-and-circumstances test - 2012.
stop here.
Private foundation.
Schedule A (Form 990 or 990-EZ) 2013
|
Add lines 7 through 10
Schedule A (Form 990 or 990-EZ) 2013 Page
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization
fails to qualify under the tests listed below, please complete Part III.)
2009 2010 2011 2012 2013 Total
Gifts, grants, contributions, and
membership fees received. (Do not
include any "unusual grants.") ~~
Tax revenues levied for the organ-
ization's benefit and either paid to
or expended on its behalf ~~~~
The value of services or facilities
furnished by a governmental unit to
the organization without charge ~
Add lines 1 through 3 ~~~
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) ~~~~~~~~~~~~
2009 2010 2011 2012 2013 Total
Amounts from line 4 ~~~~~~~
Gross income from interest,
dividends, payments received on
securities loans, rents, royalties
and income from similar sources ~
Net income from unrelated business
activities, whether or not the
business is regularly carried on ~
Other income. Do not include gain
or loss from the sale of capital
assets (Explain in Part IV.) ~~~~
Gross receipts from related activities, etc. (see instructions) ~~~~~~~~~~~~~~~~~~~~~~~
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3)
organization, check this box and ��������������������������������������������� |
~~~~~~~~~~~~Public support percentage for 2013 (line 6, column (f) divided by line 11, column (f))
Public support percentage from 2012 Schedule A, Part II, line 14
%
%~~~~~~~~~~~~~~~~~~~~~
If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box and
The organization qualifies as a publicly supported organization ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ |
If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this box
and The organization qualifies as a publicly supported organization ~~~~~~~~~~~~~~~~~~~~~~~~~~~~ |
If the organization did not check a box on line 13, 16a, or 16b, and line 14 is 10% or more,
and if the organization meets the "facts-and-circumstances" test, check this box and Explain in Part IV how the organization
meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization ~~~~~~~~~~~~~~~ |
If the organization did not check a box on line 13, 16a, 16b, or 17a, and line 15 is 10% or
more, and if the organization meets the "facts-and-circumstances" test, check this box and Explain in Part IV how the
organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization ~~~~~~~~ |
If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see instructions ��� |
Part II Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
Section A. Public Support
Section B. Total Support
Section C. Computation of Public Support Percentage
NATIONAL MEDICAL ASSOCIATION 53-6010805
3,738,403. 2,800,835. 2,845,220. 2,567,331. 2,665,478. 14,617,267.
3,738,403. 2,800,835. 2,845,220. 2,567,331. 2,665,478. 14,617,267.
1,790,712.12,826,555.
3,738,403. 2,800,835. 2,845,220. 2,567,331. 2,665,478. 14,617,267.
106,156. 70,470. 70,996. 71,948. 42,011. 361,581.
14,828. 14,621. 56,837. 140,759. 75,720. 302,765.15,281,613.13,285,452.
83.9381.76
X
14
DR
AFT
(Subtract line 7c from line 6.)
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
(Add lines 9, 10c, 11, and 12.)
332023 09-25-13
Calendar year (or fiscal year beginning in) |
Calendar year (or fiscal year beginning in) |
Total support.
3
(a) (b) (c) (d) (e) (f)
1
2
3
4
5
6
7
Total.
a
b
c
8 Public support
(a) (b) (c) (d) (e) (f)
9
10a
b
c11
12
13
14 First five years.
stop here
15
16
15
16
17
18
19
20
2013
2012
17
18
a
b
33 1/3% support tests - 2013.
stop here.
33 1/3% support tests - 2012.
stop here.
Private foundation.
Schedule A (Form 990 or 990-EZ) 2013
Unrelated business taxable income
(less section 511 taxes) from businesses
acquired after June 30, 1975
Schedule A (Form 990 or 990-EZ) 2013 Page
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to
qualify under the tests listed below, please complete Part II.)
2009 2010 2011 2012 2013 Total
Gifts, grants, contributions, and
membership fees received. (Do not
include any "unusual grants.") ~~
Gross receipts from admissions,merchandise sold or services per-formed, or facilities furnished inany activity that is related to theorganization's tax-exempt purpose
Gross receipts from activities that
are not an unrelated trade or bus-
iness under section 513 ~~~~~
Tax revenues levied for the organ-
ization's benefit and either paid to
or expended on its behalf ~~~~
The value of services or facilities
furnished by a governmental unit to
the organization without charge ~
~~~ Add lines 1 through 5
Amounts included on lines 1, 2, and
3 received from disqualified persons
~~~~~~
Add lines 7a and 7b ~~~~~~~
2009 2010 2011 2012 2013 Total
Amounts from line 6 ~~~~~~~Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources ~
~~~~
Add lines 10a and 10b ~~~~~~Net income from unrelated businessactivities not included in line 10b, whether or not the business is regularly carried on ~~~~~~~Other income. Do not include gainor loss from the sale of capitalassets (Explain in Part IV.) ~~~~
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization,
check this box and ���������������������������������������������������� |
Public support percentage for 2013 (line 8, column (f) divided by line 13, column (f))
Public support percentage from 2012 Schedule A, Part III, line 15
~~~~~~~~~~~~ %
%��������������������
Investment income percentage for (line 10c, column (f) divided by line 13, column (f))
Investment income percentage from Schedule A, Part III, line 17
~~~~~~~~ %
%~~~~~~~~~~~~~~~~~~
If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not
more than 33 1/3%, check this box and The organization qualifies as a publicly supported organization ~~~~~~~~~~ |
If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3%, and
line 18 is not more than 33 1/3%, check this box and The organization qualifies as a publicly supported organization~~~~ |
If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions �������� |
Part III Support Schedule for Organizations Described in Section 509(a)(2)
Section A. Public Support
Section B. Total Support
Section C. Computation of Public Support Percentage
Section D. Computation of Investment Income Percentage
15
DR
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332024 09-25-13
4
Schedule A (Form 990 or 990-EZ) 2013
Schedule A (Form 990 or 990-EZ) 2013 Page
Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; and Part III, line 12.
Also complete this part for any additional information. (See instructions).
Part IV Supplemental Information.
NATIONAL MEDICAL ASSOCIATION 53-6010805
16
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323171 05-01-13
Contributor's Name TotalContributions
ExcessContributions
Total Excess Contributions to Schedule A, Part II, Line 5 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
** Do Not File ***** Not Open to Public Inspection ***
Identification of Excess ContributionsIncluded on Part II, Line 5Schedule A 2013
NATIONAL MEDICAL ASSOCIATION 53-6010805
BOEHRINGER INGELHEIM PHARMACEUTICALS 527,500. 221,868.
ELI LILLY & COMPANY 647,500. 341,868.
GLAXOSMITHKLINE 350,330. 44,698.
MERCK & CO 932,774. 627,142.
PFIZER PHARMACEUTICALS GROUP 786,400. 480,768.
W.K. KELLOGG FDN 380,000. 74,368.
1,790,712.
DR
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OMB No. 1545-0047
Department of the TreasuryInternal Revenue Service
32345110-24-13
Schedule B (Form 990, 990-EZ, or 990-PF) (2013)
(Form 990, 990-EZ,or 990-PF)
| Attach to Form 990, Form 990-EZ, or Form 990-PF.| Information about Schedule B (Form 990, 990-EZ, or 990-PF) and
its instructions is at .
Name of the organization Employer identification number
Organization type
Filers of: Section:
not
General Rule Special Rule.
Note.
General Rule
Special Rules
(1) (2)
General Rule
Caution.
must
For Paperwork Reduction Act Notice, see the Instructions for Form 990, 990-EZ, or 990-PF.
exclusively
exclusively exclusively
nonexclusively
(check one):
Form 990 or 990-EZ 501(c)( ) (enter number) organization
4947(a)(1) nonexempt charitable trust treated as a private foundation
527 political organization
Form 990-PF 501(c)(3) exempt private foundation
4947(a)(1) nonexempt charitable trust treated as a private foundation
501(c)(3) taxable private foundation
Check if your organization is covered by the or a
Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, $5,000 or more (in money or property) from any one
contributor. Complete Parts I and II.
For a section 501(c)(3) organization filing Form 990 or 990-EZ that met the 33 1/3% support test of the regulations under sections
509(a)(1) and 170(b)(1)(A)(vi) and received from any one contributor, during the year, a contribution of the greater of $5,000 or 2%
of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.
For a section 501(c)(7), (8), or (10) organization filing Form 990 or 990-EZ that received from any one contributor, during the year,
total contributions of more than $1,000 for use for religious, charitable, scientific, literary, or educational purposes, or
the prevention of cruelty to children or animals. Complete Parts I, II, and III.
For a section 501(c)(7), (8), or (10) organization filing Form 990 or 990-EZ that received from any one contributor, during the year,
contributions for use for religious, charitable, etc., purposes, but these contributions did not total to more than $1,000.
If this box is checked, enter here the total contributions that were received during the year for an religious, charitable, etc.,
purpose. Do not complete any of the parts unless the applies to this organization because it received
religious, charitable, etc., contributions of $5,000 or more during the year ~~~~~~~~~~~~~~~~~ | $
An organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990, 990-EZ, or 990-PF),
but it answer "No" on Part IV, line 2, of its Form 990; or check the box on line H of its Form 990-EZ or on its Form 990-PF, Part I, line 2, to
certify that it does not meet the filing requirements of Schedule B (Form 990, 990-EZ, or 990-PF).
LHA
www.irs.gov/form990
Schedule B Schedule of Contributors
2013
NATIONAL MEDICAL ASSOCIATION 53-6010805
X 3
X
DR
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323452 10-24-13
Name of organization Employer identification number
Schedule B (Form 990, 990-EZ, or 990-PF) (2013)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
Person
Payroll
Noncash
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
Person
Payroll
Noncash
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
Person
Payroll
Noncash
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
Person
Payroll
Noncash
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
Person
Payroll
Noncash
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
Person
Payroll
Noncash
Schedule B (Form 990, 990-EZ, or 990-PF) (2013) Page
(see instructions). Use duplicate copies of Part I if additional space is needed.
$
(Complete Part II fornoncash contributions.)
$
(Complete Part II fornoncash contributions.)
$
(Complete Part II fornoncash contributions.)
$
(Complete Part II fornoncash contributions.)
$
(Complete Part II fornoncash contributions.)
$
(Complete Part II fornoncash contributions.)
2
Part I Contributors
NATIONAL MEDICAL ASSOCIATION 53-6010805
1 ABBVIE, INC. X
1 N. WAUKEGAN RD. 255,000.
NORTH CHICAGO, IL 60064
2 AMERICAN UROLOGICAL ASSOCIATION X
1000 CORPORATE BLVD. 60,000.
LINTHICUM, MD 21090
3 ASTRAZENECA X
1800 CONCORD PIKE, PO BOX 15437 125,000.
WILMINGTON, DE 19850
4 ELI LILLY AND COMPANY X
LILLY CORPORATE CENTER (DC 4117) 270,000.
INDIANAPOLIS, IN 46285
5 GLAXOSMITHKLINE X
ONE FRANKLIN PLAZA 100,000.
PHILADELPHIA, PA 19102
6 JANSSEN PHARMACEUTICA, INC. X
1125 TRENTON-HARBOURTON RD. 119,000.
TITUSVILLE, NJ 08560
18
DR
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323452 10-24-13
Name of organization Employer identification number
Schedule B (Form 990, 990-EZ, or 990-PF) (2013)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
Person
Payroll
Noncash
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
Person
Payroll
Noncash
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
Person
Payroll
Noncash
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
Person
Payroll
Noncash
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
Person
Payroll
Noncash
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
Person
Payroll
Noncash
Schedule B (Form 990, 990-EZ, or 990-PF) (2013) Page
(see instructions). Use duplicate copies of Part I if additional space is needed.
$
(Complete Part II fornoncash contributions.)
$
(Complete Part II fornoncash contributions.)
$
(Complete Part II fornoncash contributions.)
$
(Complete Part II fornoncash contributions.)
$
(Complete Part II fornoncash contributions.)
$
(Complete Part II fornoncash contributions.)
2
Part I Contributors
NATIONAL MEDICAL ASSOCIATION 53-6010805
7 MERCK & CO., INC. X
SUMNEYTOWN PIKE WP39-139 190,000.
WEST POINT, PA 19486
8 MYLAN INC. X
1500 CORPORATE DRIVE, SUITE 400 100,000.
CANONSBURG, PA 15317
9 NATIONAL DAIRY COUNCIL X
676 N. ST. CLAIR, SUITE 1000 62,500.
CHICAGO, IL 60611
10 OTSUKA AMERICA PHARMACEUTICAL, INC. X
2440 RESEARCH BLVD., SUITE 100 125,000.
ROCKVILLE, MD 20850
11 THE JOHN MERCK FUND X
2 OLIVER ST, 8TH FLOOR 75,000.
BOSTON, MA 02109
12 W.K. KELLOGG FOUNDATION X
ONE MICHIGAN AVE. EAST 80,000.
