Form990-PF


Department of the Treasury
Internal Revenue Service

Return of Private Foundation
or Section 4947(a)(1) Trust Treated as Private Foundation
bulletDo not enter social security numbers on this form as it may be made public.
bulletGo to www.irs.gov/Form990PF for instructions and the latest information.
OMB No. 1545-0047
2021
Open to Public Inspection
For calendar year 2021, or tax year beginning 07-01-2021 , and ending 06-30-2022
Name of foundation
HEALTHCARE INITIATIVE FOUNDATION
 
Number and street (or P.O. box number if mail is not delivered to street address)12850 MIDDLEBROOK ROAD 400
  Room/suite
City or town, state or province, country, and ZIP or foreign postal code
GERMANTOWN, MD20874
A Employer identification number

23-7324576
B Telephone number (see instructions)

(301) 907-9144
C bullet
G Check all that apply:

D 1. Foreign organizations, check here............. bullet
2. Foreign organizations meeting the 85%
test, check here and attach computation ... bullet
E bullet
H Check type of organization:
F bullet
I Fair market value of all assets at end
of year (from Part II, col. (c),
line 16)bullet$35,253,177J Accounting method:
 
(Part I, column (d) must be on cash basis.)
Part I Analysis of Revenue and Expenses (The total of amounts in columns (b), (c), and (d) may not necessarily equal the amounts in column (a) (see instructions).) (a) Revenue and
expenses per
books 		(b) Net investment
income 		(c) Adjusted net
income 		(d) Disbursements
for charitable
purposes
(cash basis only)
Revenue 1 Contributions, gifts, grants, etc., received (attach schedule) 0
2 Check bullet.............
3 Interest on savings and temporary cash investments 165 165  
4 Dividends and interest from securities... 878,403 878,403  
5a Gross rents............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 640,390
b Gross sales price for all assets on line 6a 1,455,375
7 Capital gain net income (from Part IV, line 2)... 640,390
8 Net short-term capital gain.........  
9 Income modifications...........  
10a Gross sales less returns and allowances  
b Less: Cost of goods sold....  
c Gross profit or (loss) (attach schedule).....    
11 Other income (attach schedule)....... Click to see attachment 45 0  
12 Total. Add lines 1 through 11........ 1,519,003 1,518,958  
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc. 209,515 2,445   205,275
14 Other employee salaries and wages...... 161,057 0   159,677
15 Pension plans, employee benefits....... 70,021 0   70,021
16a Legal fees (attach schedule).........        
b Accounting fees (attach schedule)....... Click to see attachment 82,722 3,750   85,620
c Other professional fees (attach schedule).... Click to see attachment 48,234 47,234   1,000
17 Interest...............        
18 Taxes (attach schedule) (see instructions)... Click to see attachment 20,207 0   0
19 Depreciation (attach schedule) and depletion...      
20 Occupancy.............. 2,210 0   2,210
21 Travel, conferences, and meetings....... 7,104 0   7,104
22 Printing and publications..........        
23 Other expenses (attach schedule)....... Click to see attachment 64,186 0   58,952
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 665,256 53,429   589,859
25 Contributions, gifts, grants paid....... 2,084,500 1,392,000
26 Total expenses and disbursements. Add lines 24 and 25 2,749,756 53,429   1,981,859
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements -1,230,753
b Net investment income (if negative, enter -0-) 1,465,529
c Adjusted net income (if negative, enter -0-)...  
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 11289X Form 990-PF (2021)
Form 990-PF (2021)
Page 2
Part II Balance Sheets Attached schedules and amounts in the description column
should be for end-of-year amounts only. (See instructions.) 		Beginning of year End of year
(a) Book Value (b) Book Value (c) Fair Market Value
Assets 1 Cash—non-interest-bearing............. 186,344 180,499 180,499
2 Savings and temporary cash investments.........      
3 Accounts receivable bullet8,981
Less: allowance for doubtful accounts bullet   1,187 8,981 8,981
4 Pledges receivable bullet  
Less: allowance for doubtful accounts bullet        
5 Grants receivable.................      
6 Receivables due from officers, directors, trustees, and other
disqualified persons (attach schedule) (see instructions).....      
7 Other notes and loans receivable (attach schedule) bullet  
Less: allowance for doubtful accounts bullet        
8 Inventories for sale or use..............      
9 Prepaid expenses and deferred charges.......... 2,119,397 1,401,663 1,401,663
10a Investments—U.S. and state government obligations (attach schedule)      
b Investments—corporate stock (attach schedule).......      
c Investments—corporate bonds (attach schedule).......      
11 Investments—land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
12 Investments—mortgage loans.............      
13 Investments—other (attach schedule).......... 29,141,351 Click to see attachment28,602,910 33,470,787
14 Land, buildings, and equipment: basis bullet4,115
Less: accumulated depreciation (attach schedule) bullet4,115      
