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.") .. | 137,173 | 672,385 | 554,796 | 593,242 | 602,891 | 2,560,487 |
| 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 | 137,173 | 672,385 | 554,796 | 593,242 | 602,891 | 2,560,487 |
| 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. | 2,560,487 | |||||
Calendar year
(or fiscal year beginning in)
![]() |
(a) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 137,173 | 672,385 | 554,796 | 593,242 | 602,891 | 2,560,487 |
| 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 | 2,560,487 | |||||
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 | HEALTHY CHESAPEAKE'S MISSION IS COMMITTED TO BUILDING A CULTURE OF WELLNESS THAT SUPPORTS, SUSTAINS, AND ADVOCATES FOR A HEALTHIER CHESAPEAKE. ITS VISION IS TO BE RANKED THE HEALTHIEST COMMUNITY IN VIRGINIA. HEALTHY CHESAPEAKE WORKS WITH A WIDE VARIETY OF COMMUNITY PARTNERS TO BUILD A CULTURE OF HEALTH TO PROVIDE ALL CHESAPEAKE RESIDENTS A FAIR AND JUST OPPORTUNITY FOR HEALTH, PARTICULARLY INDIVIDUALS AND NEIGHBORHOODS THAT HAVE HISTORICALLY NOT HAD EQUAL ACCESS. PROGRAMMING FOCUSES ON FOUR KEY FACTORS, AS IDENTIFIED BY THE ROBERT WOOD JOHNSON FOUNDATION, COMMONLY LABELED, "SOCIAL DETERMINANTS OF HEALTH." THESE INCLUDE: HEALTH BEHAVIORS; CLINICAL CARE; SOCIAL AND ECONOMIC FACTORS; AND PHYSICAL ENVIRONMENT. HEALTHY CHESAPEAKE IS COMMITTED TO ADDRESSING THESE IN COLLABORATION WITH COMMUNITY PARTNERS THROUGH PROGRAMMING IN OUR FOCUS AREAS. CURRENT ACTIVITIES FOCUS PRIMARILY ON PROGRAMS THAT ENCOURAGE ACCESS AND UTILIZATION OF HEALTHY FOODS, HEALTHY ACTIVE LIFESTYLES FOR SENIORS AND YOUTH, AND CHRONIC DISEASE EDUCATION/MANAGEMENT. |
| FORM 990, PAGE 2, PART III, LINE 4A | HEALTHY CHESAPEAKE DEVELOPS AND DELIVERS COLLABORATIVE PROGRAMS TO SUPPORT ACCESS AND UTILIZATION OF HEALTHY FOOD AND COMBAT FOOD INSECURITY. THIS PROGRAM HAS THREE MAIN ARMS, INCLUDING SUPPORTING COMMUNITY GARDENS, NUTRITION EDUCATION, AND PREPARATION OF HEALTHY FOOD. FISCAL YEAR 2022 EFFORTS INCLUDED: 1)SUPPORTING 19 COMMUNITY GARDENS IN A VARIETY OF SETTINGS TO INCREASE ACCESS TO HEALTHY FOODS FOR CITY RESIDENTS MOST IN NEED. 2)COLLABORATING WITH THE CHESAPEAKE PUBLIC LIBRARY TO DEVELOP A SEED LIBRARY AND ANNUAL SEED FESTIVAL, DISTRIBUTING OVER 1,300 SEED PACKETS TO MORE THAN 475 RESIDENTS. 3)COLLABORATING WITH COMMUNITY PARTNERS TO DISTRIBUTE HEALTHY FOOD AND RECIPES TO ENCOURAGE HEALTHIER MEAL PREPARATION AND UNDERSTANDING THE USE OF FOOD TO IMPROVE OVERALL HEALTH. 4)PILOTING THE HEALTHY FOUNDATIONS EDUCATIONAL PROGRAM AT CHESAPEAKE JUVENILE SERVICES AS PART OF THEIR HEALTH AND PHYSICAL EDUCATION COURSES. THE PROGRAM INTRODUCED HEALTHY COOKING AND PROVIDED WORKFORCE OPPORTUNITIES FOR 18 STUDENTS IN THE INAUGURAL CLASS. 5)SUPPORTING FORKIDS WITH COOKING AND DISTRIBUTION OF MEALS TO RESIDENTS AS WELL AS MEALS TO THEIR AFTER-SCHOOL EDUCATION PROGRAMS. 800 MEALS ARE SERVED WEEKLY. |