BATTLE CREEK, MI 49017
19
DR
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323453 10-24-13
Name of organization Employer identification number
Schedule B (Form 990, 990-EZ, or 990-PF) (2013)
(a)
No.
from
Part I
(c)
FMV (or estimate)
(see instructions)
(b)
Description of noncash property given
(d)
Date received
(a)
No.
from
Part I
(c)
FMV (or estimate)
(see instructions)
(b)
Description of noncash property given
(d)
Date received
(a)
No.
from
Part I
(c)
FMV (or estimate)
(see instructions)
(b)
Description of noncash property given
(d)
Date received
(a)
No.
from
Part I
(c)
FMV (or estimate)
(see instructions)
(b)
Description of noncash property given
(d)
Date received
(a)
No.
from
Part I
(c)
FMV (or estimate)
(see instructions)
(b)
Description of noncash property given
(d)
Date received
(a)
No.
from
Part I
(c)
FMV (or estimate)
(see instructions)
(b)
Description of noncash property given
(d)
Date received
Schedule B (Form 990, 990-EZ, or 990-PF) (2013) Page
(see instructions). Use duplicate copies of Part II if additional space is needed.
$
$
$
$
$
$
3
Part II Noncash Property
NATIONAL MEDICAL ASSOCIATION 53-6010805
20
DR
AFT
(Enter this information once.)
323454 10-24-13
Name of organization Employer identification number
religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations that total more than $1,000 for theyear. (a) (e) and
$1,000 or less
Schedule B (Form 990, 990-EZ, or 990-PF) (2013)
(a) No.fromPart I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
(e) Transfer of gift
Transferee's name, address, and ZIP + 4 Relationship of transferor to transferee
(a) No.fromPart I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
(e) Transfer of gift
Transferee's name, address, and ZIP + 4 Relationship of transferor to transferee
(a) No.fromPart I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
(e) Transfer of gift
Transferee's name, address, and ZIP + 4 Relationship of transferor to transferee
(a) No.fromPart I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
(e) Transfer of gift
Transferee's name, address, and ZIP + 4 Relationship of transferor to transferee
exclusively Complete columns through the following line entry. For organizations completing Part III, enter
the total of religious, charitable, etc., contributions of for the year.
Schedule B (Form 990, 990-EZ, or 990-PF) (2013) Page
| $
Use duplicate copies of Part III if additional space is needed.
Exclusively
4
Part IIINATIONAL MEDICAL ASSOCIATION 53-6010805
21
DR
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OMB No. 1545-0047
Department of the TreasuryInternal Revenue Service
33205109-25-13
Held at the End of the Tax Year
(Form 990) | Complete if the organization answered "Yes," to Form 990,Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
| Attach to Form 990.| Information about Schedule D (Form 990) and its instructions is at
Open to PublicInspection
Name of the organization Employer identification number
(a) (b)
1
2
3
4
5
6
Yes No
Yes No
1
2
3
4
5
6
7
8
9
a
b
c
d
2a
2b
2c
2d
Yes No
Yes No
1
2
a
b
(i)
(ii)
a
b
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Schedule D (Form 990) 2013
Complete if the
organization answered "Yes" to Form 990, Part IV, line 6.
Donor advised funds Funds and other accounts
Total number at end of year
Aggregate contributions to (during year)
Aggregate grants from (during year)
Aggregate value at end of year
~~~~~~~~~~~~~~~
~~~~~~~~
~~~~~~~~~~
~~~~~~~~~~~~~
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds
are the organization's property, subject to the organization's exclusive legal control?~~~~~~~~~~~~~~~~~~
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only
for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring
impermissible private benefit? ��������������������������������������������
Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
Purpose(s) of conservation easements held by the organization (check all that apply).
Preservation of land for public use (e.g., recreation or education)
Protection of natural habitat
Preservation of open space
Preservation of an historically important land area
Preservation of a certified historic structure
Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last
day of the tax year.
Total number of conservation easements
Total acreage restricted by conservation easements
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~
Number of conservation easements on a certified historic structure included in (a)
Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure
listed in the National Register
~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the tax
year |
Number of states where property subject to conservation easement is located |
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of
violations, and enforcement of the conservation easements it holds? ~~~~~~~~~~~~~~~~~~~~~~~~~
Staff and volunteer hours devoted to monitoring, inspecting, and enforcing conservation easements during the year |
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year | $
Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i)
and section 170(h)(4)(B)(ii)? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and balance sheet, and
include, if applicable, the text of the footnote to the organization's financial statements that describes the organization's accounting for
conservation easements.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.
If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art,
historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII,
the text of the footnote to its financial statements that describes these items.
If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical
treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts
relating to these items:
Revenues included in Form 990, Part VIII, line 1
Assets included in Form 990, Part X
~~~~~~~~~~~~~~~~~~~~~~~~~~~~ | $
$~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ |
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide
the following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:
Revenues included in Form 990, Part VIII, line 1
Assets included in Form 990, Part X
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ | $
$~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ |
LHA
www.irs.gov/form990.
Part I Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts.
Part II Conservation Easements.
Part III Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
SCHEDULE D Supplemental Financial Statements 2013
NATIONAL MEDICAL ASSOCIATION 53-6010805
22
DR
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33205209-25-13
3
4
5
a
b
c
d
e
Yes No
1
2
a
b
c
d
e
f
a
b
Yes No
1c
1d
1e
1f
Yes No
(a) (b) (c) (d) (e)
1
2
3
4
a
b
c
d
e
f
g
a
b
c
a
b
Yes No
(i)
(ii)
3a(i)
3a(ii)
3b
(a) (b) (c) (d)
1a
b
c
d
e
Total.
Schedule D (Form 990) 2013
(continued)
(Column (d) must equal Form 990, Part X, column (B), line 10(c).)
Two years back Three years back Four years back
Schedule D (Form 990) 2013 Page
Using the organization's acquisition, accession, and other records, check any of the following that are a significant use of its collection items
(check all that apply):
Public exhibition
Scholarly research
Preservation for future generations
Loan or exchange programs
Other
Provide a description of the organization's collections and explain how they further the organization's exempt purpose in Part XIII.
During the year, did the organization solicit or receive donations of art, historical treasures, or other similar assets
to be sold to raise funds rather than to be maintained as part of the organization's collection? ������������
Complete if the organization answered "Yes" to Form 990, Part IV, line 9, orreported an amount on Form 990, Part X, line 21.
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not included
on Form 990, Part X?
If "Yes," explain the arrangement in Part XIII and complete the following table:
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Amount
Beginning balance
Additions during the year
Distributions during the year
Ending balance
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization include an amount on Form 990, Part X, line 21?
If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII
~~~~~~~~~~~~~~~~~~~~~~~~~
�������������
Complete if the organization answered "Yes" to Form 990, Part IV, line 10.
Current year Prior year
Beginning of year balance
Contributions
Net investment earnings, gains, and losses
Grants or scholarships
~~~~~~~
~~~~~~~~~~~~~~
~~~~~~~~~
Other expenditures for facilities
and programs
Administrative expenses
End of year balance
~~~~~~~~~~~~~
~~~~~~~~
~~~~~~~~~~
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
Board designated or quasi-endowment
Permanent endowment
Temporarily restricted endowment
The percentages in lines 2a, 2b, and 2c should equal 100%.
| %
| %
| %
Are there endowment funds not in the possession of the organization that are held and administered for the organization
by:
unrelated organizations
related organizations
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R?
Describe in Part XIII the intended uses of the organization's endowment funds.
~~~~~~~~~~~~~~~~~~~~~~
Complete if the organization answered "Yes" to Form 990, Part IV, line 11a. See Form 990, Part X, line 10.
Description of property Cost or otherbasis (investment)
Cost or otherbasis (other)
Accumulateddepreciation
Book value
Land
Buildings
Leasehold improvements
~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~
~~~~~~~~~~
Equipment
Other
~~~~~~~~~~~~~~~~~
��������������������
Add lines 1a through 1e. |������������
2Part III Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets
Part IV Escrow and Custodial Arrangements.
Part V Endowment Funds.
Part VI Land, Buildings, and Equipment.
NATIONAL MEDICAL ASSOCIATION 53-6010805
600,214. 552,341. 47,873.47,873.
23
DR
AFT
(including name of security)
33205309-25-13
Total.
Total.
(a) (b) (c)
(a) (b) (c)
(a) (b)
Total.
(a) (b) 1.
Total.
2.
Schedule D (Form 990) 2013
(Column (b) must equal Form 990, Part X, col. (B) line 15.)
(Column (b) must equal Form 990, Part X, col. (B) line 25.)
Description of security or category
(Col. (b) must equal Form 990, Part X, col. (B) line 12.) |
(Col. (b) must equal Form 990, Part X, col. (B) line 13.) |
Schedule D (Form 990) 2013 Page
Complete if the organization answered "Yes" to Form 990, Part IV, line 11b. See Form 990, Part X, line 12.
Book value Method of valuation: Cost or end-of-year market value
(1)
(2)
(3)
Financial derivatives
Closely-held equity interests
Other
~~~~~~~~~~~~~~~
~~~~~~~~~~~
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Complete if the organization answered "Yes" to Form 990, Part IV, line 11c. See Form 990, Part X, line 13.Description of investment Book value Method of valuation: Cost or end-of-year market value
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Complete if the organization answered "Yes" to Form 990, Part IV, line 11d. See Form 990, Part X, line 15.
Description Book value
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
���������������������������� |
Complete if the organization answered "Yes" to Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.
Description of liability Book value
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Federal income taxes
����� |
Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the
organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII
3Part VII Investments - Other Securities.
Part VIII Investments - Program Related.
Part IX Other Assets.
Part X Other Liabilities.
NATIONAL MEDICAL ASSOCIATION 53-6010805
GRANT LIABILITY 173,389.DEFERRED RENT 143,167.PRESENT VALUE OF LEASES - LONG TERM 59,964.OTHER LIABILITIES 21,955.
398,475.
24
DR
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33205409-25-13
1
2
3
4
5
1
a
b
c
d
e
2a
2b
2c
2d
2a 2d 2e
32e 1
a
b
c
4a
4b
4a 4b
3 4c.
4c
5
1
2
3
4
5
1
a
b
c
d
e
2a
2b
2c
2d
2a 2d
2e 1
2e
3
a
b
c
4a
4b
4a 4b
3 4c.
4c
5
Schedule D (Form 990) 2013
(This must equal Form 990, Part I, line 12.)
(This must equal Form 990, Part I, line 18.)
Schedule D (Form 990) 2013 Page
Complete if the organization answered "Yes" to Form 990, Part IV, line 12a.
Total revenue, gains, and other support per audited financial statements
Amounts included on line 1 but not on Form 990, Part VIII, line 12:
~~~~~~~~~~~~~~~~~~~
Net unrealized gains on investments
Donated services and use of facilities
Recoveries of prior year grants
Other (Describe in Part XIII.)
~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~
Add lines through ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Subtract line from line ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Amounts included on Form 990, Part VIII, line 12, but not on line 1:
Investment expenses not included on Form 990, Part VIII, line 7b
Other (Describe in Part XIII.)
~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~
Add lines and
Total revenue. Add lines and
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
�����������������
Complete if the organization answered "Yes" to Form 990, Part IV, line 12a.
Total expenses and losses per audited financial statements
Amounts included on line 1 but not on Form 990, Part IX, line 25:
~~~~~~~~~~~~~~~~~~~~~~~~~~
Donated services and use of facilities
Prior year adjustments
Other losses
Other (Describe in Part XIII.)
~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~
Add lines through
Subtract line from line
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Amounts included on Form 990, Part IX, line 25, but not on line 1:
Investment expenses not included on Form 990, Part VIII, line 7b
Other (Describe in Part XIII.)
~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~
Add lines and
Total expenses. Add lines and
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
����������������
Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part IV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI,
lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.
4Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return.
Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return.
Part XIII Supplemental Information.
NATIONAL MEDICAL ASSOCIATION 53-6010805
25
DR
AFT
OMB No. 1545-0047
Department of the TreasuryInternal Revenue Service
33211109-13-13
For certain Officers, Directors, Trustees, Key Employees, and HighestCompensated Employees
Complete if the organization answered "Yes" on Form 990, Part IV, line 23.Open to Public
InspectionAttach to Form 990. See separate instructions.
| Information about Schedule J (Form 990) and its instructions is at Employer identification number
Yes No
1a
b
1b
2
2
3
4
a
b
c
4a
4b
4c
Only section 501(c)(3) and 501(c)(4) organizations must complete lines 5-9.
