TY 2020 Form 990

(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)	(E) Reportable compensation from related organizations (W-2/1099-MISC)
(1) JEFFREY S RUSSELL...................................................................... PRESIDENT	0.39 ................. 40.00	X	X	0	1,152,205	60,242
(2) JEFF CHAFFIN DDS...................................................................... DIRECTOR	1.17 ................. 40.00	X		0	522,413	24,656
(3) SHERRY PERKINS...................................................................... SECRETARY-TREASURER	0.67 ................. 40.00		X	0	406,201	24,487
(4) SUZANNE HECKENLAIBLE...................................................................... EXECUTIVE DIRECTOR	10.00 ................. 30.00		X	0	365,508	60,290
(5) ROWENA CROSBIE...................................................................... DIRECTOR, VICE CHAIR	1.00 ................. 1.60	X	X	900	800	19,500
(6) JOEL WULF...................................................................... DIRECTOR, CHAIR	1.00 .................	X	X	900	0	0
(7) MISSY GOWEY...................................................................... DIRECTOR, STARTING AUGUST	0.50 .................	X		600	0	0
(8) SUZANNA DE BACA...................................................................... DIRECTOR, STARTING AUGUST	0.50 .................	X		600	0	0
(9) HOWARD COWEN DDS...................................................................... DIRECTOR	0.50 .................	X		0	0	0
(10) DAN CAPLAN DDS...................................................................... DIRECTOR	0.50 .................	X		0	0	0
(11) TRACY RODGERS...................................................................... DIRECTOR	0.50 .................	X		0	0	0
(12) JENNIFER VERMEER...................................................................... DIRECTOR	0.50 .................	X		0	0	0
(13) SCOTT RAECKER...................................................................... DIRECTOR	0.50 .................	X		0	0	0
(14) LYNN CURRY DDS...................................................................... DIRECTOR	0.50 .................	X		0	0	0
(15) KEN JONES...................................................................... DIRECTOR	0.50 .................	X		0	0	0
(16) DR NAFISSA CISSE EGBUONYE...................................................................... DIRECTOR, STARTING AUGUST	0.50 .................	X		0	0	0
(17) MATT MENDENHALL...................................................................... DIRECTOR, THROUGH JUNE	1.00 .................	X		0	0	0

- 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.
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Attach to Form 990 or Form 990-EZ.
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Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2020

Open to Public
Inspection

Name of the organization

DELTA DENTAL OF IOWA FOUNDATION

Employer identification number

26-0762771

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 ...............................1

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

(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)
(i) Name of supported organization	(ii) EIN		Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(A) DELTA DENTAL OF IOWA	420959302	10	Yes		0	0

Total 1					0	0

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

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2020

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization failed to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2016	(b) 2017	(c) 2018	(d) 2019	(e) 2020	(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.

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2016	(b) 2017	(c) 2018	(d) 2019	(e) 2020	(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

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

First 5 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 2020 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2019 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2020. 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—2019. 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—2020. 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—2019. 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) 2020

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) 2016	(b) 2017	(c) 2018	(d) 2019	(e) 2020	(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) 2016	(b) 2017	(c) 2018	(d) 2019	(e) 2020	(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 5 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 2020 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2019 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2020 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2019 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2020. 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—2019. 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) 2020

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, 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.

Yes

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 lines 3b and 3c below.

Yes

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.

Yes

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.

Yes

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked box 12a or 12b in Part I, answer lines 4b and 4c 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 lines 5b and 5c 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) 2020

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 lines 11b and 11c below, the governing body of a supported organization?

11a

A family member of a person described in 11a above?

11b

A 35% controlled entity of a person described in line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the officers, 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.

Yes

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 line 2 above, 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 lines 2a and 2b 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 line 2a, above 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 lines 3a and 3b 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?If "Yes" or "No", 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) 2020

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 0.015 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 0.035	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) 2020

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	1
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity	2
3 Administrative expenses paid to accomplish exempt purposes of supported organizations	3
4 Amounts paid to acquire exempt-use assets	4
5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI)	5
6 Other distributions (describe in Part VI). See instructions	6
7Total annual distributions. Add lines 1 through 6.	7
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions	8
9 Distributable amount for 2020 from Section C, line 6	9
10 Line 8 amount divided by Line 9 amount	10

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2020	(iii) Distributable Amount for 2020
1 Distributable amount for 2020 from Section C, line 6
2 Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2020:
a From 2015.......
b From 2016.......
c From 2017.......
d From 2018.......
e From 2019.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2020 distributable amount
i Carryover from 2015 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
4Distributions for 2020 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2020 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.
5 Remaining underdistributions for years prior to 2020, 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 2020. 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 2021. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2016.....
b Excess from 2017.....
c Excess from 2018.....
d Excess from 2019.....
e Excess from 2020.....

Schedule A (Form 990 or 990-EZ) (2020)

Schedule A (Form 990 or 990-EZ) 2020

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, PART 1, LINE 12G, COLUMN V:	DELTA DENTAL OF IOWA'S MISSION IS TO STRENGTHEN AND TRANSFORM THE HEALTH AND SMILES OF THE PEOPLE WE SERVE. AN AMOUNT IS SET ASIDE EACH YEAR TO FUND THIS MISSION. THE AMOUNT IS DETERMINED BY THE PERFORMANCE AND FINANCIAL STRENGTH OF DELTA DENTAL. AFTER THE AUDITED FINANCIALS ARE COMPLETE, THE AMOUNT IS PAID TO THE FOUNDATION. THE FOUNDATION IS A SEC. 501(C)(3) ORGANIZATION AND IS A TYPE 1 SUPPORTING ORGANIZATION UNDER SEC. 509(A)(3). IT IS THE RESPONSIBILITY OF THE FOUNDATION TO DISTRIBUTE THE MONIES CONSISTENT WITH ITS MISSION AND FOUNDING DOCUMENTS. THE MISSION OF THE FOUNDATION IS TO STRENGTHEN AND TRANSFORM THE HEALTH AND SMILES OF ALL IOWANS. THE FOUNDATION WILL PROVIDE FUNDS TO OTHER SEC. 501(C)(3) ORGANIZATIONS, GOVERNMENTS, OR ACADEMIC INSTITUTIONS THROUGH THEIR GRANTS PROGRAM THAT ALIGN WITH THE PROJECTS OF ORAL HEALTH, ORAL AND OVERALL HEALTH INTEGRATION AND OVERALL HEALTH. THE AMOUNT CONTRIBUTED TO THE FOUNDATION IN 2020 WAS $5,608,977.
SCHEDULE A, PART IV, LINE 3B:	DELTA DENTAL OF IOWA HAS PROVIDED A COPY OF THEIR 501(C)(4) IRS DETERMINATION LETTER AND HAS COMPLETED THE PROFORMA PUBLIC SUPPORT CALCULATIONS FOR THE APPLICABLE YEARS. DURING THE CURRENT YEAR, DELTA DENTAL OF IOWA MET THE PUBLIC SUPPORT TEST REQUIREMENTS. DELTA DENTAL OF IOWA FOUNDATION HAS A FORMAL POLICY APPROVED BY THE BOARD TO ANNUALLY CONFIRM THAT DELTA DENTAL OF IOWA HAS MAINTAINED ITS SUPPORTED ORGANZATION STATUS AS A 501(C)(4) AND HAS SATISIFIED THE PUBLIC SUPPORT TESTS UNDER SECTION 509(A)(2) OF THE INTERNAL REVENUE CODE.
SCHEDULE A, PART IV, LINE 3C:	ALL GRANTEES THAT RECEIVE FUNDS FROM THE DELTA DENTAL OF IOWA FOUNDATION ARE REQUIRED TO COMPLETE AN OUTCOMES REPORT WITHIN 30 DAYS OF COMPLETION OF THE PROJECT. FOR GRANTEES UNDER $25,000, THIS INCLUDES INFORMATION SUCH AS NUMBER OF INDIVIDUALS SERVICED, CHALLENGES, OPPORTUNITIES AND LESSONS LEARNED. FOR GRANTEES THAT RECEIVE OVER $25,000 AN EVALUATION PLAN IS DEVELOPED IN COORDINATION WITH THE GRANTEE AND THE FOUNDATION SPECIFIC TO THE PROJECT AND TO ALIGN WITH A CORE SET OF INDICATORS OF SUCCESS. IN ADDITION, GRANTEES OVER $50,000 PRESENT TO THE DELTA DENTAL OF IOWA FOUNDATION BOARD AT THE COMPLETION OF THE PROJECT. GRANTEES MAY REQUEST A ONE TIME EXTENSION TO SPEND DOWN ANY UNUSED FUNDS, BUT IT MUST BE FOR THE SAME PROJECT OTHERWISE THEY FUNDS ARE REQUIRED TO BE RETURNED. ANY CHANGE FROM THE INITIAL REQUEST FOR FUNDS REQUIRES A WRITTEN REQUEST AND APPROVAL.

Schedule A (Form 990 or 990-EZ) 2020

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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

2020

Name of the organization

DELTA DENTAL OF IOWA FOUNDATION

Employer identification number

26-0762771

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) (2020)

Schedule B (Form 990, 990-EZ, or 990-PF) (2020) Page 2

Name of organization DELTA DENTAL OF IOWA FOUNDATION

Part I Contributors	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) (2020)

Schedule B (Form 990, 990-EZ, or 990-PF) (2020)

Page 3

Name of organization DELTA DENTAL OF IOWA FOUNDATION		Employer identification number 26-0762771

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) (2020)

Schedule B (Form 990, 990-EZ, or 990-PF) (2020)

Page 4


Name of organization DELTA DENTAL OF IOWA FOUNDATION			Employer identification number 26-0762771
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) (2020)

Additional Data

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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 instructions and the latest information.

OMB No. 1545-0047

2020

Open to Public Inspection

Name of the organization

DELTA DENTAL OF IOWA FOUNDATION

Employer identification number

26-0762771

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 FASB 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 FASB 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 FASB 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) 2020

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 ....	20,030,878	14,922,781	14,214,533	11,650,509	8,219,425
b	Contributions ...	1,000,000	2,000,000	1,650,000	1,000,000	3,000,000
c	Net investment earnings, gains, and losses	2,684,491	3,138,857	-914,801	1,590,116	469,972
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....	34,916	30,760	26,951	26,092	38,888
g	End of year balance ......	23,680,453	20,030,878	14,922,781	14,214,533	11,650,509

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

Term endowment SchDMd Bullet

100.000 %

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)

Yes

(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 ....
e	Other .....
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..		0

Schedule D (Form 990) 2020

Page 3

Part VII

Investments - Other 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
(B)
(C)
(D)
(E)
(F)
(G)
(H)
(I)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

Investments - Program 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

(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
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

(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
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.)	46,299
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) 2020

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	8,283,018
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a	2,085,249
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d .....................			2e	2,085,249
3	Subtract line 2e from line 1..................			3	6,197,769
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	34,916
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b....................			4c	34,916
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......			5	6,232,685

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	3,699,138
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities .........	2a
b	Prior year adjustments ............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d	6,900
e	Add lines 2a through 2d....................			2e	6,900
3	Subtract line 2e from line 1...................			3	3,692,238
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	34,916
b	Other (Describe in Part XIII.) ............	4b
c	Add lines 4a and 4b.....................			4c	34,916
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......			5	3,727,154

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
PART V, LINE 4:	THE INTENDED USE OF THE ENDOWMENT FUND IS TO PROVIDE A FUTURE STREAM OF INCOME FOR THE FOUNDATION TO BE USED TO FUND THE MISSION OF THE FOUNDATION.
PART X, LINE 2:	AS OF DECEMBER 31, 2020 AND 2019, THE COMPANY'S UNRECOGNIZED TAX BENEFITS WERE NOT SIGNIFICANT. THERE WERE NO SIGNIFICANT PENALTIES OR INTEREST RECOGNIZED OR ACCRUED DURING 2020 AND 2019.
PART XII, LINE 2D - OTHER ADJUSTMENTS:	DONATED BOARD SERVICES 6,900.

