TY 2018 Form 990

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow

Attach to Form 990 or Form 990-EZ.
right arrow

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization

HEALTHVISIONS MIDWEST INC

Employer identification number

35-2064919

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions.

The organization is not a private foundation because it is: (For lines 1 through 12, check only one box.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990 or 990-EZ).)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). 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 section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

An organization that normally receives: (1) more than 331/3% 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 331/3% 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 section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

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 section 509(a)(3). Check the box in lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ...............................

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i) Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2018

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv), 170(b)(1)(A)(vi), and 170(b)(1)(A)(ix)
(Complete only if you checked the box on line 5, 7, 8, or 9 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.)

Section A. Public Support

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.") ..	2,053,998	1,896,975	1,781,250	2,053,038	1,704,539	9,489,800
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	2,053,998	1,896,975	1,781,250	2,053,038	1,704,539	9,489,800
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)..						2,295,483
6	Public support. Subtract line 5 from line 4.						7,194,317

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(f) Total
7	Amounts from line 4..	2,053,998	1,896,975	1,781,250	2,053,038	1,704,539	9,489,800
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...	20,706	16,727	16,796	27,231	36,764	118,224
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						9,608,024

Gross receipts from related activities, etc. (see instructions) ..................

818,942

First five years. 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 stop here........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2018 (line 6, column (f) divided by line 11, column (f)) .........

74.880 %

Public support percentage for 2017 Schedule A, Part II, line 14 ...............

65.890 %

16a

33 1/3% support test—2018. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2017. 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 stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2018. 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 stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2017. 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 stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow

Schedule A (Form 990 or 990-EZ) 2018

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 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.)

Section A. Public Support

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.)

Section B. Total Support

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.)..

First five years. 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 stop here............................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2018 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2017 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2018 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2017 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2018. 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 stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2017. 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 stop here. The organization qualifies as a publicly supported organization .... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990 or 990-EZ) 2018

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked 12a of Part I, complete Sections A and B. If you checked 12b of Part I, complete Sections A and C. If you checked 12c of Part I, complete Sections A, D, and E. If you checked 12d of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 12a or 12b in Part I, answer (b) and (c) below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined in line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Schedule A (Form 990 or 990-EZ) 2018

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?

11a

A family member of a person described in (a) above?

11b

A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer (a) and (b) below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer (a) and (b) below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.

Schedule A (Form 990 or 990-EZ) 2018

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
1	Net short-term capital gain	1
2	Recoveries of prior-year distributions	2
3	Other gross income (see instructions)	3
4	Add lines 1 through 3	4
5	Depreciation and depletion	5
6	Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions)	6
7	Other expenses (see instructions)	7
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8

	Section B - Minimum Asset Amount		(A) Prior Year	(B) Current Year (optional)
1	Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year):	1
a	Average monthly value of securities	1a
b	Average monthly cash balances	1b
c	Fair market value of other non-exempt-use assets	1c
d	Total (add lines 1a, 1b, and 1c)	1d
e	Discount claimed for blockage or other factors (explain in detail in Part VI):
2	Acquisition indebtedness applicable to non-exempt use assets	2
3	Subtract line 2 from line 1d	3
4	Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions).	4
5	Net value of non-exempt-use assets (subtract line 4 from line 3)	5
6	Multiply line 5 by .035	6
7	Recoveries of prior-year distributions	7
8	Minimum Asset Amount (add line 7 to line 6)	8

	Section C - Distributable Amount		Current Year
1	Adjusted net income for prior year (from Section A, line 8, Column A)	1
2	Enter 85% of line 1	2
3	Minimum asset amount for prior year (from Section B, line 8, Column A)	3
4	Enter greater of line 2 or line 3	4
5	Income tax imposed in prior year	5
6	Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions)	6

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990 or 990-EZ) 2018

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations (continued)

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
2 Underdistributions, if any, for years prior to 2018 (reasonable cause required-- explain in Part VI). See instructions.
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)
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.
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.
7 Excess distributions carryover to 2019. Add lines 3j and 4c.
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.....

Schedule A (Form 990 or 990-EZ) (2018)

Schedule A (Form 990 or 990-EZ) 2018

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990 or 990-EZ) 2018

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990, 990-EZ,
or 990-PF)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Name of the organization

HEALTHVISIONS MIDWEST INC

Employer identification number

35-2064919

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not 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 General Rule or a Special Rule.
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 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 an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Don't complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... Arrow Bullet

Caution. An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,
990-EZ, or 990-PF), but it must 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 990PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.

Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2018)

Schedule B (Form 990, 990-EZ, or 990-PF) (2018) Page 2

Name of organization HEALTHVISIONS MIDWEST INC

Part I	Contributors (See instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	,	$ RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Page 3

Name of organization HEALTHVISIONS MIDWEST INC		Employer identification number 35-2064919

Part II	Noncash Property (See instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Page 4


Name of organization HEALTHVISIONS MIDWEST INC			Employer identification number 35-2064919
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose 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. from Part I

(b) Purpose 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. from Part I

(b) Purpose 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. from Part I

(b) Purpose 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

Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet

Attach to Form 990.
SchDMd Bullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

HEALTHVISIONS MIDWEST INC

Employer identification number

35-2064919

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	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? ............

Yes No

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? ...................................

Yes No

Part II

Conservation Easements. Complete if the organization answered "Yes" on 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) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

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.


a	Total number of conservation easements ......................	2a
b	Total acreage restricted by conservation easements ....................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register ...	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

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)? .............................

Yes No

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.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on 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:

(i)

Revenue included on Form 990, Part VIII, line 1 ......................... SchDMd Bullet

(ii)

Assets included in Form 990, Part X ............................... SchDMd Bullet

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:

Revenue included on Form 990, Part VIII, line 1 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 52283D

Schedule D (Form 990) 2018

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

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

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

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?...