5
5a
5b
6a
6b
7
8
9
a
b
6
a
b
7
8
9
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Schedule J (Form 990) 2013
|| |
Name of the organization
Check the appropriate box(es) if the organization provided any of the following to or for a person listed in Form 990,
Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
First-class or charter travel
Travel for companions
Housing allowance or residence for personal use
Payments for business use of personal residence
Tax indemnification and gross-up payments
Discretionary spending account
Health or social club dues or initiation fees
Personal services (e.g., maid, chauffeur, chef)
If any of the boxes on line 1a are checked, did the organization follow a written policy regarding payment or
reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain~~~~~~~~~~~
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all directors,
trustees, and officers, including the CEO/Executive Director, regarding the items checked in line 1a? ~~~~~~~~~~~~
Indicate which, if any, of the following the filing organization used to establish the compensation of the organization's
CEO/Executive Director. Check all that apply. Do not check any boxes for methods used by a related organization to
establish compensation of the CEO/Executive Director, but explain in Part III.
Compensation committee
Independent compensation consultant
Form 990 of other organizations
Written employment contract
Compensation survey or study
Approval by the board or compensation committee
During the year, did any person listed in Form 990, Part VII, Section A, line 1a, with respect to the filing
organization or a related organization:
Receive a severance payment or change-of-control payment?
Participate in, or receive payment from, a supplemental nonqualified retirement plan?
Participate in, or receive payment from, an equity-based compensation arrangement?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any compensation
contingent on the revenues of:
The organization?
Any related organization?
If "Yes" to line 5a or 5b, describe in Part III.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any compensation
contingent on the net earnings of:
The organization?
Any related organization?
If "Yes" to line 6a or 6b, describe in Part III.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed payments
not described in lines 5 and 6? If "Yes," describe in Part III
Were any amounts reported in Form 990, Part VII, paid or accrued pursuant to a contract that was subject to the
initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe in Part III
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in
Regulations section 53.4958-6(c)? ���������������������������������������������
LHA
www.irs.gov/form990.
SCHEDULE J(Form 990)
Part I Questions Regarding Compensation
Compensation Information
2013
NATIONAL MEDICAL ASSOCIATION 53-6010805
XX XX X
XXX
XX
XX
X
X
26
DRAFT
33211209-13-13
2
Part II Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees.
Note.
(B) (C) (D) (E) (F)
(i) (ii) (iii) (A)
(i)
(ii)
(i)
(ii)
(i)
(ii)
(i)
(ii)
(i)
(ii)
(i)
(ii)
(i)
(ii)
(i)
(ii)
(i)
(ii)
(i)
(ii)
(i)
(ii)
(i)
(ii)
(i)
(ii)
(i)
(ii)
(i)
(ii)
(i)
(ii)
Schedule J (Form 990) 2013
Schedule J (Form 990) 2013 Page
Use duplicate copies if additional space is needed.
For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the instructions, on row (ii).Do not list any individuals that are not listed on Form 990, Part VII.
The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.
Breakdown of W-2 and/or 1099-MISC compensation Retirement andother deferredcompensation
Nontaxablebenefits
Total of columns(B)(i)-(D)
Compensationreported as deferred
in prior Form 990Basecompensation
Bonus &incentive
compensation
Otherreportable
compensation
Name and Title
NATIONAL MEDICAL ASSOCIATION 53-6010805
(1) DARRYL R. MATTHEWS SR. 198,363. 0. 792. 0. 9,957. 209,112. 0.EXECUTIVE DIRECTOR 0. 0. 0. 0. 0. 0. 0.
27
DRAFT
33211309-13-13
3
Part III Supplemental Information
Schedule J (Form 990) 2013
Schedule J (Form 990) 2013 Page
Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.
NATIONAL MEDICAL ASSOCIATION 53-6010805
28
DR
AFT
OMB No. 1545-0047
Department of the TreasuryInternal Revenue Service
33221109-04-13
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
Complete to provide information for responses to specific questions onForm 990 or 990-EZ or to provide any additional information.
| Attach to Form 990 or 990-EZ.|
(Form 990 or 990-EZ)
Open to PublicInspection
Employer identification number
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ. Schedule O (Form 990 or 990-EZ) (2013)
Name of the organization
LHA
www.irs.gov/form990.
SCHEDULE O Supplemental Information to Form 990 or 990-EZ 2013
NATIONAL MEDICAL ASSOCIATION 53-6010805
FORM 990, PART III, LINE 4D, OTHER PROGRAM SERVICES:
OTHER PROGRAMS
EXPENSES $ 617,697. INCLUDING GRANTS OF $ 0. REVENUE $ 0.
FORM 990, PART VI, SECTION A, LINE 6:
EXPLANATION: THE ACTIVE MEMBERS HAVE VOTING RIGHTS THROUGH REPRESENTATION
IN THE HOUSE OF DELEGATES.
FORM 990, PART VI, SECTION A, LINE 7A:
EXPLANATION: ACTIVE MEMBERS, THROUGH THEIR STATE DELEGATES, NOMINATE AND
ELECT THE OFFICERS AND BOARD MEMBERS. ACTIVE MEMBERS MAY PRESENT MOTIONS
TO RATIFY OR VETO ANY ACTION OF THE BOARD. THE MOTION IS VOTED ON BY THE
ENTIRE HOUSE OF DELEGATES. A VOTE TO RATIFY OR VETO A BOARD ACTION ME BE
TWO-THIRDS OF THE DELEGATES.
FORM 990, PART VI, SECTION A, LINE 7B:
EXPLANATION: THE ORGANIZATION'S BY-LAWS MAY BE AMENDED ON THE APPROVAL OF
TWO-THIRDS OF THE MEMBERS OF THE HOUSE OF DELEGATES.
FORM 990, PART VI, SECTION B, LINE 11:
EXPLANATION: THE TAX RETURN IS REVIEWED BY THE AUDIT AND FINANCE COMMITTEES
ALONG WITH THE AUDIT REPORT. THESE COMMITTEES REPORT TO THE BOARD ON THEIR
REVIEWS. A COPY OF THE RETURN IS PROVIDED TO EACH BOARD MEMBER.
FORM 990, PART VI, SECTION B, LINE 12C:
EXPLANATION: EACH BOARD MEMBER SIGNS A CONFLICT OF INTEREST STATEMENT UPON
29
DR
AFT
33221209-04-13
2
Employer identification number
Schedule O (Form 990 or 990-EZ) (2013)
Schedule O (Form 990 or 990-EZ) (2013) Page
Name of the organizationNATIONAL MEDICAL ASSOCIATION 53-6010805
TAKING OFFICE EACH YEAR (INCLUDING CONTINUING MEMBERS). ALL BOARD MEMBERS
PARTICIPATE IN A "BOARD MEMBER ORIENTATION" MEETING IN OCTOBER OF EACH
YEAR. BECAUSE OUR BOARD MEMBERS ARE PROFESSIONALLY ACTIVE, THERE IS A
DISCUSSION OF THE NATURE OF THEIR RELATIONSHIPS WITH THE NMA AND OTHER
ORGANIZATIONS IDENTIFYING COMMON RELATIONSHIPS THAT MIGHT CONFLICTS OF
INTEREST. ALL EMPLOYEES SIGN A CONFLICT OF INTEREST STATEMENT UPON
EMPLOYMENT. THE NMA'S POLICIES INCLUDE PROCEDURES FOR REPORTING SUSPECTED
CONFLICTS.
FORM 990, PART VI, SECTION B, LINE 15A:
EXPLANATION: THE BOARD OF DIRECTORS REVIEWS AND APPROVES THE COMPENSATION
OF THE EXECUTIVE DIRECTOR. THE EXECUTIVE DIRECTOR REVIEWS AND APPROVES THE
COMPENSATION FOR ALL OTHER EMPLOYEES AND CONSULTS WITH THE BOARD ON SENIOR
POSITIONS. THE BOARD AND THE EXECUTIVE DIRECTOR CONSULT WITH COMPENSATION
FIRMS FOR INFORMATION ON SALARY AND BENEFIT LEVELS. DECISIONS ARE
DOCUMENTED IN THE BOARD MINUTES. OTHER TOP MANAGEMENT OFFICIALS AND KEY
EMPLOYEES ARE HIRED DIRECTLY BY THE ORGANIZATION, BUT COMPARABLE DATA IS
OBTAINED FROM OUTSIDE SOURCES, SUCH AS ASAE OR PERSONNEL FIRMS TO DETERMINE
A SALARY OFFER. THE BOARD OF DIRECTORS APPROVES COMPENSATION. THE DATA IS
GATHERED THROUGH EXECUTIVE SEARCH FIRMS, ASAE AND GUIDESTAR. THE DECISIONS
ARE DOCUMENTED IN THE COMMITTEE MINUTES.
FORM 990, PART VI, SECTION C, LINE 19:
EXPLANATION: THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF
INTEREST POLICY, FINANCIAL STATEMENTS AND OTHER DOCUMENTS ARE MADE
AVAILABLE AT THE HEADQUARTERS ON REQUEST. FINANCIAL STATEMENTS, CONFLICT OF
INTEREST POLICY AND GOVERNING DOCUMENTS ARE AVAILABLE UPON REQUEST FOR THE
SAME PERIOD OF DISCLOSURE AS SET FORTH IN SECTION 6104(D).
30
DR
AFT
33221209-04-13
2
Employer identification number
Schedule O (Form 990 or 990-EZ) (2013)
Schedule O (Form 990 or 990-EZ) (2013) Page
Name of the organizationNATIONAL MEDICAL ASSOCIATION 53-6010805
FORM 990, PART IX, LINE 11G, OTHER FEES:
OTHER PROFESSIONAL FEES:
PROGRAM SERVICE EXPENSES 100.
MANAGEMENT AND GENERAL EXPENSES 3,247.
FUNDRAISING EXPENSES 0.
TOTAL EXPENSES 3,347.
CONSULTING FEES:
PROGRAM SERVICE EXPENSES 920,987.
MANAGEMENT AND GENERAL EXPENSES 296,165.
FUNDRAISING EXPENSES 140,457.
TOTAL EXPENSES 1,357,609.
TOTAL OTHER FEES ON FORM 990, PART IX, LINE 11G, COL A 1,360,956.
FORM 990, PART IV, LINE 12
EXPLANATION: AT THE TIME WHEN THE FORM 990 IS PREPARED AND FILED TO THE
IRS, THE ORGANIZATION HAS NOT RECEIVED THE FINALIZED 2013 AUDITED
FINANCIAL STATEMENTS.
31
DR
AFT
OMB No. 1545-0687Form
For calendar year 2013 or other tax year beginning , and ending .
Department of the TreasuryInternal Revenue Service
Open to Public Inspection for501(c)(3) Organizations Only
Employer identification number(Employees' trust, seeinstructions.)
Unrelated business activity codes(See instructions.)
Book value of all assetsat end of year
32370112-12-13
| Information about Form 990-T and its instructions is available at
| Do not enter SSN numbers on this form as it may be made public if your organization is a 501(c)(3).DA
B Printor
TypeE
C F
G
H
I
J(A) Income (B) Expenses (C) Net
1
2
3
4
5
6
7
8
9
10
11
12
13
a
b
a
b
c
c 1c
2
3
4a
4b
4c
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
14
15
16
17
18
19
20
21
22a 22b
23
24
25
26
27
28
29
30
31
32
33
34
Unrelated business taxable income.
For Paperwork Reduction Act Notice, see instructions.
Total.
Total deductions.
Check box ifaddress changed
Name of organization ( Check box if name changed and see instructions.)
Exempt under section
501( )( ) Number, street, and room or suite no. If a P.O. box, see instructions.
220(e)408(e)
408A 530(a) City or town, state or province, country, and ZIP or foreign postal code
529(a)
|Group exemption number (See instructions.)
|Check organization type 501(c) corporation 501(c) trust 401(a) trust Other trust
Describe the organization's primary unrelated business activity. |
During the tax year, was the corporation a subsidiary in an affiliated group or a parent-subsidiary controlled group?
If "Yes," enter the name and identifying number of the parent corporation.
