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 | |||||
|
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.") .. | 5,969,129 | 5,980,721 | 5,466,805 | 6,708,951 | 6,115,438 | 30,241,044 |
| 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 | 5,969,129 | 5,980,721 | 5,466,805 | 6,708,951 | 6,115,438 | 30,241,044 |
| 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).. | 417,518 | |||||
| 6 | Public support. Subtract line 5 from line 4. | 29,823,526 | |||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 5,969,129 | 5,980,721 | 5,466,805 | 6,708,951 | 6,115,438 | 30,241,044 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | 63,253 | 21,221 | 27,342 | 34,504 | 36,275 | 182,595 |
| 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.).. | 363,216 | 21,785 | 19,217 | 24,129 | 52,923 | 481,270 |
| 11 | Total support. Add lines 7 through 10 | 30,904,909 | |||||
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.") . | ||||||
| 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) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (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 |
||
| 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 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 |
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| Return Reference | Explanation |
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| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | THE MEMBERSHIP OF THE ASSOCIATION IS COMPRISED OF TITLE V PROGRAM (STATE AND TERRITORY MCH/CYSHCN PROGRAM), REGULAR MEMBERS, AND ASSOCIATE MEMBERS. EACH TITLE V PROGRAM MAY APPOINT UP TO FIVE DELEGATES, WHO HAVE VOTING AUTHORITY ON BEHALF OF THE TITLE V PROGRAM MEMBERS. ONLY DELEGATES ARE ELIGIBLE TO VOTE IN THE ELECTION OF ASSOCIATION OFFICERS AND DIRECTORS, AND ONLY DELEGATES ARE ELIGIBLE FOR ELECTION AS OFFICERS AND DIRECTORS, EXCEPT FOR THE TWO FAMILY REPRESENTATIVE POSITIONS ON THE BOARD OF DIRECTORS. REGULAR MEMBERS ARE STAFF OF TITLE V PROGRAMS OR INDIVIDUALS WHO WORK IN PARTNERSHIPS WITH TITLE V PROGRAMS, INCLUDING FAMILY LIAISONS WORKING IN CONNECTION WITH STATE TITLE V PROGRAMS. ASSCOIATE MEMBERS ARE INDIVIDUALS AND ORGANIZATIONS INTERESTED IN MATERNAL AND CHILD HEALTH. |
| FORM 990, PART VI, SECTION A, LINE 7A | MEMBERS ARE ALLOWED TO VOTE IN ELECTIONS. ASSOCIATE MEMBERS ARE NOT ELIGIBLE TO VOTE ON ANY MATTER OR TO HOLD AND OFFICE OR BOARD OF DIRECTOR POSITION, BUT MAY SERVE ON COMMITTEES OF THE ASSOCIATION. |
| FORM 990, PART VI, SECTION A, LINE 7B | REGULAR MEMBER ARE ELIGIBLE TO VOTE ON ALL MATTERS BEFORE THE ASSOCIATION, EXCEPT ELECTION OF OFFICERS AND DIRECTORS INCLUDING REMOVAL OF DIRECTORS AND CERTAIN AMENDMENTS TO THE BYLAWS. ASSOCIATE MEMBERS ARE NOT ELIGIBLE TO VOTE ON ANY MATTER OR TO HOLD AND OFFICE OR BOARD OF DIRECTOR POSITION, BUT MAY SERVE ON COMMITTEES OF THE ASSOCIATION. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE DRAFT 990 WAS PREPARED BY EXTERNAL ACCOUNTANTS AND REVIEWED BY SENIOR MANAGEMENT. THE DRAFT WAS PROVIDED TO THE EXECUTIVE/FINANCE COMMITTEE FOR REVIEW AND COMMENT. A FINAL COPY OF FORM 990 WAS SENT TO THE ENTIRE BOARD BEFORE IT WAS FILED WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | ALL AMCHP DIRECTORS MUST ANNUALLY COMPLETE A CONFLICT OF INTEREST STATEMENT THAT DISCLOSES ANY EXISTING OR POTENTIAL RELATIONSHIPS THAT MAY LEAD TO AN ACTUAL OR PERCEIVED CONFLICT OF INTEREST. BOARD MEMBERS ARE RESPONSIBLE FOR INFORMING THE GOVERNANCE COMMITTEE CHAIR OF ANY SUBSEQUENT CHANGES IN A TIMELY MANNER. THE GOVERNANCE COMMITTEE CHAIR REVIEWS ALL CONFLICT OF INTEREST STATEMENTS. THESE STATEMENTS MAY BE DISTRIBUTED TO THE BOARD OF DIRECTORS AND CHIEF EXECUTIVE OFFICER AND ALSO MAY BE DISCLOSED PUBLICLY. ON REQUEST, AN INTERESTED BOARD MEMBER, OFFICER, OR STAFF MEMBER DOES NOT PARTICIPATE IN ANY DISCUSSION OR DEBATE OF THE BOARD OF DIRECTORS, OR OF ANY COMMITTEE OR SUBCOMMITTEE THEREOF IN WHICH THE SUBJECT OF IS A CONTRACT, TRANSACTION, OR SITUATION IN WHICH THERE MAY BE A PERCEIVED OR ACTUAL CONFLICT OF INTEREST. HOWEVER, THEY MAY BE PRESENT TO PROVIDE CLARIFYING INFORMATION IN SUCH A DISCUSSION OR DEBATE UNLESS OBJECTED TO BY ANY PRESENT BOARD OR COMMITTEE MEMBER FOLLOWING FULL DISCLOSURE OF A POSSIBLE CONFLICT OF INTEREST OR ANY CONDITION LISTED ABOVE. THE BOARD OF DIRECTORS DETERMINES WHETHER A CONFLICT OF INTEREST EXISTS AND, IF SO, THE BOARD VOTES TO AUTHORIZE OR REJECT THE TRANSACTION OR TAKES ANY OTHER ACTION DEEMED NECESSARY TO ADDRESS THE CONFLICT AND PROTECT AMCHP'S BEST INTEREST. VOTES SHALL BE BY A MAJORITY VOTE WITHOUT COUNTING THE VOTE OF ANY INTERESTED DIRECTOR, EVEN IF THE DISINTERESTED DIRECTORS ARE LESS THAN A QUORUM PROVIDED THAT AT LEAST ONE CONSENTING DIRECTOR IS DISINTERESTED. |
| FORM 990, PART VI, SECTION B, LINE 15A | THE CEO'S SALARY IS REVIEWED AND APPROVED BY THE BOARD ON AN ANNUAL BASIS. IN CONJUNCTION WITH A 360 DEGREE PERFORMANCE MANAGEMENT SYSTEM, THE BOARD USES MARKET SURVEYS OF OTHER NGOS. THE PROCESS AND DECISION IS DOCUMENTED IN WRITTEN FORM AND PLACED IN THE PERSONNEL FILES. WITH AN ESTABLISHED COMPENSATION SYSTEM, THE CEO DETERMINES THE SALARIES OF THE OTHER EMPLOYEES. THE LAST COMPENSATION REVIEW TOOK PLACE IN FEBRUARY 2021. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, FINANCIAL STATEMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | CONSULTING EXPENSES: PROGRAM SERVICE EXPENSES 260,762. MANAGEMENT AND GENERAL EXPENSES 141,744. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 402,506. TEMPORARY HELP: PROGRAM SERVICE EXPENSES 54,995. MANAGEMENT AND GENERAL EXPENSES 29,895. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 84,890. COMMUNICATION SERVICES: PROGRAM SERVICE EXPENSES 53,912. MANAGEMENT AND GENERAL EXPENSES 29,306. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 83,218. AUDIO/VISUAL EXPENSES: PROGRAM SERVICE EXPENSES 37,867. MANAGEMENT AND GENERAL EXPENSES 20,584. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 58,451. HUMAN RESOURCES: PROGRAM SERVICE EXPENSES 18,035. MANAGEMENT AND GENERAL EXPENSES 9,804. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 27,839. PROCESSING FEES: PROGRAM SERVICE EXPENSES 6,256. MANAGEMENT AND GENERAL EXPENSES 3,401. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 9,657. OTHER PROFESSIONAL SERVICES: PROGRAM SERVICE EXPENSES 108,551. MANAGEMENT AND GENERAL EXPENSES 59,702. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 168,253. |
| FORM 990, PART XI, LINE 9: | BAD DEBT EXPENSE -53,253. RETURN GRANTS 77,668. |
| Software ID: | |
| Software Version: |