15 Other assets (describe bullet) Click to see attachment76,579 Click to see attachment76,579 Click to see attachment191,247
16 Total assets (to be completed by all filers—see the
instructions. Also, see page 1, item I) 31,524,858 30,270,632 35,253,177
Liabilities 17 Accounts payable and accrued expenses.......... 37,657 34,184
18 Grants payable................. 25,000 5,000
19 Deferred revenue.................    
20 Loans from officers, directors, trustees, and other disqualified persons    
21 Mortgages and other notes payable (attach schedule)......    
22 Other liabilities (describe bullet) Click to see attachment169,308 Click to see attachment67,663
23 Total liabilities (add lines 17 through 22)......... 231,965 106,847
Net Assets or Fund Balances Foundations that follow FASB ASC 958, check here bullet
and complete lines 24, 25, 29 and 30.
24 Net assets without donor restrictions........... 31,292,893 30,163,785
25 Net assets with donor restrictions............    
Foundations that do not follow FASB ASC 958, check here bullet
and complete lines 26 through 30.
26 Capital stock, trust principal, or current funds........    
27 Paid-in or capital surplus, or land, bldg., and equipment fund    
28 Retained earnings, accumulated income, endowment, or other funds    
29 Total net assets or fund balances (see instructions)..... 31,292,893 30,163,785
30 Total liabilities and net assets/fund balances (see instructions). 31,524,858 30,270,632
Part III
Analysis of Changes in Net Assets or Fund Balances
1
Total net assets or fund balances at beginning of year—Part II, column (a), line 29 (must agree with end-of-year figure reported on prior year’s return) ...............
1
31,292,893
2
Enter amount from Part I, line 27a .....................
2
-1,230,753
3
Other increases not included in line 2 (itemize) bulletClick to see attachment
3
101,645
4
Add lines 1, 2, and 3 ..........................
4
30,163,785
5
Decreases not included in line 2 (itemize) bullet
5
0
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29 .
6
30,163,785
Form 990-PF (2021)
Form 990-PF (2021)
Page 3
Part IV
Capital Gains and Losses for Tax on Investment Income
(a) List and describe the kind(s) of property sold (e.g., real estate,
2-story brick warehouse; or common stock, 200 shs. MLC Co.)		 (b)
How acquired
P—Purchase
D—Donation 		(c)
Date acquired
(mo., day, yr.) 		(d)
Date sold
(mo., day, yr.)
1 a SALE OF PUBLICLY TRADED SECURITIES   2021-07-01 2022-06-30
b
c
d
e
(e)
Gross sales price 		(f)
Depreciation allowed
(or allowable) 		(g)
Cost or other basis
plus expense of sale 		(h)
Gain or (loss)
(e) plus (f) minus (g)
a 1,455,375   814,985 640,390
b
c
d
e
Complete only for assets showing gain in column (h) and owned by the foundation on 12/31/69 (l)
Gains (Col. (h) gain minus
col. (k), but not less than -0-) or
Losses (from col.(h))
(i)
F.M.V. as of 12/31/69 		(j)
Adjusted basis
as of 12/31/69 		(k)
Excess of col. (i)
over col. (j), if any
a       640,390
b
c
d
e
2 Capital gain net income or (net capital loss) Bracket If gain, also enter in Part I, line 7
If (loss), enter -0- in Part I, line 7		 Bracket 2 640,390
3 Net short-term capital gain or (loss) as defined in sections 1222(5) and (6):
If gain, also enter in Part I, line 8, column (c) (see instructions). If (loss), enter -0-
in Part I, line 8 ................... 		Bracket 3  
Form 990-PF (2021)
Form 990-PF (2021)
Page 4
Part V
Excise Tax Based on Investment Income (Section 4940(a), 4940(b), 4940(e), or 4948—see instructions)
1a Exempt operating foundations described in section 4940(d)(2), check here Bullet and enter “N/A" on line 1. Bracket for line 1a
Date of ruling or determination letter:   (attach copy of letter if necessary–see instructions)
b All other domestic foundations enter 1.39% (0.0139) of line 27b. Exempt foreign organizations enter 4% (0.04) of Part I, line 12, col. (b)
2 Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 2 0
3 Add lines 1 and 2........................... 3 20,371
4 Subtitle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 4 0
5 Tax based on investment income. Subtract line 4 from line 3. If zero or less, enter -0- ..... 5 20,371
6 Credits/Payments:
a 2021 estimated tax payments and 2020 overpayment credited to 2021 6a 24,001
b Exempt foreign organizations—tax withheld at source...... 6b 0
c Tax paid with application for extension of time to file (Form 8868)... 6c 0
d Backup withholding erroneously withheld ........... 6d 0
7 Total credits and payments. Add lines 6a through 6d.............. 7 24,001
8 Enter any penalty for underpayment of estimated tax. Check here if Form 2220 is attached. 8 0
9 Tax due. If the total of lines 5 and 8 is more than line 7, enter amount owed.......Bullet 9  
10 Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid...Bullet 10 3,630
11 Enter the amount of line 10 to be: Credited to 2022 estimated taxBullet3,630 RefundedBullet 11 0
Part VI-A
Statements Regarding Activities
1a
During the tax year, did the foundation attempt to influence any national, state, or local legislation or did
Yes
No
it participate or intervene in any political campaign? ....................
1a
 
