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)
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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.") .. | 337,730 | 365,144 | 474,126 | 453,577 | 532,000 | 2,162,577 |
| 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 | 337,730 | 365,144 | 474,126 | 453,577 | 532,000 | 2,162,577 |
| 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) .. | 356,992 | |||||
| 6 | Public support. Subtract line 5 from line 4. | 1,805,585 | |||||
Calendar year
(or fiscal year beginning in)
![]() |
(a) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 337,730 | 365,144 | 474,126 | 453,577 | 532,000 | 2,162,577 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | 2,228 | 3,387 | 14,573 | 11,978 | 10,754 | 42,920 |
| 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 | 2,205,497 | |||||
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.") . | 337,730 | 365,144 | 474,126 | 453,577 | 532,000 | 2,162,577 |
| 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 | 337,730 | 365,144 | 474,126 | 453,577 | 532,000 | 2,162,577 |
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons | 151,031 | 141,680 | 198,814 | 229,029 | 188,403 | 908,957 |
| 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.. | 151,031 | 141,680 | 198,814 | 229,029 | 188,403 | 908,957 |
| 8 | Public support. (Subtract line 7c from line 6.) | 1,253,620 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 337,730 | 365,144 | 474,126 | 453,577 | 532,000 | 2,162,577 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 2,228 | 3,387 | 14,573 | 11,978 | 10,754 | 42,920 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | 2,228 | 3,387 | 14,573 | 11,978 | 10,754 | 42,920 |
| 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.).. | 339,958 | 368,531 | 488,699 | 465,555 | 542,754 | 2,205,497 |
| 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, PAGE 1, PART I, LINE 6 | BOARD MEMBERS AND OFFICERS ARE ALL VOLUNTEERS. VOLUNTEERS PROVIDE CONSULTING SERVICES IN A NUMBER OF AREAS, INCLUDING LEGAL, FINANCIAL, GRANT WRITING, TRAINING COURSE DEVELOPMENT, AND DESIGN. THEY ALSO TRAVEL TO AFRICA AS TRAINERS AND TEACHERS, AND ASSIST IN PREPARATION OF MEALS FOR CHILDREN. |
| FORM 990, PAGE 2, PART III, LINE 4A | HEALTHED CONNECT SUPPORTS PROGRAMS IN FOUR COUNTRIES: ZAMBIA, MALAWI, DEMOCRATIC REPUBLIC OF THE CONGO, AND NEPAL. THE REAL HEROES IN EACH COUNTRY ARE THE VOLUNTEER COMMUNITY HEALTH WORKERS (CHWS). THESE ARE THE VILLAGE WOMEN (AND SEVERAL MEN) WITH THE DESIRE TO IMPROVE THE HEALTH AND WELL BEING OF THEIR COMMUNITIES. IN 2021 HEALTHED CONNECT SUPPORTED INITIATIVES THROUGH THE EFFORTS OF VOLUNTEER CHWS AND SCHOOL PROGRAMS. DURING THE YEAR, 68,327 CHILDREN UNDER FIVE YEARS OF AGE WERE WEIGHED AND MONITORED TO ENSURE GROWTH; 40,926 BABIES WERE IMMUNIZED; 71,396 MOTHERS WERE TAUGHT ABOUT HEALTH, NUTRITION, SANITATION, AND FAMILY PLANNING; AND 2,082 HOME CARE VISITS WERE MADE. ELEVEN NURSING SCHOLARSHIPS WERE AWARDED. IN OUR SCHOOL PROGRAMS, 1,446 ORPHANS AND VULNERABLE CHILDREN WERE ENROLLED BETWEEN OUR THREE ELEMENTARY SCHOOLS; 5,631 BOOKS WERE CHECKED OUT FROM THE SCHOOL LIBRARIES; AND 60 HIGH SCHOOL SCHOLARSHIPS WERE AWARDED TO GIRLS AS