Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for instructions and 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 | |||||
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Total |
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Calendar year (or fiscal year beginning in) ![]() |
(a) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | ||||||
| 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 | ||||||
| 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).. | ||||||
| 6 | Public support. Subtract line 5 from line 4. | ||||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | ||||||
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | ||||||
| 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 | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | 77,623 | 83,942 | 105,635 | 91,577 | 37,857 | 396,634 |
| 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 | 16,783 | 40,065 | 53,020 | 160,219 | 105,196 | 375,283 |
| 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 | 94,406 | 124,007 | 158,655 | 251,796 | 143,053 | 771,917 |
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons | 5,400 | 400 | 1,610 | 7,308 | 14,718 | |
| 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. | 41,779 | 53,615 | 111,137 | 127,006 | 59,686 | 393,223 |
| c | Add lines 7a and 7b.. | 41,779 | 59,015 | 111,537 | 128,616 | 66,994 | 407,941 |
| 8 | Public support. (Subtract line 7c from line 6.) | 363,976 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 94,406 | 124,007 | 158,655 | 251,796 | 143,053 | 771,917 |
| 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.) .. | 925 | 925 | ||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 94,406 | 124,932 | 158,655 | 251,796 | 143,053 | 772,842 |
| 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 |
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| 9 Distributable amount for 2019 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-2019 |
(iii) Distributable Amount for 2019 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2019 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI). See instructions. |
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| 3 Excess distributions carryover, if any, to 2019: | ||||
| a From 2014....... | ||||
| b From 2015....... | ||||
| c From 2016....... | ||||
| d From 2017....... | ||||
| e From 2018....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2019 distributable amount | ||||
|
i
Carryover from 2014 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | ||||
| 4Distributions for 2019 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2019 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from 4. | ||||
|
5
Remaining underdistributions for years prior to 2019, 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 2019. 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 2020. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2015..... | ||||