Schedule D (Form 990) 2020

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Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

Grants and Other Assistance to Organizations,
Governments and Individuals in the United States

Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990.
lBullet

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

OMB No. 1545-0047

2020

Open to Public
Inspection

Name of the organization
DELTA DENTAL OF IOWA FOUNDATION

Employer identification number
26-0762771

Part I

General Information on Grants and Assistance

Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................

Yes No

Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.

Part II

Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient

that received more than $5,000. Part II can be duplicated if additional space is needed.

(a) Name and address of organization or government	(b) EIN	(c) IRC section (if applicable)	(d) Amount of cash grant	(e) Amount of non-cash assistance	(f) Method of valuation (book, FMV, appraisal, other)	(g) Description of noncash assistance	(h) Purpose of grant or assistance
(1) ALL CARE HEALTH CENTER 902 SOUTH 6TH STREET COUNCIL BLUFFS,IA51501	42-1466508	501(C)3	20,000				FUNDING TO SUPPORT COVID-19 RELIEF
(2) ALLEN COLLEGE 1825 LOGAN AVENUE WATERLOO,IA50713	42-1351526	501(C)3	24,234				FUNDING FOR MEDICAL DENTAL COLLABORATION WITHIN CLINIC TO PROVIDE CARE COORDINATOR, EDUCATION, AND INTERPRETATION/TRANSLATION SERVICES.
(3) AMERICAN HOME FINDING ASSOCIATION 217 E 5TH STREET OTTUMWA,IA52501	42-0713654	501(C)3	5,000				FUNDING TO PURCHASE AND/OR DISTRIBUTE PRODUCTS, SUPPLIES, OR EDUCATION MATERIALS TO EDUCATE CHILDREN 0-5 AND YOUTH ON IMPROVING ORAL HEALTH
(4) AMERICAN HOME FINDING ASSOCIATION 217 E 5TH STREET OTTUMWA,IA52501	42-0713654	501(C)3	0	2,183	AMOUNT PAID	PROVIDED 8,640 TOOTHBRUSHES	PROVIDED 8,640 TOOTHBRUSHES TO I-SMILE PROGRAM.
(5) BALLARD COMMUNITY SCHOOL DISTRICT 105 E MAIN STREET SLATER,IA50244	42-6025573	STATE OF IOWA	0	8,647	AMOUNT PAID	WATER BOTTLE FILLING STATION	INSTALLED A WATER BOTTLE FILING STATION FOR BALLARD WEST ELEMENTARY SCHOOL AND PROVIDED WATER BOTTLES, TOOTHBRUSHES, BOOKMARKS, AND ELECTRONIC/PRINTABLE EDUCATIONAL ACTIVITIES FOR STUDENTS.
(6) BETHANY CHRISTIAN SERVICES 316 E 6TH STREET DES MOINES,IA50309	38-3393984	501(C)3	25,000				FUNDING TO SUPPORT DEVELOPMENT OF COALITION PLANNING TO COLLECTIVELY WORK TO IMPROVE BLACK MATERNAL HEALTH OUTCOMES INCLUDING ADDRESSING ORAL HEALTH, MENTAL HEALTH, AND OVERALL HEALTH DURING PREGNANCY AND AFTER.
(7) BIDWELL RIVERSIDE CENTER 1203 HARTFORD AVENUE DES MOINES,IA50315	42-0680259	501(C)3	5,000				FUNDING TO SUPPORT COVID-19 RELIEF
(8) BOYS AND GIRLS CLUB OF GREATER DUBUQUE 1299 LOCUST STREET DES MOINES,IA52001	42-0710263	501(C)3	5,000				FUNDING TO SUPPORT COVID-19 RELIEF
(9) BOYS AND GIRLS CLUB OF SIOUX CITY 2101 COURT STREET SIOUX CITY,IA51102	93-0991864	501(C)3	25,000				FUNDING TO SUPPORT DEVELOPMENT AND IMPLEMENTATION OF SELF-HELP MENTAL WELLNESS SESSIONS FOR INDIVIDUALS IN COMMUNITY EXPERIENCING STRESS, ISOLATION, DEPRESSION EXACERBATED BY THE PANDEMIC.
(10) BOYS AND GIRLS CLUB OF SIOUX CITY 2101 COURT STREET SIOUX CITY,IA51102	93-0991864	501(C)3	10,000				FUNDING TO SUPPORT COVID-19 RELIEF
(11) BROADLAWNS MEDICAL CENTER FOUNDATION 1801 HICKMAN ROAD DES MOINES,IA50314	42-1527407	501(C)3	20,000				FUNDING TO SUPPORT COVID-19 RELIEF
(12) CAPSTONE BEHAVIORAL HEALTHCARE 1123 1ST AVE E NEWTON,IA50208	42-0883707	501(C)3	5,000				FUNDING TO SUPPORT COVID-19 RELIEF
(13) CATHERINE MCAULEY CENTER 866 4TH AVENUE SE CEDAR RAPIDS,IA52403	42-1342872	501(C)3	25,000				FUNDING TO SUPPORT REFUGEES AND IMMIGRANTS IN INCREASING HEALTH LITERACY AND TO UNDERSTAND/IMPLEMENT COVID-19 HEALTH PRECAUTIONS.
(14) CATHERINE MCAULEY CENTER 866 4TH AVENUE SE CEDAR RAPIDS,IA52403	42-1342872	501(C)3	5,000				FUNDING TO SUPPORT COVID-19 RELIEF
(15) CENTER ASSOCIATES 9 N 4TH AVENUE MARSHALLTOWN,IA50158	42-0805386	501(C)3	17,500				FUNDING TO SUPPORT MENTAL AND EMOTIONAL HEALTH EDUCATION/TRAINING AND ACCESS TO SERVICES FOR TEACHERS, STUDENTS, AND FAMILIES TO HELP COPE WITH COVID-19 AND DERECHO.
(16) CENTER ASSOCIATES 9 N 4TH AVENUE MARSHALLTOWN,IA50158	42-0805386	501(C)3	2,500				FUNDING TO SUPPORT COVID-19 RELIEF
(17) CENTRAL IOWA SHELTER AND SERIVCES 1420 MULBERRY STREET DES MOINES,IA50309	42-1394212	501(C)3	25,000				FUNDING FOR AN AQUAPONIC SYSTEM TO ENABLE SUSTAINABLE ACCESS TO HEALTHY FOODS FOR SHELTER CLIENTS AND THE LARGER COMMUNITY ALONG WITH EDUCATION FOR CLIENTS THROUGH JOB TRAINING PROGRAM.
(18) CENTRAL IOWA SHELTER AND SERIVCES 1420 MULBERRY STREET DES MOINES,IA50309	42-1394212	501(C)3	10,000				FUNDING TO SUPPORT COVID-19 RELIEF
(19) CHRISTIAN COMMUNITY DEVELOPMENT 845 W 4TH STREET WATERLOO,IA50702	42-1397528	501(C)3	15,000				FUNDING TO SUPPORT HEALTH AND WELLNESS SERVICES TO SINGLE MOTHERS, THEIR CHILDREN, AND WOMEN WHO AGE OUT OF FOSTER CARE ENROLLED IN PROGRAMS DURING COVID-19.
(20) CHRISTIAN COMMUNITY DEVELOPMENT 845 W 4TH STREET WATERLOO,IA50702	42-1397528	501(C)3	1,000				FUNDING TO SUPPORT COVID-19 RELIEF
(21) CITY OF CLARINDA 200 S 15TH STREET CLARINDA,IA51632	42-6004378	CITY OF CLARINDA	0	8,192	AMOUNT PAID	WATER BOTTLE FILLING STATION	INSTALLED AN OUTDOOR WATER BOTTLE FILING STATION FOR THE CITY OF CLARINDA.
(22) CITY OF JEFFERSON 204 W HARRISON STREET JEFFERSON,IA50129	42-6004818	CITY OF JEFFERSON	0	6,478	AMOUNT PAID	WATER BOTTLE FILLING STATION	INSTALLED A WATER BOTTLE FILLING STATION FOR GREENE COUNTY COMMUNITY CENTER.
(23) CITY OF URBANDALE 3600 86TH STREET URBANDALE,IA50322	42-6004576	CITY OF URBANDALE	0	5,992	AMOUNT PAID	WATER BOTTLE FILLING STATION	INSTALLED A WATER BOTTLE FILING STATION FOR ALL INCLUSIVE PLAYGROUND.
(24) CITY OF URBANDALE 3600 86TH STREET URBANDALE,IA50322	42-6004576	CITY OF URBANDALE	0	2,648	AMOUNT PAID	WATER BOTTLE FILLING STATION	INSTALLED A WATER BOTTLE FILING STATION FOR SENIOR RECREATION CENTER.
(25) COMMUNITY ACTION OF EASTERN IOWA 500 EAST 59TH STREET DAVENPORT,IA52807	42-0921929	501(C)3	5,000				FUNDING TO SUPPORT COVID-19 RELIEF
(26) COMMUNITY ACTION OF EASTERN IOWA 500 EAST 59TH STREET DAVENPORT,IA52807	42-0921929	501(C)3	0	379	AMOUNT PAID	PROVIDED 1,728 TOOTHBRUSHES	PROVIDED 1,728 TOOTHBRUSHES TO CAEI HEAD START.
(27) COMMUNITY HEALTH CENTERS OF SOUTHEASTERN IOWA INC 1706 WEST AGENCY ROAD WEST BURLINGTON,IA52655	42-1527584	501(C)3	20,000				FUNDING TO SUPPORT COVID-19 RELIEF
(28) COMMUNITY HEALTH CARE INC 500 W RIVER DR DAVENPORT,IA52801	42-1060724	501(C)3	20,000				FUNDING TO SUPPORT COVID-19 RELIEF
(29) COMMUNITY HEALTH CARE INC 500 W RIVER DR DAVENPORT,IA52801	42-1060724	501(C)3	0	1,702	AMOUNT PAID	PROVIDED 3,384 TOOTHBRUSHES, PASTE, AND FLOSS	PROVIDED 3,384 TOOTHBRUSHES, PASTE, AND FLOSS TO COMMUNITY HEALTH CARE, INC.
(30) COMMUNITY HEALTH CENTER OF FORT DODGE 404 N FEDERAL MASON CITY,IA50401	20-0597324	501(C)3	20,000				FUNDING TO SUPPORT COVID-19 RELIEF
(31) COMMUNITY HEALTH CENTERS OF SOUTHERN IOWA INC 302 NE 14TH STREET LEON,IA50144	39-1908462	501(C)3	49,999				FUNDING TO SUPPORT THE PURCHASE OF EQUIPMENT FOR A NEW SATELLITE OSCEOLA DENTAL CLINIC.
(32) COMMUNITY HEALTH CENTERS OF SOUTHERN IOWA INC 302 NE 14TH STREET LEON,IA50144	39-1908462	501(C)3	20,000				FUNDING TO SUPPORT COVID-19 RELIEF
(33) COMMUNITY HEALTH PARTNERS OF SIOUX COUNTY 211 CENTRAL AVENUE SE ORANGE CITY,IA51041	42-1450604	501(C)3	20,000				FUNDING TO SUPPORT ORGANIZATION'S EFFORTS IN STRATEGIC PLANNING AND COMMUNITY OUTREACH ACTIVITIES TO STRENGTHEN COLLABORATIVE EFFORTS OF LATINO COMMUNITY IN ACCESSING HEALTH SERVICES.
(34) COMMUNITY HEALTH PARTNERS OF SIOUX COUNTY 211 CENTRAL AVENUE SE ORANGE CITY,IA51041	42-1450604	501(C)3	2,500				FUNDING TO SUPPORT COVID-19 RELIEF
(35) COMMUNITY YOUTH CONCEPTS 1446 MARTIN LUTHER KING JR PKWY DES MOINES,IA50314	26-2996028	501(C)3	6,000				FUNDING TO SUPPORT YOUTH PHILANTHROPHY BOARD FOCUSED ON HEALTH RELATED RESEARCH PROJECT, POLICY RECOMMENDATIONS AND ADVOCACY ON SELECTED ISSUE.