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported 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? ....................................

Yes No


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
c	Beginning balance .............................	1c
d	Additions during the year ............................	1d
e	Distributions during the year ..........................	1e
f	Ending balance ................................	1f

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....

Part V

Endowment Funds. Complete if the organization answered "Yes" on Form 990, Part IV, line 10.

		(a)Current year	(b)Prior year	(c)Two years back	(d)Three years back	(e)Four years back

1a	Beginning of year balance ....
b	Contributions ...
c	Net investment earnings, gains, and losses
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....
g	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 SchDMd Bullet

Permanent endowment SchDMd Bullet

Temporarily restricted endowment SchDMd Bullet

The percentages on 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:

Yes

(i) unrelated organizations .................

3a(i)

(ii) related organizations .................

3a(ii)

If "Yes" on 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.

Part VI

Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b) Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value

1a	Land .....
b	Buildings ....
c	Leasehold improvements
d	Equipment ....	116,750	94,127	22,623
e	Other .....
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				22,623

Schedule D (Form 990) 2018

Page 3

Part VII

InvestmentsOther Securities. Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)	(b) Book value	(c) Method of valuation: Cost or end-of-year market value
(1) Financial derivatives.........
(2) Closely-held equity interests........
(3)Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

InvestmentsProgram Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment	(b) Book value	(c) Method of valuation: Cost or end-of-year market value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........

Part X

Other Liabilities. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability	(b) Book value
(1) Federal income taxes
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)
2. 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

Schedule D (Form 990) 2018

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......			1	1,974,198
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a	-132,274
b	Donated services and use of facilities .........	2b	42,983
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d .....................			2e	-89,291
3	Subtract line 2e from line 1..................			3	2,063,489
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a	3,269
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b....................			4c	3,269
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......			5	2,066,758

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........			1	1,829,720
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities .........	2a	42,983
b	Prior year adjustments ............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d....................			2e	42,983
3	Subtract line 2e from line 1...................			3	1,786,737
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a	3,269
b	Other (Describe in Part XIII.) ............	4b
c	Add lines 4a and 4b.....................			4c	3,269
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......			5	1,790,006

Part XIII

Supplemental Information

Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, 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.

Return Reference

Explanation

SCHEDULE D, PAGE 3, PART X

HEALTHVISIONS MIDWEST IS SUBJECT TO FEDERAL INCOME TAX ON ANY UNRELATED BUSINESS INCOME. HEALTHVISIONS MIDWEST PROVIDES LIABILITIES FOR UNCERTAIN INCOME TAX POSITIONS WHEN A LIABILITY IS PROBABLE AND ESTIMABLE. MANAGEMENT BELIEVES THAT IT HAS APPROPRIATE SUPPORT FOR ANY TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN AND AS SUCH, DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS THAT SHOULD BE RECOGNIZED, MEASURED, OR DISCLOSED IN THE FINANCIAL STATEMENTS. MANAGEMENT BELIEVES HEALTHVISIONS MIDWEST IS NO LONGER SUBJECT TO EXAMINATION BY TAXING AUTHORITIES FOR YEARS BEFORE DECEMBER 31, 2015.

Schedule D (Form 990) 2018

Additional Data

Software ID:
Software Version:

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet

Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
SchJMediumBullet

Attach to Form 990.
SchJMediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

HEALTHVISIONS MIDWEST INC

Employer identification number

35-2064919

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes in 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, 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 Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed on 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? .............

Yes

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.

Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

For persons listed on 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," on line 5a or 5b, describe in Part III.

For persons listed on 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," on line 6a or 6b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Were any amounts reported on Form 990, Part VII, paid or accured 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" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2018

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.

For each individual whose compensation must be reported on 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.
Note. 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.

(A) Name and Title		(B) Breakdown of W-2 and/or 1099-MISC compensation			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation in column (B) reported as deferred on prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1DONALD BARNES FORMER PRESIDENT/CEO	(i) (ii)	-------------	-------------	135,853 -------------	-------------	9,513 -------------	145,366 -------------	-------------

Schedule J (Form 990) 2018

Page 3

Part III

Supplemental Information

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.

Return Reference	Explanation
SCHEDULE J, PAGE 1, PART I, LINE 4	DONALD BARNES 135,853 0 0

Schedule J (Form 990) 2018

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.
MediumBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization

