Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for instructions and the latest information.
| (i) Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 10 above (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
|
Total |
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Calendar year (or fiscal year beginning in) ![]() |
(a) 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. | ||||||
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 | ||||||
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.") . | 83,942 | 105,635 | 91,577 | 37,857 | 118,645 | 437,656 |
| 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 | 40,065 | 53,020 | 160,219 | 105,196 | 8,400 | 366,900 |
| 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 | 124,007 | 158,655 | 251,796 | 143,053 | 127,045 | 804,556 |
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons | 5,400 | 400 | 1,610 | 7,308 | 2,793 | 17,511 |
| 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. | 53,615 | 111,137 | 127,006 | 59,686 | 105,052 | 456,496 |
| c | Add lines 7a and 7b.. | 59,015 | 111,537 | 128,616 | 66,994 | 107,845 | 474,007 |
| 8 | Public support. (Subtract line 7c from line 6.) | 330,549 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2016 | (b) 2017 | (c) 2018 | (d) 2019 | (e) 2020 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 124,007 | 158,655 | 251,796 | 143,053 | 127,045 | 804,556 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | ||||||
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | ||||||
| 11 | Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on. | ||||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) .. | 925 | 925 | ||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 124,932 | 158,655 | 251,796 | 143,053 | 127,045 | 805,481 |
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e |
Discount claimed for blockage or other factors (explain in detail in Part VI): |
|||||
| 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 | ||||
| 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. |
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| 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) |
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| 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. |
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|
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. |
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|
7 Excess distributions carryover to 2021. Add lines 3j and 4c. |
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| 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..... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|---|
| PART III, LINE 12 | 925 |
| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| FORM 990-EZ, PART I, LINE 16 | EXPENSES OFFICE 478 INFORMATION TECHNOLOGY 2,324 TRAVEL 84 PROGRAM SUPPLIES 208 MISCELLANEOUS 651 TOTAL 3,745 |
| FORM 990-EZ, PART II, LINE 24 | ACCOUNTS RECEIVABLE 800 900 PREPAID EXPENSES AND DEFERRED CHARGES 343 0 TOTAL 1,143 900 |
| FORM 990-EZ, PART II, LINE 26 | DEFERRED REVENUE 25,000 138,194 |
| FORM 990-EZ, PART III | THE MINNESOTA COMMUNITY HEALTH WORK ALLIANCE BUILDS COMMUNITY AND SYSTEMS CAPACITY FOR BETTER HEALTH THROUGH THE INTEGRATION OF COMMUNITY HEALTH WORKER (CHW) STRATEGIES. OUR VISION IS EQUITABLE AND OPTIMAL HEALTH OUTCOMES FOR ALL COMMUNITIES. AS A CATALYST, CONVENER, EXPERT, RESOURCE AND PARTNER, WE ADVANCE OUR MISSION THROUGH EDUCATION, TRAINING, CAPACITY- BUILDING AND SHARED LEARNING. |