(36) CRAWFORD COUNTY HOME HEALTH HOSPICE & PUBLIC HEALTH 105 N MAIN ST DENISON,IA51442	42-6004496	501(C)3	5,000				FUNDING FOR SUPPLIES FOR AN ORAL HEALTH EDUCATION PROGRAM FOR CHILDREN LIVING IN CASS, CRAWFORD, SHELBY, HARRISON, AND MONONA COUNTIES WHO DO NOT HAVE ACCESS TO ORAL HEALTH CARE.
(37) CRAWFORD COUNTY HOME HEALTH HOSPICE & PUBLIC HEALTH 105 N MAIN ST DENISON,IA51442	42-6004496	501(C)3	0	2,686	AMOUNT PAID	PROVIDED 8,352 TOOTHBRUSHES	PROVIDED 8,352 TOOTHBRUSHES TO I-SMILE PROGRAM.
(38) CRESCENT COMMUNITY HEALTH CENTER 1690 ELM STREET STE 300 DUBUQUE,IA52001	48-1302204	501(C)3	20,000				FUNDING TO SUPPORT COVID-19 RELIEF
(39) CRITTENTON CENTER 814 PIERCE STREET STE 100 SIOUX CITY,IA51102	42-0698246	501(C)3	5,000				FUNDING TO SUPPORT COVID-19 RELIEF
(40) CROSSROADS OF WESTERN IOWA 1851 MADISON AVENUE 718 COUNCIL BLUFFS,IA51503	42-1041046	501(C)3	10,000				FUNDING TO SUPPORT COVID-19 RELIEF
(41) DENTAL CONNECTIONS 1111 9TH STREET STE 190 DES MOINES,IA50314	42-0680421	501(C)3	20,000				FUNDING TO SUPPORT COVID-19 RELIEF
(42) DENTAL CONNECTIONS 1111 9TH STREET STE 190 DES MOINES,IA50314	42-0680421	501(C)3	13,725				FUNDING TO SUPPORT ORGANIZATION'S STRATEGIC PLANNING AND CRISIS EVENT PLANNING EFFORTS TO BETTER POSITION FOR FUTURE CRISIS EVENTS AND PROMOTE CONTINUED, LONG-TERM SUSTAINABILITY IN PROVIDING ACCESS TO ORAL CARE FOR HIGH PRIORITY POPULATIONS.
(43) DENTAL LIFELINE NETWORK - IOWA 1800 15TH STREET STE 100 DENVER,CO80202	90-0293509	501(C)3	13,383				FUNDING TO SUPORT DENTAL LIFELINE NETWORK'S OUTREACH TO DENTISTS THAT VOLUNTEER IN THEIR NETWORK ACROSS IOWA.
(44) DES MOINES AREA RELIGIOUS COUNCIL 1435 MULBERRY STREET DES MOINES,IA50309	42-0788211	501(C)3	20,000				FUNDING TO SUPPORT ENHANCED DATA COLLECTION SYSTEMS IN RURAL COMMUNITIES TO BE ABLE TO BETTER EDUCATE AND ADVOCATE ON ISSUES OF FOOD INSECURITY IN RURAL IOWA AND BETTER INFORM POLICY.
(45) DES MOINES AREA RELIGIOUS COUNCIL 1435 MULBERRY STREET DES MOINES,IA50309	42-0788211	501(C)3	10,000				FUNDING TO SUPPORT COVID-19 RELIEF
(46) DES MOINES PASTORAL COUNSELING CENTER 8553 URBANDALE AVEUE URBANDALE,IA50322	42-0995074	501(C)3	25,000				FUNDING TO PROVIDE ACCESS TO AFFORDABLE MENTAL HEALTH CARE WHILE SIMULTANEOUSLY ADDRESSING IOWA'S MENTAL HEALTH WORKFORCE SHORTAGE THROUGH TRAINING PROGRAM
(47) DES MOINES PASTORAL COUNSELING CENTER 8553 URBANDALE AVEUE URBANDALE,IA50322	42-0995074	501(C)3	10,000				FUNDING TO SUPPORT COVID-19 RELIEF
(48) DUBUQUE DREAM CENTER 1600 WHITE STREET DUBUQUE,IA52001	81-1062794	501(C)3	10,000				FUNDING TO SUPPORT COVID-19 RELIEF
(49) DUBUQUE VISITING NURSE ASSOCIATION 1454 IOWA STREET DUBUQUE,IA52001	42-0680410	501(C)3	5,000				FUNDING TO SUPPORT COVID-19 RELIEF
(50) DUBUQUE VISITING NURSE ASSOCIATION 1454 IOWA STREET DUBUQUE,IA52001	42-0680410	501(C)3	0	1,872	AMOUNT PAID	PROVIDED 6,048 TOOTHBRUSHES	PROVIDED 6,048 TOOTHBRUSHES TO I-SMILE PROGRAM.
(51) DUBUQUE VISITING NURSE ASSOCIATION 1454 IOWA STREET DUBUQUE,IA52001	42-0680410	501(C)3	0	72	AMOUNT PAID	PROVIDED 144 TOOTHBRUSHES, PASTE, AND FLOSS	PROVIDED 144 TOOTHBRUSHES, PASTE, AND FLOSS TO DUBUQUE VISITING NURSE ASSOCIATION.
(52) EASTERSEALS IOWA 401 NE 66TH AVENUE DES MOINES,IA50313	42-0707100	501(C)3	5,000				FUNDING TO SUPPORT COVID-19 RELIEF
(53) EASTERN IOWA HEALTH CENTER 1225 3RD AVENUE SE CEDAR RAPIDS,IA52403	20-2405575	501(C)3	20,000				FUNDING TO SUPPORT COVID-19 RELIEF
(54) EAT GREATER DES MOINES 501 SW 7TH STREET STE G DES MOINES,IA50309	47-2914255	501(C)3	5,000				FUNDING TO SUPPORT COVID-19 RELIEF
(55) EMBARC 2309 EUCLID AVENUE DES MOINES,IA50310	46-1017191	501(C)3	25,000				FUNDING TO SUPPORT REFUGEE AND IMMIGRANT CASE MANAGEMENT TO ACCESS HEALTH, WELLNESS SERVICES, AND COMMUNITY RESOURCES DURING COVID-19.
(56) EMBARC 2309 EUCLID AVENUE DES MOINES,IA50310	46-1017191	501(C)3	10,000				FUNDING TO SUPPORT COVID-19 RELIEF
(57) FAMILY INC 3501 HARRY LANGDON BLVD STE 150 COUNCIL BLUFFS,IA51503	51-0657063	501(C)3	25,000				FUNDING FOR MEDICAL AND DENTAL WELLNESS RV
(58) FAMILY INC 3501 HARRY LANGDON BLVD STE 150 COUNCIL BLUFFS,IA51503	51-0657063	501(C)3	5,000				FUNDING TO SUPPORT COVID-19 RELIEF
(59) FAMILY INC 3501 HARRY LANGDON BLVD STE 150 COUNCIL BLUFFS,IA51503	51-0657063	501(C)3	5,000				FUNDING USED TO PURCHASE AND/OR DISTRIBUTE PRODUCTS, SUPPLIES, OR EDUCATION MATERIALS FOR THE ANNUAL GIVE KIDS A SMILE DAY
(60) FAMILY INC 3501 HARRY LANGDON BLVD STE 150 COUNCIL BLUFFS,IA51503	51-0657063	501(C)3	0	3,849	AMOUNT PAID	PROVIDED 9,216 TOOTHBRUSHES	PROVIDED 9,216 TOOTHBRUSHES TO I-SMILE PROGRAM.
(61) FAMILY RESOURCES INC 2800 EASTERN AVENUE DAVENPORT,IA52803	42-0698225	501(C)3	5,000				FUNDING TO SUPPORT COVID-19 RELIEF
(62) FEED IOWA FIRST PO BOX 1190 CEDAR RAPIDS,IA52406	45-4058376	501(C)3	10,000				FUNDING TO FOCUS ON CHANGING FOOD SYSTEMS FOR THOSE IN NEED IN LINN COUNTY THROUGH INCREASING ACCESS TO LOCALLY, HEALTHY GROWN FOODS BY FARMING ON UNUSED URBAN LANDSCAPES.
(63) FEED IOWA FIRST PO BOX 1190 CEDAR RAPIDS,IA52406	45-4058376	501(C)3	2,500				FUNDING TO SUPPORT COVID-19 RELIEF
(64) FOOD BANK OF IOWA PO BOX 1517 DES MOINES,IA50305	42-1177880	501(C)3	10,000				FUNDING TO SUPPORT COVID-19 RELIEF
(65) FOOD BANK OF SIOUXLAND 1313 11TH STREET SIOUX CITY,IA51105	42-1381516	501(C)3	5,000				FUNDING TO SUPPORT COVID-19 RELIEF
(66) FORT MADISON COMMUNITY SCHOOL DISTRICT 1930 AVENUE M FORT MADISON,IA52627	46-0781180	STATE OF IOWA	0	5,512	AMOUNT PAID	WATER BOTTLE FILLING STATION	INSTALLED A WATER BOTTLE FILING STATION FOR LINCOLN ELEMENTARY SCHOOL AND PROVIDED WATER BOTTLES, TOOTHBRUSHES, BOOKMARKS, AND ELECTRONIC/PRINTABLE EDUCATIONAL ACTIVITIES FOR STUDENTS.
(67) GRACE FITNESS 2643 BEAVER AVENUE 171 DES MOINES,IA50310	83-4304621	501(C)3	25,000				FUNDING TO SUPPORT NONPROFIT GRACE FITNESS IN OFFERING ACCESS TO HEALTH AND FITNESS COACHING SERVICES FOR BLACK AND LATINO COMMUNITIES AS WELL AS LOW-INCOME INDIVIDUALS TO ADDRESS DISPROPORTIONATE HEALTH DISPARITIES.
(68) THE GREATER BETTENDORF COMMUNITY FOUNDATION 2511 BELLEVUE AVENUE BETTENDORF,IA52722	42-1402712	501(C)3	5,000				FUNDING TO SUPPORT COVID-19 RELIEF
(69) HAWKEYE AREA COMMUNITY ACTION PROGRAM 1328 2ND AVE SE CEDAR RAPIDS,IA52403	42-0898405	501(C)3	5,000				FUNDING TO SUPPORT COVID-19 RELIEF
(70) HAWKEYE AREA COMMUNITY ACTION PROGRAM 1328 2ND AVE SE CEDAR RAPIDS,IA52403	42-0898405	501(C)3		5,497	AMOUNT PAID	PROVIDED 18,144 TOOTHBRUSHES	PROVIDED 18,144 TOOTHBRUSHES TO HAWKEYE AREA COMMUNITY ACTION I-SMILE PROGRAM.
(71) HAWKEYE AREA COMMUNITY ACTION PROGRAM 1328 2ND AVE SE CEDAR RAPIDS,IA52403	42-0898405	501(C)3		750	AMOUNT PAID	PROVIDED 3,456 TOOTHBRUSHES	PROVIDED 3,456 TOOTHBRUSHES TO HAWKEYE AREA COMMUNITY ACTION HEAD START PROGRAM.
(72) HEALTHY BIRTH DAY 501 SW 7TH STREET STE G DES MOINES,IA50309	26-3998964	501(C)3	21,500				FUNDING FOR ORAL HEALTH MESSAGING INTEGRATION THROUGH COUNT THE KICKS APP.
(73) HEALTHY BIRTH DAY 501 SW 7TH STREET STE G DES MOINES,IA50309	26-3998964	501(C)3	0	615	AMOUNT PAID	PROVIDED 1,008 TOOTHBRUSHES, PASTE, AND FLOSS	PROVIDED 1,008 TOOTHBRUSHES, PASTE, AND FLOSS TO HEALTHY BIRTH DAY.
(74) HIP HOPE INC PO BOX 65342 WEST DES MOINES,IA50265	46-4735234	501(C)3	12,500				FUNDING FOR ORAL HEALTH EDUCATION THROUGH MUSIC, DANCE, AND TECHNOLOGY
(75) HIP HOPE INC PO BOX 65342 WEST DES MOINES,IA50265	46-4735234	501(C)3	0	810	AMOUNT PAID	PROVIDED 2,304 TOOTHBRUSHES	PROVIDED 2,304 TOOTHBRUSHES TO HIP HOPE INC.
(76) HIS HANDS MINISTRIES 400 12 STREET SE CEDAR RAPIDS,IA52403	39-1878606	501(C)3	25,000				FUNDING FOR OPERATROY UPGRADE AND MEDICAL/DENTAL INTEGRATION AT CLINIC.
(77) HIS HANDS MINISTRIES 400 12 STREET SE CEDAR RAPIDS,IA52403	39-1878606	501(C)3	2,500				FUNDING TO SUPPORT COVID-19 RELIEF
(78) HORIZONS A FAMILY SERVICE ALLIANCE 819 5TH STREET SE CEDAR RAPIDS,IA52406	42-1135083	501(C)3	5,000				FUNDING TO SUPPORT COVID-19 RELIEF
