Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990.
lBullet Information about Schedule I (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public
Inspection
Name of the organization
Houston Academy of Medicine
 
Employer identification number
74-1277657
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient
that received more than $5,000. Part II can be duplicated if additional space is needed.
(a) Name and address of organization
or government
(b) EIN (c) IRC section
if applicable
(d) Amount of cash grant (e) Amount of non-cash
assistance
(f) Method of valuation
(book, FMV, appraisal,
other)
(g) Description of
non-cash assistance
(h) Purpose of grant
or assistance
(1) Alliance of Border Collaborat
5400 Suncrest 7D
El Paso,TX79912
27-1747560 501(c)(3) 11,734 0     Outreach services
(2) Assoc Academic Health Librs
2150 N 107th Street Ste 205
Seattle,WA98133
36-4072494 501(c)(3) 130,000 0     Outreach Services
(3) Blue Triangle Multi Cult Assn
4005 McGowen St
Houston,TX77004
76-0578155 501(c)(3) 8,326 0     Outreach services
(4) Greather Houston Area Health
4014 Market Ste W111
Houston,TX77020
76-0437727 501(c)(3) 18,080 0     Outreach services
(5) JP McGovern Museum HealthMed
1515 Hermann Drive
Houston,TX77030
74-6106357 501(c)(3) 160,000 0     General support
(6) Louisiana St Univ Health Ctr
403 Bolivar St
New Orleans,LA70112
72-6087770 Gov't 13,596 0     Outreach/Technology
(7) Louisiana St Univ Health Ctr
PO Box 33932
Shreveport,LA71103
72-0702002 Gov't 14,099 0     Outreach/Technology
(8) Oklahoma State University CHS
1111 W 17th Street
Tulsa,OK74128
73-6017987 Gov't 13,622 0     Improve Technology
(9) Pawnee Nation College
861 Little Dee Dr
Pawnee,OK74058
83-0459992 501(c)(3) 16,635 0     Outreach services
(10) Scott & White HC Fdn-Haines L
2401 S 31st St
Temple,TX76508
27-3513154 501(c)(3) 13,477 0     Outreach services
(11) South TX Independent Sch Dist
100 Med High Dr
Mercedes,TX78570
74-1507696 501(c)(3) 19,845 0     Outreach services
(12) Texas A&M Health Science Ctr
400 Harvey Mitchell Parkway S
College Station,TX77845
74-2907553 501(c)(3) 16,189 0     Outreach Services
(13) Texas Tech University HSC
3601 4th StreetMS 7781
Lubbock,TX79430
75-6002622 501(c)(3) 27,053 0     Outreach services
(14) Tulane University Health Sci
1430 Tulane Ave
New Orleans,LA70112
72-0423889 501(c)(3) 8,335 0     Outreach services
(15) Univeristy of Oklahoma HSC
PO Box 26901
Oklahoma City,OK73126
73-6017987 Gov't 27,490 0     Outreach/Technology
(16) University of Arkansas Med Sc
4301 Markham Slot 586
Little Rock,AR72205
71-6046242 Gov't 19,453 0     Outreach Services
(17) University of New Mexico
1 Univ of New Mexico Dr
Albuquerque,NM87131
85-6000642 Gov't 41,017 0     Outreach services
(18) University of North TX HSC FW
3500 Camp Bowie
Forth Worth,TX76107
75-6064033 501(c)(3) 14,875 0     Outreach/Technology
(19) University of TX Health Sci
PO Box 1898
San Antonio,TX78297
74-1586031 501(c)(3) 16,449 0     Outreach services
(20) University of TX SW Med Ctr
PO Box 841765
Dallas,TX75284
75-6002868 501(c)(3) 15,650 0     Outreach/Technology
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
20
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
0
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2015
Page 2

Schedule I (Form 990) 2015
Page 2
Part III
Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.
(a) Type of grant or assistance (b) Number of
recipients
(c) Amount of
cash grant
(d) Amount of
non-cash assistance
(e) Method of valuation (book,
FMV, appraisal, other)
(f) Description of non-cash assistance
(1)
(2)
(3)
(4)
(5)
(6)
(7)
Part IV
Supplemental Information. Provide the information required in Part I, line 2, Part III, column (b), and any other additional information.
Return Reference Explanation
Grantmaker's Description of How Grants are Used Houston Academy of Medicine voluntarily supports organizations that have a close relationship with the organization. The Grantee has a monthly review of Financial Statements and annual presentation to the Board. All applicants are required to submit detailed budget with their proposal that clearly delineates, by specific category, all expenses related to the project. Most of the awards are cost reimbursements. Library funding recipients are required to submit reports on project progress and invoices detailing their expenses for the reporting period. The invoice is matched with the original budget submission to ensure that there are no deviations in target population and/or project plan and that all funds are spent to fulfill the project objectives.
Schedule I (Form 990) 2015



Additional Data


Software ID: 15000324
Software Version: 2015v2.0