Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for the latest information.
| (i) Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 10 above (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
|
Total |
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Calendar year (or fiscal year beginning in) ![]() |
(a) 2014 | (b) 2015 | (c) 2016 | (d) 2017 | (e) 2018 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | 2,020,785 | 1,611,125 | 1,120,194 | 788,160 | 930,821 | 6,471,085 |
| 2 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.... | ||||||
| 3 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 4 | Total. Add lines 1 through 3 | 2,020,785 | 1,611,125 | 1,120,194 | 788,160 | 930,821 | 6,471,085 |
| 5 | The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f).. | 3,411,466 | |||||
| 6 | Public support. Subtract line 5 from line 4. | 3,059,619 | |||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2014 | (b) 2015 | (c) 2016 | (d) 2017 | (e) 2018 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 2,020,785 | 1,611,125 | 1,120,194 | 788,160 | 930,821 | 6,471,085 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | 6,427 | 6,982 | 7,521 | 5,477 | 5,000 | 31,407 |
| 9 | Net income from unrelated business activities, whether or not the business is regularly carried on.. | ||||||
| 10 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.).. | ||||||
| 11 | Total support. Add lines 7 through 10 | 6,502,492 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2014 | (b) 2015 | (c) 2016 | (d) 2017 | (e) 2018 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | ||||||
| 2 | Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose | ||||||
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513 ..... | ||||||
| 4 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... | ||||||
| 5 | The value of services or facilities furnished by a governmental unit to the organization without charge | ||||||
| 6 | Total. Add lines 1 through 5 | ||||||
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons | ||||||
| b | Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year. | ||||||
| c | Add lines 7a and 7b.. | ||||||
| 8 | Public support. (Subtract line 7c from line 6.) | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2014 | (b) 2015 | (c) 2016 | (d) 2017 | (e) 2018 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | ||||||
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | ||||||
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | ||||||
| 11 | Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on. | ||||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) .. | ||||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | ||||||
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e |
Discount claimed for blockage or other factors (explain in detail in Part VI): |
|||||
| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). | 4 | ||||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | ||||
| 6 | Multiply line 5 by .035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | ||
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
||
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | ||
| 4 Amounts paid to acquire exempt-use assets | ||
| 5 Qualified set-aside amounts (prior IRS approval required) | ||
| 6 Other distributions (describe in Part VI). See instructions | ||
| 7Total annual distributions. Add lines 1 through 6. | ||
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
||
| 9 Distributable amount for 2018 from Section C, line 6 | ||
| 10 Line 8 amount divided by Line 9 amount | ||