~~~~~~ | Yes No|
| |The books are in care of Telephone number
Gross receipts or sales
Less returns and allowances Balance ~~~ |
Cost of goods sold (Schedule A, line 7)
Gross profit. Subtract line 2 from line 1c
Capital gain net income (attach Form 8949 and Schedule D)
~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~
~~~~~~~~
Net gain (loss) (Form 4797, Part II, line 17) (attach Form 4797) ~~~~~~
Capital loss deduction for trusts ~~~~~~~~~~~~~~~~~~~~
Income (loss) from partnerships and S corporations (attach statement)
Rent income (Schedule C)
~~~
~~~~~~~~~~~~~~~~~~~~~~
Unrelated debt-financed income (Schedule E) ~~~~~~~~~~~~~~
Interest, annuities, royalties, and rents from controlled organizations (Sch. F)~
Investment income of a section 501(c)(7), (9), or (17) organization (Schedule G)
Exploited exempt activity income (Schedule I)
Advertising income (Schedule J)
Other income (See instructions; attach schedule.)
~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~
Combine lines 3 through 12�������������������
Compensation of officers, directors, and trustees (Schedule K)
Salaries and wages
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Repairs and maintenance
Bad debts
Interest (attach schedule)
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Taxes and licenses ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Charitable contributions (See instructions for limitation rules.) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Depreciation (attach Form 4562)
Less depreciation claimed on Schedule A and elsewhere on return
~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~
Depletion
Contributions to deferred compensation plans
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Employee benefit programs ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Excess exempt expenses (Schedule I)
Excess readership costs (Schedule J)
Other deductions (attach schedule)
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Add lines 14 through 28 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Unrelated business taxable income before net operating loss deduction. Subtract line 29 from line 13 ~~~~~~~~~~~~
Net operating loss deduction (limited to the amount on line 30)
Unrelated business taxable income before specific deduction. Subtract line 31 from line 30
Specific deduction (Generally $1,000, but see instructions for exceptions.)
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~
Subtract line 33 from line 32. If line 33 is greater than line 32, enter the smaller of zero or
line 32 �����������������������������������������������������
Form (2013)
(See instructions for limitations on deductions.)(Except for contributions, deductions must be directly connected with the unrelated business income.)
LHA
www.irs.gov/form990t.
(and proxy tax under section 6033(e))
Part I Unrelated Trade or Business Income
Part II Deductions Not Taken Elsewhere
990-T
Exempt Organization Business Income Tax Return990-T
2013
SEE STATEMENT 2
NATIONAL MEDICAL ASSOCIATION 53-6010805X c 3
8403 COLESVILLE ROAD, NO. 920
SILVER SPRING, MD 20910 541800
4,063,534. XADVERTISING
X
JUAN G. GONZALEZ, CPA (202) 347-1895
49,014. 25,883. 23,131.
49,014. 25,883. 23,131.
0.
0.23,131.23,131.
0.1,000.
0.
33
DR
AFT
PageForm 990-T (2013)
(attach schedule)
During the tax year, did the organization receive a distribution from, or was it the grantor of, or transferor to, a foreign trust?If YES, see instructions for other forms the organization may have to file.
Additional section 263A costs (att. schedule)
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true,correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
May the IRS discuss this return with
the preparer shown below (see
instructions)?
323711 12-12-13
2
35 Organizations Taxable as Corporations.
See instructions
a
b
c
(1) (2) (3)
(1)
(2)
35c
36
37
38
39
36
37
38
39
Trusts Taxable at Trust Rates.
Proxy tax.
Total
40
41
42
43
44
a
b
c
d
e
40a
40b
40c
40d
Total credits. 40e
41
42
43Total tax.
a
b
c
d
e
f
g
44a
44b
44c
44d
44e
44f
44g
45
46
47
48
49
Total payments 45
46
47
48
49
Tax due
Overpayment.
Credited to 2014 estimated tax Refunded
1 Yes No
2
3
1
2
3
4
1
2
3
4a
4b
6
7
8
6
7
Cost of goods sold.
a
b
Yes No
5 Total. 5
Yes No
See instructions for tax computation.
Controlled group members (sections 1561 and 1563) check here | and:
Enter your share of the $50,000, $25,000, and $9,925,000 taxable income brackets (in that order):
$ $ $
Enter organization's share of: Additional 5% tax (not more than $11,750) $
Additional 3% tax (not more than $100,000) ~~~~~~~~~~~~~ $
Income tax on the amount on line 34 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ |
|
|
See instructions for tax computation. Income tax on the amount on line 34 from:
Tax rate schedule or Schedule D (Form 1041) ~~~~~~~~~~~~~~~~~~~~~~~~~~~
See instructions
Alternative minimum tax
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
. Add lines 37 and 38 to line 35c or 36, whichever applies ���������������������������
Foreign tax credit (corporations attach Form 1118; trusts attach Form 1116)
Other credits (see instructions)
~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~
General business credit. Attach Form 3800 ~~~~~~~~~~~~~~~~~~~~~~
Credit for prior year minimum tax (attach Form 8801 or 8827) ~~~~~~~~~~~~~~
Add lines 40a through 40d ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Subtract line 40e from line 39 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Other taxes. Check if from: Form 4255 Form 8611 Form 8697 Form 8866 Other
Add lines 41 and 42 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Payments: A 2012 overpayment credited to 2013 ~~~~~~~~~~~~~~~~~~~
2013 estimated tax payments ~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Tax deposited with Form 8868 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Foreign organizations: Tax paid or withheld at source (see instructions) ~~~~~~~~~~
Backup withholding (see instructions)
Credit for small employer health insurance premiums (Attach Form 8941)
Other credits and payments:
~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~
Form 2439
OtherForm 4136 Total |
. Add lines 44a through 44g ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Estimated tax penalty (see instructions). Check if Form 2220 is attached | ~~~~~~~~~~~~~~~~~~~
. If line 45 is less than the total of lines 43 and 46, enter amount owed ~~~~~~~~~~~~~~~~~~~ |
|
|
If line 45 is larger than the total of lines 43 and 46, enter amount overpaid ~~~~~~~~~~~~~~
Enter the amount of line 48 you want: |
At any time during the 2013 calendar year, did the organization have an interest in or a signature or other authority over a financial account (bank,
securities, or other) in a foreign country? If YES, the organization may have to file Form TD F 90-22.1, Report of Foreign Bank and Financial
Accounts. If YES, enter the name of the foreign country here |
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Enter the amount of tax-exempt interest received or accrued during the tax year $|
|
Inventory at beginning of year
Purchases
~~~ Inventory at end of year ~~~~~~~~~~~~
~~~~~~~~~~~ Subtract line 6
Cost of labor~~~~~~~~~~~ from line 5. Enter here and in Part I, line 2 ~~~~
Other costs (attach schedule)
Do the rules of section 263A (with respect to
property produced or acquired for resale) apply to
the organization?
~~~
Add lines 1 through 4b ��� �����������������������
Signature of officer Date Title
Print/Type preparer's name Preparer's signature Date Check
self- employed
if PTIN
Firm's name Firm's EIN
Firm's address Phone no.
(see instructions)
Enter method of inventory valuation
Form (2013)
Tax ComputationPart III
Tax and PaymentsPart IV
Statements Regarding Certain Activities and Other InformationPart V
Schedule A - Cost of Goods Sold.
SignHere
PaidPreparerUse Only
990-T
= =
999
NATIONAL MEDICAL ASSOCIATION 53-6010805
0.
0.
0.
0.
0.0.
XX
N/A
CHAIRMANX
YONG ZHANG, CPA P01249785MCGLADREY LLP 42-0714325
1861 INTERNATIONAL DRIVE, SUITE 400MCLEAN, VA 22102 703-336-6400
34
DR
AFT
Description of property
Rent received or accrued
Deductions directly connected with the income incolumns 2(a) and 2(b) (attach schedule) From personal property (if the percentage of
rent for personal property is more than 10% but not more than 50%)
From real and personal property (if the percentageof rent for personal property exceeds 50% or if
the rent is based on profit or income)
Total Total
Enter here and on page 1,Part I, line 6, column (B)
Deductions directly connected with or allocableto debt-financed property Gross income from
or allocable to debt-financed property
Straight line depreciation(attach schedule)
Other deductions(attach schedule)
Description of debt-financed property
Amount of average acquisition debt on or allocable to debt-financed
property (attach schedule)
Average adjusted basisof or allocable to
debt-financed property(attach schedule)
Column 4 divided by column 5
Gross incomereportable (column
2 x column 6)
Allocable deductions(column 6 x total of columns
3(a) and 3(b))
Enter here and on page 1,
Part I, line 7, column (A).
Enter here and on page 1,
Part I, line 7, column (B).
Name of controlled organization Deductions directlyPart of column 4 that isEmployer identification
numberNet unrelated income
(loss) (see instructions)Total of specifiedpayments made
included in the controllingorganization's gross income
connected with incomein column 5
Taxable Income Net unrelated income (loss) Total of specified payments Part of column 9 that is included Deductions directly connectedin the controlling organization's
gross incomemade(see instructions) with income in column 10
Add columns 5 and 10.
Enter here and on page 1, Part I,
line 8, column (A).
Add columns 6 and 11.
Enter here and on page 1, Part I,
line 8, column (B).
323721 12-12-13
3
1.
2.3(a)
(a) (b)
(b) Total deductions.(c) Total income.
3.2.
(a) (b)1.
4. 7.5. 6. 8.
Totals
Total dividends-received deductions
1. 2. 3. 4. 5. 6.
7. 8. 9. 10. 11.
Totals
990-T
Form 990-T (2013) Page(see instructions)
Add totals of columns 2(a) and 2(b). Enter
here and on page 1, Part I, line 6, column (A) ������� | � |
%
%
%
%
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ |
included in column 8 ��������������������������������� |
����������������������������������������
Form (2013)
(1)
(2)
(3)
(4)
(1)
(2)
(3)
(4)
(see instructions)
(1)
(2)
(3)
(4)
(1)
(2)
(3)
(4)
(see instructions)
Exempt Controlled Organizations
(1)
(2)
(3)
(4)
Nonexempt Controlled Organizations
(1)
(2)
(3)
(4)
Schedule C - Rent Income (From Real Property and Personal Property Leased With Real Property)
Schedule E - Unrelated Debt-Financed Income
Schedule F - Interest, Annuities, Royalties, and Rents From Controlled Organizations
J
NATIONAL MEDICAL ASSOCIATION 53-6010805
0. 0.
0. 0.
0. 0.0.
0. 0.
35
DR
AFT
Deductionsdirectly connected(attach schedule)
Total deductionsand set-asides
(col. 3 plus col. 4)
Set-asides(attach schedule)
Description of income Amount of income
Enter here and on page 1,Part I, line 9, column (A).
Enter here and on page 1,Part I, line 9, column (B).
Description ofexploited activity
Grossunrelated business
income fromtrade or business
Expensesdirectly connected
with productionof unrelated
business income
Net income (loss)from unrelated trade or
business (column 2minus column 3). If again, compute cols. 5
through 7.
Gross incomefrom activity thatis not unrelated
business income
Expensesattributable to
column 5
Excess exemptexpenses (column6 minus column 5,but not more than
column 4).
Enter here and onpage 1, Part I,
line 10, col. (A).
Enter here and onpage 1, Part I,
line 10, col. (B).
Enter here andon page 1,
Part II, line 26.
Grossadvertising
income
Directadvertising costs
Advertising gainor (loss) (col. 2 minus
col. 3). If a gain, computecols. 5 through 7.
Circulationincome
Readershipcosts
Excess readershipcosts (column 6 minuscolumn 5, but not more
than column 4).
Name of periodical
Grossadvertising
income
Directadvertising costs
Advertising gainor (loss) (col. 2 minus
col. 3). If a gain, computecols. 5 through 7.
Circulationincome
Readershipcosts
Excess readershipcosts (column 6 minuscolumn 5, but not more
than column 4).
Name of periodical
Enter here and onpage 1, Part I,
line 11, col. (A).
Enter here and onpage 1, Part I,
line 11, col. (B).
Enter here andon page 1,
Part II, line 27.
Percent oftime devoted to
business
Compensation attributableto unrelated businessTitleName
32373112-12-13
4
3. 5.4.1. 2.
Totals
1. 2. 3. 4.
5. 6. 7.
Totals
2. 3. 4.
5. 6. 7.
1.
Totals
2. 3. 4.
5. 6. 7.
1.
Totals from Part I
Totals,
3. 4.2.1.
Total.
Form 990-T (2013) Page
������������������������������
����������
(carry to Part II, line (5)) ��
Part II (lines 1-5)�����
%
%
%
%
Enter here and on page 1, Part II, line 14 �����������������������������������
(see instructions)
(1)
(2)
(3)
(4)
(see instructions)
(1)
(2)
(3)
(4)
(see instructions)
(1)
(2)
(3)
(4)
(For each periodical listed in Part II, fill incolumns 2 through 7 on a line-by-line basis.)