HEALTHVISIONS MIDWEST INC

Employer identification number

35-2064919

Return Reference	Explanation
FORM 990, PAGE 2, PART III, LINE 4B	THE CCHW TRAINING PROGRAM IS A 40-HOUR TRAINING PROGRAM THAT PREPARES THE PARTICIPANT TO TAKE THE CERTIFICATION EXAM. THE TRAINING CONSISTS OF A 40 -HOUR INTERACTIVE CLASSROOM CURRICULUM THAT FOCUSES ON ROLES, SKILLS AND COMPETENCIES OF A SUCCESSFUL COMMUNITY HEALTH WORKER (CHW). PARTICIPANTS LEARN TO ASSESS IDIVIDUAL AND COMMUNITY HEALTH CARE NEEDS, MAKE REFERRALS TO APPROPRIATE SERVICE PROVIDERS, AND IMPLEMENT PROGRAMS THAT PROMOTE, MAINTAIN, AND IMPROVE BOTH INDIVIDUAL AND COMMUNITY HEALTH. A CHW IS A FRONTLINE PUBLIC HEALTH WORKER WHO IS A TRUSTED MEMBER OF A OF THE COMMUNITY SERVED THAT ENABLES THE WORKER TO SERVE AS A LIASION/LINK/INTERMEDIARY BETWEEN HEALTH/SOCIAL SERVICES AND THE COMMUNITY TO FACILITATE ACCESS TO SERVICES AND IMPROVE THE QUALITY AND CULTURAL COMPETENCE OF SERVICE DELIVERY. THE SKILL UP PROGRAM IS A PROGRAM DEVELOPED BY ESPERANZA MINISTRIES TO TRAIN AND CREATE A PIPELINE FOR THE HISPANICS IN THE HEALTHCARE INDUSTRY AND IS FUNDED BY THE INDIANA OFFICE OF WORKFORCE DEVELOPMENT. HEALTHVISIONS IS A SUB-GRANTEE FOR THIS GRANT. THE PROGRAM GOALS ARE TO "SKILL UP" THE HISPANIC POPULATION WHILE MEETING THE NEED FOR COMMUNITY HEALTH WORKERS (CHW) IN THE HEALTHCARE SECTOR. HEALTHVISIONS RESPONSIBILITY FOR THIS GRANT IS TO PROVIDE 50 HISPANIC PARTICIPANTS WITH CERTIFIED COMMUNITY HEALTH WORKER TRAINING AND ASSIST THEM IN FINDING CHW POSITIONS IN BOTH HEALTHCARE AND MANUFACTURING SETTINGS IN LAKE AND ALLEN COUNTIES, IN. ADDITIONALLY, PARTICIPANTS WILL RECEIVE MENTORING AND ENGLISH LANGUAGE TRAINING THROUGHOUT THE TRAINING. THE SKILL UP PROGRAM COMPLETED ITS GRANT RESPONSIBILITIES IN MARCH 2018.
FORM 990, PAGE 2, PART III, LINE 4D	ST. CLAIR COUNTY, IL THE MISSION OUTREACH REACHING EVERYONE (MORE) PROGRAM WORKS WITH LOCAL CONGREGATIONS TO PROVIDE TRAINING AND SUPPORT TO ENGAGE IN SOCIAL OUTREACH AND REACH HURTING PEOPLE FOR GOD. HEALTHVISIONS PROVIDES EVIDENCE BASED WELLNESS PROGRAMS. WE SEEK TO REDUCE HEALTH DISPARITIES, EMPOWER HEALTHY LIVING THROUGH THE HEALING PRESENCE OF JESUS CHRIST. ALLEN COUNTY, IN THE ALLEN COUNTY HEALTH DISPARITY COALITION IS A COMMUNITY WIDE COALITION THAT ADDRESSES HEALTH DISPARITIES AMONG RACIAL AND ETHNIC MINORITY POPULATIONS IN ALLEN COUNTY THROUGH ADVOCACY, EDUCATION, EVALUATIONS, RESEARCH, POLICY AND TRAINING. THIS YEAR WE EDUCATED OVER 400 COMMUNITY LEADERS ON SUCH TOPIC AS: MENTAL HEALTH, OBESITY, DIABETES, CHRONIC DISEASE, AND SMOKING. THE WELLNESS AND EDUCATION CLINIC PROVIDES A NO COST PREVENTIVE HEALTHCARE AND EDUCATION TO UNDERSERVED PEOPLE AND WORKING FAMILIES IN CENTRAL AND SOUTHEAST FORT WAYNE. THE CLINIC OPERATES QUARTERLY AND IN CONJUNCTION WITH COMMUNITY AND HEALTH EVENTS. THE CLINIC HOURS ARE FROM 5:00 PM - 7:00 PM AT SEVERAL LOCATIONS IN THE COMMUNITY. THE FOLLOWING SCREENINGS ARE OFFERED: HEIGHT, WEIGHT, HIV TESTING, BLOOD PRESSURE, BLOOD SUGARS, FOOT CARE AND BODY MASS INDEX (BMI) AND HEARING TEST. OUR SERVICES ARE PROVIDED AT NO COST TO THE PARTICIPANTS. IT IS THE PARTNERS THAT PROVIDE DONATIONS AND IN-KIND SERVICES TO THE CLINIC. WE SERVED 112 INDIVIDUALS. THE EAT SMART-BE ACTIVE PROGRAM IS A NUTRITION PROGRAM IS DONE IN BOTH ENGLISH AND SPANISH. IT IS GEARED FOR PEOPLE ON A LIMITED/FIXED INCOME TO HELP THEM GAIN KNOWLEDGE OF CHOOSING HEALTHY, AFFORDABLE AND TASTY FOOD. THESE WORKSHOPS ALSO PROMOTE PHYSICAL ACTIVITIES FOR THE ENTIRE FAMILY. LAST YEAR WE PARTNERED WITH A LOCAL CHURCH TO FACILITATE THESE SESSIONS AND WE SERVED 102 PARTICIPANTS FOR THE YEAR. THE CHRONIC DISEASE SELF-MANAGEMENT PROGRAM IS A WORKSHOP GIVEN FOR TWO AND A HALF HOURS PER WEEK FOR SIX WEEKS. THIS PROGRAM IS CONDUCTED IN COMMUNITY SETTINGS SUCH AS SENIOR CENTERS, CHURCHES, LIBRARIES AND HOSPITALS. PEOPLE WITH DIFFERENT CHRONIC HEALTH PROBLEMS ATTEND TOGETHER. WORKSHOPS ARE FACILITATED BY TWO TRAINED LEADERS, ONE OR BOTH OF WHOM ARE NON-HEALTH PROFESSIONALS WITH CHRONIC DISEASES THEMSELVES. HEALTHVISIONS PARTNERED WITH A SENIOR COMPLEX TO OFFER THE CHRONIC DISEASE SELF- MANAGEMENT PROGRAM. WE SERVED OVER 100 