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2018 |
(iii) Distributable Amount for 2018 |
|
|---|---|---|---|---|
|
1
Distributable amount for 2018 from Section C, line 6 |
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|
2
Underdistributions, if any, for years prior to 2018 (reasonable cause required-- explain in Part VI). See instructions. |
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| 3 Excess distributions carryover, if any, to 2018: | ||||
| a From 2013....... | ||||
| b From 2014....... | ||||
| c From 2015....... | ||||
| d From 2016....... | ||||
| e From 2017....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2018 distributable amount | ||||
|
i
Carryover from 2013 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | ||||
| 4Distributions for 2018 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2018 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from 4. | ||||
|
5
Remaining underdistributions for years prior to 2018, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
6
Remaining underdistributions for 2018. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
7 Excess distributions carryover to 2019. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2014...... | ||||
| b Excess from 2015..... | ||||
| c Excess from 2016..... | ||||
| d Excess from 2017..... | ||||
| e Excess from 2018..... | ||||
| Facts And Circumstances Test |
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| Return Reference | Explanation |
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| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| FORM 990 | THE ORGANIZATION HAS A CO-EMPLOYMENT ARRANGEMENT WITH A THIRD-PARTY ENTITY WHEREBY THE THIRD-PARTY IS THE EMPLOYER OF RECORD AND THE ORGANIZATION IS THE SITE EMPLOYER. DURING 2018, THE ORGANIZATION HAD 93 EMPLOYEES. |
| FORM 990, PAGE 2, PART III, LINE 4A | INTEGRATED INFORMATION TECHNOLOGY: NCHA MANAGES A SHARED AND INTEGRATED IT PLATFORM FOR PARTNER MEMBERS WHO WISH TO USE THE PLATFORM. NCHA EMPLOYS A DIRECTOR OF INFORMATION TECHNOLOGY TO OVERSEE ALL PROGRAM ACTIVITIES AND HAS A SERVICES AGREEMENT WITH A HIPAA-COMPLIANT EXTERNAL HOSTING COMPANY FOR HARDWARE INCLUDING DATABASE AND CITRIX SERVERS, SYSTEM DESIGN AND MAINTENANCE, AND ENGINEERING SUPPORT. IN ADDITION TO BASIC E-MAIL, OFFICE PRODUCTIVITY SOFTWARE, GENERAL LEDGER AND PAYROLL PROGRAMS, NCHA HOSTS A SHARED PRACTICE MANAGEMENT AND ELECTRONIC HEALTH RECORD SOLUTION (GE CENTRICITY PRACTICE SOLUTION) THAT SUPPORTS THE INTEGRATED HEALTH CARE PROGRAMS OPERATED BY ALLIANCE PARTNER ORGANIZATIONS. OPERATING COSTS ARE SHARED ON A PRO-RATED BASIS DETERMINED BY NUMBER OF ORGANIZATIONAL USERS. |
| FORM 990, PAGE 2, PART III, LINE 4B | REGIONAL COLLABORATIVE CARE ORGANIZATION (RCCO-CARE MANAGEMENT): NCHA PROVIDES CARE MANAGEMENT SERVICES IN TWO OF SEVEN REGIONS IN COLORADO UNDER DELEGATION AGREEMENTS WITH COLORADO ACCESS AND ROCKY MOUNTAIN HEALTH PLANS. NCHA IS COMPENSATED ON A PER CAPITA BASIS TO PROVIDE CARE MANAGEMENT SERVICES TO ATTRIBUTED MEDICAID AND MEDICAID/ MEDICARE BENEFICIARIES. NCHA IS RESPONSIBLE FOR AN AVERAGE POPULATION OF 26,461 MEMBERS. THE PERFORMANCE METRICS OF THE CARE MANAGEMENT PROGRAM INCLUDE: REDUCING EMERGENCY DEPARTMENT UTILIZATION; REDUCING HOSPITAL ADMISSION AND READMISSION; INCREASING THE RATE OF POSTPARTUM VISITS; INCREASING WELL CHILD CHECKS, REDUCING THE USE OF HIGH COST/LOW YIELD DIAGNOSTIC IMAGING, AND INCREASING YOUTH DEPRESSION SCREENING. AT THE CURRENT ENROLLMENT AND CARE MANAGEMENT ACTIVITY LEVEL, THE OVERALL COST MANAGED, IF SUSTAINED IS POTENTIALLY 3,668,016. CURRENTLY, THE CARE MANAGEMENT TEAM HAS A TOTAL OF 36 POSITIONS, 2 OF THESE ARE FUNDED THROUGH OTHER SOURCES. |
