Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for instructions and the latest information.
| (i) Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 10 above (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
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Total |
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Calendar year
(or fiscal year beginning in)
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(a) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (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) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (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) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | 2,000 | 16,500 | 94,833 | 113,333 | ||
| 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 | 46,825 | 13,513 | 301,150 | 318,905 | 261,655 | 942,048 |
| 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 | 46,825 | 13,513 | 303,150 | 335,405 | 356,488 | 1,055,381 |
| 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.) | 1,055,381 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 46,825 | 13,513 | 303,150 | 335,405 | 356,488 | 1,055,381 |
| 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 on 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.).. | 46,825 | 13,513 | 303,150 | 335,405 | 356,488 | 1,055,381 |
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e |
Discount claimed for blockage or other factors (explain in detail in Part VI): |
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| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 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 2021 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-2021 |
(iii) Distributable Amount for 2021 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2021 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2021 (reasonable cause required-- explain in Part VI). See instructions. |
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| 3 Excess distributions carryover, if any, to 2021: | ||||
| a From 2016....... | ||||
| b From 2017....... | ||||
| c From 2018....... | ||||
| d From 2019....... | ||||
| e From 2020....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2021 distributable amount | ||||
|
i
Carryover from 2016 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from line 3f. | ||||
| 4Distributions for 2021 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2021 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from line 4. | ||||
|
5
Remaining underdistributions for years prior to 2021, 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 2021. 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 2022. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2017..... | ||||
| b Excess from 2018..... | ||||
| c Excess from 2019..... | ||||
| d Excess from 2020..... | ||||
| e Excess from 2021..... | ||||
| Facts And Circumstances Test |
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| Return Reference | Explanation |
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| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| FORM 990 - ORGANIZATION'S MISSION | THE MISSION OF THE NEW MEXICO PERINATAL COLLABORATIVE IS TO CONVENE STAKEHOLDERS TO ACHIEVE HEALTH EQUITY THROUGH THE PROMOTION OF EVIDENCE- BASED REPRODUCTIVE AND PERINATAL HEALTH PRACTICES THAT: INCREASE COLLABORATION WITH COMMUNITIES AND ACROSS HEALTHCARE DISCIPLINES FOCUS ON QUALITY IMPROVEMENT STRATEGIES EMPOWER HEALTHCARE TEAMS STATEWIDE TO OFFER THE HIGHEST QUALITY CARE - ENSURE PROVISION OF HOLISTIC AND CULTURALLY RESPECTFUL CARE |