(1)
(2)
(3)
(4)
(see instructions)
(1)
(2)
(3)
(4)
Form (2013)
Schedule G - Investment Income of a Section 501(c)(7), (9), or (17) Organization
Schedule I - Exploited Exempt Activity Income, Other Than Advertising Income
Schedule J - Advertising IncomeIncome From Periodicals Reported on a Consolidated BasisPart I
Income From Periodicals Reported on a Separate BasisPart II
Schedule K - Compensation of Officers, Directors, and Trustees
990-T
9
9
9
9
9
NATIONAL MEDICAL ASSOCIATION 53-6010805
0. 0.
0. 0. 0.
0. 0. 0.
JOURNAL OF NATIONALMEDICAL ASSOCIATION 6,280. 13,013. -6,733.CAREER CENTER 34,634. 0. 34,634.E-NMA 8,100. 12,870. -4,770.
0. 0. 0.
49,014. 25,883. 0.
0.
36
DR
AFT
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~FOOTNOTES STATEMENT 1
}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}
NOL CARRYOVER
2007 NOL AVAILABLE 45,365.2011 NOL AVAILABLE 128,166.
}}}}}}}}}}}}}
2013 NOL AVAILABLE 173,531.~~~~~~~~~~~~~
NATIONAL MEDICAL ASSOCIATION 53-6010805}}}}}}}}}}}}}}}}}}}}}}}}}}}} }}}}}}}}}}
STATEMENT(S) 1 37
DR
AFT
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~FORM 990-T CONTRIBUTIONS SUMMARY}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}
QUALIFIED CONTRIBUTIONS SUBJECT TO 100% LIMIT
CARRYOVER OF PRIOR YEARS UNUSED CONTRIBUTIONSFOR TAX YEARFOR TAX YEARFOR TAX YEARFOR TAX YEARFOR TAX YEAR
}}}}}}}}}}}}}}TOTAL CARRYOVERTOTAL CURRENT YEAR 10% CONTRIBUTIONS
}}}}}}}}}}}}}}TOTAL CONTRIBUTIONS AVAILABLETAXABLE INCOME LIMITATION AS ADJUSTED
}}}}}}}}}}}}}}EXCESS 10% CONTRIBUTIONSEXCESS 100% CONTRIBUTIONSTOTAL EXCESS CONTRIBUTIONS
}}}}}}}}}}}}}}ALLOWABLE CONTRIBUTIONS DEDUCTION
}}}}}}}}}}}}}}TOTAL CONTRIBUTION DEDUCTION
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
128,166
128,166
128,166
128,166
0
128,1660
20082009201020112012
0
0
NATIONAL MEDICAL ASSOCIATION 53-6010805}}}}}}}}}}}}}}}}}}}}}}}}}}}} }}}}}}}}}}
STATEMENT 2
STATEMENT(S) 2 38
DR
AFT
2013, ENDINGOR FISCAL YEAR BEGINNING
Name
Number and street
State ZIP codeCity / town
Federal Employer Identification No. (9 digits) Do not write in this space
ME
YEFEIN Applied for date
Date of Organization or Incorporation (MMDDYY) Business Activity Code No. (6 digits)
35630110-11-13 COM/RAD-001 13-05
MARYLANDFORM
1 a
b
c
1a
1b
1c
MARYLAND ADJUSTMENTS TO FEDERAL TAXABLE INCOME (All entries must be positive amounts.)ADDITION ADJUSTMENTS
2 a
b
c
2a
b
2c
SUBTRACTION ADJUSTMENTS
3 a
b
c
d
e
3a
b
c
d
3e
4
5
6
4
5
6
MARYLAND ADDITION MODIFICATIONS (All entries must be positive amounts.)
7 a
b
c
d
e
f
g
7a
b
c
d
e
f
7g
|
|
| |
NAME OR ADDRESS HAS CHANGED INACTIVE CORPORATION FIRST FILING OF THE CORPORATION FINAL RETURN
| THIS TAX YEAR'S BEGINNING AND ENDING DATES ARE DIFFERENT FROM LAST YEAR'S DUE TO AN ACQUISITION OR CONSOLIDATION.
|
|
|
STA
PLE
CH
ECK
HER
E
|
|
|
|
|
|
|
|
|
|
|
$
CHECK HERE IF:
SEE CORPORATION INSTRUCTIONS. ATTACH A COPY OF THE FEDERAL INCOME TAX RETURN THROUGH SCHEDULE M2.
Federal Taxable Income (Enter amount from Federal Form 1120 line 28 or Form 1120-C line 25c.) See Instructions. Check applicable box:
1120 1120-REIT 990T
Other: IF 1120S, FILE ON FORM 510 ~~~~
Special Deductions (Federal Form 1120 line 29b or Form 1120-C line 26b.)
Federal Taxable Income before net operating loss deduction (Subtract line 1b from 1a.)
~
~~~~~~~~
Section 10-306.1 related party transactions
Decoupling Modification Addition adjustment
(Enter code letter(s) from instructions.)
~~~~~~~~~~~~~
~~~~~~ ~
Total Maryland Addition Adjustments to Federal Taxable Income (Add lines 2a and 2b.) ~~~~~~~~~~
Section 10-306.1 related party transactions
Dividends for domestic corporation claiming foreign tax credits
(Federal form 1120/1120C Schedule C line 15)
Dividends from related foreign corporations
(Federal form 1120/1120C Schedule C line 13 and 14)
~~~~~~~~~~~~~
~~~~~~~~~~~~
~~~~~~~~
Decoupling Modification Subtraction adjustment
(Enter code letter(s) from instructions.) ~~~~~~ ~
Total Maryland Subtraction Adjustments to Federal Taxable Income (Add lines 3a through 3d.) ~~~~~~
Maryland Adjusted Federal Taxable Income before NOL deduction is applied
(Add lines 1c and 2c, and subtract line 3e.) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Enter Adjusted Federal NOL Carry-forward available from previous tax years (including FDSC Carry forward)
on a separate company basis (Enter NOL as a positive amount.) ~~~~~~~~~~~~~~~~~~~
Maryland Adjusted Federal Taxable Income (If line 4 is less than or equal to zero, enter amount from line 4.)
(If line 4 is greater than zero, subtract line 5 from line 4 and enter result.
If result is less than zero, enter zero.) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
State and local income tax
Dividends and interest from another state, local or federal tax
exempt obligation
Net operating loss modification recapture
(Do not enter NOL carryover. See instructions.)
~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~
Domestic Production Activities Deduction
Deduction for Dividends paid by captive REIT
~~~~~~~~~~~~~~
~~~~~~~~~~~~
Other additions (Enter code letter(s) from
instructions and attach schedule.) ~~~~~~~~ ~
Total Addition Modifications (Add lines 7a through 7f.) ~~~~~~~~~~~~~~~~~~~~~~~~~~
CORPORATION INCOMETAX RETURN
2013500
NATIONAL MEDICAL ASSOCIATION
8403 COLESVILLE ROAD, STE 920
SILVER SPRING MD 20910
536010805
03/13/24 541800
X23131
23131
23131
173531
0
DR
AFT
Name FEIN
COM/RAD-001
35630210-11-13 13-05
MARYLANDFORM
page 2
2013
MARYLAND SUBTRACTION MODIFICATIONS(All entries must be positive amounts.)
8 a
b
c
8a
b
8c
NET MARYLAND MODIFICATIONS
9
10
9
10
APPORTIONMENT OF INCOME
(To be completed by multistate corporations whose apportionment factor is less than 1, otherwise skip to line 13.)
11
12
11
12
13
14
15
13
14
a
b
c
d
e
f
g
15a
b
f
You must file this form electronically to claim business tax credits from Form 500CR.
You must file this form electronically to claim business tax credits from Form 500CR.
15g
16
17
18
19
21
16
17
18
19
20
21
Total
20
DIRECT DEPOSIT OF REFUND
22
a
b
c
INFORMATIONAL PURPOSES ONLY (LINES 23 & 24)
23
24
23
24
|
|
|
|
|
|
Interest and/or penalty from Form 500UP
|
|
or late payment interest |
|
|
|
|
|
|
Income from US Obligations
Other Subtractions (Enter code letter(s)
from instructions and attach schedule.)
Total Subtraction Modifications (Add lines 8a and 8b.)
~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~ ~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Total Maryland Modifications (Subtract line 8c from 7g. If less than zero, enter negative amount.)
Maryland Modified Income (Add lines 6 and 9.)
~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Maryland apportionment factor (from page 3 of this form) (If factor is zero, enter .000001.) ~~~~~~~~~
Maryland apportionment income (Multiply line 10 by line 11.) ~~~~~~~~~~~~~~~~~~~~~~~~~
Maryland taxable income (from line 10 or line 12, whichever is applicable.)
Tax (Multiply line 13 by 8.25%.)
~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Estimated tax paid with Form 500D, Form MW506NRS and/or
credited from 2012 overpayment ~~~~~~~~~~~~~~~~~~~~
Tax paid with an extension request (Form 500E)
Nonrefundable business income tax credits from Part W.
(See instructions for Form 500CR.)
~~~~~~~~~~~~~
~~~~~~~~
Refundable business income tax credits from Part Z.
(See instructions for Form 500CR.) ~~~~~~~~
The Sustainable Communities Tax Credit is now claimed on line 1 of
Part Z on Form 500CR. Check here if you are a non-profit corporation.
Nonresident tax paid on behalf of the corporation by pass-through entities
(Attach Maryland Schedule K-1.)
Total payments and credits (Add lines 15a through 15f.)
~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~
Balance of tax due (If line 14 exceeds line 15g, enter the difference.)
Overpayment (If line 15g exceeds line 14, enter the difference.)
~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~
Total balance due (Add lines 16 and 18, or if line 18 exceeds line 17 enter the difference.)
Amount of overpayment to be applied to estimated tax for 2014
(not to exceed the net of line 17 less line 18)
~~~~~~~~~~~
~~~~~~~~~~~~~~~
Amount of overpayment TO BE REFUNDED
(Add lines 18 and 20, and subtract the total from line 17.)~~~~~~~~~~~~~~~~~~~~~~~~~
(See instructions.) Please be sure the account information is correct.
To comply with banking rules, please check here if this refund will go to an account
outside the United States. If checked, see instructions.
For the direct deposit option, complete the following information clearly and legibly:
Type of account: checking savings
Routing number (9 Digits)
Account number
NOL generated in Current Year - Carryforward 20 Years and back 2 Years
(If line 6 is less than zero, enter on line 23.) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
NAM generated in Current Year - Carried Forward/Back with the Loss on Line 23 per Section
10-205(e) (If line 6 is less than zero AND line 9 is greater than zero, enter the amount
from line 9 on line 24.) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
CORPORATION INCOMETAX RETURN500
NATIONAL MEDICAL 53-6010805
0
00
0
0
DR
AFT
(Add lines 1A(a) through 1A(g), for Columns 1 and 2.)
(Add lines 2a through 2f, for Columns 1 and 2.)
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements and to the best of my knowledgeand belief it is true, correct and complete. If prepared by a person other than taxpayer, the declaration is based on all information of which the preparer has any knowledge.
(required by law)
(three digits per box)
356303 10-11-13 COM/RAD-001 13-05
Make checks payable and mail to: Comptroller of Maryland, Revenue Administration Division110 Carroll StreetAnnapolis, Maryland 21411-0001(Write Federal Employer Identification Number on checkusing blue or black ink.)
MARYLANDFORM
2013
page 3
SCHEDULE A - COMPUTATION OF APPORTIONMENT FACTOR Column 1TOTALSWITHIN
MARYLAND
Column 2TOTALS
WITHIN ANDWITHOUT
MARYLAND
Column 3
DECIMAL FACTOR
(Column 1 ^ Column 2rounded to six places)
1A. Receipts
1B.
2.
Receipts
Property
3.
4.
5.
Payroll
Total of factors
Maryland apportionment factor
SCHEDULE B - ADDITIONAL INFORMATION REQUIRED (Attach a separate schedule if more space is necessary.)
If a multistate operation, provide the following:
SIGNATURE AND VERIFICATION:
.
.
.
(Add lines 3a and 3b, for Columns 1 and 2.) .
.
��������������� .
Yes No
Did the corporation file employer withholding tax returns/forms with the Maryland Revenue Administration Division for the last calendar year? Yes
Yes
No
No
Is this entity a multistate manufacturer with more than 25 employees? If so, complete and attach Form 500MC to your Form 500
Yes No
Yes No
|
|
CODE NUMBERS
Name FEIN
(Applies only to multistate corporations. See instructions.)
