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.") .. | 918,003 | 572,032 | 3,844,440 | 179,359 | 130,078 | 5,643,912 |
| 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 | 918,003 | 572,032 | 3,844,440 | 179,359 | 130,078 | 5,643,912 |
| 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).. | 4,472,960 | |||||
| 6 | Public support. Subtract line 5 from line 4. | 1,170,952 | |||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2014 | (b) 2015 | (c) 2016 | (d) 2017 | (e) 2018 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 918,003 | 572,032 | 3,844,440 | 179,359 | 130,078 | 5,643,912 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | 1,274 | 969 | 660 | 974 | 818 | 4,695 |
| 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.).. | 16,362 | 9,070 | 4,260 | 29,692 | ||
| 11 | Total support. Add lines 7 through 10 | 5,678,299 | |||||
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) |
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| 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): |
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| 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 |
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| 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 |
|---|
| HC ONE'S PUBLIC SUPPORT PERCENTAGE OF 20.62% IS SOLIDLY ABOVE THE 10% MARK. ITS PROGRAMS ARE CENTERED AROUND TRAINING, MENTORING, CONSULTING, AND COLLABORATING TO DEVELOP COMMUNITY-BASED PROGRAMS TO SUPPORT MOMS, BABIES AND FAMILIES. HC ONE FACILITATES SHARED LEARNING, ORGANIZING, AND ADVOCACY AMONG PARTNERS THROUGHOUT THE COUNTRY TO IMPROVE SUPPORT FOR FAMILIES AND MOVE TOWARDS BIRTH EQUITY. ONE KEY ACTIVITY IS TO TRAIN COMMUNITY HEALTH WORKERS, WHICH DIRECTLY IMPACTS THE GENERAL PUBLIC BY IMPROVING MATERNAL AND CHILD HEALTH PRACTICES. HC ONE BOARD MEMBERS INCLUDE PERSONS HAVING SPECIAL KNOWLEDGE AND EXPERTISE IN THE HEALTH LEADERSHIP AND MATERNAL AND CHILD HEALTH CARE AREA. THE BOARD MEMBERS INCLUDE MEMBERS FROM ACCESS COMMUNITY HEALTH NETWORK, AN ASSISTANT PROFESSOR OF HEALTH SCIENCES AT DEPAUL UNIVERSITY AND AN ASSISTANT PROFESSOR OF FAMILY HEALTH CARE NURSING AT THE UNIVERSITY OF CALIFORNIA TO HELP ENSURE THAT HC ONE'S WORK IS RESPONSIVE TO THE MATERNAL AND FAMILY HEALTH CARE COMMUNITY AT LARGE.WHILE MUCH OF ITS FUNDING COMES FROM A FEW KEY DONORS, HC ONE HAS A PROGRAM TO SOLICIT THE GENERAL PUBLIC ROUTINELY. FUNDRAISING EVENTS HELD ARE ATTENDED BY THE GENERAL PUBLIC, DONATION CAPABILITIES ARE FOUND ON OUR WEBSITE AND AN ANNUAL REPORT IS PRODUCED TO SHOW THE PUBLIC OUR ACCOMPLISHMENTS SO THAT THEY WILL CONTRIBUTE AND ENABLE US TO CONTINUE TO IMPACT THE HEALTH OF WOMEN AND CHILDREN NATIONALLY. TWO LARGE GRANTS PLEDGED IN THE FISCAL YEAR 2016 ARE PRIMARILY RELATED TO GRANT PERIODS FALLING IN SUBSEQUENT YEARS, BUT WERE RECORDED IN THE YEAR PLEDGED UNDER GENERALLY ACCEPTED ACCOUNTING PRINCIPLES. IF THE TIMING OF RECORDING THE GRANT REVENUE MATCHED THE GRANT PERIOD, THE PUBLIC SUPPORT TEST WOULD HAVE BEEN MET. |
| Return Reference | Explanation |