FAMILIES. THE AMERICAN DIABETES ASSOCIATION - LIVE EMPOWERED PROGRAM TAKES A TARGETED APPROACH TO INCREASING THE AWARENESS OF THE SERIOUSNESS OF DIABETES AND THE COMPLICATIONS AMONG THE AFRICAN AMERICAN POPULATION. THE PROGRAM IS AN 8- WEEK SESSION FOR ONE HOUR PER WEEK. WE SERVED OVER 30 FAMILIES. DIABETES EDUCATION EMPOWERMENT PROGRAM (DEEP) PROVIDES COMMUNITY RESIDENTS WITH TOOLS TO BETTER MANAGE THEIR DIABETES. THE PROGRAM IS DONE IN SPANISH AND TARGETS THE LATINO POPULATION. THIS IS AN 8-WEEK PROGRAM FOR 2.5 HOURS PER WEEK. THE CLASS IS OFFERED TO INDIVIDUALS, CHURCHES AND COMMUNITY PARTNERS. WE ALSO PARTNERS WITH HOSPITALS IN THE COMMUNITY. LAST YEAR WE SERVED 125 INDIVIDUALS. THE BIENVENIDO PROGRAM IS A PREVENTIVE INTERVENTION PROGRAM THAT INCREASES ACCESS TO MENTAL HEALTH SERVICES FOR THE LATINO IMMIGRANTS. THIS PROGRAM ASSISTS THE IMMIGRANTS IN ACKNOWLEDGING THE TRAUMA THAT THEY SUFFER FROM IMMIGRATION AND CURRENT STIGMATIZED SOCIAL STATUS. ELEVEN FAMILIES COMPLETED THE PROGRAM. WE WERE ABLE TO PARTNER WITH HEALTHY CITIES OF FORT WAYNE TO ORGANIZE A HEALTH FAIR WHERE WE PROVIDED MEDICAL TRANSLATION FOR OVER 40 INDIVIDUALS. WE SERVED OVER 700 PARTICIPANTS. THE PROGRAM IS DONE IN THE COMMUNITY TO EMPOWER THE COMMUNITY AT CHURCHES, WORSHIP CENTERS, AND COMMUNITY CENTERS.
FORM 990, PAGE 6, PART VI, LINE 6	THE PROVINCIAL OF THE AMERICAN PROVINCE OF THE POOR HANDMAIDS AND THE INDIVIDUALS HOLDING MEMBERSHIP POSITIONS IN THE PROVINCIAL COUNCIL OF THE AMERICAN PROVINCE OF THE POOR HANDMAIDS ARE THE VOTING MEMBERS OF HEALTHVISIONS MIDWEST, INC. (HVM).
FORM 990, PAGE 6, PART VI, LINE 7A	THE MEMBERS OF HVM APPROVE NEW MEMBERS OF THE BOARD OF DIRECTORS. THE MEMBERS OF HVM APPOINT THE CHAIRPERSON OF HVM.
FORM 990, PAGE 6, PART VI, LINE 7B	THE APPROVAL OF THE MEMBERS IS REQUIRED WITH RESPECT TO THE FOLLOWING: -ANY AMENDMENTS TO THE ARTICLES OF INCORPORATION AND BYLAWS -THE ACQUISITION, SALE, LEASE, TRANSFER, ASSIGNMENT, MORTGAGE OR ENCUMBRANCE OF ANY FIXED CAPITAL, BUILDINGS OR REAL ESTATE -ANY ACTION WHICH MIGHT BE CONSIDERED INCONSISTENT WITH THE OBJECTIVES AND PURPOSES SET FORTH IN THE BYLAWS -THE INCURRENCE OF DEBT WHICH WOULD BIND HVM IN AN AMOUNT EXCEEDING THE LESSER OF ONE MILLION DOLLARS OR TEN PERCENT OF THE BOOK VALUE OF THE FIXED ASSET OF HVM -THE ACQUISITION OF, OR ESTABLISHMENT OF ANY ENTITY WHICH HVM PROPOSES TO OWN OR CONTROL ON AN ON-GOING BASIS -THE ACCEPTANCE OF A DONATION/BEQUEST WHICH WOULD IMPOSE AN OBLIGATION ON THE CORPORATION OR ITS MEMBERS -ANY MAJOR STRUCTURAL CHANGES - MERGER, CONSOLIDATION, DISSOLUTION, OR SALE OF SUBSTANTIALLY ALL THE ASSETS OF HVM -THE SELECTION OF THE CERTIFIED PUBLIC ACCOUNTANTS
FORM 990, PAGE 6, PART VI, LINE 11B	THE FORM 990 WAS PREPARED BY HAINES, ISENBARGER AND SKIBA, LLC, INDEPENDENT AUDITORS OF HVM AND REVIEWED BY THE HVM DIRECTOR OF OPERATIONS AND THE TREASURER OF ANCILLA DOMINI SISTERS, INC. A COPY OF THE FORM 990 WAS PROVIDED TO ALL DIRECTORS FOR REVIEW PRIOR TO FILING THE RETURN.
FORM 990, PAGE 6, PART VI, LINE 12C	EACH OFFICER, DIRECTOR, AND KEY EMPLOYEE ARE REQUIRED TO COMPLETE A DISCLOSURE STATEMENT, WHICH IDENTIFIES CONFLICTS OF INTEREST, ANNUALLY. THE COMPLIANCE OFFICER REVIEWS THE DISCLOSURE STATEMENTS AND REPORTS ANY POTENTIAL CONFLICTS OF INTEREST TO THE EXECUTIVE DIRECTOR, WHO WOULD SUBSEQUENTLY DISCLOSE THE POTENTIAL CONFLICTS OF INTEREST TO THE BOARD. IN 2018, NO POTENTIAL CONFLICTS OF INTEREST WERE NOTED.
FORM 990, PAGE 6, PART VI, LINE 15A	THE DIRECTOR OF HUMAN RESOURCES PREPARES AN ANALYSIS BY COMPARING THE EXECUTIVE DIRECTOR POSITION WITH OTHER NOT-FOR-PROFIT ORGANIZATIONS USING MARKET COMPENSATION INFORMATION FROM SEVERAL COMPENSATION REPORTS. ONCE THIS ANALYSIS IS COMPILED THE REPORT IS FORWARDED TO THE BOARD OF DIRECTORS, WHICH REVIEW AND APPROVE THE EXECUTIVE DIRECTOR'S COMPENSATION.
FORM 990, PAGE 6, PART VI, LINE 18	PUBLIC DISCLOSURE OF FORM 990 ALSO AVAILABLE ON GUIDESTAR.ORG.
FORM 990, PAGE 6, PART VI, LINE 19	HVM DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC, EXCEPT TO THE EXTENT THAT THEY ARE PUBLICLY AVAILABLE DOCUMENTS SUCH AS FORM 990 OR 1023.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2018