(79) HUMILITY HOMES AND SERVICES INC 3805 MISSISSIPPI AVENUE DAVENPORT,IA52807	01-0916973	501(C)3	5,000				FUNDING TO SUPPORT COVID-19 RELIEF
(80) COMMUNITY FOUNDATION OF GREATER DES MOINES 1915 GRAND AVENUE DES MOINES,IA50312	42-6139033	501(C)3	25,000				FUNDING WILL SUPPORT CAPACITY WORK TO EDUCATE, ORGANIZE, AND ACTIVATE COALITION ADVOCATES ACROSS THE STATE TO ADDRESS SYSTEMIC ISSUES AND ADDRESS POLICY IMPACTING HEALTH EQUITY FOR CHILDREN AND FAMILIES.
(81) IOWA CAREGIVERS 939 OFFICE PARK ROAD 332 WEST DES MOINES,IA50265	42-1457592	501(C)3	25,000				FUNDING SUPPORTS VIRTUAL MOUTHCARE MATTERS PROGRAM
(82) IOWA CHRONIC CARE CONSORTIUM 2700 WESTOWN PKWY 330 WEST DES MOINES,IA50266	41-2088296	501(C)3	25,000				FUNDING FOR ADVANCING COMMUNITY HEALTH WORKERS ORAL HEALTH KNOWLEDGE AND CAPACITY THROUGH EDUCATION/MODULES.
(83) IOWA DENTAL ASSOCIATION 666 GRAND AVENUE STE 901 DES MOINES,IA50309	42-0335455	501(C)3	5,000				FUNDING USED FOR ONE COURSE IN COORDINATION WITH IDA'S FALL CE WEBINAR SERIES TO PROVIDE DENTISTS, HYGIENISTS, ASSISTANTS WITH ONLINE EDUCATION ON TELEDENTISTRY.
(84) IOWA DENTAL FOUNDATION 666 GRAND AVENUE STE 901 DES MOINES,IA50131	42-1405188	501(C)3	25,000				FUNDING TO PROVIDE EQUIPMENT AND SUPPLIES IN ORDER TO PERFORM SERVICES FOR ORAL HEALTH CARE TO UNDERSERVED CHILDREN AND OLDER ADULTS, MEALS TO OVER 1,000 VOLUNTEERS THROUGHTOUT THE DAYS OF THE I-MOM EVENT, MARKETING EFFORTS AND STAFF TRAVEL/SALARY COSTS.
(85) IOWA DEPT OF PUBLIC HEALTH-IOWA BOARD OF PHARMACY 400 SW 8TH STREET STE E DES MOINES,IA50309	42-6004523	STATE OF IOWA	169,336				FUNDING CONTINUES TO SUPPORT THE PROGRESS OF THE I-SMILE SILVER PROJECT AND EXPAND THE REACH OF I-SMILE SILVER TO ALL AT-RISK IOWA ADULTS, PARTICULARLY ADULTS ENROLLED IN MEDICAID TO ACCESS ORAL HEALTH SERVICES AND MAINTAIN OVERALL AND ORAL HEALTH.
(86) IOWA DEPT OF PUBLIC HEALTH-ORAL HEALTH BUREAU 321 EAST 12TH STREET DES MOINES,IA50319	42-6004523	STATE OF IOWA	200,000				FUNDING CONTINUES TO SUPPORT I-SMILE@SCHOOL, A STATE WIDE SCHOOL-BASED SEALANT PROGRAM FOR UNDERSERVED CHILDREN.
(87) IOWA DEPT OF PUBLIC HEALTH-ORAL HEALTH BUREAU 321 EAST 12TH STREET DES MOINES,IA50319	42-6004523	STATE OF IOWA	12,000				FUNDING TO UTILIZE LIBRARIES AS ACCESS POINT TO HEALTH-RELATED SERVICES AND EDUCATION.
(88) IOWA DEPT OF PUBLIC HEALTH-ORAL HEALTH BUREAU 321 EAST 12TH STREET DES MOINES,IA50319	42-6004523	STATE OF IOWA	2,210				FUNDING USED BY CAVITY FREE IOWA COALITION TO SEND LETTERS TO ALL PEDIATRICIANS AND FAMILY PRACTICE PHYSICIANS IN IA TO EXPLAIN CAVITY FREE IOWA PROGRAM AND UPDATE TRAINING VIDEO ON PROVIDING FLUORIDE VARNISH.
(89) IOWA DEPT OF PUBLIC HEALTH-ORAL HEALTH BUREAU 321 EAST 12TH STREET DES MOINES,IA50319	42-6004523	STATE OF IOWA	0	715	AMOUNT PAID	PROVIDED 2,016 TOOTHBRUSHES	PROVIDED 2,016 TOOTHBRUSHES TO IOWA DEPT OF PUBLIC HEALTH FOR I-SMILE AND HEAD START PROGRAM
(90) IOWA DEPT OF PUBLIC HEALTH-ORAL HEALTH BUREAU 321 EAST 12TH STREET DES MOINES,IA50319	42-6004523	STATE OF IOWA	0	401	AMOUNT PAID	PROVIDED 1,440 TOOTHBRUSHES	PROVIDED 1,440 TOOTHBRUSHES TO IOWA DEPT OF PUBLIC HEALTH.
(91) IOWA HEALTHIEST STATE INITIATIVE 301 GRAND AVENUE DES MOINES,IA50309	45-4570642	501(C)3	25,000				FUNDING TO SUPPORT CAMPAIGN TO INCREASE AWARENESS, REDUCE STIGMA OF MENTAL ILLNESS, AND CREATE COMMUNITY ADVOCATES.
(92) IOWA HEALTHIEST STATE INITIATIVE 301 GRAND AVENUE DES MOINES,IA50309	45-4570642	501(C)3	2,500				FUNDING TO SUPPORT COVID-19 RELIEF
(93) IOWA PRIMARY CARE ASSOCIATION 9943 HICKMAN ROAD STE 103 URBANDALE,IA50322	42-1311646	501(C)3	25,000				FUNDING TO SUPPORT THE NETWORK OF HEALTH CENTERS ACROSS THE STATE IN SCENARIO PLANNING AND STRATEGIC GROWTH IN LIGHT OF CHALLENGES FROM THE PANDEMIC.
(94) IOWA PRIMARY CARE ASSOCIATION 9943 HICKMAN ROAD STE 103 URBANDALE,IA50322	42-1311646	501(C)3	3,000				FUNDING TO ATTEND THE BUSINESS RECORDS EDUCATIONAL PROGRAM ON RACE AND EQUITY FOR EXECUTIVE LEADERS TO EDUCATE AND SUPPORT LEARNING AMONG COMMUNITY HEALTH CENTER DENTAL CLINIC LEADERS.
(95) IOWA PUBLIC HEALTH ASSOCIATION 501 SW 7TH STREET DES MOINES,IA50309	23-7327835	501(C)3	20,901				FUNDING TO SUPPORT HEALTH EQUITY STRATEGIC COMMUNICATION NETWORK TO BE INDEPENDENT, MEMBER-LED PUBLIC HEALTH COMMUNICATION TO PROVIDE COORDINATED HEALTH EQUITY RESOURCES STATEWIDE.
(96) IOWA PUBLIC HEALTH ASSOCIATION 501 SW 7TH STREET DES MOINES,IA50309	23-7327835	501(C)3	2,500				FUNDING TO SUPPORT A SPONSORSHIP OF THE IOWA GOVERNOR'S CONFERENCE ON PUBLIC HEALTH TO PROVIDE A FOCUS ON ORAL HEALTH EDUCATION.
(97) LEE COUNTY HEALTH DEPARTMENT 2218 AVENUE H FORT MADISON,IA52627	42-6004689	501(C)3	0	6,639	AMOUNT PAID	PROVIDED 21,888 TOOTHBRUSHES	PROVIDED 21,888 TOOTHBRUSHES TO LEE COUNTY HEALTH DEPARTMENT.
(98) LEE COUNTY HEALTH DEPARTMENT 2218 AVENUE H FORT MADISON,IA52627	42-6004689	501(C)3	0	730	AMOUNT PAID	PROVIDED 3,024 TOOTHBRUSHES	PROVIDED 3,024 TOOTHBRUSHES TO I-SMILE AND HEAD START PROGRAM.
(99) LEWIS CENTRAL COMMUNITY SCHOOL DISTRICT 3206 RENNER DRIVE COUNCIL BLUFFS,IA51501	42-6001287	STATE OF IOWA	0	5,412	AMOUNT PAID	WATER BOTTLE FILLING STATION	INSTALLED A WATER BOTTLE FILLING STATION FOR LEWIS CENTRAL KREFRT PRIMARY SCHOOL AND PROVIDED WATER BOTTLES, TOOTHBRUSHES, BOOKMARKS, AND ELECTRONIC/PRINTABLE EDUCATIONAL ACTIVITIES FOR STUDENTS.
(100) LINN COUNTY PUBLIC HEALTH 1020 6TH STREET SE CEDAR RAPIDS,IA52401	42-6004338	501(C)3	25,000				FUNDING FOR IMPLEMENTATION OF MYCARE COMMUNITY ENABLES STEAMLINED CARE COORDINATION/IMPROVED ACCESS TO SERVICES AND DATA TRACKING.
(101) MARION COUNTY PUBLIC HEALTH 2003 LINCOLN STREET KNOXVILLE,IA50138	42-6004844	501(C)3	5,000				FUNDING TO COVER THE COST OF ORAL HEALTH BROCHURES, POSTERS, AND CARE COORDINATION SERVICES FOR PRE-SCHOOL, HEAD START, AND CHILDCARE CENTERS TO EDUCATE PARENTS, TEACHERS, AND PROVIDERS ON IMPROVING ORAL HEALTH.
(102) MARION COUNTY PUBLIC HEALTH 2003 LINCOLN STREET KNOXVILLE,IA50138	42-6004844	501(C)3	0	1,076	AMOUNT PAID	PROVIDED 3,456 TOOTHBRUSHES	PROVIDED 3,456 TOOTHBRUSHES TO I-SMILE PROGRAM.
(103) MATTHEW 25 201 3RD AVENUE SW CEDAR RAPIDS,IA52404	26-0467321	501(C)3	6,550				FUNDING TO SUPPORT EXTERNAL REVIEW AND ENHANCEMENT OF ORGANIZATION'S HUMAN RESOURCES POLICIES AND PROCESSES IN LIGHT OF THE PANDEMIC.
(104) MATTHEW 25 201 3RD AVENUE SW CEDAR RAPIDS,IA52404	26-0467321	501(C)3	2,500				FUNDING TO SUPPORT COVID-19 RELIEF
(105) MEDICAID MEDICARE CHIP SERVICES DENTAL ASSOCIATION PO BOX 1024 SANDWICH,MA02563	20-1957993	501(C)3	25,000				FUNDING TO SUPPORT ASSESSMENT IMPROVEMENTS AND ENVIRONMENTAL SCANS FOR DWP POPULATION/MEMBERS.
(106) MID-IOWA COMMUNITY ACTION INC 1001 S 18TH AVE MARSHALLTOWN,IA50158	42-0923311	501(C)3	20,000				FUNDING TO ASSIST IOWA MEDICAL AND DENTAL SAFETY NET PROVIDERS WITH EMERGENCY OPERATING RELIEF.
(107) MID-IOWA COMMUNITY ACTION INC 1001 S 18TH AVE MARSHALLTOWN,IA50158	42-0923311	501(C)3	5,000				FUNDING TO SUPPORT COVID-19 RELIEF
(108) MID-IOWA COMMUNITY ACTION INC 1001 S 18TH AVE MARSHALLTOWN,IA50158	42-0923311	501(C)3		2,791	AMOUNT PAID	PROVIDED 10,080 TOOTHBRUSHES	PROVIDED 10,080 TOOTHBRUSHES TO MID-IOWA COMMUNITY ACTION CENTER.
(109) DAVENPORT COMMUNITY SCHOOLS 1926 WEST 4TH STREET DAVENPORT,IA52802	42-6001350	STATE OF IOWA		8,900	AMOUNT PAID	WATER BOTTLE FILLING STATION AND WATER BOTTLES	INSTALLED A WATER BOTTLE FILLING STATION FOR MONROE ELEMENTARY SCHOOL AND PROVIDED WATER BOTTLES, TOOTHBRUSHES, BOOKMARKS, AND ELECTRONIC/PRINTABLE EDUCATIONAL ACTIVITIES FOR STUDENTS.
(110) NATIONAL ALLIANCE ON MENTAL ILLNESS IOWA 3839 MERLE HAY ROAD STE 229 DES MOINES,IA50310	23-7084780	501(C)3	25,000				FUNDING SUPPORTS DEVELOPMENT OF PEER-LED MODELS OF MENTAL HEALTH SERVICE AND EDUCATION DIRECTLY INVOLVING COMMUNITIES OF COLOR, REFUGEES, AND IMMIGRANTS IN EDUCATING COMMUNITY PROVIDERS, THE NEXT GENERATION OF PHYSICIANS AND MEMBERS OF THEIR COMMUNITY.
(111) NEW OPPORTUNITIES 23751 HWY 30 CARROLL,IA51401	42-0923412	501(C)3	5,000				FUNDING TO SUPPORT COVID-19 RELIEF