| FORM 990, PAGE 2, PART III, LINE 4C | THE COLORADO HEALTH FOUNDATION - HEALTHY RE-1 WELD COUNTY SCHOOL DISTRICT 1 (RE-1), LOCATED IN SOUTH WELD COUNTY, SERVES THE SMALL, RURAL TOWNS OF GILCREST, PLATTEVILLE, AND LASALLE. AS OF 2018, THE DIVERSE STUDENT BODY CONSISTED OF ROUGHLY 2000 STUDENTS IN GRADES PK- 12. THE DISTRICT CONSISTS OF ONE HIGH SCHOOL, TWO MIDDLE SCHOOLS, AND THREE ELEMENTARY SCHOOLS, WITH 59% OF CHILDREN REPRESENTING A MINORITY RACE, AND 51% OF CHILDREN QUALIFYING FOR FREE AND REDUCED LUNCH. THE SMALL, RURAL TOWNS OF RE-1 ARE ISOLATED FROM THE REST OF THE COUNTY AND ARE LACKING RESOURCES KEY TO A HEALTHY COMMUNITY, SUCH AS GROCERY STORES, PUBLIC TRANSPORTATION, AND HEALTH CLINICS. THE NORTH COLORADO HEALTH ALLIANCE HAS BEEN WORKING IN PARTNERSHIP WITH RE-1 FOR SCHOOL HEALTH AND WELLNESS SINCE 2013. IN 2016, NCHA RECEIVED PLANNING FUNDING FOR TWO YEARS TO CREATE A COMPREHENSIVE DISTRICT HEALTH AND WELLNESS PLAN, BUILDING OFF THE STRONG FOUNDATION THAT ALREADY EXISTED. THROUGHOUT THE COURSE OF THE PLANNING GRANT, THE FOLLOWING GOALS WERE ACCOMPLISHED: 1) THE NUTRITION AND PHYSICAL ADVISORY COUNCIL (NPAAC) WAS EXPANDED AND STRENGTHENED 2) ALL HEALTH AND WELLNESS EFFORTS WERE ALIGNED WITH THE WHOLE SCHOOL, WHOLE CHILD, WHOLE COMMUNITY (WSCC) MODEL 3) A COMPREHENSIVE ASSESSMENT OF DISTRICT HEALTH EFFORTS AND ENVIRONMENT WAS CONDUCTED 4) SCHOOL-BASED WELLNESS TEAMS WERE FORMED AND IMPLEMENTED 5) A COMPREHENSIVE DISTRICT HEALTH AND WELLNESS PLAN WAS WRITTEN. |
| FORM 990, PAGE 2, PART III, LINE 4D | OTHER PROGRAM ACCOMPLISHMENTS INCLUDE A PROJECT TO CONTINUE TO EXPAND ACCESS TO COMPREHENSIVE INTEGRATED HEALTH CARE FOR ALL RESIDENTS OF NORTHERN COLORADO FUNDED BY A GRANT FROM THE COLORADO HEALTH FOUNDATION, AND A PROGRAM TO PROVIDE A MEDICAL VAN TO TRANSPORT LOW INCOME INDIVIDUALS TO SERVICE LOCATIONS. |
| FORM 990, PAGE 6, PART VI, LINE 6 | THE ORGANIZATION'S GOVERNING DOCUMENTS PROVIDE FOR ONE CLASS OF VOTING MEMBERSHIP. MEMBERSHIP DOES NOT CREATE ANY OWNERSHIP RIGHTS TO OR INTEREST IN THE INCOME OR ASSETS OF THE ORGANIZATION. |
| FORM 990, PAGE 6, PART VI, LINE 7A | THE ONE CLASS OF VOTING STOCK INCLUDES THE POWER TO APPOINT AND REMOVE ONE DIRECTOR EACH AND TO ELECT OR REMOVE OTHER ORGANIZATIONS TO VOTING MEMBERSHIP. |
| FORM 990, PAGE 6, PART VI, LINE 11B | A COPY OF THE FORM 990 IS REVIEWED BY THE CFO AND WITH THE BOARD OF DIRECTORS PRIOR TO FILING IT WITH THE IRS. |
| FORM 990, PAGE 6, PART VI, LINE 12C | SECTION 5.13 OF THE BYLAWS RELATING TO CONFLICT OF INTEREST IS MONITORED AT THE BOARD OF DIRECTORS LEVEL. IT IS ADDRESSED IN BOARD MEETINGS AND MEMBERS ARE ASKED TO ACKNOWLEDGE ANY CONFLICT OF INTEREST AS MATTERS ARE DISCUSSED. THIS IS DONE CONSISTENTLY. |
| FORM 990, PAGE 6, PART VI, LINE 15A | THE CEO'S COMPENSATION IS AGREED UPON BY THE BOARD OF DIRECTORS. EVERY TWO YEARS, THE ORGANIZATION HAS ACCESS TO DATA FROM THE FEDERAL, STATE, AND LOCAL LEVELS TO RE-EVALUATE THE APPROPRIATENESS OF THE COMPENSATION. THIS DATA IS COLLECTED FROM ORGANIZATIONS SIMILAR TO NCHA. |
| FORM 990, PAGE 6, PART VI, LINE 15B | KEY EMPLOYEE COMPENSATION IS AGREED UPON BY THE BOARD OF DIRECTORS AND THE CEO. EVERY TWO YEARS, THE ORGANIZATION HAS ACCESS TO DATA FROM THE FEDERAL, STATE, AND LOCAL LEVELS TO RE-EVALUATE THE APPROPRIATENESS OF THE COMPENSATION. THIS DATA IS COLLECTED FROM ORGANIZATIONS SIMILAR TO NCHA. |
| FORM 990, PAGE 6, PART VI, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| Software ID: | |
| Software Version: |