NOTE: Special apportionment formulas are required for rental/leasing,financial institutions, transportation and manufacturing companies.
a.
b.
c.
d.
e.
f.
g.
h.
Gross receipts or sales less returns and allowances | |
Dividends
Interest
Gross rents
Gross royalties
~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~
Capital gain net income
Other income (Attach schedule.)
Total receipts
~~~~~~~~~~~~~~~~
~~~~~~~~~~~~
| |
Enter the same factor shown on line 1A, Column 3.
Disregard this line if special apportionment formula used ~
a.
b.
c.
d.
e.
f.
g.
a.
b.
c.
Inventory
Machinery and equipment
Buildings
Land
~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~
Other tangible assets (Attach schedule.)
Rent expense capitalized (multiplied by eight)
Total property
~~~~~~~~
~~~~~~
~ | |
Compensation of officers
Other salaries and wages
Total payroll
~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~
~ | |
(Add entries in Column 3.) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Divide line 4 by four for three-factor formula, or by the number of factors used if
special apportionment formula required. (If factor is zero, enter .000001 on line 11 page 2.)
1. Telephone number of corporation tax department:
2.
3.
4.
5.
6.
7.
8.
Address of principal place of business in Maryland (if other than indicated on page 1):
Brief description of operations in Maryland:
Has the Internal Revenue Service made adjustments (for a tax year in which a Maryland return was required)
that were not previously reported to the Maryland Revenue Administration Division? ~~~~~~~~~~~~~~~~~~~~
If "yes", indicate tax year(s) here:
with a copy of the IRS adjustment report(s) under separate cover.
and submit an amended return(s) together
Is this entity part of a federal consolidated filing? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ |
|
|
Is this entity a multistate corporation that is a member of a unitary group? ~~~~~~~~~~~~~~~~~~~~~~~
~~~
Check here if you authorize your tax preparer to discuss this return with us.
Date Preparer's PTIN Officer's signature Preparer's signature
Officer's Name and Title Preparer's name, address and telephone number
CORPORATION INCOMETAX RETURN
500
§
§
§
NATIONAL MEDI 53-6010805
202-347-1895
NOT FOR PROFIT
X
XXXX
X
P01249785
CHAIRMAN MCGLADREY LLP
1861 INTERNATIONAL DRIVE, SUITE 400MCLEAN, VA 22102
703-336-6400
NATIONAL MEDICAL ASSOCIATION
PROPOSED REVISED 2013 TOTAL BUDGET
DISCUSSION VERSION
ACCT REVENUE - OPERATIONS
4031-37 DUES 175,000 110,000 80,000 40,000 20,000 30,000 60,000 10,000 5,000
5051-66 REGISTRATION & TICKET SALES 0 0 0 0 0 0 0 0 0
5051-66 REGIONAL DUES 0 0 0 0 0 0 0 0 0
4091 INTEREST 0 0 0 0 0 0 0 0 0
4,020 CONTRIBUTIONS 0 0 40,000 50,000 200,000 350,000 70,000 250,000 120,000
4,010 ADVERTISING-PHARMA 0 0 0 0 0 0 0 0 0
401X ADVERTISING-NON PHARMA 0 0 0 0 0 0 0 0 0
4051-52 EXHIBITS 0 0 0 0 0 0 0 0 0
5080-85 SUBSCRIPTIONS & ROYALTIES 7,500 4,400 2,000 500 500 2,500 0 0 0
MISC RENTAL, MAILING LIST, AND OTHER INCOME 1,500 0 0 750 1,200 600 400 0 1,500
XXX SUBLESSOR INCOME 0 0 0 0 0 0 0 0 0
TOTAL BUDGETED REVENUE 184,000 114,400 122,000 91,250 221,700 383,100 130,400 260,000 126,500
ACCT EXPENSES - OPERATIONS
7,060 ACCOUNTING SERVICES 16,000 16,000 16,000 16,000 16,000 16,000 16,000 16,000 16,000
AUDITING 0 0 0 10,000 10,000 10,000 0 0 0
7,070 ADVERTISING 83 83 83 84 84 84 84 83 83
7,078 AUDIO VISUAL 5,833 5,833 5,833 5,833 5,833 5,833 5,833 5,833 5,833
7,080 AUTO/PARKING-GROUND TRANSPORTATION 1,667 1,667 1,667 1,667 1,667 1,667 1,667 1,667 1,667
7,100 BANK CHARGES 1,667 1,667 1,667 1,667 1,667 1,667 1,667 1,667 1,667
7,110 CONSULTANTS 29,167 29,167 29,167 29,167 29,167 29,167 29,167 29,167 29,167
7,120 CONSULTANT TRAVEL 792 792 792 792 792 792 792 792 792
7,130 CONTRACTUAL/COMMISSIONS 8,333 8,333 8,333 8,334 8,334 8,334 8,334 8,333 8,333
7,135 0 0 0 0 0 0 0 0 0
7,150 CREDIT CARD FEES 4,167 4,167 4,167 4,167 4,167 4,167 4,167 4,167 4,167
7,160 DATA PROCESSING/COMPUTER SERVICES 8,000 8,000 8,000 8,000 8,000 8,000 8,000 8,000 8,000
7,170 DECORATIONS 0 0 0 0 0 0 0 0 0
7,180 DEPRECIATION & AMORTIZATION 500 500 500 500 500 500 500 500 500
7,200 EQUIPMENT RENTALS/LEASES 4,000 4,000 4,000 4,000 4,000 4,000 4,000 4,000 4,000
7,210 FACILITY RENTAL 500 500 500 500 500 500 500 500 500
7210A OFFICE RENT 16,054 16,054 16,054 16,054 16,054 16,054 16,054 16,054 16,054
7,211 EQUIPMENT PURCHASE 0 0 0 0 0 0 0 0 0
7,221 FICA 5,500 5,500 5,500 5,500 5,500 5,500 5,500 5,500 5,500
7,222 SUI 3,000 3,000 3,000 3,000 3,000 3,000 3,000 3,000 3,000
7,230 PROMOTIONAL MATERIALS/GIFTS/AWARDS 0 0 0 0 0 0 0 0 0
7,240 INDIRECT COST RECOVERY 0 0 0 0 0 0 0 0 0
7,250 INSURANCE - BUSINESS 1,350 1,350 1,350 1,350 1,350 1,350 1,350 1,350 1,350
7,262 INSURANCE - HEALTH & DENTAL 10,000 10,000 10,000 10,000 10,000 10,000 10,000 10,000 10,000
7,263 INSURANCE - LIFE 600 600 600 600 600 600 600 600 600
7,264 EMPLOYEE TRANSPORTATION SUBSIDY 2,400 2,400 2,400 2,400 2,400 2,400 2,400 2,400 2,400
7,270 INTEREST EXPENSE 2,500 0 0 0 0 0 0 0 0
7,280 INVESTMENT MANAGEMENT FEES 417 417 417 417 417 417 417 417 417
7,290 BUILDING-JANITORIAL SERVICES 0 0 0 0 0 0 0 0 0
7,300 LEGAL FEES 1,000 1,000 1,000 1,000 1,000 1,000 1,000 1,000 1,000
7,320 LICENSES/PERMITS 0 0 0 0 0 0 0 0 0
MAY 2014
BUDGET
JUNE 2014
BUDGET
JAN 2014
BUDGET
FEB 2014
BUDGET
MAR 2014
BUDGET
APR 2014
BUDGET
JULY 2014
BUDGET
AUG 2014
BUDGET
SEPT 2014
BUDGET
Page 1 of 10
NATIONAL MEDICAL ASSOCIATION
PROPOSED REVISED 2013 TOTAL BUDGET
DISCUSSION VERSION
MAY 2014
BUDGET
JUNE 2014
BUDGET
JAN 2014
BUDGET
FEB 2014
BUDGET
MAR 2014
BUDGET
APR 2014
BUDGET
JULY 2014
BUDGET
AUG 2014
BUDGET
SEPT 2014
BUDGET
7,325 MAILING LIST 0 0 0 0 0 0 0 0 0
7,330 CONFERENCES/MEETINGS/MEAL FUNCTIONS 1,000 1,000 1,000 1,000 1,000 1,000 1,000 1,000 1,000
7,335 0 0 0 0 0 0 0 0 0
7,346 0 0 0 0 0 0 0 0 0
7,350 OFFICE SUPPLIES 833 833 833 833 833 833 833 833 833
7,355 0 0 0 0 0 0 0 0 0
7,360 PENALTIES/FINES/LATE FEES 0 0 0 0 0 0 0 0 0
7,370 PENSION PLAN 1,350 1,350 1,350 1,350 1,350 1,350 1,350 1,350 1,350
7,380 PHOTOGRAPHY 0 0 0 0 0 0 0 0 0
7,390 POSTAGE 3,750 3,750 3,750 3,750 3,750 3,750 3,750 3,750 3,750
7,395 PRESS RELEASES 0 0 0 0 0 0 0 0 0
7,400 PRINTING, MAILING, & DUPLICATION 4,167 4,167 4,167 4,167 4,167 4,167 4,167 4,167 4,167
7,410 PROFESSIONAL FEES 0 0 0 0 0 0 0 0 0
7,425 ENTERTAINMENT 0 0 0 0 0 0 0 0 0
7,430 REGISTRATION FEES 0 0 0 0 0 0 0 0 0
7,440 RENT/STORAGE - FACILITY RENTAL 0 0 0 0 0 0 0 0 0
7,450 REPAIRS/MAINTENANCE 600 600 600 600 600 600 600 600 600
7,455 BUILDING-REPAIRS/MAINTENANCE/SUPPLIES 0 0 0 0 0 0 0 0 0
7,460 SALARIES/PAYROLL TAXES 66,667 66,667 66,667 66,667 66,667 66,667 66,667 66,667 66,667
7,463 0 0 0 0 0 0 0 0 0
7,470 DONATIONS/SCHOLARSHIPS 0 0 0 0 0 0 0 0 0
7,480 BUILDING - SECURITY 0 0 0 0 0 0 0 0 0
7,490 SHIPPING/DELIVERY (FEDEX/COURIER) 0 0 0 0 0 0 0 0 0
7,500 SPEAKER FEES/WRITER FEES 0 0 0 0 0 0 0 0 0
7,510 SPEAKER/WRITER TRAVEL 0 0 0 0 0 0 0 0 0
7,520 STAFF DEVELOPMENT/EMPLOYEE MORALE 0 0 0 0 0 0 0 0 0
7,530 SUBSCRIPTIONS/DUES/BOOKS/MEMBERSHIPS 115 115 115 115 115 115 115 115 115
7,542 TAXES-PERSONAL PROPERTY 0 0 0 0 0 0 0 0 0
7,551 TELEPHONE - LOCAL & LONG DISTANCE 3,083 3,083 3,083 3,083 3,083 3,083 3,083 3,083 3,083
7,560 TEMP/AGENCY FEES/PLCMNT ADS 1,633 1,633 1,633 1,633 1,633 1,633 1,633 1,633 1,633
7,580 BUILDING - TRASH REMOVAL 0 0 0 0 0 0 0 0 0
7,591 TRAVEL - AIRFARE 5,000 5,000 5,000 5,000 5,000 5,000 5,000 5,000 5,000
7,592 TRAVEL - LODGING, MEALS & OTHER 5,000 5,000 5,000 5,000 5,000 5,000 5,000 5,000 5,000
7,593 TRAVEL - OTHER 0 0 0 0 0 0 0 0 0
7,600 BUILDING - UTILITIES 0 0 0 0 0 0 0 0 0
7,700 MISCELLANEOUS/OTHER 5,000 5,000 5,000 5,000 5,000 5,000 5,000 5,000 5,000
