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.") .. | 255,004 | 296,500 | 58,675 | 40,333 | 27,538 | 678,050 |
| 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 | 255,004 | 296,500 | 58,675 | 40,333 | 27,538 | 678,050 |
| 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) .. | 38,668 | |||||
| 6 | Public support. Subtract line 5 from line 4. | 639,382 | |||||
Calendar year
(or fiscal year beginning in)
![]() |
(a) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 255,004 | 296,500 | 58,675 | 40,333 | 27,538 | 678,050 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | 1,510 | 1,951 | 1,021 | 344 | 442 | 5,268 |
| 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 | 683,318 | |||||
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 | 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) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (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 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.).. | ||||||
| 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 | NEW MEXICO ALLIANCE FOR SCHOOL-BASED HEALTH CARE REPRESENTS SCHOOL-BASED HEALTH CENTERS IN NM AND COLLABORATES WITH OTHER PARTNERS TO PROMOTE, FACILITATE, AND ADVOCATE FOR COMPREHENSIVE, INTEGRATED, AND CULTURALLY COMPETENT HEALTH CARE, INCLUDING HEALTH EDUCATION IN SCHOOLS. |
| FORM 990, PAGE 1, PART I, LINE 6 | VOLUNTEERS SUPPORT ORGANIZATION PLANNING AND IMPLEMENTATION THROUGH SUPPORTING SPECIAL EVENTS (TRAINING, FUNDRAISING AND STAFFING COMMUNITY EDUCATION EVENTS) AND PARTICIPATING IN COMMITTEES. |
| FORM 990, PAGE 2, PART III, LINE 4A | NMASBHC CONDUCTS ACTIVITIES THAT SUPPORT SCHOOL-BASED HEALTH CENTERS (SBHCS) THROUGH TRAINING, TECHNICAL ASSISTANCE, AND POLICY DEVELOPMENT. THIS WORK OCCURS IN CONJUNCTION WITH A NUMBER OF FUNDING ENTITIES, INCLUDING THE STATE'S DEPARTMENT OF HEALTH, OFFICE OF SCHOOL AND ADOLESCENT HEALTH AND THE HUMAN SERVICES DEPARTMENT, MEDICAL ASSISTANCE DIVISION. NMASBHC IS ALSO SUPPORTED BY FOUNDATIONS, CORPORATE GRANTS, FUNDRAISERS, AND INDIVIDUAL DONATIONS. THE TRAINING AND TECHNICAL ASSISTANCE OFFERED INCLUDES ON-SITE TRAININGS, CONFERENCE CALLS AND ONLINE-BASED ACCESSIBILITY TO SBHC TOOLKITS AND INFORMATION TO SBHCS AROUND THE STATE. TECHNICAL INFORMATION PROVIDED COVERS INFORMATION ON BEST PRACTICES FOR SCHOOL HEALTH PROVISION, MEDICAID, HEALTH LITERACY, PRIMARY CARE RESOURCES, AS WELL AS OTHER TECHNICAL MANUALS AND FORMS RELATED TO THE HEALTH CARE PROVISION AND BUSINESS PRACTICES OF SCHOOL-BASED HEALTH CENTERS. POLICY DEVELOPMENT IS RELATED TO ANY REGULATORY, ADMINISTRATIVE, OR LEGISLATIVE OBSTACLE ISSUES RELEVANT TO THE SUCCESSFUL OPERATION OF SCHOOL-BASED HEALTH CENTERS. IN THE YEAR REPORTED, NMASBHC PROVIDED THE FOLLOWING TO THE FIELD OF SERVICE: DOZENS OF NEW PRINT TOOLS, MONTHLY NEWSLETTERS, VIRTUAL TRAININGS AT A STATE-WIDE CONFERENCE FOR MORE THAN 500 SCHOOL-BASED HEALTH PERSONNEL, ADDITIONAL TRAINING AND EXPERTISE AT MULTIPLE OTHER TRAINING SESSIONS, ONGOING SUPPORT FOR STATE ADMINISTRATIVE IMPROVEMENTS AND FUNDING EXPANSION FOR SBHCS, AND INDIVIDUAL COLLABORATION WITH PARTNERS TO IMPROVE THE CROSS-COLLABORATION BETWEEN ALL ENTITIES WHOSE WORK TOUCHES THE HEALTH AND ACADEMIC LIVES OF YOUTH. NMASBHC CONDUCTS ACTIVITIES THAT SUPPORT SCHOOL- BASED HEALTH CENTERS AND THE SCHOOL HEALTH FIELD BROADLY. |
