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 | |||||
| (A)
EL RIO SANTA CRUZ NEIGHBORHOOD HEALTH CENTER |
860285857 | 3 | Yes | 1,195,022 | 90 | |
|
Total 1
|
1,195,022 | 90 | ||||
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.") . | ||||||
| 2 | Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose | ||||||
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513 ..... | ||||||
| 4 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... | ||||||
| 5 | The value of services or facilities furnished by a governmental unit to the organization without charge | ||||||
| 6 | Total. Add lines 1 through 5 | ||||||
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons | ||||||
| b | Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year. | ||||||
| c | Add lines 7a and 7b.. | ||||||
| 8 | Public support. (Subtract line 7c from line 6.) | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 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.).. | ||||||
| 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 | ||||
| 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..... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|
| 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, PAGE 2, PART III, LINE 4A | EL RIO FOUNDATION SUPPORTED PROGRAMS / CAPITAL PROJECTS 2020 TOTAL DISTRIBUTION ADOPT A FAMILY 13,080 FOOD GIFT CARDS ARE DISTRIBUTED TO IDENTIFIED EL RIO PATIENTS NOMINATED BY HEALTH CENTER EMPLOYEES. BREAST/CERVICAL CANCER TREATMENT 51,907 SUPPORT FOR PATIENTS DIAGNOSED WITH CANCER WHO HAVE NO HEALTH INSURANCE. BEHAVIORAL HEALTH (GRANT FROM RBC WEALTH MGMT - DEPRESSION SCREENING FOR KIDS/TEENS) 2,500 SUPPORT FOR SCREENING TEENS AGE 12+ FOR DEPRESSION BJS EMPLOYMENT ENHANCEMENT SCHOLARSHIP FUND 11,466 SCHOLARSHIPS FOR EL RIO EMPLOYEES PURSUING ADVANCED DEGREES/CERTIFICATIONS. BIRTHING CENTER - BWH 20,000 SUPPORT FOR MIDWIFERY SERVICES, TRAINING, AND EDUCATION WITH PARENTS. CHERRYBELL CAPITAL CAMPAIGN 20,000 CAPITAL SUPPORT FOR OUR HEALTH CENTER SITE THAT OPENED IN 2019 AT 22ND & KINO PARKWAY. CHILDREN'S HEALTH - ASTHMA 75,000 DONOR FUNDING HELPS 100-150 KIDS ANNUALLY SUFFERING FROM SEVERE ASTHMA. SERVICES INCLUDE EDUCATION, SUPPORT, LIFE-SAVING MEDICATION, AND EQUIPMENT. CHILDREN'S HEALTH - IMMUNIZATIONS 65,000 DONOR CONTRIBUTIONS HELP ENSURE CHILDREN ARE VACCINATED IN A TIMELY MANNER. OVER 20,000 KIDS ARE SERVED ANNUALLY. EL RIO HAS WON NUMEROUS STATE AWARDS FOR IT'S EFFECTIVE, LIFE-SAVING IMMUNIZATION PROGRAMS. CHILDREN'S HEALTH - ROAR 49,819 REACH OUT READ IS AN EARLY CHILDHOOD LITERACY PROGRAM THAT SUPPORTS LANGUAGE AND LITERACY DEVELOPMENT IN CHILDREN AGES 0-5. DONOR SUPPORT COVERS FREE, DISCOUNTED NEW BOOKS GIFTED TO PEDIATRIC PATIENTS. CHILDREN'S HEALTH SCREENING COPAY 3,500 DONOR SUPPORT COVERS TESTING/PROCEDURES