| FORM 990-EZ, PART III, LINE 28 | MINNESOTA COMMUNITY HEALTH WORKER ALLIANCE 2020 990 PROGRAM SERVICE ACCOMPLISHMENTS - SUMMARY THE MISSION OF THE MINNESOTA COMMUNITY HEALTH WORKER ALLIANCE ("ALLIANCE") IS TO "BUILD COMMUNITY AND SYSTEM'S CAPACITY FOR BETTER HEALTH THROUGH THE INTEGRATION OF COMMUNITY HEALTH WORKER STRATEGIES. OUR VISION IS EQUITABLE AND OPTIMAL OUTCOMES FOR ALL COMMUNITIES. COMMUNITY HEALTH WORKERS (CHWS) BRIDGE CLINICAL SETTINGS AND DIVERSE COMMUNITIES TO IMPROVE ACCESS, REDUCE COSTS, IMPROVE HEALTH OUTCOMES, AND DIVERSIFY THE WORKPLACE. THE ALLIANCE IS A STATE-WIDE NOT FOR PROFIT ORGANIZATION GOVERNED BY A BOARD OF DIRECTORS COMPRISED OF CHWS, HEALTH PROFESSIONALS, EDUCATORS, PUBLIC AND NONPROFIT LEADERS. THERE ARE THREE PRIMARY AREAS OF PROGRAMMATIC FOCUS: EDUCATION & TRAINING, FIELD BUILDING, AND PUBLIC POLICY. 2020 PROGRAM HIGHLIGHTS INCLUDE: BLUE CROSS BLUE SHIELD SPONSORSHIP GRANT DESPITE THE CHALLENGES PRESENTED BY COVID-19 THROUGHOUT ALL OF 2020, THE ALLIANCE ESTABLISHED AND IMPLEMENTED A MINNESOTA COMMUNITY HEALTH WORKER REGISTRY; REVISED AND UPDATED THE MINNESOTA COMMUNITY HEALTH WORKER CERTIFICATE CURRICULUM; DEVELOPED A PROGRAM TO AWARD SCHOLARSHIPS, MENTOR AND COACH AND SUPPORT COMPLETION OF THE CHW CERTIFICATE PROGRAM TO GREATER MINNESOTA STUDENTS; AND DEVELOPED AND CONDUCTED VIRTUAL REGIONAL MEETINGS FOR CHWS AND CHW SUPERVISORS IN GREATER MINNESOTA. INITIATIVES INITIATIVE 1: DEVELOPMENT OF A CHW DATABASE MNCHWA WAS TASKED WITH DEVELOPMENT A ROBUST SEARCHABLE DATABASE OF CHW CERTIFICATE HOLDERS, TO INCLUDE AT LEAST THE FOLLOWING ELEMENTS: CERTIFICATION YEAR, CITY OF RESIDENCE, EMPLOYER, DEMOGRAPHIC PROFILE (INCLUDING LANGUAGES SPOKEN) AND ADDITIONAL TRAINING AND CREDENTIALS. OA REGISTRY COMMITTEE WAS FORMED. THE WORK OF THE COMMITTEE INCLUDED CONSULTATION WITH THE OREGON, ARIZONA, AND MICHIGAN CHW ALLIANCES ABOUT THE DESIGN OF THEIR REGISTRIES, INTERVIEWS WITH CHWS AND EMPLOYERS, REGARDING THE COMPONENTS THEY WOULD LIKE TO SEE IN A REGISTRY, AND SELECTION OF A PREFERRED MODEL FOR THE MN REGISTRY. OA FINANCIAL MODEL WAS DEVELOPED TO ENSURE SUSTAINABILITY OF THE REGISTRY AND REGISTRATION WAS ESTABLISHED AT THE FOLLOWING LEVELS: "30 A YEAR FOR CHWS "120 A YEAR- NONPROFIT STAKEHOLDERS "200 A YEAR- FOR-PROFIT STAKEHOLDERS OCONDUCTED STATEWIDE OUTREACH AND INFORMATIONAL MEETINGS ON ZOOM ABOUT THE REGISTRY. OPENED REGISTRATION TO CHWS AND STAKEHOLDERS. ENROLLMENTS AS OF 12/31/20: CHWS - 65 AND STAKEHOLDERS - 14. INITIATIVE 2: UPDATE AND REVISE STANDARDIZED CHW CERTIFICATE CURRICULUM "WORK WITH MNHWA'S EDUCATION COMMITTEE, CHWS, INDUSTRY EXPERTS AND EMPLOYERS TO UPDATE AND REVISE THE STANDARDIZED CURRICULUM. "CURRICULUM REVISIONS INCLUDED: (1) UPDATING EXISTING COMPETENCIES AND RESOURCES; (2) ADDING RECOMMENDED KNOWLEDGE AND SKILLS'-BASED COMPONENTS BASED ON THE NATIONAL CHW CORE CONSENSUS PROJECT; (3) INTEGRATING INFORMATION ON ASTHMA, TRAUMA INFORMED CARE AND MENTAL HEALTH; (4) STRENGTHENING THE MOTIVATIONAL INTERVIEWING FOCUS; (5) INCORPORATING UPDATED INSTRUCTIONAL APPROACHES AND RESOURCES; AND (6) ADDRESSING PROFESSIONALISM AND "SOFT" SKILLS. INITIATIVE 3: SCHOLARSHIPS, SUPPORT