| FORM 990, PAGE 6, PART VI, LINE 11B | NMASBHCS IRS FORM 990 IS REVIEWED BY THE BOARD OF DIRECTORS PRIOR TO ITS SUBMISSION TO THE IRS BY THE NOVEMBER 15TH DUE DATE. A DRAFT OF THE IRS FORM 990 IS MADE AVAILABLE ELECTRONICALLY TO THE BOARD FOR ITS REVIEW, FOLLOWING WHICH THE BOARD TAKES ACTION TO APPROVE IT. |
| FORM 990, PAGE 6, PART VI, LINE 12C | NMASBHC HAS A CONFLICT OF INTEREST POLICY WHICH IS REVIEWED REGULARLY BY THE BOARD OF DIRECTORS. ALL BOARD AND COMMITTEE MEMBERS ARE REQUIRED ANNUALLY TO DISCLOSE ALL BUSINESSES OR OTHER ORGANIZATIONS OF WHICH THE MEMBER OR LEADER, OR A MEMBER OF HIS FAMILY, IS AN OFFICER, MEMBER, OWNER, OR EMPLOYEE; OR FOR WHICH THE MEMBER OR LEADER, OR A MEMBER OF HIS FAMILY, ACTS AS AN AGENT; OR FROM WHICH THE MEMBER OR LEADER, OR A MEMBER OF HIS FAMILY, RECEIVES COMPENSATION OR REMUNERATION OF ANY SORT, WITH WHICH NMASBHC COMPETES OR WITH WHICH NMASBHC HAS, OR MIGHT REASONABLY IN FUTURE ENTER INTO, A RELATIONSHIP OR A TRANSACTION. NMASBHC REQUIRES THE BOARD PRESIDENT AND OTHER BOARD MEMBERS TO DISCLOSE POTENTIAL CONFLICTS OF INTEREST WHEN ISSUES ARE DISCUSSED OR VOTED ON, WHICH INCLUDES DISCLOSURE AND THE PARTY REMOVING THEMSELVES FROM THE MEETING DURING DISCUSSION AND VOTE. THE BOARD OR COMMITTEE IS REQUIRED TO SEEK ALTERNATES TO THE PROPOSED TRANSACTION TO AVOID A CONFLICT OF INTEREST. |
| FORM 990, PAGE 6, PART VI, LINE 15A | NMASBHC'S EXECUTIVE COMMITTEE CONDUCTS AN ANNUAL REVIEW OF THE EXECUTIVE DIRECTOR'S COMPENSATION TO DETERMINE IF: 1) COMPENSATION ARRANGEMENTS AND BENEFITS ARE REASONABLE IN COMPARISON TO COMPETENT SURVEY INFORMATION ON SALARIES IN ORGANIZATIONS OF SIMILAR SIZE AND NATURE, AND 2) IT CONFORMS TO NMASBHC 'S WRITTEN POLICIES, IS PROPERLY RECORDED, REFLECTS A REASONABLE INVESTMENT FOR SERVICES, FURTHERS CHARITABLE PURPOSE AND DOES NOT RESULT IN IMPERMISSIBLE PRIVATE BENEFIT OR IN AN EXCESS BENEFIT TRANSACTION. THE EXECUTIVE DIRECTOR IS NMASBHC'S ONLY KEY EMPLOYEE. |
| FORM 990, PAGE 6, PART VI, LINE 15B | THE COMPENSATION REVIEW POLICY FOR THE EXECUTIVE DIRECTOR WOULD ALSO BE APPLICABLE TO ANY KEY EMPLOYEES SHOULD ONE BE HIRED IN FUTURE. |
| FORM 990, PAGE 6, PART VI, LINE 19 | GOVERNING DOCUMENTS, POLICIES, FINANCIAL STATEMENTS AND THE IRS FORM 990 ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST WITHIN THREE WORKING DAYS OF THE DATE THE REQUEST WAS MADE. NMASBHC'S FINANCIAL STATEMENTS, 990 AND OTHER INFORMATION MAY ALSO BE FOUND ON THE WEBSITE OF THE NEW MEXICO ATTORNEY GENERAL'S OFFICE. |
| Software ID: | |
| Software Version: |