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBullet

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

HEALTHVISIONS MIDWEST INC

Employer identification number

35-2064919

Part I

Identification of Disregarded Entities Complete if the organization answered "Yes" on Form 990, Part IV, line 33.

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity

Part II

Identification of Related Tax-Exempt Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)CATHERINE KASPER PLACE INC 347 WEST BERRY STREET SUITE 101 FORT WAYNE,IN46802 27-3213747	SOCIAL SVS	IN	501C3	7	ST JOSEPH		No
(2)EARTHWORKS INC 9815 UNION ROAD PLYMOUTH,IN46563 35-1793328	EDUCATION	IN	501C3	10	ANCILLA DO		No
(3)THE LINDEN HOUSE OF GARY INC 566 W LAKE STREET CHICAGO,IL60661 35-1954576	HOUSING	IN	501C3	10	ANCILLA SY		No
(4)THE LINDEN HOUSE OF HOBART INC 566 W LAKE STREET CHICAGO,IL60661 35-2006008	HOUSING	IN	501C3	10	ANCILLA SY		No
(5)THE LINDEN HOUSE OF MISHAWAKA INC 566 W LAKE STREET CHICAGO,IL60661 35-1968002	HOUSING	IN	501C3	10	ANCILLA SY		No
(6)PHJC FOUNDATION INC 1419 S LAKE PARK AVE HOBART,IN46342 27-1688707	FUNDRAISIN	IN	501C3	7	ANCILLA DO		No
(7)WEST TOWN SENIOR RESIDENCE INC C/O EVERGREEN REAL ESTATE566 W LAKE STREET CHICAGO,IL60661 36-3768678	HOUSING	IL	501C3	10	ANCILLA SY		No
(8)SOJOURNER TRUTH HOUSE INC 1419 S LAKE PARK AVE HOBART,IN46342 27-0296707	SOCIAL SVS	IN	501C3	7	ANCILLA SY		No
(9)ST JOSEPH COMMUNITY HEALTH FOUNDAT 347 W BERRY STREET SUITE 101 FORT WAYNE,IN46802 31-1016570	HEALTHCARE	IN	501C3	12A	ANCILLA DO ANCILLA DOMINI SISTERS		No

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2018

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	Yes	No
(1) ANCILLA HEALTH SERVICES INC 1419 S LAKE PARK AVE HOBART,IN46342 35-1938745	MANAGEMENT	IN	NA	C CORP				No
(2) LGILBRAITH SPC LTD 23 LIME TREE BAY AVENUE PO BOX 105 GRAND CAYMAN CJ	EXCESS INS	CJ	NA					No

Schedule R (Form 990) 2018

Page 3

Part V

Transactions With Related Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.

Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................

b Gift, grant, or capital contribution to related organization(s) ............................

c Gift, grant, or capital contribution from related organization(s) ............................

Yes

d Loans or loan guarantees to or for related organization(s) ............................

e Loans or loan guarantees by related organization(s) ............................

f Dividends from related organization(s) ............................

g Sale of assets to related organization(s) ............................

h Purchase of assets from related organization(s) ............................

i Exchange of assets with related organization(s) ............................

j Lease of facilities, equipment, or other assets to related organization(s) .......................

k Lease of facilities, equipment, or other assets from related organization(s) ......................

l Performance of services or membership or fundraising solicitations for related organization(s) .....................

Yes

m Performance of services or membership or fundraising solicitations by related organization(s) .................

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................

o Sharing of paid employees with related organization(s) ............................

p Reimbursement paid to related organization(s) for expenses ............................

q Reimbursement paid by related organization(s) for expenses ............................

r Other transfer of cash or property to related organization(s) ............................

s Other transfer of cash or property from related organization(s) ............................

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) ANCILLA SYSTEMS INC	C	1,241,000	CASH

Schedule R (Form 990) 2018

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 37.

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(e) Are all partners section 501(c)(3) organizations?		(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2018

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R (see instructions).

Return Reference	Explanation

Schedule R (Form 990) 2018

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: FAITH BASED COLLABORATIVE ORGANIZATION SPONSORED BY THE POOR HANDMAIDS OF JESUS CHRIST TO IMPROVE AND SUSTAIN THE HEALTH STATUS OF THE COMMUNITIES WE SERVE.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	9
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	9
5	Total number of individuals employed in calendar year 2018 (Part V, line 2a) ......	5	27
6	Total number of volunteers (estimate if necessary) .............	6	100
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	2,053,038	1,704,539
9	Program service revenue (Part VIII, line 2g) .........	33,048	8,930
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	42,159	70,145
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	112,321	283,144
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	2,240,566	2,066,758
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...		0
14	Benefits paid to or for members (Part IX, column (A), line 4).....		0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	1,460,414	1,122,615
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....		0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	644,048	667,391
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	2,104,462	1,790,006
19	Revenue less expenses. Subtract line 18 from line 12.......	136,104	276,752
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	1,313,224	1,340,484
21	Total liabilities (Part X, line 26).............	280,039	162,821
22	Net assets or fund balances. Subtract line 21 from line 20.....	1,033,185	1,177,663

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 160,019 including grants of $ ) (Revenue $ )
	THE EMERGENCY SOLUTIONS GRANT PROGRAM IS A COLLABORATION BETWEEN HEALTHVISIONS AND CONTINUUM OF CARE NETWORK, NWI, INC TO ASSIST PEOPLE IN LAKE COUNTY, IN WHO ARE HOMELESS, OR AT RISK OF HOMELESSNESS BY PROVIDING HOUSING AND OTHER SERVICES APPROPRIATE TO THE WHOLE RANGE OF HOMELESS NEEDS IN THE COMMUNITY.