| b Excess from 2016..... | ||||
| c Excess from 2017..... | ||||
| d Excess from 2018..... | ||||
| e Excess from 2019..... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|---|
| PART III, LINE 12 | 925 |
| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| FORM 990-EZ, PART I, LINE 16 | EXPENSES OFFICE 1,074 INFORMATION TECHNOLOGY 6,618 TRAVEL 7,761 CONFERENCES/MEETINGS 7,756 INSURANCE 937 PROGRAM SUPPLIES 970 MISCELLANEOUS 83 TOTAL 25,199 |
| FORM 990-EZ, PART II, LINE 24 | ACCOUNTS RECEIVABLE 50,841 800 PREPAID EXPENSES AND DEFERRED CHARGES 1,000 343 TOTAL 51,841 1,143 |
| FORM 990-EZ, PART II, LINE 26 | ACCOUNTS PAYABLE AND ACCRUED EXPENSES 17,443 0 DEFERRED REVENUE 0 25,000 |
| FORM 990-EZ, PART III | THE MISSION OF THE MINNESOTA COMMUNITY HEALTH WORKER ALLIANCE (ALLIANCE) IS TO "BUILD COMMUNITY AND SYSTEM'S CAPACITY FOR BETTER HEALTH THROUGH THE INTEGRATION OF COMMUNITY HEALTH WORKER STRATEGIES. OUR VISION IS EQUITABLE AND OPTIMAL OUTCOMES FOR ALL COMMUNITIES. COMMUNITY HEALTH WORKERS (CHWS) BRIDGE CLINICAL SETTINGS AND DIVERSE COMMUNITIES TO IMPROVE ACCESS, REDUCE COSTS, IMPROVE HEALTH OUTCOMES, AND DIVERSIFY THE WORKPLACE. |
| FORM 990-EZ, PART III, LINE 28 | THE ALLIANCE IS A STATE-WIDE NOT FOR PROFIT ORGANIZATION GOVERNED BY A BOARD OF DIRECTORS COMPRISED OF CHWS, HEALTH PROFESSIONALS, EDUCATORS, PUBLIC AND NONPROFIT LEADERS. THERE ARE THREE PRIMARY AREAS OF PROGRAMMATIC FOCUS; EDUCATION & TRAINING, FIELD BUILDING, AND PUBLIC POLICY. 2019 PROGRAM HIGHLIGHTS INCLUDE: OTTO BREMER GRANT: MNCHWA COMPLETED A STRATEGIC PARTNERSHIP WITH STRATIS HEALTH. THE ALLIANCE IS NOW HOUSED WITH STRATIS HEALTH WITH AN AGREEMENT FOR FINANCIAL, ACCOUNTING AND ADMINISTRATIVE SERVICES AS WELL AS OFFICE AND CLASSROOM SPACE. A NEW WAY OF OPERATING AND NEW FINANCIAL SYSTEM WERE BOTH GOALS OF THIS PROPOSAL ACCOMPLISHED WITH THIS PARTNERSHIP. THE ALLIANCE HIRED A CHW, LATANYA BLACK, AS EXECUTIVE DIRECTOR, STARTING IN SEPTEMBER 2019. THE ALLIANCE ALSO NOW CONTRACTS WITH CHWS WHO SERVE AS COMMUNITY ENGAGEMENT SPECIALISTS AND/OR IN OTHER ROLES WHO WORK DIRECTLY WITH CHWS AND OTHERS THROUGH THE CHW CIRCLE, THE CHW LEADERSHIP PROGRAM, THE CHW SUPERVISORS ROUND TABLE AND VARIOUS TRAINING PROGRAMS. THIS HAS SOLIDIFIED THESE DIRECT SERVICES TO CHWS AND OTHERS AND ADVANCES THE FIELD. THE ALLIANCE HELD A SERIES OF STAKEHOLDER FOCUS GROUPS AND DEVELOPED A SURVEY REGARDING THE CHW CERTIFICATE CURRICULUM TO GUIDE REVISIONS AND UPDATES WHICH ARE NOW UNDERWAY. UCARE GRANT: RESULTED IN MANY SIGNIFICANT OUTCOMES FOR THE MINNESOTA COMMUNITY HEALTH WORKER ALLIANCE'S (ALLIANCE) IMPORTANT WORK IN ADVANCING HEALTH ACCESS AND HEALTH EQUITY. THIS GRANT ALSO LEVERAGED ADDITIONAL