(112) NEW OPPORTUNITIES 23751 HWY 30 CARROLL,IA51401	42-0923412	501(C)3		1,315	AMOUNT PAID	PROVIDED 5,184 TOOTHBRUSHES	PROVIDED 5,184 TOOTHBRUSHES TO I-SMILE PROGRAM.
(113) NORTH IOWA COMMUNITY ACTION ORGANIZATION 100 1ST STREET NW STE 200 MASON CITY,IA50401	42-0921505	501(C)3	5,000				FUNDING USED TO PURCHASE AND/OR DISTRIBUTE PRODUCTS, SUPPLIES, OR EDUCATION MATERIALS FOR THE "A REASON TO SMILE PROJECT."
(114) NORTH IOWA COMMUNITY ACTION ORGANIZATION 100 1ST STREET NW STE 200 MASON CITY,IA50401	42-0921505	501(C)3		2,926	AMOUNT PAID	PROVIDED 9,792 TOOTHBRUSHES	PROVIDED 9,792 TOOTHBRUSHES TO NORTH IOWA COMMUNITY ACTION ORGANIZATION
(115) NORTH LIBERTY COMMUNITY PANTRY 89 NORTH JONES BOULEVARD NORTH LIBERTY,IA52317	42-1233284	501(C)3	17,525				FUNDING TO SUPPORT COMMUNITY SURVEY AND STRATEGIC PLANNING EFFORTS TO ADDRESS SIGNIFICANT CHANGES TO FOOD PANTRY'S OPERATIONS AND NEEDS AS A RESULT OF THE PANDEMIC.
(116) NORTHEAST IOWA COMMUNITY ACTION CORPORATION 305 MONTGOMERY STREET STE 7 DECORAH,IA52101	42-6092713	501(C)3	5,000				FUNDING TO SUPPORT COVID-19 RELIEF
(117) NORTHEAST IOWA COMMUNITY ACTION CORPORATION 305 MONTGOMERY STREET STE 7 DECORAH,IA52101	42-6092713	501(C)3		748	AMOUNT PAID	PROVIDED 2,304 TOOTHBRUSHES	PROVIDED 2,034 TOOTHBRUSHES TO NEICAC HEAD START PROGRAM.
(118) NORTHEAST IOWA FOOD BANK 1605 LAFAYETTE STREET WATERLOO,IA50704	42-1169648	501(C)3	10,000				FUNDING TO SUPPORT COVID-19 RELIEF
(119) NORTHWEST IOWA MENTAL HEALTH CENTER 201 EAST 11TH STREET SPENCER,IA51301	42-0840465	501(C)3	10,000				FUNDING TO SUPPORT COVID-19 RELIEF
(120) OPPORTUNITY ON DECK 4420 104TH STREET 11 URBANDALE,IA50322	46-4974174	501(C)3	10,000				FUNDING INVESTMENT IN A COLLABORATIVE MODEL (MERGER OF TWO ORGANIZATIONS) TO ADDRESS A LARGER SYSTEMIC ISSUE OF BARRIERS TO PHYSICAL ACTIVITY.
(121) ORAL HEALTH PROJECT 8933 WHITE OAK AVENUE MUNSTER,IN46321	85-1514886	501(C)3	25,000				FUNDING TO SUPPORT ORAL HEALTH AWARENESS, EDUCATION, AND COORDINATION OF ACCESS FOR AFRICAN IMMIGRANTS AND REFUGEES.
(122) ORCHARD PLACE 2116 GRAND AVENUE DES MOINES,IA50312	42-1193285	501(C)3	5,000				FUNDING TO SUPPORT COVID-19 RELIEF
(123) PEOPLES COMMUNITY HEALTH CENTER 905 FRANKLIN STREET WATERLOO,IA50703	42-1058629	501(C)3	20,000				FUNDING TO SUPPORT COVID-19 RELIEF
(124) PEOPLES COMMUNITY HEALTH CENTER 905 FRANKLIN STREET WATERLOO,IA50703	42-1058629	501(C)3		72	AMOUNT PAID	PROVIDED 144 TOOTHBRUSHES, PASTE, AND FLOSS	PROVIDED 144 TOOTHBRUSHES, PASTE, AND FLOSS TO PEOPLES COMMUNITY HEALTH CENTER
(125) PERRY LUTHERAN HOMES 2323 WILLIS AVENUE PERRY,IA50220	42-1402559	501(C)3	5,000				FUNDING TO SUPPORT COVID-19 RELIEF
(126) PLEASE PASS THE LOVE 4801 FRANKLIN AVENUE DES MOINES,IA50310	46-4492345	501(C)3	25,000				FUNDING TO SUPPORT EXPANSION OF MENTAL HEALTH SUPPORT GROUPS FOR TEACHERS/STAFF AND STUDENTS (WITH FOCUS ON BLACK AND LATINO STUDENTS) DURING COVID-19.
(127) PLEASANTVILLE COMMUNITY SCHOOL DISTRICT 415 JONES STREET PLEASTANTVILLE,IA50225	42-6021929	STATE OF IOWA		6,255	AMOUNT PAID	WATER BOTTLE FILLING STATION	INSTALLED A WATER BOTTLE FILLING STATION FOR PLEASANTVILLE JUNIOR HIGH SCHOOL AND PROVIDED WATER BOTTLES, TOOTHBRUSHES, BOOKMARKS, AND ELECTRONIC/PRINTABLE EDUCATIONAL ACTIVITIES FOR STUDENTS.
(128) PRAIRIE CITY MONROE COMMUNITY SCHOOL DISTRIC 400 IA-163 BUS MONROE,IA50170	42-1358436	STATE OF IOWA		5,512	AMOUNT PAID	WATER BOTTLE FILLING STATION	INSTALLED A WATER BOTTLE FILLING STATION FOR PRAIRIE CITY ELEMENTARY SCHOOL AND PROVIDED WATER BOTTLES, TOOTHBRUSHES, BOOKMARKS, AND ELECTRONIC/PRINTABLE EDUCATIONAL ACTIVITIES FOR STUDENTS.
(129) PRAIRIE CITY MONROE COMMUNITY SCHOOL DISTRIC 400 IA-163 BUS MONROE,IA50170	42-1358436	STATE OF IOWA		181	AMOUNT PAID	PROVIDED 360 TOOTHBRUSHES, PASTE, AND FLOSS	PROVIDED 360 TOOTHBRUSHES, PASTE, AND FLOSS TO MONROE ELEMENTARY SCHOOL
(130) PREVENT BLINDNESS IOWA 1111 NINTH STREET STE 250 DES MOINES,IA50314	42-6083207	501(C)3	10,000				FUNDING TO SUPPORT CHILDREN'S VISION SCREENING PROGRAM FOR EARLY DETECTION OF VISION PROBLEMS & INITIATE TREATEMENT.
(131) PRIMARY HEALTH CARE 1200 UNIVERSITY AVE 200 DES MOINES,IA50314	42-1350092	501(C)3	250,000				FUNDING TO SUPPORT DENTAL CLINIC MOVE TO BE ADJACENT TO MEDICAL CLINIC TO STREAMLINE STAFF AND INCREASE ACCESS TO DENTAL SERVICES.
(132) PRIMARY HEALTH CARE 1200 UNIVERSITY AVE 200 DES MOINES,IA50314	42-1350092	501(C)3	20,000				FUNDING TO SUPPORT COVID-19 RELIEF
(133) PROMISE COMMUNITY HEALTH CENTER 338 1ST AVENUE NW SIOUX CENTER,IA51250	20-5896415	501(C)3	20,000				FUNDING TO SUPPORT COVID-19 RELIEF
(134) PROTEUS INC 1221 CENTER STREET STE 16 DES MOINES,IA52309	42-1186501	501(C)3	25,000				FUNDING TO SUPPORT PILOT HEALTHCARE DELIVERY PROGRAM FOR MIGRANT MEAT PROCESSING WORKERS AND THEIR FAMILIES TO MEET NEEDS DURING COVID-19 AND BEYOND.
(135) PROTEUS INC 1221 CENTER STREET STE 16 DES MOINES,IA52309	42-1186501	501(C)3	20,000				FUNDING TO SUPPORT COVID-19 RELIEF
(136) QUAD CITIES COMMUNITY BROADCASTING GROUP 1800 3RD AVENUE STE 420 ROCK ISLAND,IL61201	32-0066891	501(C)3	16,950				FUNDING TO SUPPORT SERIES OF PUBLIC SERVICE ANNOUNCEMENTS PROMOTING ACCESS TO ORAL HEALTH SERVICES AND DENTAL CARE TO BLACK AND HISPANIC COMMUNITIES.
(137) RIVER BEND FOODBANK 4010 KIMMEL DRIVE DAVENPORT,IA52802	36-3147342	501(C)3	21,050				FUNDING TO SUPPORT A COMPLETE EXTERNAL REVIEW AND ENHANCEMENT OF HUMAN RESOURCE PRACTICES AND POLICIES TO INVEST IN AND STRENGTHEN EMPLOYEES AND VOLUNTEERS IN LIGHT OF THE PANDEMIC.
(138) RIVER BEND FOODBANK 4010 KIMMEL DRIVE DAVENPORT,IA52802	36-3147342	501(C)3	5,000				FUNDING TO SUPPORT COVID-19 RELIEF
(139) RIVER HILLS COMMUNITY HEALTH CENTER 201 SOUTH MARKET STREET OTTUMWA,IA52501	42-1489471	501(C)3	49,932				FUNDING TO SUPPORT PURCHASE OF EQUIPMENT TO EXPAND DENTAL SERVICES IN RICHLAND IA WITH FOUR ADDITIONAL DENTAL OPERATORIES.
(140) RIVER HILLS COMMUNITY HEALTH CENTER 201 SOUTH MARKET STREET OTTUMWA,IA52501	42-1489471	501(C)3	20,000				FUNDING TO SUPPORT COVID-19 RELIEF
(141) RIVER HILLS COMMUNITY HEALTH CENTER 201 SOUTH MARKET STREET OTTUMWA,IA52501	42-1489471	501(C)3	4,745				FUNDING FOR SUPPLIES FOR CHILDREN WITHOUT ORAL HEALTH ACCESS TO CARE IN WAPELLO AND KEOKUK COMMUNITY SCHOOL DISTRICTS.
(142) RURAL COMMUNITY FOOD PANTRY PO BOX 22 DYERVILLE,IA52040	20-8196586	501(C)3	5,000				FUNDING TO SUPPORT COVID-19 RELIEF
(143) SACK PACK PROGRAM ORANGE CITY 4348 IBEX AVENUE ORANGE CITY,IA51041	47-4185290	501(C)3	5,000				FUNDING TO SUPPORT COVID-19 RELIEF
(144) THE SALVATION ARMY 1326 6TH AVE DES MOINES,IA50314	36-2167910	501(C)3	22,500				FUNDING TO SUPPORT COVID-19 RELIEF IN CEDAR RAPIDS, NEWTON, AMES, MARSHALLTOWN, DES MOINES, DAVENPORT, AND SIOUX CITY.
(145) SCOTT COUNTY HEALTH DEPARTMENT 600 W 4TH STREET DAVENPORT,IA52801	42-6004465	STATE OF IOWA		8,446	AMOUNT PAID	PROVIDED 26,496 TOOTHBRUSHES	PROVIDED 26,496 TOOTHBRUSHES TO SCOTT COUNTY I-SMILE PROGRAM.
(146) SIOUXLAND COMMUNITY HEALTH CENTER 1021 NEBRASKA STREET SIOUX CITY,IA51105	42-1374894	501(C)3	20,000				FUNDING TO SUPPORT COVID-19 RELIEF
(147) SOUTH CENTRAL IOWA COMMUNITY ACTION PROGRAM 1711 OSCEOLA AVE CHARITON,IA50049	42-0921920	501(C)3	5,000				FUNDING TO SUPPORT COVID-19 RELIEF
(148) SOUTH CENTRAL IOWA COMMUNITY ACTION PROGRAM 1711 OSCEOLA AVE CHARITON,IA50049	42-0921920	501(C)3		369	AMOUNT PAID	PROVIDED 1,440 TOOTHBRUSHES	PROVIDED 1,440 TOOTHBRUSHES TO SCICAP HEAD START PROGRAM.
(149) STORM LAKE COMMUNITY SCHOOL DISTRICT 1810 HYLAND DRIVE STORM LAKE,IA50588	42-6040431	STATE OF IOWA		7,146	AMOUNT PAID	WATER BOTTLE FILLING STATION	INSTALLED A WATER BOTTLE FILING STATION FOR STORM LAKE ELEMENTARY SCHOOL AND PROVIDED WATER BOTTLES, TOOTHBRUSHES, BOOKMARKS, AND ELECTRONIC/PRINTABLE EDUCATIONAL ACTIVITIES FOR STUDENTS.
(150) ST LUKE'S HEALTH CARE FOUNDATION 855 A AVE NE STE 105 CEDAR RAPIDS,IA52402	42-1106819	501(C)3	20,000				FUNDING TO SUPPORT COVID-19 RELIEF
(151) ST VINCENT DE PAUL 1426 6TH AVENUE DES MOINES,IA50314	42-6021808	501(C)3	5,000				FUNDING TO SUPPORT COVID-19 RELIEF