4b	(Code: ) (Expenses $ 199,431 including grants of $ ) (Revenue $ )
	THE CCHW TRAINING PROGRAM IS A 40-HOUR TRAINING PROGRAM THAT PREPARES THE PARTICIPANT TO TAKE THE CERTIFICATION EXAM. THE TRAINING CONSISTS OF A 40 -HOUR INTERACTIVE CLASSROOM CURRICULUM THAT FOCUSES ON ROLES, SKILLS AND COMPETENCIES OF A SUCCESSFUL COMMUNITY HEALTH WORKER (CHW). PARTICIPANTS LEARN TO ASSESS IDIVIDUAL AND COMMUNITY HEALTH CARE NEEDS, MAKE REFERRALS TO APPROPRIATE SERVICE PROVIDERS, AND IMPLEMENT PROGRAMS THAT PROMOTE, MAINTAIN, AND IMPROVE BOTH INDIVIDUAL AND COMMUNITY HEALTH. A CHW IS A FRONTLINE PUBLIC HEALTH WORKER WHO IS A TRUSTED MEMBER OF A OF THE COMMUNITY SERVED THAT ENABLES THE WORKER TO SERVE AS A LIASION/LINK/INTERMEDIARY BETWEEN HEALTH/SOCIAL SERVICES AND THE COMMUNITY TO FACILITATE ACCESS TO SERVICES AND IMPROVE THE QUALITY AND CULTURAL COMPETENCE OF SERVICE DELIVERY. THE SKILL UP PROGRAM IS A PROGRAM DEVELOPED BY ESPERANZA MINISTRIES TO TRAIN AND CREATE A PIPELINE FOR THE HISPANICS IN THE HEALTHCARE INDUSTRY AND IS FUNDED BY THE INDIANA OFFICE OF WORKFORCE DEVELOPMENT. HEALTHVISIONS IS A SUB-GRANTEE FOR THIS GRANT. THE PROGRAM GOALS ARE TO "SKILL UP" THE HISPANIC POPULATION WHILE MEETING THE NEED FOR COMMUNITY HEALTH WORKERS (CHW) IN THE HEALTHCARE SECTOR. HEALTHVISIONS RESPONSIBILITY FOR THIS GRANT IS TO PROVIDE 50 HISPANIC PARTICIPANTS WITH CERTIFIED COMMUNITY HEALTH WORKER TRAINING AND ASSIST THEM IN FINDING CHW POSITIONS IN BOTH HEALTHCARE AND MANUFACTURING SETTINGS IN LAKE AND ALLEN COUNTIES, IN. ADDITIONALLY, PARTICIPANTS WILL RECEIVE MENTORING AND ENGLISH LANGUAGE TRAINING THROUGHOUT THE TRAINING. THE SKILL UP PROGRAM COMPLETED ITS GRANT RESPONSIBILITIES IN MARCH 2018.

4c	(Code: ) (Expenses $ 291,358 including grants of $ ) (Revenue $ 8,930 )
	THE FAITH IN ACTION TO SERVE AND TRANSFORM (FAST) PROGRAM PROVIDES NON- MEDICAL AND VOLUNTEER CARE-GIVING SERVICES TO SENIORS, AGE 60 AND OLDER AND PERSONS WITH DISABILITIES IN ST. CLAIR COUNTY, IL. THESE SERVICES INCLUDE ASSISTED TRANSPORTATION, FRIENDLY VISITS, AND REASSURANCE CALLS TO PROMOTE HEALTHY LIVING AND REDUCE ISOLATION. SENIORS ARE ABLE TO ACCESS SERVICES THAT WOULD OTHERWISE BE INACCESSIBLE OUTSIDE OF THEIR COMMUNITIES. HEALTHVISIONS PROVIDES INFORMATION AND ASSISTANCE SERVICES WHICH HELP PERSONS GET FREE BUS PASSES AND DISCOUNT LICENSE PLATES, AS WELL AS FREE MEDICARE COUNSELING, MEDICARE SAVINGS AND LOW INCOME SUBSIDY COUNSELING AND ASSISTANCE WITH MEDICARE PART D APPLICATIONS.