| FORM 990, PAGE 2, PART III, LINE 4A | "ADVANCED ORGANIZATIONAL DEVELOPMENT: -IMPLEMENTING THE UNMHSC/J&J GRANT. -APPLIED FOR OTHER FUNDING INCLUDING AIM SUPPLEMENTAL, UNITED HEALTHCARE, AND UBS (ALL AWARDED IN FY23). ALSO APPLIED FOR A CDC GRANT (RESULTS TO BE ANNOUNCED SEPTEMBER 2022). -SUPPORTED A BOARD-LED EVALUATION PROCESS OF THE ORGANIZATION, INCLUDING CONVERSATIONS WITH THE UNIVERSITY OF NEW MEXICO AND THE NM DEPARTMENT OF HEALTH ABOUT THE FUTURE OF NMPC. -RECRUITED NEW BOARD MEMBERS, RESULTING IN THE ELECTION IN JULY 2022 OF 8 NEW BOARD MEMBERS REPRESENTING VARIOUS DISCIPLINES AND GEOGRAPHIC AREAS OF NEW MEXICO. PLANNED AN INTENSIVE BOARD ORIENTATION AS PART OF THE RECRUITMENT PROCESS. -PLANNED A DAY-LONG PROGRAM TEAM MEETING TO EVALUATE CURRENT ACTIVITIES AND OPPORTUNITIES FOR FY23. |
| FORM 990, PAGE 2, PART III, LINE 4B | "SUPPORTING THE ENROLLED 26 OF 29 NM BIRTHING HOSPITALS IN OUR MATERNAL SAFETY INITIATIVE AS PART OF THE ALLIANCE FOR INNOVATION ON MATERNAL HEALTH (AIM), WHICH INCLUDES 6 CRITICAL ACCESS HOSPITALS AND 3 INDIAN HEALTH SERVICES FACILITIES. "CONTINUING MATERNAL SAFETY INITIATIVES UNDER THE PREVIOUSLY AWARDED MULTI-YEAR NM DOH CONTRACT AND THROUGH OTHER FUNDING INCLUDING A COLLABORATION WITH UNM HEALTH SCIENCES CENTER FOR A GRANT FROM JOHNSON & JOHNSON. "OBTAINED COMMITMENTS FROM ENROLLED HOSPITALS TO SHARE DATA ON IMPLEMENTATION OF BEST PRACTICES AND MATERNAL OUTCOMES. CONTINUED ONGOING DATA ANALYSIS FOR QUALITY IMPROVEMENT PURPOSES. PROGRAM MANAGERS CONDUCTED MONTHLY/QUARTERLY DATA COACHING CALLS WITH ENROLLED HOSPITALS AND DEVELOPED A WORKPLAN TO BEGIN QUARTERLY GROUP LEARNING SESSIONS FOR LIKE-VOLUME HOSPITAL TEAMS TO IMPLEMENT QUALITY IMPROVEMENT. "PRESENTED ON NMPC AIM MATERNAL SAFETY INITIATIVE PROGRESS TO THE AIM NATIONAL NETWORK AND THE NATIONAL NETWORK OF PERINATAL QUALITY COLLABORATIVES (NNPQC). "CONTINUING AND IMPROVING UPON NMPC OUTREACH TEAM ON-SITE, PLACE-BASED TRAININGS WITH A RANGE OF MULTIDISCIPLINARY PROVIDERS AS VOLUNTEERS TO ASSIST WITH TRAININGS. VISITS WERE COMPLETED AT HOLY CROSS MEDICAL CENTER IN TAOS, SOCORRO GENERAL HOSPITAL, AND GILA REGIONAL MEDICAL CENTER. "CONDUCTED TELE-MENTORING SESSIONS FOR AN AVERAGE OF 50 PARTICIPANTS TWICE MONTHLY ON MATERNAL SAFETY BEST PRACTICES THROUGH THE IMPROVING PERINATAL HEALTH PROJECT ECHO. THE AIM CARING FOR PREGNANT AND POSTPARTUM PEOPLE WITH SUBSTANCE USE DISORDER WORK IS CONTINUING, AS WELL AS SESSIONS AROUND LIVED EXPERIENCED AND CONTINUING EDUCATION CREDITS FOR PHARMACY, SOCIAL WORK, PSYCHOLOGY, AND COMMUNITY HEALTH WORKERS IN ADDITION TO OUR OFFERINGS FOR MEDICINE, NURSING, AND MIDWIFERY. THE APRIL 4TH SESSION HAD THE MOST ATTENDEES EVER, WITH 115 PARTICIPANTS, AND A PRESENTATION BY DR. MISHKA TERPLAN. "HOSTED THE VIRTUAL NMPC FALL STAKEHOLDER MEETING IN OCTOBER 2021, "WORKING IN PARTNERSHIP: LISTENING TO THE PATIENT EXPERIENCE." THIS MEETING PROVIDED CONTINUING EDUCATION CREDITS TO PERINATAL HEALTHCARE PROVIDERS WHO ATTEND. "CONTINUED THE MONTHLY MULTIDISCIPLINARY NMPC SUBSTANCE USE DISORDER IN PREGNANCY WORKGROUP. THE GROUP REVIEWS THE AIM SUBSTANCE USE DISORDER (SUD) BUNDLE CURRICULUM AND IS WORKING TO OFFER A BUPRENORPHINE WAIVER TRAINING FOCUSED ON OB PROVIDERS TO INCREASE THE PROVISION OF MOUD ACROSS THE STATE. "CONTRIBUTED TO THE DEVELOPMENT OF AN EMS/OB WORKGROUP TO IMPROVE EMS SERVICES FOR PREGNANT PEOPLE IN RURAL AREAS OF THE STATE. |