AND ACTIVITIES TO DEVELOP CHWS IN GREATER MINNESOTA MNCHWA AWARDED SCHOLARSHIPS, PROVIDED MENTORSHIP, AND SUPPORTED SCHOLARSHIP RECIPIENTS IN GREATER MINNESOTA TO COMPLETE A CERTIFICATE THROUGH THE STATEWIDE STANDARDIZED, COMPETENCY BASED CHW CURRICULUM. MNCHWA DEVELOPED AND IMPLEMENTED A CHW LEADERSHIP DEVELOPMENT PROGRAM FOR CHWS IN OLMSTEAD, BLUE EARTH & WINONA COUNTIES. THIS PROGRAM IS INTENDED TO ENHANCE CHW LEADERSHIP AND SKILLS. MINNESOTA DEPARTMENT OF HUMAN SERVICES MNCHWA TRAINED 50 PEER SUPPORT SPECIALISTS (PSS) AND COMMUNITY HEALTH WORKERS (CHW) ACROSS MINNESOTA IN A CHW MOTHER'S RECOVERY TRAINING PROGRAM. OCREATED THE CHW MOTHER'S RECOVERY PROGRAM. THE PROGRAM WAS REFINED FOR THE ONLINE ENVIRONMENT. ORECRUITED 50 PSS AND CHWS ACROSS THE STATE. STUDENTS WERE ETHNICALLY AND GEOGRAPHICALLY DIVERSE. OPROVIDED TRAINING TO 50 PSS AND CHWS IN THREE COHORTS BLUE CROSS BLUE SHIELD OF MINNESOTA "CHWS AS CATALYSTS FOR COMMUNITY CHANGE FOR HEALTH EQUITY" THE PROGRAM GOAL WAS TO DEVELOP AND TRAIN A NETWORK OF 60 CHW LEADERS FROM ACROSS THE STATE TO WORK IN COMMUNITY COALITION BUILDING AND COMMUNITY- BASED EFFORTS ON POLICIES, SYSTEMS, AND ENVIRONMENTS (PSE) CHANGE. EMPHASIS WAS ON EQUITY AND HEALTH EQUITY. WE PROVIDED PROBLEM SOLVING SESSIONS AS PART OF THE PROGRAM AND TECHNICAL ASSISTANCE AND MENTORING TO CHWS TO SUPPORT THEM AS THEY SERVED CLIENTS DURING THE TIME OF COVID-19, WHILE PRACTICING THEIR NEW KNOWLEDGE AND SKILLS. ENGAGED A CHW ADVISORY COMMITTEE TO LEAD, EVALUATE AND SUSTAIN THE NETWORK AND SHARE RESULTS AND LESSONS LEARNED. THE TARGET WAS TO REACH COMMUNITY HEALTH WORKERS (CHWS) ACROSS THE STATE OF MINNESOTA. WE HAD A NEW COHORT OF 25 CHWS FROM ACROSS THE STATE PLUS 60 CHWS WHO PREVIOUSLY COMPLETED THE MNCHWA LEADERSHIP INSTITUTE WHO JOINED IN FROM TIME TO TIME, SERVED AS ADVISORY COMMITTEE MEMBERS AND SPEAKERS. WE REACHED 3,080 PEOPLE. WE DIRECTLY SERVED 85 CHWS AND 20 SPEAKERS AND ESTIMATE THAT WE INDIRECTLY REACHED 2,975. CHWS ARE OUR COMMUNITY. THEY WERE INVOLVED IN CREATING THE ORIGINAL PROPOSAL, DETERMINING THE CONTENT OF THE PROGRAM, LEADING SESSIONS, HELPING TO REVISE THE PROGRAM WHEN COVID 19 HIT, AND SERVED AS PEER SUPPORT TO EACH OTHER. RELATIONSHIPS BETWEEN CHWS IN THE PROGRAM WERE STRENGTHENED. CHWS REPORTED THAT RELATIONSHIPS WITH THEIR SUPERVISOR AND THEIR AGENCY WERE STRENGTHENED DUE TO THEIR ENHANCED CAPACITY TO EXPLAIN THEIR ROLE AND BENEFIT. MANY CHWS HAD CONTACT (FROM A DISTANCE) WITH AN ELECTED OFFICIAL FOR THE FIRST TIME. MINNESOTA BREASTFEEDING COALITION (MBC) MNCHWA COLLABORATED WITH MBC ON THE CHWS AS INFANT FEEDING SPECIALISTS, WHICH INCLUDED PLANNING AND HOSTING A BABY BEHAVIOR TRAINING FOR CHWS AND SIMILAR PROFESSIONALS IN RAMSEY COUNTY; REVIEWING AND UPDATING THE INFANT FEEDING/BREASTFEEDING RELATED CONTENT OF THE CHW CERTIFICATE CURRICULUM; AND PLANNING AND CREATING ONE TO THREE CONTINUING EDUCATION WEBINARS FOR CHWS ON TOPICS RELATED TO INFANT FEEDING/BREASTFEEDING RELATED EDUCATION, ANTICIPATORY GUIDANCE, AND REFERRALS FOR ADVANCED CARE. |
| Software ID: | |
| Software Version: |
| Person Name | Explanation |
|---|---|
| LATANYA BLACK | |
| CATHY WEIK | |
| LAURA GUZMANCORRALES | |
| GARY OFTEDAHL | |
| KIMBERLI BARKER | |
| MATT FLORY | |
| VONYEE HOWARD | |
| JERI PETERS | |
| JULIE RALSTON AOKI | |
| CATHY VONRUEDEN | |
| MARY RAPPS |