| FORM 990, PAGE 2, PART III, LINE 4B | HEALTHY CHESAPEAKE DEVELOPS AND DELIVERS COLLABORATIVE INITIATIVES THAT SUPPORT PHYSICALLY AND MENTALLY ACTIVE LIFESTYLES FOR SENIORS AND CHILDREN WHO MIGHT OTHERWISE LACK ACCESS TO THESE OPPORTUNITIES. FISCAL YEAR 2022, EFFORTS INCLUDED: 1)PROVIDING 300 SENIOR ACTIVITY BAGS FOR SENIORS TO COMBAT SOCIAL ISOLATION AND DEPRESSION. 2)SUPPORTING AND ATTENDING COMMUNITY RESOURCE AND HEALTH FAIRS TO DISTRIBUTE NEEDED SUPPLIES FOR HEALTH AND SAFETY, SUCH AS FACEMASKS AND HAND SANITIZERS; BACK TO SCHOOL, SUCH AS BACKPACKS, WATER BOTTLES; AND MANY OTHER NEEDED ITEMS TO SUPPORT PHYSICAL AND MENTAL HEALTH. MORE THAN 2,000 PARTICIPANTS WERE SERVED. 3)PARTICIPATING IN MULTIPLE LOCAL AND REGIONAL TEAMS DESIGNED TO SUPPORT AREA YOUTH WITH IDENTIFYING RESOURCES, PROGRAMS, AND AVAILABLE ACTIVITIES FOR SUCCESS, INCLUDING AN EDUCATIONAL WORKSHOP AND CULINARY EDUCATION CLASS CREATED TO SUPPORT FINANCIAL RESPONSIBILITY IN TEENS AND THE CHESAPEAKE REDEVELOPMENT AND HOUSING AUTHORITY STRONG FAMILIES INITIATIVES SUPPORTING MORE THAN 170 FAMILIES. |
| FORM 990, PAGE 2, PART III, LINE 4C | HEALTHY CHESAPEAKE PROMOTES ACCESS TO AND ENGAGEMENT IN PROGRAMS SUPPORTIVE OF BEHAVIORAL AND MENTAL HEALTH. THIS INCLUDES A NO-COST CHRONIC DISEASE MANAGEMENT CLINIC FOR LOW-INCOME INDIVIDUALS WITH UNCONTROLLED DIABETES / HYPERTENSION; SUPPORT GROUPS, ON-SITE TRAINING; A VARIETY OF FREE HEALTH- AND ENGAGEMENT-FOCUSED COMMUNITY EVENTS; AND OTHER EFFORTS TO PROMOTE HEALTHY, ACTIVE LIFESTYLES, AND PROMOTE SOCIAL ENGAGEMENT. FISCAL YEAR 2022, EFFORTS INCLUDED: 1)OFFERING A FREE WEEKLY HIGH-TOUCH CHRONIC DISEASE MANAGEMENT CLINIC TO ADDRESS PARTICIPANTS' MEDICAL, SOCIAL, AND TRANSPORTATION NEEDS SERVING AN AVERAGE 45 INDIVIDUALS EACH QUARTER. PARTNERING WITH THE FOODBANK OF SOUTHEASTERN VIRGINIA AND THE EASTERN SHORE HAS PROVIDED 30-40 POUNDS OF MEAT AND FRESH PRODUCE TO THE INDIVIDUAL AT EACH VISIT. OVER 22,000 POUNDS OF FOOD WAS DISTRIBUTED. 2)SPONSORING 6 INTERNS AND STUDENT EXPERIENCES BOTH VIRTUALLY AND IN PERSON FOR ON-THE-JOB TRAINING IN HEALTH PROMOTION AND COMMUNITY SERVICES POSITIONS. 3)SUPPORTING CHESAPEAKE INTEGRATED BEHAVIORAL HEALTHCARE'S COMMUNITY OPTIONS PROGRAM CLIENTS BY PROVIDING TASKS DESIGNED TO GIVE THEM AN OPPORTUNITY TO CONNECT AND FEEL PRODUCTIVE AND ENGAGED. 4)FACILITATING AND ORIGINATING COMMUNITY COALITIONS FOR EARLY CHILDHOOD DEVELOPMENT, TO PROVIDE CRITICAL PREVENTION AND EARLY INTERVENTION STRATEGIES TO IMPROVE OUTCOMES AND DEVELOPMENTAL GOALS FOR YOUNG CHILDREN AND THEIR PARENTS; HEALTH LITERACY, TO PROVIDE CONSISTENT HEALTH EDUCATION AND INFORMATION ACROSS THE CITY OF CHESAPEAKE; AND BREAST CANCER, TO ADDRESS STRATEGIES TO IMPROVE BREAST HEALTH AND INCREASE SCREENING/ACCESS TO CARE AND GENETIC COUNSELING FOR BLACK AND BROWN WOMEN. |
| FORM 990, PAGE 6, PART VI, LINE 11B | THE GOVERNING BODY RECEIVED A DRAFT OF THE 990 TO APPROVE BEFORE FINAL PROCESSING. |
| FORM 990, PAGE 6, PART VI, LINE 12C | ANNUALLY THE CONFLICT OF INTEREST IS REVIEWED BY THE BOARD. |
| FORM 990, PAGE 6, PART VI, LINE 15A | ANNUAL REVIEW AND APPROVAL BY THE BOARD. |
| FORM 990, PAGE 6, PART VI, LINE 15B | ANNUAL REVIEW AND APPROVAL BY THE BOARD. |
| FORM 990, PAGE 6, PART VI, LINE 19 | A COPY OF FORM 990 IS AVAILABLE UPON REQUEST. |
| Software ID: | |
| Software Version: |