(152) SUBSTANCE ABUSE SERVICES CENTER 799 MAIN STREET STE 110 DUBUQUE,IA52001	42-1033304	501(C)3	5,000				FUNDING TO SUPPORT COVID-19 RELIEF
(153) SUCCESSLINK 229 E PARK AVENUE WATERLOO,IA50703	42-1444315	501(C)3	25,000				FUNDING TO SUPPORT SUCCESS STREET SCHOOL-BASED HEALTH CLINICS PROVIDING ACCESS TO HEALTH AND MENTAL HEALTH SERVICES FOR STUDENTS AND THEIR FAMILIES.
(154) THE BRIDGE OF STORM LAKE 529 SENECA STREET STORM LAKE,IA50588	47-4770141	501(C)3	17,500				FUNDING TO SUPPORT THE TREEHOUSE PROGRAM IMPLEMENTATION TO SERVE MENTAL AND SOCIAL/EMOTIONAL HEALTH AND WELL-BEING NEEDS OF UNDERSERVED YOUTH.
(155) THE BRIDGE OF STORM LAKE 529 SENECA STREET STORM LAKE,IA50588	47-4770141	501(C)3	2,000				FUNDING TO SUPPORT COVID-19 RELIEF
(156) TMBC AT THE LINCOLN CENTER 318 E 7TH STREET DAVENPORT,IA52804	81-2252531	501(C)3	5,600				FUNDING TO SUPPORT ORGANIZATION STRATEGIC PLANNING TO STRENGTHEN TARGETED HEALTH AND WELLNESS PROGRAMS FOR THE BLACK COMMUNITY SUCH AS THE WALK-IN WEDNESDAYS HEALTH CLINIC.
(157) TOOTHBRUSHERS AND BALAAM'S DONKEY 129 CRANDALL CT NE CEDAR RAPIDS,IA52402	85-1280991	501(C)3	5,000				FUNDING TO PROVIDE ORAL HEALTH SUPPLIES AND MATERIALS TO DO OUTREACH AND EDUCATION TO OLDER ADULTS AND PEOPLE WITH DISABILITIES.
(158) UNITED COMMUITY HEATH CENTER 715 W MILWAUKEE AVENUE STORM LAKE,IA50588	30-0225826	501(C)3	20,000				FUNDING TO SUPPORT COVID-19 RELIEF
(159) UNITED COMMUITY HEATH CENTER 715 W MILWAUKEE AVENUE STORM LAKE,IA50588	30-0225826	501(C)3		790	AMOUNT PAID	PROVIDED 1,296 TOOTHBRUSHES, PASTE, AND FLOSS	PROVIDED 1,296 TOOTHBRUSHES, PASTE, AND FLOSS TO UNITED COMMUNITY HEALTH CENTER.
(160) UNITED WAY AND COMMUNITY FOUNDATION OF GREATER FORT DODGE 24 NORTH 9TH STREET STE B FORT DODGE,IA50501	42-1439853	501(C)3	10,000				FUNDING TO SUPPORT COVID-19 RELIEF
(161) UCS HEALTHCARE 4908 FRANKLIN AVENUE DES MOINES,IA50310	42-1407566	501(C)3	5,000				FUNDING TO SUPPORT COVID-19 RELIEF
(162) UNITED WAY OF CENTRAL IOWA 1111 NINTH STREET STE 100 DES MOINES,IA50314	42-0680425	501(C)3	10,000				FUNDING TO SUPPORT COVID-19 RELIEF
(163) UNITED WAY OF CENTRAL IOWA 1111 NINTH STREET STE 100 DES MOINES,IA50314	42-0680425	501(C)3		72	AMOUNT PAID	PROVIDED 144 TOOTHBRUSHES, PASTE, AND FLOSS	PROVIDED 144 TOOTHBRUSHES, PASTE, AND FLOSS TO UNITED WAY OF CENTRAL IOWA.
(164) UNITED WAY OF CLINTON COUNTY IOWA 405 S 3RD STREET STE 200 CLINTON,IA52732	42-0698299	501(C)3	5,000				FUNDING TO SUPPORT COVID-19 RELIEF
(165) UNITED WAY OF DUBUQUE AREA TRI-STATES 215 W 6TH STREET DUBUQUE,IA52001	42-0761060	501(C)3	5,000				FUNDING TO SUPPORT COVID-19 RELIEF
(166) UNITED WAY OF EAST CENTRAL IOWA 317 7TH AVENUE SE STE 401 CEDAR RAPIDS,IA52401	42-0861239	501(C)3	23,600				FUNDING TO SUPPORT COMMUNITY ENGAGEMENT, DATA ANALYSIS, AND MARKETING OF FIVE COUNTY COMMUNITY NEEDS ASSESSMENT IN ORDER TO BETTER INVEST IN SOLUTIONS THAT FILL GAPS AND IMPROVE THE OVERALL HEALTH AND WELL-BEING OF THE COMMUNITY.
(167) UNITED WAY OF STORY COUNTY 315 CLARK AVENUE AMES,IA50010	42-0947489	501(C)3	5,000				FUNDING TO SUPPORT COVID-19 RELIEF
(168) UNITED WAY OF STORY COUNTY 315 CLARK AVENUE AMES,IA50010	42-0947489	501(C)3		72	AMOUNT PAID	PROVIDED 144 TOOTHBRUSHES, PASTE, AND FLOSS	PROVIDED 144 TOOTHBRUSHES, PASTE, AND FLOSS TO UNITED WAY OF STORY COUNTY
(169) UNIVERSITY OF IOWA COLLEGE OF DENTISTRY 801 NEWTON STREET IOWA CITY,IA52242	42-6004813	STATE OF IOWA	200,000				FUNDING TO PLAN AND IMPLEMENT A TELEDENTISTRY PROGRAM FOR OLDER ADULTS IN NURSING FACILITIES, AND EXAMINE MEASURES OF EFFECTIVENESS OF PROGRAM INCLUDING INDICATORS OF ACCESS TO CARE, COST, AND CLINICAL OUTCOMES.
(170) UNIVERSITY OF IOWA COLLEGE OF DENTISTRY 801 NEWTON STREET IOWA CITY,IA52242	42-6004813	STATE OF IOWA	16,000				FUNDING FOR VIRTUAL DENTAL EDUCATION OPPORTUNITY
(171) UNIVERSITY OF IOWA COLLEGE OF DENTISTRY 801 NEWTON STREET IOWA CITY,IA52242	42-6004813	STATE OF IOWA	10,000				FUNDING FOR THE PRESENTATION OF UI-COD STUDENT ORAL HEALTH RESEARCH.
(172) STATE UNIVERSITY OF IOWA FOUNDATION ONE WEST PARK ROAD IOWA CITY,IA52244	42-0796760	501(C)3	12,000				FUNDING TO SUPPORT ACCESS TO VISION PREVENTATIVE SCREENINGS FOR IOWA CHILDREN 0-5.
(173) UPPER DES MOINES OPPORTUNITY INC 101 ROBINS STREET GRAETTINGER,IA51334	42-0923424	501(C)3	5,000				FUNDING TO SUPPORT COVID-19 RELIEF
(174) UPPER DES MOINES OPPORTUNITY INC 101 ROBINS STREET GRAETTINGER,IA51334	42-0923424	501(C)3		1,311	AMOUNT PAID	PROVIDED 4,896 TOOTHBRUSHES	PROVIDED 4,896 TOOTHBRUSHES TO HEAD START PROGRAM.
(175) US COMMITTEE FOR REFUGEES AND IMMIGRANTS 1200 UNIVERSITY AVE 205 DES MOINES,IA50314	13-1878704	501(C)3	25,000				FUNDING TO SUPPORT THE REFUGEE WELLNESS PROGRAM-HEALTH NAVIGATORS THAT SUPPORT REFUGEES AND IMMIGRANTS IN ACCESSING HEALTH CARE.
(176) VISION TO LEARN 900 JACKSON STREET STE LL5-2C DUBUQUE,IA52001	45-3457853	501(C)3	25,000				FUNDING TO SUPPORT VISION SCREENING ACCESS AND GLASSES FOR UNDERSERVED SCHOOL-AGED CHILDREN.
(177) VISITING NURSE SERVICES 1111 9TH ST STE 320 DES MOINES,IA50314	42-0680446	501(C)3	5,000				FUNDING TO SUPPORT COVID-19 RELIEF
(178) VISITING NURSE SERVICES 1111 9TH ST STE 320 DES MOINES,IA50314	42-0680446	501(C)3		3,611	AMOUNT PAID	PROVIDED 11,520 TOOTHBRUSHES	PROVIDED 11,520 TOOTHBRUSHES TO VNS I-SMILE PROGRAM
(179) VISITING NURSE SERVICES 1111 9TH ST STE 320 DES MOINES,IA50314	42-0680446	501(C)3		994	AMOUNT PAID	PROVIDED 2,880 TOOTHBRUSHES	PROVIDED 2,880 TOOTHBRUSHES TO VNS I-SMILE PROGRAM.
(180) WAPSIE VALLEY COMMUNITY SCHOOL DISTRICT 200 E 4TH STREET READLYN,IA50668	42-6025836	STATE OF IOWA		4,440	AMOUNT PAID	WATER BOTTLE FILLING STATION	INSTALLED AN OUTDOOR WATER BOTTLE FILING STATION FOR FAIRBANK ELEMENTARY SCHOOL AND PROVIDED WATER BOTTLES, TOOTHBRUSHES, BOOKMARKS, AND ELECTRONIC/PRINTABLE EDUCATIONAL ACTIVITIES FOR STUDENTS.
(181) WAPSIE VALLEY COMMUNITY SCHOOL DISTRICT 200 E 4TH STREET READLYN,IA50668	42-6025836	STATE OF IOWA		3,641	AMOUNT PAID	WATER BOTTLE FILLING STATION	INSTALLED AN OUTDOOR WATER BOTTLE FILING STATION FOR READLYN ELEMENTARY SCHOOL AND PROVIDED WATER BOTTLES, TOOTHBRUSHES, BOOKMARKS, AND ELECTRONIC/PRINTABLE EDUCATIONAL ACTIVITIES FOR STUDENTS.
(182) WATERLOO CHRISTIAN SCHOOL 1307 W RIDGEWAY AVE WATERLOO,IA50701	42-0681066	501(C)3		5,129	AMOUNT PAID	WATER BOTTLE FILLING STATION	INSTALLED A WATER BOTTLE FILLING STATION FOR WATERLOO CHRISTIAN SCHOOL AND PROVIDED WATER BOTTLES, TOOTHBRUSHES, BOOKMARKS, AND ELECTRONIC/PRINTABLE EDUCATIONAL ACTIVITIES FOR STUDENTS.
(183) WESLEY COMMUNITY SERVICES 5508 NW 88TH STREET JOHNSTON,IA50131	20-3970256	501(C)3	5,000				FUNDING TO SUPPORT COVID-19 RELIEF
(184) WESTERN DUBUQUE COMMUNITY SCHOOL DISTRICT 310 4TH STREET FARLEY,IA52046	42-6039078	STATE OF IOWA		6,577	AMOUNT PAID	WATER BOTTLE FILLING STATION	INSTALLED A WATER BOTTLE FILLING STATION FOR DREXLER MIDDLE SCHOOL AND PROVIDED WATER BOTTLES, TOOTHBRUSHES, BOOKMARKS, AND ELECTRONIC/PRINTABLE EDUCATIONAL ACTIVITIES FOR STUDENTS.
(185) WEST CENTRAL COMMUNITY ACTION 1408 IA-44 HARLAN,IA51537	42-0919214	501(C)3	5,000				FUNDING TO SUPPORT COVID-19 RELIEF
(186) WEST CENTRAL COMMUNITY ACTION 1408 IA-44 HARLAN,IA51537	42-0919214	501(C)3		586	AMOUNT PAID	PROVIDED 2,016 TOOTHBRUSHES	PROVIDED 2,016 TOOTHBRUSHES TO WCCA HEAD START PROGRAM.
(187) YMCA OF GREATER DES MOINES 501 GRAND AVENUE DES MOINES,IA50309	42-0680438	501(C)3	25,000				FUNDING TO SUPORT ENGAGEMENT OF PROFESSIONAL CONSULTING IN THE AREAS OF FINANCE AND FINANCIAL ANALYSIS, STRATEGIC PLANNING, OPERATIONAL MANAGEMENT AND PROCESS IMPROVEMENT FOR THE ORGANIZATION.
(188) YOUTH AND SHELTER SERVICES INC 420 KELLOGG AVENUE AMES,IA50010	42-1051609	501(C)3	5,000				FUNDING TO SUPPORT COVID-19 RELIEF
(189) YOUTH EMERGENCY SERVICES & SHELTER 918 SE 11TH STREET DES MOINES,IA50309	23-7442304	501(C)3	10,000				FUNDING TO SUPPORT COVID-19 RELIEF
(190) YOUTH HOMES OF MID-AMERICA 7225 NW 58TH STREET JOHNSTON,IA50131	42-0680439	501(C)3	5,000				FUNDING TO SUPPORT COVID-19 RELIEF