A PART OF THE MIND THE GAP (GIRLS ACHIEVEMENT PROGRAM) INIATIVE ENSURING THAT GIRLS HAVE EQUAL OPPORTUNITY TO ATTEND SECONDARY SCHOOL WITHOUT FEAR OF THE COSTS. WE DO NOT CREATE POLICY, BUT ADVOCACY THROUGH EDUCATION AND THROUGH THE CHWS IS INTEGRAL TO WHAT WE DO. CHWS ARE THE PRIMARY HEALTH ADVOCATES FOR THEIR CLIENTS. WE ALSO ADVOCATE FOR EDUCATING THE NEXT GENERATION OF WORLD- CHANGERS, THE CAREGIVERS WHO WILL RAISE THEM, AND THE COMMUNITY HEROES WHO SUPPORT BOTH GROUPS ON THEIR JOURNEY TO A MORE EDUCATED, EMPOWERED FUTURE. VILLAGE CHIEFS RESPECT OUR VOLUNTEER CHWS BECAUSE THEY KNOW THE IMPACT THEY ARE MAKING IN THE LIVES OF WOMEN AND CHILDREN. CHIEFS IN SEVERAL AREAS HAVE GIFTED LAND TO THE CHWS SO THEY CAN HAVE A PHYSICAL LOCATION TO DO THE WORK THEY LOVE, AND THESE HEALTH CENTERS ARE QUICKLY BECOMING THE PRIDE OF THEIR COMMUNITIES. |
| FORM 990, PAGE 6, PART VI, LINE 2 | CHERRY NEWCOM SHANDRA NEWCOM BD MEMBER BD MEMBER FAMILY RELATIONSHIP SHERRI KIRKPATRICK JULIE KIRKPATRICK BD MEMBER BD MEMBER FAMILY RELATIONSHIP |
| FORM 990, PAGE 6, PART VI, LINE 11B | THE TREASURER, IN CONSULTATION WITH THE EXECUTIVE DIRECTOR, PRESIDENT, AND THE ACCOUNTANT, WILL BE RESPONSIBLE FOR FILLING OUT THE REQUIRED FORM 990 IN A TIMELY MANNER. THE FINANCE COMMITTEE AND THE BOARD OF DIRECTORS WILL REVIEW THE ENTIRE 990, WITH THE EXCEPTION OF SCHEDULE B WHICH WILL BE WITHHELD TO PROTECT THE CONFIDENTIALITY OF DONORS, BEFORE THE RETURN IS FILED. ANY DISCREPANCIES OR ERRORS NOTED DURING THE REVIEW WILL BE CORRECTED PRIOR TO FILING. |
| FORM 990, PAGE 6, PART VI, LINE 12C | DIRECTORS & OFFICERS SIGN CONFLICT OF INTEREST DOCUMENT ANNUALLY IN CASE OF ANY SUCH CONFLICT OR THE APPEARANCE THEREOF, AFFILIATED PERSONS ARE EXPECTED TO DISCLOSE THE CONFLICT IN ADVANCE. ONCE SUCH A DISCLOSURE HAS BEEN MADE, EITHER THE DISINTERESTED BOARD MEMBERS (IF THE AFFILIATED PERSON IS A BOARD MEMBER) OR THE EXECUTIVE DIRECTOR (ASSUMING HE OR SHE IS DISINTERESTED) OR THE PRESIDENT (ASSUMING HE OR SHE IS DISINTERESTED) OF THE ORGANIZATION (IF THE AFFILIATED PERSON IS NOT A BOARD MEMBER) SHALL DETERMINE WHETHER THERE IS A POTENTIAL CONFLICT OF INTEREST. IF IT IS DETERMINED THAT THERE IS A POTENTIAL CONFLICT OF INTEREST, THE AFFILIATED PERSON INVOLVED SHALL ABSTAIN FROM VOTING AND SHALL NOT PARTICIPATE IN THE DISCUSSION OF THE MATTER AT ISSUE EXCEPT TO STATE BRIEFLY HIS OR HER POSITION IN THE MATTER AND TO ANSWER SPECIFIC QUESTIONS OF OTHER AFFILIATED PERSONS. WHENEVER ANY PERSON ABSTAINS FROM VOTING OR RECUSES HIMSELF OR HERSELF BECAUSE OF A CONFLICT OF INTEREST OR THE APPEARANCE THEREOF, THE MINUTES OF THE MEETING OR THE PROCEEDINGS OF THE ORGANIZATION SHALL REFLECT THE ABSTENTION OR RECUSAL. GUIDELINES FOR IMPLEMENTING AND COMPLYING WITH THIS CONFLICT OF INTEREST POLICY INCLUDE THE FOLLOWING: "AFFILIATED PERSONS SHOULD ABSTAIN FROM PROMOTING OR VOTING ON GRANTS TO ORGANIZATIONS IN WHICH THEY OR IMMEDIATE FAMILY MEMBERS HAVE AN INTEREST. "AFFILIATED PERSONS SHOULD NOT LOBBY ONE ANOTHER ON BEHALF OF AN ORGANIZATION IN WHICH THEY OR THEIR IMMEDIATE FAMILY MEMBERS HAVE AN INTEREST. "ON-SITE REPRESENTATIVES SHOULD DECLARE A PERCEIVED CONFLICT OF INTEREST IN WRITING TO HEALTHED CONNECT WHEN FAMILY MEMBERS