TOTAL BUDGETED EXPENSES 221,728 219,228 219,228 229,230 229,230 229,230 219,230 219,228 219,228
NET INCOME FROM OPERATIONS (37,728) (104,828) (97,228) (137,980) (7,530) 153,870 (88,830) 40,772 (92,728)
ACCT REVENUE - CONVENTION
4031-37 DUES 0 0 0 0 0 0 0 0 0
5051-66 REGISTRATION & TICKET SALES 0 0 0 50,000 250,000 100,000 200,000 400,000 0
5051-66 REGIONAL DUES 0 0 0 0 0 0 0 0 0
4091 INTEREST 0 0 0 0 0 0 0 0 0
4,020 CONTRIBUTIONS 0 0 0 0 0 0 0 0 0
4,010 ADVERTISING-PHARMA 0 0 0 0 0 0 0 0 0
Page 2 of 10
NATIONAL MEDICAL ASSOCIATION
PROPOSED REVISED 2013 TOTAL BUDGET
DISCUSSION VERSION
MAY 2014
BUDGET
JUNE 2014
BUDGET
JAN 2014
BUDGET
FEB 2014
BUDGET
MAR 2014
BUDGET
APR 2014
BUDGET
JULY 2014
BUDGET
AUG 2014
BUDGET
SEPT 2014
BUDGET
401X ADVERTISING-NON PHARMA 0 0 0 0 0 0 0 0 0
4051-52 EXHIBITS 25,000 12,000 50,000 20,000 25,000 25,000 25,000 25,000 30,000
5080-85 SUBSCRIPTIONS & ROYALTIES 0 0 0 0 0 0 0 0 0
MISC RENTAL, MAILING LIST, AND OTHER INCOME 0 0 0 25,000 25,000 25,000 0 0 0
TOTAL BUDGETED REVENUE 25,000 12,000 50,000 95,000 300,000 150,000 225,000 425,000 30,000
ACCT EXPENSES - CONVENTION
7,060 ACCOUNTING SERVICES 0 0 0 0 0 0 0 0 0
XXXX AUDITING
7,070 ADVERTISING 83 83 83 83 83 83 83 83 83
7,078 AUDIO VISUAL 4,167 4,167 4,167 4,167 4,167 4,167 4,167 4,167 4,167
7,080 AUTO/PARKING-GROUND TRANSPORTATION 0 0 0 0 0 0 0 0 0
7,100 BANK CHARGES 83 83 83 83 83 83 83 83 83
7,110 CONSULTANTS 8,333 8,333 8,333 8,333 8,333 8,333 8,333 8,333 8,333
7,120 CONSULTANT TRAVEL 0 0 0 0 0 0 0 0 0
7,130 CONTRACTUAL/COMMISSIONS 20,833 20,833 20,833 20,833 20,833 20,833 20,833 20,833 20,833
7,135 0 0 0 0 0 0 0 0 0
7,150 CREDIT CARD FEES 1,667 1,667 1,667 1,667 1,667 1,667 1,667 1,667 1,667
7,160 DATA PROCESSING/COMPUTER SERVICES 83 83 83 83 83 83 83 83 83
7,170 DECORATIONS 0 0 0 0 0 0 20,000 0 0
7,180 DEPRECIATION & AMORTIZATION 0 0 0 0 0 0 0 0 0
7,200 EQUIPMENT RENTALS/LEASES 0 0 0 0 0 0 6,000 0 0
7,210 FACILITY RENTAL 0 0 0 0 0 0 85,000 0 0
7210A OFFICE RENT 0 0 0 0 0 0 0 0 0
7,211 EQUIPMENT PURCHASE 0 0 0 0 0 0 0 0 0
7,221 FICA 500 500 500 500 500 500 500 500 500
7,222 SUI 42 42 42 42 42 42 42 42 42
7,230 PROMOTIONAL MATERIALS/GIFTS/AWARDS 0 0 0 0 0 0 20,000 5,000 5,000
7,240 INDIRECT COST RECOVERY 0 0 0 0 0 0 0 0 0
7,250 INSURANCE - BUSINESS 0 0 0 0 0 0 0 0 0
7,262 INSURANCE - HEALTH & DENTAL 1,000 1,000 1,000 1,000 1,000 1,000 1,000 1,000 1,000
7,263 INSURANCE - LIFE 100 100 100 100 100 100 100 100 100
7,264 EMPLOYEE TRANSPORTATION SUBSIDY 0 0 0 0 0 0 0 0 0
7,270 INTEREST EXPENSE 0 0 0 0 0 0 0 0 0
7,280 INVESTMENT MANAGEMENT FEES 0 0 0 0 0 0 0 0 0
7,290 BUILDING-JANITORIAL SERVICES 0 0 0 0 0 0 0 0 0
7,300 LEGAL FEES 0 0 0 0 0 0 0 0 0
7,320 LICENSES/PERMITS 0 0 0 0 0 0 0 0 0
7,325 MAILING LIST 0 0 0 0 0 0 0 0 0
7,330 CONFERENCES/MEETINGS/MEAL FUNCTIONS 4,167 4,167 4,167 4,167 4,167 4,167 4,167 4,167 4,167
7,335 0 0 0 0 0 0 0 0 0
7,346 0 0 0 0 0 0 0 0 0
7,350 OFFICE SUPPLIES 833 833 833 833 833 833 833 833 833
7,355 0 0 0 0 0 0 0 0 0
7,360 PENALTIES/FINES/LATE FEES 0 0 0 0 0 0 0 0 0
7,370 PENSION PLAN 250 250 250 250 250 250 250 250 250
Page 3 of 10
NATIONAL MEDICAL ASSOCIATION
PROPOSED REVISED 2013 TOTAL BUDGET
DISCUSSION VERSION
MAY 2014
BUDGET
JUNE 2014
BUDGET
JAN 2014
BUDGET
FEB 2014
BUDGET
MAR 2014
BUDGET
APR 2014
BUDGET
JULY 2014
BUDGET
AUG 2014
BUDGET
SEPT 2014
BUDGET
7,380 PHOTOGRAPHY 0 0 0 0 0 0 7,000 0 0
7,390 POSTAGE 0 0 0 0 0 0 0 0 0
7,395 PRESS RELEASES 0 0 0 0 0 0 1,300 0 0
7,400 PRINTING, MAILING, & DUPLICATION 4,167 4,167 4,167 4,167 4,167 4,167 4,167 4,167 4,167
7,410 PROFESSIONAL FEES 0 0 0 0 0 0 0 0 0
7,425 ENTERTAINMENT 0 0 0 0 0 0 0 0 0
7,430 REGISTRATION FEES 83 83 83 83 83 83 83 83 83
7,440 RENT/STORAGE - FACILITY RENTAL 0 0 0 0 0 0 0 0 0
7,450 REPAIRS/MAINTENANCE 250 250 250 250 250 250 250 250 250
7,455 BUILDING-REPAIRS/MAINTENANCE/SUPPLIES 0 0 0 0 0 0 0 0 0
7,460 SALARIES/PAYROLL TAXES 6,667 6,667 6,667 6,667 6,667 6,667 6,667 6,667 6,667
7,463 0 0 0 0 0 0 0 0 0
7,470 DONATIONS/SCHOLARSHIPS 0 0 0 0 0 0 0 0 0
7,480 BUILDING - SECURITY 0 0 0 0 0 0 0 0 0
7,490 SHIPPING/DELIVERY (FEDEX/COURIER) 0 0 0 0 0 1,000 1,000 14,000 1,000
7,500 SPEAKER FEES/WRITER FEES 0 0 0 0 0 0 0 0 0
7,510 SPEAKER/WRITER TRAVEL 0 0 0 0 0 0 0 0 0
7,520 STAFF DEVELOPMENT/EMPLOYEE MORALE 0 0 0 0 0 0 0 0 0
7,530 SUBSCRIPTIONS/DUES/BOOKS/MEMBERSHIPS 0 0 0 0 0 0 0 0 0
7,542 TAXES-PERSONAL PROPERTY 0 0 0 0 0 0 0 0 0
7,551 TELEPHONE - LOCAL & LONG DISTANCE 0 0 0 0 0 0 5,000 0 0
7,560 TEMP/AGENCY FEES/PLCMNT ADS 0 0 0 0 0 0 20,000 0 0
7,580 BUILDING - TRASH REMOVAL 0 0 0 0 0 0 1,000 0 0
7,591 TRAVEL - AIRFARE 0 0 0 0 0 0 10,000 0 0
7,592 TRAVEL - LODGING, MEALS & OTHER 0 0 0 0 0 0 10,000 0 0
7,593 TRAVEL - OTHER 0 0 0 0 0 0 0 0 0
7,600 BUILDING - UTILITIES 0 0 0 0 0 0 5,000 0 0
7,700 MISCELLANEOUS/OTHER 0 0 0 0 0 0 30,000 0 0
TOTAL BUDGETED EXPENSES 53,308 53,308 53,308 53,308 53,308 54,308 274,608 72,308 59,308
NET INCOME FROM CONVENTION (28,308) (41,308) (3,308) 41,692 246,692 95,692 (49,608) 352,692 (29,308)
TOTAL NET INCOME (66,036) (146,136) (100,536) (96,288) 239,162 249,562 (138,438) 393,464 (122,036)
BEG. OPERATING ACCOUNT BALANCE 100,000 447,964 265,827 129,291 108,003 347,164 596,726 458,288 851,751
OTHER CASH ITEMS:
TRANSFER FROM BUILDING FUND 80,000 0 0 0 0 0 0 0 0
TRANSFER FROM INVESTMENT ACCOUNT 370,000 0 0 75,000 0 0 0 0 0
LEASE TERMINATION FEE 0 0 0 0 0 0 0 0 0
VARIOUS PAYABLES 2012 AND PRIOR (36,000) (36,000) (36,000) 0 0 0 0 0 0
TOTAL OTHER CASH ITEMS 414,000 (36,000) (36,000) 75,000 0 0 0 0 0
END OPERATING ACCOUNT BALANCE 447,964 265,827 129,291 108,003 347,164 596,726 458,288 851,751 729,715
BEG. BUILDING FUND BALANCE 80,000 0 0 0 0 0 0 0 0
TRANSFER TO OPERATING ACCOUNT (80,000) 0 0 0 0 0 0 0 0
END. BUILDING FUND BALANCE 0 0 0 0 0 0 0 0 0
Page 4 of 10
NATIONAL MEDICAL ASSOCIATION
PROPOSED REVISED 2013 TOTAL BUDGET
DISCUSSION VERSION
MAY 2014
BUDGET
JUNE 2014
BUDGET
JAN 2014
BUDGET
FEB 2014
BUDGET
MAR 2014
BUDGET
APR 2014
BUDGET
JULY 2014
BUDGET
AUG 2014
BUDGET
SEPT 2014
BUDGET
BEG. INVESTMENT ACCOUNT BALANCE 2,000,000 1,130,000 1,130,000 1,130,000 1,055,000 1,055,000 1,055,000 1,055,000 1,055,000
TRANSFER TO OPERATING ACCOUNT (370,000) 0 0 (75,000) 0 0 0 0 0
LOC REPAYMENT (500,000)
END. INVESTMENT ACCOUNT BALANCE 1,130,000 1,130,000 1,130,000 1,055,000 1,055,000 1,055,000 1,055,000 1,055,000 1,055,000
Page 5 of 10
NATIONAL MEDICAL ASSOCIATION
PROPOSED REVISED 2013 TOTAL BUDGET
DISCUSSION VERSION
ACCT REVENUE - OPERATIONS
4031-37 DUES
5051-66 REGISTRATION & TICKET SALES
5051-66 REGIONAL DUES
4091 INTEREST
4,020 CONTRIBUTIONS
4,010 ADVERTISING-PHARMA
401X ADVERTISING-NON PHARMA
4051-52 EXHIBITS
5080-85 SUBSCRIPTIONS & ROYALTIES
MISC RENTAL, MAILING LIST, AND OTHER INCOME
XXX SUBLESSOR INCOME
TOTAL BUDGETED REVENUE
ACCT EXPENSES - OPERATIONS
7,060 ACCOUNTING SERVICES
AUDITING
7,070 ADVERTISING
7,078 AUDIO VISUAL
7,080 AUTO/PARKING-GROUND TRANSPORTATION
7,100 BANK CHARGES
7,110 CONSULTANTS
7,120 CONSULTANT TRAVEL
7,130 CONTRACTUAL/COMMISSIONS
7,135
7,150 CREDIT CARD FEES
7,160 DATA PROCESSING/COMPUTER SERVICES
7,170 DECORATIONS
7,180 DEPRECIATION & AMORTIZATION
7,200 EQUIPMENT RENTALS/LEASES
7,210 FACILITY RENTAL
7210A OFFICE RENT
7,211 EQUIPMENT PURCHASE
7,221 FICA
7,222 SUI
7,230 PROMOTIONAL MATERIALS/GIFTS/AWARDS
7,240 INDIRECT COST RECOVERY
7,250 INSURANCE - BUSINESS
7,262 INSURANCE - HEALTH & DENTAL
7,263 INSURANCE - LIFE
7,264 EMPLOYEE TRANSPORTATION SUBSIDY
7,270 INTEREST EXPENSE
7,280 INVESTMENT MANAGEMENT FEES
7,290 BUILDING-JANITORIAL SERVICES
7,300 LEGAL FEES
7,320 LICENSES/PERMITS
25,000 40,000 60,000 655,000
0 0 0 0
0 0 0 0
0 0 0 0
40,000 0 5,000 1,125,000
0 0 0 0
0 0 0 0
0 0 0 0
300 12,000 14,000 43,700
0 0 1,000 6,950
0 0 0 0