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image

128

Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image

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

Cat. No. 50055P

Schedule I (Form 990) 2020

Page 2

Part III

Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.

(a) Type of grant or assistance	(b) Number of recipients	(c) Amount of cash grant	(d) Amount of noncash assistance	(e) Method of valuation (book, FMV, appraisal, other)	(f) Description of noncash assistance
(1)
(2)
(3)
(4)
(5)
(6)
(7)

Part IV

Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.

Return Reference	Explanation
PART I, LINE 2:	THE DELTA DENTAL OF IOWA FOUNDATION HAS ACCESS TO GUIDESTAR.COM TO REVIEW ANY ORGANIZATION'S FORM 990. ONCE AWARDED FUNDS, DELTA DENTAL OF IOWA FOUNDATION NOTIFIES GRANTEES OF AN OUTCOMES REPORTING FORM THAT MUST BE COMPLETED WITHIN A YEAR OF THE GRANT PERIOD END DATE BASED ON THE ALLOCATED FUNDS PROVIDED UNLESS ANOTHER DATE HAS BEEN AGREED UPON.

Schedule I (Form 990) 2020

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
Graphic Arrow

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

Attach to Form 990.
Graphic Arrow

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

OMB No. 1545-0047

2020

Open to Public Inspection

Name of the organization

DELTA DENTAL OF IOWA FOUNDATION

Employer identification number

26-0762771

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 on 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 on 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? .............

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Yes

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) 2020

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)
1JEFFREY S RUSSELL PRESIDENT	(i) (ii)	0 ------------- 744,733	0 ------------- 270,421	0 ------------- 137,051	0 ------------- 22,800	0 ------------- 37,442	0 ------------- 1,212,447	0 ------------- 121,310
2JEFF CHAFFIN DDS DIRECTOR	(i) (ii)	0 ------------- 329,636	0 ------------- 105,520	0 ------------- 87,257	0 ------------- 22,800	0 ------------- 1,856	0 ------------- 547,069	0 ------------- 83,715
3SHERRY PERKINS SECRETARY-TREASURER	(i) (ii)	0 ------------- 271,638	0 ------------- 91,121	0 ------------- 43,442	0 ------------- 22,800	0 ------------- 1,687	0 ------------- 430,688	0 ------------- 41,546
4SUZANNE HECKENLAIBLE EXECUTIVE DIRECTOR	(i) (ii)	0 ------------- 249,501	0 ------------- 86,024	0 ------------- 29,983	0 ------------- 22,800	0 ------------- 37,490	0 ------------- 425,798	0 ------------- 28,057

Schedule J (Form 990) 2020

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

PART I, LINE 4B

EFFECTIVE JANUARY 1, 2016, THE OFFICERS OF DELTA DENTAL OF IOWA, A RELATED ORGANIZATION, PARTICIPATE IN A SEC. 457(F) PLAN. DELTA DENTAL OF IOWA MAKES A CONTRIBUTION TO THE PLAN ANNUALLY ON BEHALF OF THE OFFICERS. THIS CONTRIBUTION IS A PERCENTAGE OF SALARY AND IS SET AND APPROVED BY THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS OF DELTA DENTAL OF IOWA. THE PORTION OF A PARTICIPANT'S ACCOUNT BALANCE ALLOCATED TO A PARTICULAR PLAN YEAR'S AWARD BECOMES VESTED ON JANUARY 1ST OF THE FOURTH YEAR FOLLOWING THE PLAN YEAR FOR WHICH THE AWARD IS GRANTED. THAT AMOUNT IS THEN PAID TO THE OFFICER. OTHER THAN THE VESTING CRITERIA, THE OFFICERS CANNOT ACCESS THE FUNDS UNTIL RETIREMENT, LEAVING THE COMPANY, OR DEATH. OFFICERS WHO RECEIVED DEPOSITS IN 2020 FROM DELTA DENTAL OF IOWA AND THE AMOUNTS ARE: JEFFREY S. RUSSELL $ 54,727 SHERRY PERKINS $ 8,162 SUZANNE HECKENLAIBLE $ 6,792 JEFF CHAFFIN $ 29,254 OFFICERS THAT RECEIVED PAYMENTS OF VESTED AMOUNTS IN 2020 AND THE AMOUNTS ARE: JEFFREY S. RUSSELL $ 121,310 SHERRY PERKINS $ 41,546 SUZANNE HECKENLAIBLE $ 28,057 JEFF CHAFFIN $ 83,715 THE OFFICERS OF DELTA DENTAL OF IOWA, A RELATED ORGANIZATION, PARTICIPATE IN A LONG-TERM INCENTIVE PLAN. THE PLAN IS INTENDED AND AT ALL TIMES SHALL BE AN UNFUNDED AND UNSECURED PLAN THAT IS LIMITED TO KEY MANAGEMENT EMPLOYEES OF THE ORGANIZATION DESIGNED TO ENHANCE THE BOARD'S EFFORT AT RETENTION OF ITS EXECUTIVE STAFF. OFFICERS WHO RECEIVED PAYMENTS OF VESTED AMOUNTS IN 2020 AND THE AMOUNTS ARE: JEFFREY S. RUSSELL $ 185,762 SHERRY PERKINS $ 60,459 SUZANNE HECKENLAIBLE $ 56,064 JEFF CHAFFIN $ 67,103

SCHEDULE J, PART I, LINE 3

THE EXECUTIVE DIRECTOR AND OFFICERS EXCLUDING THE CHAIR AND VICE CHAIR OF THE BOARD OF THE FOUNDATION ARE EMPLOYEES OF DELTA DENTAL OF IOWA. DELTA DENTAL OF IOWA CHARGES THE FOUNDATION A MANAGEMENT FEE FOR THE TIME SPENT BY THE PRESIDENT, SECRETARY AND TREASURER, AND EXECUTIVE DIRECTOR.