ARE APPOINTED TO PAID OR DECISION-MAKING POSITIONS. THE HEALTHED CONNECT EXECUTIVE COMMITTEE MUST REVIEW AND ACCEPT CONFLICT PROPOSAL PRIOR TO HIRING OR APPOINTING OF SAID INDIVIDUALS. "WHEN AN AGENDA ITEM IS BEING CONSIDERED AS TO WHICH AN AFFILIATED PERSON HAS A CONFLICT OF INTEREST, THE CONFLICTED PERSON SHALL DISCLOSE THE CONFLICT AND ABSTAIN FROM DECISION-MAKING ACTIONS AS PROVIDED IN THIS POLICY. WITH DISCLOSURE TO OTHER PARTICIPANTS, THE WORK OF THE ORGANIZATION IS FURTHERED BY THE WILLINGNESS OF IT BOARD MEMBERS, OFFICERS, STAFF MEMBERS, ASSOCIATES, AND ADVISORY COMMITTEE MEMBERS, HOWEVER INTERESTED, TO SHARE INFORMATION BEARING UPON THE MATTER UNDER CONSIDERATION. SUCH PARTICIPATION IS ENCOURAGED. "AFFILIATED PERSONS MAY NOT HAVE AN INTEREST IN ANY VENDOR OR SUPPLIER OF GOODS OR SERVICES TO THE ORGANIZATION. "CONFIDENTIAL FINANCIAL AND INVESTMENT INFORMATION MAY NOT BE USED FOR PERSONAL GAIN. THE ORGANIZATION IS A SIGNIFICANT PRIVATE INVESTOR AND RECEIVES SUBSTANTIAL CONFIDENTIAL INFORMATION IN THE PERFORMANCE OF ITS INVESTMENT OBLIGATIONS. NO ONE SHOULD USE SUCH CONFIDENTIAL INFORMATION FOR PERSONAL PURPOSES OR TRANSMIT SUCH INFORMATION TO OTHERS EXCEPT IN THE COURSE OF HIS OR HER DUTIES ON BEHALF OF THE ORGANIZATION. "STAFF MEMBERS AND ASSOCIATES SHOULD NOTIFY THE EXECUTIVE DIRECTOR BEFORE ACCEPTING ANY OUTSIDE AFFILIATIONS, SUCH AS SPEAKING ENGAGEMENTS, WRITING ARTICLES FOR PUBLICATION, BOARD SERVICE, CONSULTANCIES, HONORARY DEGREES OR REWARDS, OR OTHER ACTIVITIES WHICH MIGHT CONFER REAL OR PERCEIVED BENEFIT ON A STAFF MEMBER OR ASSOCIATE OR WHICH MIGHT BE CONSTRUED AS INFLUENCING DECISION OF THE ORGANIZATION OR OTHERWISE COMPROMISING THE ORGANIZATION. "THE EXECUTIVE DIRECTOR OF THE ORGANIZATION SHOULD NOTIFY THE PRESIDENT IN ADVANCE OF HIS OR HER POSSIBLE PARTICIPATION IN OUTSIDE ACTIVITIES SUCH AS THOSE DESCRIBED ABOVE. "BOARD MEMBERS, OFFICERS, STAFF MEMBERS, ASSOCIATES, AND ADVISORY COMMITTEE MEMBERS SHOULD NOT ACCEPT OUTSIDE FEES, HONORARIA, OR OTHER COMPENSATION FOR ORGANIZATION-RELATED ACTIVITIES. |
| FORM 990, PAGE 6, PART VI, LINE 15A | THE EXECUTIVE DIRECTOR'S COMPENSATION IS DETERMINED BY MAKING REASONABLE EFFORTS TO OFFER COMPENSATION COMMENSURATE WITH SALARIES OFFERED BY NONPROFITS GENERATING SIMILAR REVENUE STREAMS IN THE KANSAS CITY AREA. FINDINGS FROM THE MOST RECENT KANSAS CITY REGIONAL NONPROFIT ASSOCIATION SALARY AND BENEFITS SURVEY IS CONSULTED TO DETERMINE BENCHMARKS. THE BOARD OF DIRECTORS AND SEARCH COMMITTEE APPROVE THE COMPENSATION AMOUNT. |
| FORM 990, PAGE 6, PART VI, LINE 15B | HEALTHED CONNECT EMPLOYS TWO FULL-TIME EMPLOYEES. THE SALARY FOR THE EXECUTIVE DIRECTOR WAS DETERMINED BY A BOARD COMMITTEE THAT CONSULTED AN OUTSIDE UNIVERSITY NOT-FOR-PROFIT ORGANIZATION. DATA WAS USED FOR THE IMMEDIATE GEOGRAPHIC AREA AND DETERMINED BASED ON SIZE OF HEALTHED CONNECT COMPARED TO SIMILAR ORGANIZATIONS. OTHER EMPLOYEE COMPENSATION IS APPROVED BY THE BOARD OF DIRECTORS AS PART OF THE ANNUAL BUDGET AND IS DETERMINED USING THE SAME OUTSIDE UNIVERSITY NOT-FOR PROFIT ORGANIZATION DATA. |
| FORM 990, PAGE 6, PART VI, LINE 19 | GOVERNING DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. |
| Software ID: | |
| Software Version: |