PARTNERSHIPS AND RESOURCES TO DEVELOP A FOUNDATION FOR THE FUTURE WORK OF THE ALLIANCE. THE ALLIANCE HAS FOUR STRATEGIC GOALS THAT WERE ADDRESSED THROUGH THIS GRANT: EDUCATION AND TRAINING ADVANCING THE FIELD ORGANIZATIONAL CAPACITY BUILDING PUBLIC POLICY LISTED BELOW BY FUNDING CATEGORY ARE THE HIGHLIGHTS AND OUTCOMES RESULTING FROM THE GRANT: ORGANIZATIONAL CAPACITY BUILDING THE ALLIANCE ALLOCATED FUNDS TO STRATEGIC PARTNERSHIP EXPLORATION. BEGINNING IN THE FIRST QUARTER, THE BOARD BEGAN PARTNERSHIP EXPLORATION IN EARNEST AND CREATED CRITERIA TO EVALUATE A STRATEGIC PARTNERSHIP RELATIONSHIP WHICH INCLUDED MISSION ALIGNMENT, COMPLEMENTARY PROGRAMS, COMMITMENT TO HEALTH EQUITY, ABILITY TO PROVIDE ADMINISTRATIVE AND FINANCIAL SUPPORT, AND ABILITY TO CO-LOCATE. THE OUTREACH RESULTED IN A FOCUS ON SHARED PROGRAMMING OPPORTUNITIES, AN ADMINISTRATIVE SERVICE AGREEMENT THAT INCLUDED OFFICE SPACE AND USE OF MEETING ROOMS, AND FEE- BASED ACCOUNTING AND FINANCIAL SERVICES. FOR THE FIRST TIME IN THE ORGANIZATION'S HISTORY, THE ALLIANCE NOW HAS PROFESSIONAL OFFICE SPACE AS OF SEPTEMBER 1, 2019. ACCOUNTING SERVICES WERE ALSO TRANSITIONED AT THAT TIME. THE ALLIANCE ALSO ALLOCATED FUNDS TO SYSTEMS IMPROVEMENT INCLUDING TECHNOLOGY. DURING 2019, THE ALLIANCE PURCHASED A CONFERENCE LINE AND REMOTE MEETING SOFTWARE. IN ADDITION, THE ORGANIZATION RETAINED THE PROFESSIONAL SERVICES OF SOCIAL GOOD, LLC, A TECHNOLOGY SUPPORT COMPANY THAT SPECIALIZES IN SERVICES TO NONPROFITS. SOCIAL GOOD CREATED A FACEBOOK PAGE THAT IS NOW MANAGED AND UPDATED BY A COMMUNITY HEALTH WORKER (CHW) FROM GREATER MINNESOTA, ADDED MANY ITEMS TO THE VAST ONLINE LIBRARY, AND OPTIMIZED THE MONTHLY E-NEWSLETTER. EDUCATION AND TRAINING THE ALLIANCE CREATED AND IMPLEMENTED THE NATION'S FIRST STATEWIDE COMPETENCY-BASED CURRICULUM IN 2010 THAT IS TAUGHT IN HIGHER EDUCATION VIA THE MN STATE SYSTEM (OF COLLEGES AND UNIVERSITIES), ST. CATHERINE'S UNIVERSITY, AND SUMMIT ACADEMY OIC. THE CURRICULUM HAS BEEN ADOPTED BY 18 STATES. SEVERAL UNITS WERE ADDED TO THE HEALTH PROMOTION MODULE OF THE CURRICULUM OVER THE YEARS, INCLUDING MENTAL/BEHAVIORAL HEALTH/ACES; TRAUMA IMPACT AND TRAUMA HEALING; PREDIABETES; AND PREHYPERTENSION. HEALTH EQUITY, TRAUMA, MOTIVATIONAL INTERVIEWING, AND SELF-CARE ARE WOVEN THROUGHOUT THE CORE COMPETENCIES. THE UCARE FUNDING ALLOWED THE ALLIANCE TO CONTRACT WITH ANNE GANEY, MPH, ONE OF THE ORIGINAL AUTHORS WHO PILOTED THE CURRICULUM. MS. GANEY LED THE EFFORTS OF THE ALLIANCE'S EDUCATION COMMITTEE WHICH IS COMPRISED OF FACULTY FROM VARIOUS SCHOOLS AND CHW CERTIFICATE HOLDERS WHO HAVE GRADUATED FROM ONE OF THE PROGRAMS. THE UCARE FUNDING SUPPORTED THE GATHERING OF SIX STATEWIDE FOCUS GROUPS. NEARLY 50 DIFFERENT INDIVIDUALS PARTICIPATED IN THE FOCUS GROUPS REPRESENTING VOLUNTARY AND COMMUNITY ORGANIZATIONS, MINNESOTA