Schedule J (Form 990) 2020

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

2020

Open to Public
Inspection

Name of the organization

DELTA DENTAL OF IOWA FOUNDATION

Employer identification number

26-0762771

Return Reference	Explanation
FORM 990, PART III, LINE 2	THE FOUNDATION CHANGED ITS PROGRAM SERVICES IN 2020 TO EXPAND THEIR SERVICES AS A RESULT OF THEIR NEW MISSION THE BOARD APPROVED. THESE INCLUDE ORAL HEALTH, ORAL AND OVERALL HEALTH INTEGRATION AND OVERALL HEALTH.
FORM 990, PART VI, SECTION A, LINE 2	J. CHAFFIN HAD A GOVERNMENT PROGRAM RELATED BUSINESS RELATIONSHIP WITH BOARD MEMBER T. RODGERS IN 2020. S. HECKENLAIBLE HAD A GOVERNMENT PROGRAM RELATED BUSINESS RELATIONSHIP WITH BOARD MEMBER T. RODGERS IN 2020. T. RODGERS HAD A BUSINESS RELATIONSHIPS WITH L. CURRY H. COWEN, D. CAPLAN, S. HECKENLAIBLE, AND J. CHAFFIN IN 2020. D. CAPLAN HAD A BUSINESS RELATIONSHIP WITH H. COWEN, K. JONES, AND T. RODGERS IN 2020. H. COWEN HAD A BUSINESS RELATIONSHIP WITH T. RODGERS AND D. CAPLAN IN 2020.
FORM 990, PART VI, SECTION A, LINE 4	THE FOUNDATION CHANGED ITS PROGRAM SERVICES IN 2020 TO EXPAND THEIR SERVICES AS A RESULT OF THEIR NEW MISSION THE BOARD APPROVED. THESE INCLUDE ORAL HEALTH, ORAL AND OVERALL HEALTH INTEGRATION AND OVERALL HEALTH.
FORM 990, PART VI, SECTION A, LINE 6	THE FOUNDATION SHALL HAVE ONE MEMBER, WHICH SHALL BE DELTA DENTAL OF IOWA ("DELTA DENTAL"), A SECTION 501(C)(4) ORGANIZATION.
FORM 990, PART VI, SECTION A, LINE 7A	EACH DIRECTOR SHALL BE ELECTED BY THE MEMBER. IN ELECTING DIRECTORS, THE MEMBER MAY SEEK RECOMMENDATIONS FROM THE FOUNDATION'S BOARD OR A COMMITTEE OF THE BOARD.
FORM 990, PART VI, SECTION B, LINE 11B	THE FORM 990 AND ALL RELATED SCHEDULES WERE REVIEWED BY BOTH THE MANAGEMENT OF THE FOUNDATION AND THE BOARD OF DIRECTORS PRIOR TO FILING. THE FORM 990 WAS REVIEWED BY MANAGEMENT OF THE FOUNDATION PRIOR TO PRESENTATION TO THE BOARD OF DIRECTORS. THE MEMBERS OF THE MANAGEMENT TEAM WHO REVIEWED THE FORM 990 WERE THE PRESIDENT, SECRETARY/TREASURER, AND EXECUTIVE DIRECTOR. A COPY OF THE FORM 990 WAS PROVIDED TO ALL BOARD MEMBERS FOR REVIEW PRIOR TO FILING THE FORM 990.
FORM 990, PART VI, SECTION B, LINE 12C	CONSISTENT WITH ITS CONFLICT OF INTEREST POLICY, ANNUALLY THE FOUNDATION CONDUCTS A CONFLICT OF INTEREST REVIEW FOR COMPLIANCE WITH FEDERAL AND STATE LAW AND COMPANY POLICY. THE REVIEW INCLUDES ALL OFFICERS AND DIRECTORS. COMPLETED CONFLICT OF INTEREST QUESTIONNAIRES AND DISCLOSURES ARE COMPARED TO THE GROUP FOR POTENTIALLY CONFLICTING TRANSACTIONS, BUSINESS AND FAMILY RELATIONSHIPS AND AFFILIATIONS. A WRITTEN REPORT OF THE FINDINGS IS GIVEN TO THE BOARD OF DIRECTORS AND OFFICERS. THE CONFLICT OF INTEREST POLICY PROVIDES GUIDANCE ON ACTIONS AND SPECIFIC SOLUTIONS TO ADDRESS CONFLICTS WHEN THEY OCCUR. THE SOLUTIONS PROVIDED BY THE GUIDANCE ARE DISCUSSED AND DOCUMENTED IN THE BOARD OF DIRECTOR'S MEETING MINUTES.
FORM 990, PART VI, SECTION B, LINE 15	THE EXECUTIVE DIRECTOR AND OFFICERS EXCLUDING THE CHAIR AND VICE CHAIR OF THE BOARD ARE EMPLOYEES OF DELTA DENTAL. DELTA DENTAL OF IOWA CHARGES THE FOUNDATION A MANAGEMENT FEE FOR THE TIME SPENT BY THE PRESIDENT, SECRETARY AND TREASURER, AND EXECUTIVE DIRECTOR.
FORM 990, PART VI, SECTION C, LINE 19	THE FOUNDATION'S ARTICLES OF INCORPORATION BECOME A MATTER OF PUBLIC RECORD WHEN THEY ARE FILED WITH THE IOWA SECRETARY OF STATE. THE FINANCIAL STATEMENTS BECOME A MATTER OF PUBLIC RECORD WHEN THEY ARE FILED AS PART OF THE FORM 990 WITH THE IRS. THE CONFLICT OF INTEREST POLICY IS NOT FILED WITH ANY AGENCY; HOWEVER, IT WOULD BE MADE AVAILABLE UPON REQUEST. ALL GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS WOULD BE MADE AVAILABLE UPON REQUEST.
FORM 990, PART XI, LINE 9:	RECOVERIES OF PRIOR YEAR GRANTS BOARD MEMBER FEES WAIVED -6,900.
FORM 990, PART VI, SECTION B, LINE 13:	THE FOUNDATION DOES NOT HAVE A WHISTELEBLOWER POLICY AS IT HAS NO EMPLOYEES. THE FOUNDATION PURCHASES MANAGEMENT SERVICES FROM DELTA DENTAL. DELTA DENTAL OF IOWA HAS A WRITTEN WHISTLEBLOWER POLICY THAT ALL EMPLOYEES ARE SUBJECT TO.

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

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2020

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

2020

Open to Public Inspection

Name of the organization

DELTA DENTAL OF IOWA FOUNDATION

Employer identification number

26-0762771

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)DELTA DENTAL OF IOWA 9000 NORTHPARK DRIVE JOHNSTON,IA50131 42-0959302	NFP ORG. TO IMPROVE THE HEALTH AND SMILES OF THE PEOPLE IT SERVES	IA	501(C)(4)				No

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

Cat. No. 50135Y

Schedule R (Form 990) 2020

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?		(k) Percentage ownership
(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	(k) Percentage ownership

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	(h) Percentage ownership	(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	(h) Percentage ownership	Yes	No

Schedule R (Form 990) 2020

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) .....................

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

Yes

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

Yes

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

Yes

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

Yes

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) DELTA DENTAL OF IOWA	C	5,608,977	SEE PART VII - SUPPLEMENTAL INFO.
(2) DELTA DENTAL OF IOWA	O	464,045	HOURS WORKED

Schedule R (Form 990) 2020

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?		(k) Percentage ownership
(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	(k) Percentage ownership

Schedule R (Form 990) 2020

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R. See instructions.

Return Reference	Explanation
FORM 990, SCHEDULE R, PART V, LINE 2(1), COLUMN D:	CASH RECEIVED BASED ON A PERCENTAGE OF DELTA DENTAL OF IOWA'S REVENUE APPROVED BY THEIR BOARD. THE AMOUNT REPORTED INCLUDES A CONTRIBUTION OF $5,608,977 WHICH IS A PROMISE TO GIVE.
FORM 990, SCHEDULE R, PART V, LINE 2(2), COLUMN B:	MANAGEMENT FEES OF $464,045 WERE PAID TO DELTA DENTAL OF IOWA WHICH COULD ALSO BE CLASSIFIED UNDER CODE M.

Schedule R (Form 990) 2020

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: THE CORPORATION IS ORGANIZED TO STRENGTHEN AND TRANSFORM THE HEALTH AND SMILES OF ALL IOWANS. THE FOUNDATION WILL PROVIDE FUNDS TO OTHER 501(C)(3) ORGANIZATIONS, GOVERNMENTS, OR ACADEMIC INSTITUTIONS THAT ARE UNDERTAKING PROJECTS THAT SUPPORT AND IMPROVE THE HEALTH OF ALL IOWANS. THE FOUNDATION WILL PROVIDE FUNDS TO OTHER TAX-EXEMPT ORGANIZATIONS THROUGH THEIR GRANT PROGRAM THAT ALIGN WITH THE PROJECTS OF ORAL HEALTH, ORAL AND OVERALL HEALTH INTEGRATION, AND OVERALL HEALTH.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	14
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	11
5	Total number of individuals employed in calendar year 2020 (Part V, line 2a) ......	5	0
6	Total number of volunteers (estimate if necessary) .............	6	0
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 39 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	4,710,796	5,617,377
9	Program service revenue (Part VIII, line 2g) .........	0	0
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	536,241	615,308
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	0	0
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	5,247,037	6,232,685
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	1,551,994	3,087,190
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	600	3,000
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	864,856	636,964
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	2,417,450	3,727,154
19	Revenue less expenses. Subtract line 18 from line 12.......	2,829,587	2,505,531
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	25,351,147	29,941,129
21	Total liabilities (Part X, line 26).............	41,689	47,791
22	Net assets or fund balances. Subtract line 21 from line 20.....	25,309,458	29,893,338

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 1,621,892 including grants of $ 1,462,229 ) (Revenue $ )
	ORAL HEALTH PROJECTS - ACTIVITIES THAT ENSURE HEALTHY SMILES FOR ALL IOWANS.

4b	(Code: ) (Expenses $ 368,476 including grants of $ 274,735 ) (Revenue $ )
	ORAL AND OVERALL HEALTH INTEGRATION PROJECTS - ACTIVITIES THAT PROMOTE TIGHTER CONNECTIONS BETWEEN DENTAL, PHYSICAL, AND BEHAVIORAL HEALTH.

4c	(Code: ) (Expenses $ 1,488,314 including grants of $ 1,350,226 ) (Revenue $ )
	OVERALL HEALTH PROJECTS - WELLNESS, VISION, AND RELATED ACTIVITIES THAT ENABLE IOWANS TO LIVE HEALTHY AND ACTIVE LIVES.

4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses3,478,682

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	3,000	2,447,127	189,175

(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
(18) JAN REINICKE........................................................................ DIRECTOR, THROUGH JUNE	0.50 .......................	X	0	0	0

(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 0

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	5,608,977
e	Government grants (contributions)		1e

f	All other contributions, gifts, grants, and similar amounts not included above		1f	8,400

g	Noncash contributions included in lines 1a - 1f:$		1g

h Total. Add lines 1a-1f.......		5,617,377

		Business Code
2a
b
c
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....

3 Investment income (including dividends, interest, and othersimilar amounts) ......			587,974			587,974
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents			6a
b	Less: rental expenses			6b
c	Rental income or (loss)			6c
d	Net rental income or (loss).......
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory		292,666	7a
b	Less: cost or other basis and sales expenses		265,332	7b
c	Gain or (loss)		27,334	7c
d	Net gain or (loss).........			27,334			27,334
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
			8a
b	Less: direct expenses ...		8b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a
b	Less: direct expenses ...		9b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
			10a
b	Less: cost of goods sold ..		10b
c	Net income or (loss) from sales of inventory..
Business Code			Miscellaneous Revenue
11a
b
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......
12	Total revenue. See instructions.....			6,232,685	0	0	615,308

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	3,087,190	3,087,190
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, lines 15 and 16. .............
4	Benefits paid to or for members .......
5	Compensation of current officers, directors, trustees, and key employees ...........	3,000		3,000
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........
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....
9	Other employee benefits .......
10	Payroll taxes ...........
11	Fees for services (non-employees):
a	Management ......	464,045	299,178	164,867
b	Legal .........	461		461
c	Accounting ...........	10,400		10,400
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......	38,416		38,416
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)
12	Advertising and promotion ....	1,705	1,499	206
13	Office expenses .......	30,004	23,319	6,685
14	Information technology ......	8,027	100	7,927
15	Royalties ..
16	Occupancy ...........
17	Travel ............	9,703	8,171	1,532
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	6,102	3,419	2,683
20	Interest ...........
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..
23	Insurance ...
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	CONSULTING	55,701	49,615	6,086
b	MEMBERSHIP FEES	5,515	4,350	1,165
c	MISCELLANEOUS EXPENSE	4,945		4,945
d	OUTREACH AND EDUCATION	1,841	1,841
e	All other expenses	99		99
25	Total functional expenses. Add lines 1 through 24e	3,727,154	3,478,682	248,472	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 ........		95,287	1	176,428
2	Savings and temporary cash investments .........		2,536,674	2	1,506,320
3	Pledges and grants receivable, net ......		4,703,950	3	5,608,977
4	Accounts receivable, net .............			4
5	Loans and other receivables from any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
				5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
				6
7	Notes and loans receivable, net ...........			7
8	Inventories for sale or use ............			8
9	Prepaid expenses and deferred charges ......		5,449	9	11,012
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a
b	Less: accumulated depreciation	10b		10c
11	Investments—publicly traded securities .		18,008,810	11	22,638,266
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 ...........		977	15	126
16	Total assets. Add lines 1 through 15 (must equal line 33)...		25,351,147	16	29,941,129

17	Accounts payable and accrued expenses .....	12,223	17	1,492
18	Grants payable ...	1,139	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 any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
			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	28,327	25	46,299
26	Total liabilities. Add lines 17 through 25..	41,689	26	47,791

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	2,574,630	27	1,603,908
28	Net assets with donor restrictions ...........	22,734,828	28	28,289,430
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....		29
30	Paid-in or capital surplus, or land, building or equipment fund ...		30
31	Retained earnings, endowment, accumulated income, or other funds		31
32	Total net assets or fund balances ...........	25,309,458	32	29,893,338
33	Total liabilities and net assets/fund balances ........	25,351,147	33	29,941,129