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Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| FORM 990, PART III, LINE 4A - PROGRAM SERVICE ACCOMPLISHMENTS | SINCE 1986, ACROSS MORE THAN 50 COMMUNITIES IN MORE THAN 20 STATES, HC ONE'S EFFORTS HAVE HELPED HEALTHIER BABIES TO BE BORN WITH FEWER C-SECTIONS, ACHIEVED HIGHER BREASTFEEDING RATES, AND EXPANDED SUPPORT FOR MOTHERS AND FAMILIES IN THE CRUCIAL FIRST FEW MONTHS OF A CHILD'S LIFE. OUR PROGRAMS HAVE ALSO GENERATED RESOURCES AND CREATED JOBS IN LOCAL COMMUNITIES. HC ONE WORKS IN CLOSE PARTNERSHIP WITH HOSPITALS, CLINICS, AND COMMUNITY ORGANIZATIONS TO JOINTLY DESIGN PROGRAMS THAT PROVIDE SUPPORT FOR MOTHERS BEFORE, DURING, AND AFTER BIRTH AND TO TRAIN COMMUNITY MEMBERS - WHO ARE THE BEST EXPERTS ON THEIR FAMILIES AND NEIGHBORHOODS- TO RUN THEM. WITH THIRTY YEARS OF EXPERIENCE WORKING ON BIRTH EQUITY ISSUES, OUR PROGRAMS ARE CONSISTENTLY LINKED TO BETTER HEALTH AND WELLBEING FOR MOMS, BABIES, FAMILIES AND COMMUNITIES. RECENT ACCOMPLISHMENTS INCLUDE: -CO PRODUCED THE AFRICAN AMERICAN BREASTFEEDING BLUEPRINT; -CONTINUED THE DEVELOPMENT AND SUPPORT OF THE NATIONAL BELA (BIRTH EQUITY LEADERSHIP ACADEMY). COMPRISED OF 125 PARTICIPANTS FROM 27 STATES, D.C. AND PUERTO RICO WITH A FOCUS ON ADDRESSING ISSUES OF BIRTH EQUITY IN LOCAL COMMUNITIES AS WELL AS AT THE STATE AND NATIONAL LEVEL. REGIONAL AND NATIONAL GATHERINGS WERE HELD FOR BELA PARTICIPANTS; -BELA COMMUNITY DEMONSTRATION PROJECTS WERE IMPLEMENTED IN LOCAL COMMUNITIES ACROSS THE COUNTRY AND TWO BRIEFS WERE DEVELOPED TO SHARE THE WORK; -ESTABLISHED NUMEROUS MOA'S WITH NATIONAL AND LOCAL ORGANIZATIONS FOR IMPLEMENTATION OF MUTUALLY REINFORCING ACTIVITIES; -DEVELOPED AND IMPLEMENTED STRUCTURES FOR EVALUATION OF PROGRAMMATIC ACTIVITIES; -COMPLETED STAKEHOLDER SURVEYS AND KEY INFORMANT INTERVIEWS ON COMMUNITY NEEDS AND AREAS OF INTEREST THAT COULD BE ADDRESSED BY HC ONE; -PROVIDED PEER BREASTFEEDING/LACTATION SUPPORT AND COMMUNITY BASED DOULA TRAININGS THROUGHOUT THE COUNTRY; -RELEASED A BRIEF REGARDING MEDICAID REIMBURSEMENT FOR DOULAS; AND -PRESENTED AT VARIOUS CONFERENCES AND GATHERINGS |
| FORM 990, PART VI, SECTION B, LINE 11B | THE BOARD OF DIRECTORS HAS DELEGATED TO THE EXECUTIVE/FINANCE COMMITTEE THE DETAILED REVIEW OF THE FORM 990 PRIOR TO FILING. THIS REVIEW INCLUDES A MEETING WITH MANAGEMENT TO WALK THROUGH AND DISCUSS THE ENTIRE RETURN. A COPY OF THE DRAFT RETURN IS THEN PROVIDED TO ALL MEMBERS OF THE BOARD OF DIRECTORS WITH A REPORT THAT THE DETAIL REVIEW HAS BEEN COMPLETED. |
| FORM 990, PART VI, SECTION B, LINE 12C | HC ONE MONITORS AND ENFORCES COMPLIANCE WITH ITS CONFLICT OF INTEREST POLICY. BOARD MEMBERS AND EMPLOYEES ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE FORM ANNUALLY. PRIOR TO A BOARD OR COMMITTEE ACTION INVOLVING A CONFLICT OF INTEREST, THE DIRECTOR OR COMMITTEE MEMBER WHO HAS A CONFLICT OF INTEREST AND IS IN ATTENDANCE AT THE MEETING SHALL DISCLOSE ALL FACTS AND THIS IS REFLECTED IN THE MEETING MINUTES. IF THE DIRECTOR OR COMMITTEE MEMBER THAT HAS A CONFLICT OF INTEREST IS NOT IN ATTENDANCE, HE/SHE SHALL DISCLOSE THE CONFLICT PRIOR TO THE MEETING AND THE CHAIR WILL REPORT THE DISCLOSURE AND THIS IS REFLECTED IN THE MEETING MINUTES. A PERSON WITH A CONFLICT OF INTEREST SHALL NOT PARTICIPATE OR HEAR THE DISCUSSION OF THE MATTER EXCEPT TO DISCLOSE MATERIAL FACTS AND TO RESPOND TO QUESTIONS. THE PERSON WITH A CONFLICT OF INTEREST WILL NOT BE COUNTED IN DETERMINING THE PRESENCE OF A QUOROM FOR PURPOSES OF A VOTE (ON SAID CONFLICT). A PERSON'S INELIGIBILITY TO VOTE SHALL BE REFLECTED IN THE MEETING MINUTES. |
| FORM 990, PART VI, SECTION B, LINE 15A | IN FISCAL YEAR 2019, HC ONE'S OPERATIONS COMMITTEE, WHICH INCLUDED 4 BOARD MEMBERS, REVIEWED AND APPROVED COMPENSATION AND MADE A FORMAL REPORT TO THE FULL BOARD. THE COMMITTEE REVIEWS COMPARABLE DATA TO DETERMINE COMPENSATION. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON WRITTEN REQUEST. |
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