	(Code: ) (Expenses $ 1,026,335 including grants of $ ) (Revenue $ )
	ST. CLAIR COUNTY, IL THE MISSION OUTREACH REACHING EVERYONE (MORE) PROGRAM WORKS WITH LOCAL CONGREGATIONS TO PROVIDE TRAINING AND SUPPORT TO ENGAGE IN SOCIAL OUTREACH AND REACH HURTING PEOPLE FOR GOD. HEALTHVISIONS PROVIDES EVIDENCE BASED WELLNESS PROGRAMS. WE SEEK TO REDUCE HEALTH DISPARITIES, EMPOWER HEALTHY LIVING THROUGH THE HEALING PRESENCE OF JESUS CHRIST. ALLEN COUNTY, IN THE ALLEN COUNTY HEALTH DISPARITY COALITION IS A COMMUNITY WIDE COALITION THAT ADDRESSES HEALTH DISPARITIES AMONG RACIAL AND ETHNIC MINORITY POPULATIONS IN ALLEN COUNTY THROUGH ADVOCACY, EDUCATION, EVALUATIONS, RESEARCH, POLICY AND TRAINING. THIS YEAR WE EDUCATED OVER 400 COMMUNITY LEADERS ON SUCH TOPIC AS: MENTAL HEALTH, OBESITY, DIABETES, CHRONIC DISEASE, AND SMOKING. THE WELLNESS AND EDUCATION CLINIC PROVIDES A NO COST PREVENTIVE HEALTHCARE AND EDUCATION TO UNDERSERVED PEOPLE AND WORKING FAMILIES IN CENTRAL AND SOUTHEAST FORT WAYNE. THE CLINIC OPERATES QUARTERLY AND IN CONJUNCTION WITH COMMUNITY AND HEALTH EVENTS. THE CLINIC HOURS ARE FROM 5:00 PM - 7:00 PM AT SEVERAL LOCATIONS IN THE COMMUNITY. THE FOLLOWING SCREENINGS ARE OFFERED: HEIGHT, WEIGHT, HIV TESTING, BLOOD PRESSURE, BLOOD SUGARS, FOOT CARE AND BODY MASS INDEX (BMI) AND HEARING TEST. OUR SERVICES ARE PROVIDED AT NO COST TO THE PARTICIPANTS. IT IS THE PARTNERS THAT PROVIDE DONATIONS AND IN-KIND SERVICES TO THE CLINIC. WE SERVED 112 INDIVIDUALS. THE EAT SMART-BE ACTIVE PROGRAM IS A NUTRITION PROGRAM IS DONE IN BOTH ENGLISH AND SPANISH. IT IS GEARED FOR PEOPLE ON A LIMITED/FIXED INCOME TO HELP THEM GAIN KNOWLEDGE OF CHOOSING HEALTHY, AFFORDABLE AND TASTY FOOD. THESE WORKSHOPS ALSO PROMOTE PHYSICAL ACTIVITIES FOR THE ENTIRE FAMILY. LAST YEAR WE PARTNERED WITH A LOCAL CHURCH TO FACILITATE THESE SESSIONS AND WE SERVED 102 PARTICIPANTS FOR THE YEAR. THE CHRONIC DISEASE SELF-MANAGEMENT PROGRAM IS A WORKSHOP GIVEN FOR TWO AND A HALF HOURS PER WEEK FOR SIX WEEKS. THIS PROGRAM IS CONDUCTED IN COMMUNITY SETTINGS SUCH AS SENIOR CENTERS, CHURCHES, LIBRARIES AND HOSPITALS. PEOPLE WITH DIFFERENT CHRONIC HEALTH PROBLEMS ATTEND TOGETHER. WORKSHOPS ARE FACILITATED BY TWO TRAINED LEADERS, ONE OR BOTH OF WHOM ARE NON-HEALTH PROFESSIONALS WITH CHRONIC DISEASES THEMSELVES. HEALTHVISIONS PARTNERED WITH A SENIOR COMPLEX TO OFFER THE CHRONIC DISEASE SELF- MANAGEMENT PROGRAM. WE SERVED OVER 100 FAMILIES. THE AMERICAN DIABETES ASSOCIATION - LIVE EMPOWERED PROGRAM TAKES A TARGETED APPROACH TO INCREASING THE AWARENESS OF THE SERIOUSNESS OF DIABETES AND THE COMPLICATIONS AMONG THE AFRICAN AMERICAN POPULATION. THE PROGRAM IS AN 8- WEEK SESSION FOR ONE HOUR PER WEEK. WE SERVED OVER 30 FAMILIES. DIABETES EDUCATION EMPOWERMENT PROGRAM (DEEP) PROVIDES COMMUNITY RESIDENTS WITH TOOLS TO BETTER MANAGE THEIR DIABETES. THE PROGRAM IS DONE IN SPANISH AND TARGETS THE LATINO POPULATION. THIS IS AN 8-WEEK PROGRAM FOR 2.5 HOURS PER WEEK. THE CLASS IS OFFERED TO INDIVIDUALS, CHURCHES AND COMMUNITY PARTNERS. WE ALSO PARTNERS WITH HOSPITALS IN THE COMMUNITY. LAST YEAR WE SERVED 125 INDIVIDUALS. THE BIENVENIDO PROGRAM IS A PREVENTIVE INTERVENTION PROGRAM THAT INCREASES ACCESS TO MENTAL HEALTH SERVICES FOR THE LATINO IMMIGRANTS. THIS PROGRAM ASSISTS THE IMMIGRANTS IN ACKNOWLEDGING THE TRAUMA THAT THEY SUFFER FROM IMMIGRATION AND CURRENT STIGMATIZED SOCIAL STATUS. ELEVEN FAMILIES COMPLETED THE PROGRAM. WE WERE ABLE TO PARTNER WITH HEALTHY CITIES OF FORT WAYNE TO ORGANIZE A HEALTH FAIR WHERE WE PROVIDED MEDICAL TRANSLATION FOR OVER 40 INDIVIDUALS. WE SERVED OVER 700 PARTICIPANTS. THE PROGRAM IS DONE IN THE COMMUNITY TO EMPOWER THE COMMUNITY AT CHURCHES, WORSHIP CENTERS, AND COMMUNITY CENTERS.