| FORM 990, PAGE 6, PART VI, LINE 3 | MS. J. MASTRIPOLITO IS EMPLOYED BY AN INDEPENDENT ORGANIZATION - DELTA MANAGEMENT GROUP, AND PURSUANT TO A CONTRACT WITH THIS ORGANIZATION PERFORMS THE SERVICES OF EXECUTIVE DIRECTOR. THE ORGANIZATION RECEIVES AN INVOICE MONTHLY FROM DELTA MANAGEMENT GROUP FOR A PORTION OF THE SALARY AND BENEFITS PAYABLE TO MS. MASTRIPOLITO, PLUS ASSOCIATED TAXES, IN AN AMOUNT AGREED TO BY THE ORGANIZATION PURSUANT TO THIS CONTRACT. MS. MASTRIPOLITO REPORTS TO THE INDEPENDENT BOARD OF DIRECTORS OF NMPC AND ORGANIZATIONAL PERFORMANCE AND IS SUBJECT TO THE DIRECTION OF THE BOARD. |
| FORM 990, PAGE 6, PART VI, LINE 11B | THE 990 RETURN IS SUBMITTED TO THE BOARD FOR REVIEW AND APPROVAL PRIOR TO FILING EACH YEAR. |
| FORM 990, PAGE 6, PART VI, LINE 12C | CONFLICT OF INTEREST POLICY 1.ANY POTENTIAL CONFLICT OF INTEREST THAT COULD RESULT IN A DIRECT OR INDIRECT FINANCIAL ORPERSONAL BENEFIT TO A DIRECTOR, OFFICER OR STAFF MEMBER MUST BE DISCLOSED IN GOOD FAITH, OR KNOWN TO THE BOARD OF DIRECTORS OR COMMITTEE AUTHORIZING A CONTRACT OR OTHER TRANSACTION. 2.ALL QUESTIONS AS TO WHETHER A CONFLICT OF INTEREST EXISTS SHALL BE RESOLVED BY A VOTE OF THE BOARD OF DIRECTORS IN WHICH THE INTERESTED PARTY MAY NOT VOTE. 3.THE INTERESTED INDIVIDUAL MAY PARTICIPATE IN THE INFORMATION-GATHERING STAGE OF THE BOARD OF DIRECTORS OR COMMITTEES DISCUSSION, BUT THE INDIVIDUAL SHALL NOT BE PRESENT OR PARTICIPATE IN THE FINAL DELIBERATION OR DECISION REGARDING SUCH CONTRACT OR OTHER TRANSACTION. SUCH INTERESTED INDIVIDUAL MAY NOT VOTE ON SUCH CONTRACT OR OTHER TRANSACTION. 4.IN CONNECTION WITH ALL ACTIONS TAKEN BY THE BOARD OF DIRECTORS WITH RESPECT TO ANY CONTRACT OR TRANSACTION BETWEEN THE NMPC AND ONE OR MORE OF ITS DIRECTORS OR OFFICERS, OR BETWEEN THE NMPC AND ANY OTHER CORPORATION, FIRM, ASSOCIATION, OR OTHER ENTITY IN WHICH ONE OR MORE OF THE DIRECTORS OR OFFICERS OF THE NMPC IS A DIRECTOR OR OFFICER OR HAS A SUBSTANTIAL FINANCIAL INTEREST, AFFILIATION, OR OTHER SIGNIFICANT RELATIONSHIP, EACH SUCH INTERESTED DIRECTOR OR OFFICER OF THE NMPC SHALL: A.DISCLOSE TO THE BOARD OF DIRECTORS THE MATERIAL FACTS AS TO SUCH DIRECTORS OR OFFICERS INTEREST IN SUCH CONTRACT OR TRANSACTION AND AS TO ANY SUCH COMMON DIRECTORSHIPS, OFFICES, OR SIGNIFICANT FINANCIAL INTEREST, AFFILIATION, OR OTHER SIGNIFICANT RELATIONSHIP, WHICH DISCLOSURE SHALL BE DULY RECORDED IN THE MINUTES OR RESOLUTIONS RELATING TO SUCH ACTIONS, AND B.ABSTAIN FROM VOTING ON ANY SUCH CONTRACT OR TRANSACTION. 5.THE CONFLICT OF INTEREST DISCLOSURE STATEMENT WILL BE DISTRIBUTED TO EACH DIRECTOR, OFFICER, AND STAFF MEMBER ANNUALLY AND MUST BE SUBMITTED FOR SUBSEQUENT REVIEW BY THE EXECUTIVE COMMITTEE, WITH A FINAL REPORT AND RECOMMENDATION TO THE BOARD OF DIRECTORS AT THE NEXT SCHEDULED MEETING. THE CONFLICT OF INTEREST DISCLOSURE STATEMENT WILL BE PROVIDED TO ALL NEW DIRECTORS AS THEY ASSUME THEIR DUTIES ON THE BOARD. |
| FORM 990, PAGE 6, PART VI, LINE 19 | GOVERNING AND OTHER DOCUMENTS ARE AVAILABLE UPON REQUEST. THEY ARE ALSO AVAILABLE ON THE NM ATTORNEY GENERAL'S COROS WEBSITE AND ON THE IRS CHARITIES WEBSITE. |
| FORM 990, PART IX, LINE 11G | CONTRACT LABOR 71,610 0 3,129 CONTRACT LABOR 24,230 0 0 TOTAL 95,840 0 3,129 |
| Software ID: | |
| Software Version: |