DEPARTMENT OF HEALTH, COMMUNITY HEALTH WORKERS, CHW EMPLOYERS, LOCAL PUBLIC HEALTH AND STATE HEALTH IMPROVEMENT PROGRAM REPRESENTING THE METROPOLITAN AND RURAL AREAS. THE ALLIANCE ALSO FACILITATED AN ONLINE SURVEY VIA THE MN STATE SYSTEM TO AUGMENT THE FOCUS GROUP RESEARCH. COMMUNITY ENGAGEMENT SPECIALIST A CHW COMMUNITY ENGAGEMENT SPECIALIST WAS A NEW ROLE FOR THE ALLIANCE IN 2018 AND IS CRITICAL TO BUILDING AWARENESS OF THE ALLIANCE'S WORK AND PROVIDING PROGRAMMATIC OFFERINGS. IN 2019, THIS POSITION CO-LED THE CHW LEADERSHIP INSTITUTE WITH THE ALLIANCE'S EDUCATOR/TRAINER, FACILITATED TRAININGS IN VARIOUS PARTS OF THE STATE, REPRESENTED THE ALLIANCE AT THE RURAL CHW CONFERENCE, SERVED AS THE MINNESOTA AMBASSADOR TO THE NATIONAL CHW ALLIANCE, PRESENTED A POSTER SESSION WITH FACULTY FROM ST. CATHERINE'S AT THE AMERICAN PUBLIC HEALTH ASSOCIATION, AND CREATED A MENTORING PROGRAM WITH CHW LEADERSHIP GRADUATES AND CURRENT SUMMIT ACADEMY CHW STUDENTS. THE COMMUNITY ENGAGEMENT SPECIALIST RECRUITED GUEST SPEAKERS EACH MONTH AND ASSISTED OTHER CHWS IN CO-LEADING THE MONTHLY CHW PEER LEARNING CIRCLE TO BUILD THEIR MEETING FACILITATION SKILLS. AS A RESULT OF THE COMMUNITY ENGAGEMENT SPECIALISTS OUTREACH IN THE FIELD, THE ALLIANCE IS BUILDING A CHW REGISTRY WHICH IS THE FIRST STEP IN CREATING A FORMAL CERTIFICATION PROCESS WHICH THE PUBLIC POLICY COMMITTEE IS CURRENTLY EXPLORING. 2019 CONFERENCE "NOTHING ABOUT US, WITHOUT US" THE ALLIANCE 2019 CONFERENCE HAD A RECORD CONFERENCE TURNOUT WITH 214 ATTENDEES (CHWS, ALLIES, SUPPORTERS, AND EXHIBITORS). ATTENDEES WERE FROM A BROAD RANGE OF LOCATIONS INCLUDING ELY TO SIOUX FALLS, SD. WORDS SEEM SO INADEQUATE TO CONVEY THE ENERGY AND PASSION FOR THE TRIPLE AIM OF HEALTH EQUITY. THE CONFERENCE WAS AN INCREDIBLE OPPORTUNITY TO THE ALLIANCE ADVANCING THE FIELD WITH TREMENDOUS SPEAKERS, PANELISTS, AND POWERFUL DISCUSSION THAT IDEALLY LEAD TO CHANGING THE HEALTH CARE DELIVERY MODEL AND MAKING PATIENT/CLIENT CENTERED CARE A REALITY. "NOTHING ABOUT US, WITHOUT US" WILL BECOME OUR CENTERING AND CORE VALUE MOVING FORWARD. THE PATHWAYS COMMUNITY HUB INSTITUTE'S (PCHI'S) THE ALLIANCE RECEIVED A ONE-TIME FULL PAYMENT FOR THE PURCHASE AND TRAINING OF THE CHW CURRICULUM. PCHI INTEGRATE TRAINING THAT WILL ALIGN WITH THE NATIONAL C3 COMPETENCIES, THE MINNESOTA CHW SCOPE OF PRACTICE COMBINED WITH THE PATHWAYS COMMUNITY HUB'S PATHWAY. 2019 FUNDRAISING BREAKFAST THE ALLIANCE HOSTED THE SECOND EDUCATIONAL AND FUNDRAISING BREAKFAST "BRIDGE TO THE FUTURE" IN SEPTEMBER LED BY CHWS AND SHOWCASING THE IMPACT OF CHW WORK WITH INDIVIDUALS AND THE COMMUNITY. WHILE WE FELL SLIGHTLY SHORT OF OUR GOAL THROUGH THE GENEROUS DONATIONS FROM BOARD MEMBERS, SPONSORS AND SUPPORTERS OF THE ALLIANCE WE RAISED ABOUT 5000. |
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