4d	Other program services (Describe in Schedule O.)
	(Expenses $ 1,026,335 including grants of $ ) (Revenue $ )
4e	Total program service expenses1,677,143

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)			(D) Reportable compensation from the organization (W- 2/1099-MISC)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and Title
(1) ADELINE TORRES...................................................................... CHAIRPERSON	1.00 .................	X	X		0	0	0
(2) SR KATHLEEN QUINN PHJC...................................................................... VICE CHAIRPE	1.00 .................	X	X		0	0	0
(3) SR JOYCE DILTZ PHJC...................................................................... BOARD SECRET	1.00 .................	X	X		0	0	0
(4) REV JOHN H SMITH JR...................................................................... BOARD MEMBER	1.00 .................	X			0	0	0
(5) CHERYL SMITH...................................................................... BOARD MEMBER	1.00 .................	X			0	0	0
(6) DAVE MCCORMICK...................................................................... BOARD MEMBER	1.00 .................	X			0	0	0
(7) CRAIG BOLDA...................................................................... BOARD MEMBER	1.00 .................	X			0	0	0
(8) SR MARGARET ANNE HENSS PHJC...................................................................... BOARD MEMBER	1.00 .................	X			0	0	0
(9) NANCY MOSER...................................................................... BOARD MEMBER	1.00 .................	X			0	0	0
(10) JERRY HART TERM...................................................................... BOARD MEMBER	1.00 .................	X			0	0	0
(11) SR MICHELE DVORAK PHJC TERM...................................................................... BOARD MEMBER	1.00 .................	X			0	0	0
(12) PAULA WILLS...................................................................... EXECUTIVE DI	40.00 .................		X		90,976	0	16,134
(13) MELISSA PIAZZA...................................................................... DIRECTOR OPE	40.00 .................		X		104,355	0	19,655
(14) DONALD BARNES...................................................................... FORMER PRESI	.................			X	135,853	0	9,513

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	331,184	45,302

(A) Name and business address	(B) Description of services	(C) Compensation





2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	1,241,000
e	Government grants (contributions)		1e	159,949

f	All other contributions, gifts, grants, and similar amounts not included above		1f	303,590

g	Noncash contributions included in lines 1a - 1f:$
h Total. Add lines 1a-1f.......		1,704,539

		Business Code
2a	FAST PROGRAM REVENUE	624100	8,930	8,930
b
c
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f ....		8,930

3 Investment income (including dividends, interest, and othersimilar amounts) ......			36,764			36,764
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents
b	Less: rental expenses
c	Rental income or (loss)
d	Net rental income or (loss)......
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory		436,107
b	Less: cost or other basis and sales expenses		402,726
c	Gain or (loss)		33,381
d	Net gain or (loss).....			33,381			33,381
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
	a
b	Less: direct expenses ...b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
	a
b	Less: cost of goods sold ..b
c	Net income or (loss) from sales of inventory..
Business Code			Miscellaneous Revenue
11a	ACCOUNTING & CONSULTING REV.		541200	283,144	283,144
b
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......			283,144
12	Total revenue. See Instructions......			2,066,758	292,074		70,145

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21
2	Grants and other assistance to domestic individuals. See Part IV, line 22
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, line 15 and 16.
4	Benefits paid to or for members
5	Compensation of current officers, directors, trustees, and key employees ....	226,689	213,344	13,345
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....
7	Other salaries and wages	695,089	654,171	40,918
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	32,671	30,748	1,923
9	Other employee benefits .......	103,693	97,589	6,104
10	Payroll taxes ...........	64,473	60,678	3,795
11	Fees for services (non-employees):
a	Management ......	1,751	1,348	403
b	Legal .........
c	Accounting ...........	15,050	11,755	3,295
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......	3,269		3,269
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	79,982	75,007	4,975
12	Advertising and promotion ....	5,331	5,120	211
13	Office expenses .......	86,820	79,940	6,880
14	Information technology ......	18,568	17,572	996
15	Royalties ..
16	Occupancy ...........	129,648	112,308	17,340
17	Travel ............	104,161	101,843	2,318
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	6,560	6,041	519
20	Interest ...........	96	93	3
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	6,388	4,982	1,406
23	Insurance ...	5,475	4,270	1,205
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	EMERGENCY SOLUTIONS PROG	160,019	160,019
b	REPAIRS & MAINTENANCE	14,744	11,929	2,815
c	DUES/SUBSCRIPTIONS	12,607	12,273	334
d	INCENTIVES/STIPENDS	5,475	5,475
e	All other expenses	11,447	10,638	809
25	Total functional expenses. Add lines 1 through 24e	1,790,006	1,677,143	112,863	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			154,219	1	80,072
2	Savings and temporary cash investments .........				2
3	Pledges and grants receivable, net ......			106,761	3	56,296
4	Accounts receivable, net .............				4	47,585
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L .............
					5
6	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 instructions) Complete Part II of Schedule L ..............
					6
7	Notes and loans receivable, net ....				7
8	Inventories for sale or use ........				8
9	Prepaid expenses and deferred charges ......			19,813	9	18,662
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	116,750
b	Less: accumulated depreciation	10b	94,127	29,012	10c	22,623
11	Investments—publicly traded securities .			964,663	11	1,048,936
12	Investments—other securities. See Part IV, line 11 .....				12
13	Investments—program-related. See Part IV, line 11 ..				13
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			38,756	15	66,310
16	Total assets. Add lines 1 through 15 (must equal line 34)...			1,313,224	16	1,340,484

17	Accounts payable and accrued expenses .....	280,039	17	162,821
18	Grants payable ...		18
19	Deferred revenue .........		19
20	Tax-exempt bond liabilities .........		20
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	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..		22
23	Secured mortgages and notes payable to unrelated third parties ..		23
24	Unsecured notes and loans payable to unrelated third parties ..		24
25	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		25
26	Total liabilities. Add lines 17 through 25..	280,039	26	162,821

	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets	944,707	27	1,107,279
28	Temporarily restricted net assets ...........	88,478	28	70,384
29	Permanently restricted net assets		29
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....		30
31	Paid-in or capital surplus, or land, building or equipment fund ...		31
32	Retained earnings, endowment, accumulated income, or other funds		32
33	Total net assets or fund balances ...........	1,033,185	33	1,177,663
34	Total liabilities and net assets/fund balances ........	1,313,224	34	1,340,484