CONDUCTED BY SPECIALISTS IN OUR COMMUNITY TO WHOM THE CHILD HAS BEEN REFERRED FOR FOLLOW UP. CELIA HIGHTOWER NURSING SCHOLARSHIP AWARD 9,000 NURSING SCHOLARSHIP GIFTED TO AN ELIGIBLE EL RIO EMPLOYEE. CONGRESS MIDWIVES CENTERING PREGNANCY PROGRAM EXPECTANT PARENTS COME TOGETHER FOR PRENATAL CLASSES AND GROUP SUPPORT. COLORECTAL CANCER PREVENTION - CSP 60,007 COLORECTAL CANCER EDUCATION AND SCREENING PROGRAM. DONOR SUPPORT PAYS FOR COLONOSCOPIES FOR QUALIFIED UNINSURED PATIENTS. CANCER TREATMENT FUND 41,835 FUNDS SUPPORT DISCOUNTED CANCER TREATMENT PROCEDURES FOR QUALIFIED, UNINSURED PATIENTS. CHILDREN'S EMERGENCY DENTAL PROGRAM 22,949 DONOR SUPPORTED EMERGENCY DENTAL SERVICES FOR QUALIFIED CHILDREN (UP TO 500 PER CHILD). ADULT DENTAL PARTNERSHIP 30,729 THIS DONOR FUNDED PROGRAM PROVIDES UP TO 500 IN ORAL HEALTH CARE FOR QUALIFIED PEOPLE WHO ARE HOMELESS, UNINSURED OR ON AHCCCS-MEDICAID. EMPLOYEE ASSISTANCE FUND 25,551 EMERGENCY SUPPORT FOR EXTREME HARDSHIP UP TO 1,000 FOR APPROVED EL RIO EMPLOYEES TO PREVENT EVICTION, COVER UNFORESEEN MEDICAL EXPENSES. SKIN CANCER PREVENTION PROGRAM 5,780 A PUBLIC AWARENESS SKIN CANCER PREVENTION CAMPAIGN. EL PUEBLO BUILDING FUNDS 6,000 CAPITAL SUPPORT FOR THIS CLINIC LOCATION. DENTAL VARNISH PROGRAM 66,667 EL RIO'S EMBEDDED HYGIENIST PROGRAM TEACHES KIDS AND THEIR PARENTS GOOD ORAL HEALTH HABITS. EL RIO PROVIDES FREE FLUORIDE VARNISH TO HELP PROTECT CHILDREN'S TEETH ALONG WITH EDUCATION, FREE TOOTH BRUSHES AND FLOSS. OVER 9,000 CHILDREN SERVED ANNUALLY. CHILDREN'S VISION SCREENING PROGRAM 1,000 DONATIONS SUPPORT VISION SCREENING SERVICES FOR CHILDREN. LESBIAN, GAY, BI-SEXUAL & TRANSGENDER HEALTH CARE SERVICES 3,000 MEDICAL CARE, SUPPORT AND OUTREACH PROVIDED TO THE LGBT COMMUNITY. PUBLIC ALLIES / INTERNSHIP WORKFORCE BEQUEST 4,125 A PARTNERSHIP STUDENT PLACEMENT LEARNING PROGRAM. MAMMOGRAPHY SCREENINGS 12,000 FREE 3D MAMMOGRAMS PROVIDED BY DONOR SUPPORT TO UNINSURED PATIENTS AT NO COST FOR 150 TO 200 WOMEN ANNUALLY. MAMMOGRAPHY MACHINE - SOUTHEAST CLINIC 10,000 DONOR SUPPORT FOR PURCHASE OF MEDICAL EQUIPMENT PHARMACY - DIABETES 13,799 CLINICAL PHARMACY PATIENT SERVICES FOR THOSE DIAGNOSED WITH TYPE 2 DIABETES. RHAP TEEN CLINIC 100,000 DONATIONS SUPPORT YOUTH LEADERS AND REPRODUCTIVE HEALTH SERVICES FOR TEAMS AND YOUNG ADULTS. SOUTHEAST CLINIC CAPITAL 20,000 DONOR SUPPORT FOR THIS CLINIC. SIA - CLUB MEDBOX 5,823 DONOR SUPPORT COVERS PRESCRIPTION CO-PAYS FOR QUALIFIED PATIENTS DIAGNOSED WITH HIV/AIDS. VENTANILLA DE SALUD - VDS 30,000 THE VENTANILLA DE SALUD (VDS) PROGRAM IS A PARTNERSHIP BETWEEN THE US- MEXICAN BORDER HEALTH COMMISSION, MEXICAN CONSULATE AND EL RIO HEALTH TO PROVIDE HEALTH SERVICES TO FAMILIES LIVING ON BOTH SIDES OF THE BORDER. WELLNESS 34,767 DONOR CONTRIBUTIONS PAY FOR FREE WELLNESS PROGRAMS