65,300 52,000 80,000 1,830,650
16,000 16,000 16,000 192,000
0 0 0 30,000
83 83 83 1,000
5,833 5,833 5,833 69,996
1,667 1,667 1,667 20,004
1,667 1,667 1,667 20,004
29,167 29,167 29,167 350,004
792 792 792 9,504
8,333 8,333 8,333 100,000
0 0 0 0
4,167 4,167 4,167 50,004
8,000 8,000 8,000 96,000
0 0 0 0
500 500 500 6,000
4,000 4,000 4,000 48,000
500 500 500 6,000
16,054 16,054 16,054 192,648
0 0 0 0
5,500 5,500 5,500 66,000
3,000 3,000 3,000 36,000
0 0 0 0
0 0 0 0
1,350 1,350 1,350 16,200
10,000 10,000 10,000 120,000
600 600 600 7,200
2,400 2,400 2,400 28,800
0 0 0 2,500
417 417 417 5,004
0 0 0 0
1,000 1,000 1,000 12,000
0 0 0 0
OCT 2014
BUDGET
2014 PROPOSED
BUDGET TOTALS
DEC 2014
BUDGET
NOV 2014
BUDGET
Page 6 of 10
NATIONAL MEDICAL ASSOCIATION
PROPOSED REVISED 2013 TOTAL BUDGET
DISCUSSION VERSION
ACCT REVENUE - OPERATIONS7,325 MAILING LIST
7,330 CONFERENCES/MEETINGS/MEAL FUNCTIONS
7,335
7,346
7,350 OFFICE SUPPLIES
7,355
7,360 PENALTIES/FINES/LATE FEES
7,370 PENSION PLAN
7,380 PHOTOGRAPHY
7,390 POSTAGE
7,395 PRESS RELEASES
7,400 PRINTING, MAILING, & DUPLICATION
7,410 PROFESSIONAL FEES
7,425 ENTERTAINMENT
7,430 REGISTRATION FEES
7,440 RENT/STORAGE - FACILITY RENTAL
7,450 REPAIRS/MAINTENANCE
7,455 BUILDING-REPAIRS/MAINTENANCE/SUPPLIES
7,460 SALARIES/PAYROLL TAXES
7,463
7,470 DONATIONS/SCHOLARSHIPS
7,480 BUILDING - SECURITY
7,490 SHIPPING/DELIVERY (FEDEX/COURIER)
7,500 SPEAKER FEES/WRITER FEES
7,510 SPEAKER/WRITER TRAVEL
7,520 STAFF DEVELOPMENT/EMPLOYEE MORALE
7,530 SUBSCRIPTIONS/DUES/BOOKS/MEMBERSHIPS
7,542 TAXES-PERSONAL PROPERTY
7,551 TELEPHONE - LOCAL & LONG DISTANCE
7,560 TEMP/AGENCY FEES/PLCMNT ADS
7,580 BUILDING - TRASH REMOVAL
7,591 TRAVEL - AIRFARE
7,592 TRAVEL - LODGING, MEALS & OTHER
7,593 TRAVEL - OTHER
7,600 BUILDING - UTILITIES
7,700 MISCELLANEOUS/OTHER
TOTAL BUDGETED EXPENSES
NET INCOME FROM OPERATIONS
ACCT REVENUE - CONVENTION
4031-37 DUES
5051-66 REGISTRATION & TICKET SALES
5051-66 REGIONAL DUES
4091 INTEREST
4,020 CONTRIBUTIONS
4,010 ADVERTISING-PHARMA
OCT 2014
BUDGET
2014 PROPOSED
BUDGET TOTALS
DEC 2014
BUDGET
NOV 2014
BUDGET
0 0 0 0
1,000 1,000 1,000 12,000
0 0 0 0
0 0 0 0
833 833 833 9,996
0 0 0 0
0 0 0 0
1,350 1,350 1,350 16,200
0 0 0 0
3,750 3,750 3,750 45,000
0 0 0 0
4,167 4,167 4,167 50,004
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
600 600 600 7,200
0 0 0 0
66,667 66,667 66,667 800,004
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
115 115 115 1,380
0 0 0 0
3,083 3,083 3,083 36,996
1,633 1,633 1,633 19,596
0 0 0 0
5,000 5,000 5,000 60,000
5,000 5,000 5,000 60,000
0 0 0 0
0 0 0 0
5,000 5,000 5,000 60,000
219,228 219,228 219,228 2,663,244
(153,928) (167,228) (139,228) (832,594)
0 0 0 0
0 0 0 1,000,000
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Page 7 of 10
NATIONAL MEDICAL ASSOCIATION
PROPOSED REVISED 2013 TOTAL BUDGET
DISCUSSION VERSION
ACCT REVENUE - OPERATIONS401X ADVERTISING-NON PHARMA
4051-52 EXHIBITS
5080-85 SUBSCRIPTIONS & ROYALTIES
MISC RENTAL, MAILING LIST, AND OTHER INCOME
TOTAL BUDGETED REVENUE
ACCT EXPENSES - CONVENTION
7,060 ACCOUNTING SERVICES
XXXX AUDITING
7,070 ADVERTISING
7,078 AUDIO VISUAL
7,080 AUTO/PARKING-GROUND TRANSPORTATION
7,100 BANK CHARGES
7,110 CONSULTANTS
7,120 CONSULTANT TRAVEL
7,130 CONTRACTUAL/COMMISSIONS
7,135
7,150 CREDIT CARD FEES
7,160 DATA PROCESSING/COMPUTER SERVICES
7,170 DECORATIONS
7,180 DEPRECIATION & AMORTIZATION
7,200 EQUIPMENT RENTALS/LEASES
7,210 FACILITY RENTAL
7210A OFFICE RENT
7,211 EQUIPMENT PURCHASE
7,221 FICA
7,222 SUI
7,230 PROMOTIONAL MATERIALS/GIFTS/AWARDS
7,240 INDIRECT COST RECOVERY
7,250 INSURANCE - BUSINESS
7,262 INSURANCE - HEALTH & DENTAL
7,263 INSURANCE - LIFE
7,264 EMPLOYEE TRANSPORTATION SUBSIDY
7,270 INTEREST EXPENSE
7,280 INVESTMENT MANAGEMENT FEES
7,290 BUILDING-JANITORIAL SERVICES
7,300 LEGAL FEES
7,320 LICENSES/PERMITS
7,325 MAILING LIST
7,330 CONFERENCES/MEETINGS/MEAL FUNCTIONS
7,335
7,346
7,350 OFFICE SUPPLIES
7,355
7,360 PENALTIES/FINES/LATE FEES
7,370 PENSION PLAN
OCT 2014
BUDGET
2014 PROPOSED
BUDGET TOTALS
DEC 2014
BUDGET
NOV 2014
BUDGET
0 0 0 0
0 0 0 237,000
0 0 0 0
0 0 0 75,000
0 0 0 1,312,000
0 0 0 0
0
83 83 83 1,000
4,167 4,167 4,167 50,000
0 0 0 0
83 83 83 1,000
8,333 8,333 8,333 100,000
0 0 0 0
20,833 20,833 20,833 250,000
0 0 0 0
1,667 1,667 1,667 20,000
83 83 83 1,000
0 0 0 20,000
0 0 0 0
0 0 0 6,000
0 0 0 85,000
0 0 0 0
0 0 0 0
500 500 500 6,000
42 42 42 500
0 0 0 30,000
0 0 0 0
0 0 0 0
1,000 1,000 1,000 12,000
100 100 100 1,200
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
4,167 4,167 4,167 50,000
0 0 0 0
0 0 0 0
833 833 833 10,000
0 0 0 0
0 0 0 0
250 250 250 3,000
Page 8 of 10
NATIONAL MEDICAL ASSOCIATION
PROPOSED REVISED 2013 TOTAL BUDGET
DISCUSSION VERSION
ACCT REVENUE - OPERATIONS7,380 PHOTOGRAPHY
7,390 POSTAGE
7,395 PRESS RELEASES
7,400 PRINTING, MAILING, & DUPLICATION
7,410 PROFESSIONAL FEES
7,425 ENTERTAINMENT
7,430 REGISTRATION FEES
7,440 RENT/STORAGE - FACILITY RENTAL
7,450 REPAIRS/MAINTENANCE
7,455 BUILDING-REPAIRS/MAINTENANCE/SUPPLIES
7,460 SALARIES/PAYROLL TAXES
7,463
7,470 DONATIONS/SCHOLARSHIPS
7,480 BUILDING - SECURITY
7,490 SHIPPING/DELIVERY (FEDEX/COURIER)
7,500 SPEAKER FEES/WRITER FEES
7,510 SPEAKER/WRITER TRAVEL
7,520 STAFF DEVELOPMENT/EMPLOYEE MORALE
7,530 SUBSCRIPTIONS/DUES/BOOKS/MEMBERSHIPS
7,542 TAXES-PERSONAL PROPERTY
7,551 TELEPHONE - LOCAL & LONG DISTANCE
7,560 TEMP/AGENCY FEES/PLCMNT ADS
7,580 BUILDING - TRASH REMOVAL
7,591 TRAVEL - AIRFARE
7,592 TRAVEL - LODGING, MEALS & OTHER
7,593 TRAVEL - OTHER
7,600 BUILDING - UTILITIES
7,700 MISCELLANEOUS/OTHER
TOTAL BUDGETED EXPENSES
NET INCOME FROM CONVENTION
TOTAL NET INCOME
BEG. OPERATING ACCOUNT BALANCE
OTHER CASH ITEMS:
TRANSFER FROM BUILDING FUND
TRANSFER FROM INVESTMENT ACCOUNT
LEASE TERMINATION FEE
VARIOUS PAYABLES 2012 AND PRIOR
TOTAL OTHER CASH ITEMS
END OPERATING ACCOUNT BALANCE
BEG. BUILDING FUND BALANCE
TRANSFER TO OPERATING ACCOUNT
END. BUILDING FUND BALANCE
OCT 2014
BUDGET
2014 PROPOSED
BUDGET TOTALS
DEC 2014
BUDGET
NOV 2014
BUDGET
0 0 0 7,000
0 0 0 0
0 0 0 1,300
4,167 4,167 4,167 50,000
0 0 0 0
0 0 0 0
83 83 83 1,000
0 0 0 0
250 250 250 3,000
0 0 0 0
6,667 6,667 6,667 80,000
0 0 0 0
0 0 0 0
0 0 0 0
1,000 1,000 0 19,000
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 5,000
0 0 0 20,000
0 0 0 1,000
0 0 0 10,000
0 0 0 10,000
0 0 0 0
0 0 0 5,000
0 0 0 30,000
54,308 54,308 53,308 889,000
(54,308) (54,308) (53,308) 423,000
(208,236) (221,536) (192,536) (409,594)
729,715 521,479 299,942 100,000
0 0 0 80,000
0 0 0 445,000
0 0 0 0
0 0 0 (108,000)
0 0 0 417,000
521,479 299,942 107,406 107,406
0 0 0 80,000
0 0 0 (80,000)
0 0 0 0
Page 9 of 10
NATIONAL MEDICAL ASSOCIATION
PROPOSED REVISED 2013 TOTAL BUDGET
DISCUSSION VERSION
ACCT REVENUE - OPERATIONS
BEG. INVESTMENT ACCOUNT BALANCE
TRANSFER TO OPERATING ACCOUNT
LOC REPAYMENT
END. INVESTMENT ACCOUNT BALANCE
OCT 2014
BUDGET
2014 PROPOSED
BUDGET TOTALS
DEC 2014
BUDGET
NOV 2014
BUDGET
1,055,000 1,055,000 1,055,000 2,000,000
0 0 0 (445,000)
(500,000)
1,055,000 1,055,000 1,055,000 1,055,000
Page 10 of 10
% of
Revenue Total Revenue
Operations 1,830,650$ 58%
Convention 1,312,000 42%
Total Revenue 3,142,650 100%
Expenses:
Operations 2,663,244$ 85%
Convention 889,000 28%
Total Expenses 3,552,244 113%
Net Surplus (Deficit) (409,594)$ -13%
National Medical Association
FY 2014 Budget
Board of Directors Orientation Notebook
Section 7:
REFERENCES 1. Summary of Parliamentary Procedures 2. Additional Resources
ADDITIONAL RESOURCES: Blue Avocado/Board Café www.blueavocado.org/category/topic/boardcafe Board Source www.boardsource.org Foundation Center www.foundationcenter.org Free toolkit for boards www.managementhelp.org/boards/boards.htm
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