TO EMPOWER AT-RISK PATIENTS TO LEARN HOW TO STAY HEALTHY AND DEVELOP NEW MIND, BODY AND SPIRIT COPING TECHNIQUES. TELEHEALTH AND CHILDCARE COVID-19 FUNDS 360,510 DONOR FUNDING HELPED WITH THE COST OF TELE-HEALTH LICENSES FOR EMPLOYEES, SOFTWARE AND IT EQUIPMENT DURING THE PANDEMIC. DENTAL EQUIPMENT AT CENTER OF OPPORTUNITY 110,000 DONOR FUNDING BEING USED TO PURCHASE DENTAL EQUIPMENT FOR THIS NEW LOCATION OPENING IN 2021. BREAST AND CERVICAL CANCER TREATMENT FOR ST. ELIZABETH'S PATIENTS 35,186 DONOR FUNDING FOR QUALIFIED, WOMEN DIAGNOSED WITH CANCER WITH NO OTHER TREATMENT RESOURCES. DENTAL EQUIPMENT FOR ST. ELIZABETH'S DENTAL SUITES 68,492 NEW DENTAL EQUIPMENT FOR SEVERAL OPERATORIES AT THIS CLINIC SITE. VECINOS 465 SUPPORT EXPENSES FOR OUR GROUP OF YOUNG PROFESSIONAL VOLUNTEERS. TOTAL PROGRAM DISTRIBUTION 1,389,956 |
| FORM 990, PAGE 6, PART VI, LINE 2 | ALEX LEVIN CLAUDIA LEVIN DIRECTOR DIRECTOR COUSINS |
| FORM 990, PAGE 6, PART VI, LINE 11B | FOUNDATION BOARD MEMBERS WILL BE PROVIDED A COPY OF THE 990 BY EMAIL AND ASKED TO ACKNOWLEDGE RECEIPT. |
| FORM 990, PAGE 6, PART VI, LINE 12C | ANNUALLY, EMPLOYEES AND BOARD MEMBERS REVIEW AND SIGN THE CONFLICT OF INTEREST CERTIFICATION. AT THE FACILITY LEVEL, THE FORM MUST BE SENT TO THE COMPLIANCE OFFICER; POTENTIAL CONFLICTS WILL BE REPORTED TO THE COMPLIANCE COMMITTEE. AT THE BOARD LEVEL, THE FORMS ARE SENT TO COMPLIANCE WITH POTENTIAL CONFLICTS REFERRED TO THE GOVERNING BOARD AND CEO. AT ANY TIME DURING THE YEAR, WHEN AN ACTUAL, POTENTIAL, OR PERCEIVED CONFLICT OF INTEREST ARISES, THE EMPLOYEE MUST CONTACT HIS OR HER SUPERVISOR AND THE COMPLIANCE OFFICER. BOARD LEVEL REPORTS SHOULD BE SUBMITTED TO THE CEO. |
| FORM 990, PAGE 6, PART VI, LINE 15A | THE EL RIO FOUNDATION DOES NOT HAVE ANY EMPLOYEES, IT DOES NOT COMPENSATE ANY OF ITS OFFICERS OR DIRECTORS, AND IT DOES NOT PARTICIPATE IN ANY DISCUSSIONS REGARDING THE LEVEL OF COMPENSATION OF ITS EXECUTIVE DIRECTOR WHO IS EMPLOYED BY A RELATED ORGANIZATION, THE EL RIO COMMUNITY HEALTH CENTER. HOWEVER, THE RELATED ORGANIZATION FOLLOWS THESE GUIDELINES IN DETERMINING THE EXECUTIVE LEVEL COMPENSATION OF ITS EMPLOYEES. THE PROCESS FOR DETERMINING COMPENSATION OF THE KEY EMPLOYEES INCLUDE A REVIEW AND APPROVAL BASED ON COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION. THE COMPENSATION IS PAID BY THE HEALTH CENTER AND FOLLOWS THEIR POLICIES. |
| FORM 990, PAGE 6, PART VI, LINE 15B | COMPENSATION PROCESS FOR OFFICERS SAME AS PROCESS FOR TOP OFFICAL. |
| FORM 990, PAGE 6, PART VI, LINE 19 | THE 990 IS AVAILABLE TO THE PUBLIC. THE ANNUAL AUDITED FINANCIALS ARE AVAILABLE TO ANY ORGANIZATION THAT REQUESTS A COPY INCLUDING THE OMB CIRCULAR A-133 COMPLIANCE SUPPLEMENT. COPIES ARE ALSO POSTED ON WWW.ELRIO.ORG |
| Software ID: | |
| Software Version: |