No
b
Did it spend more than $100 during the year (either directly or indirectly) for political purposes? See the instructions
for the definition.................................
1b
 
No
If the answer is "Yes" to 1a or 1b, attach a detailed description of the activities and copies of any materials
published or distributed by the foundation in connection with the activities.
c
Did the foundation file Form 1120-POL for this year?.....................
1c
 
No
d
Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:
(1) On the foundation. bullet$ 0(2) On foundation managers.bullet$ 0
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.bullet$ 0
2
Has the foundation engaged in any activities that have not previously been reported to the IRS?.......
2
 
No
If "Yes," attach a detailed description of the activities.
3
Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles
of incorporation, or bylaws, or other similar instruments? If "Yes," attach a conformed copy of the changes....
3
 
No
4a
Did the foundation have unrelated business gross income of $1,000 or more during the year?.........
4a
 
No
b
If "Yes," has it filed a tax return on Form 990-T for this year?...................
4b
 
 
5
Was there a liquidation, termination, dissolution, or substantial contraction during the year?.........
5
 
No
If "Yes," attach the statement required by General Instruction T.
6
Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either:
  • By language in the governing instrument, or
  • By state legislation that effectively amends the governing instrument so that no mandatory directions
    • that conflict with the state law remain in the governing instrument?................
    6
    Yes
     
    7
    Did the foundation have at least $5,000 in assets at any time during the year? If "Yes," complete Part II, col. (c),
    and Part XIV..................................
    7
    Yes
     
    8a
    Enter the states to which the foundation reports or with which it is registered (see instructions)
    bulletMD
    b
    If the answer is "Yes" to line 7, has the foundation furnished a copy of Form 990-PF to the Attorney
    General (or designate) of each state as required by General Instruction G? If "No," attach explanation .
    8b
    Yes
     
    9
    Is the foundation claiming status as a private operating foundation within the meaning of section 4942(j)(3)
    or 4942(j)(5) for calendar year 2021 or the taxable year beginning in 2021? See the instructions for Part XIII.
    If "Yes," complete Part XIII .............................
    9
     
    No
    10
    Did any persons become substantial contributors during the tax year? If "Yes," attach a schedule listing their names
    and addresses. ...............................
    10
     
    No
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 5
    Part VI-A
    Statements Regarding Activities (continued)
    11
    At any time during the year, did the foundation, directly or indirectly, own a controlled entity within the
    meaning of section 512(b)(13)? If "Yes," attach schedule. See instructions .............
    11
     
    No
    12
    Did the foundation make a distribution to a donor advised fund over which the foundation or a disqualified person had
    advisory privileges? If "Yes," attach statement. See instructions.................
    12
     
    No
    13
    Did the foundation comply with the public inspection requirements for its annual returns and exemption application?
    13
    Yes
     
    Website addressbulletWWW.HIFMC.ORG
    14
    The books are in care ofbulletTHE FOUNDATION Telephone no.bullet (301) 907-9144

    Located atbullet12850 MIDDLEBROOK ROAD 400GERMANTOWNMD ZIP+4bullet20874
    15
    Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of Form 1041 —check here .........bullet
    and enter the amount of tax-exempt interest received or accrued during the year ........bullet
    15
     
    16 At any time during calendar year 2021, did the foundation have an interest in or a signature or other authority over YesNo
    a bank, securities, or other financial account in a foreign country? .................
    16   No
    See the instructions for exceptions and filing requirements for FinCEN Form 114. If "Yes", enter the name of the foreign
    country bullet
    Part VI-B
    Statements Regarding Activities for Which Form 4720 May Be Required
    File Form 4720 if any item is checked in the "Yes" column, unless an exception applies.
    Yes
    No
    1a
    During the year did the foundation (either directly or indirectly):
    (1) Engage in the sale or exchange, or leasing of property with a disqualified person? ...........
    1a(1)
     
    No
    (2) Borrow money from, lend money to, or otherwise extend credit to (or accept it from)
    a disqualified person? ..............................
    1a(2)
     
    No
    (3) Furnish goods, services, or facilities to (or accept them from) a disqualified person? ...........
    1a(3)
     
    No
    (4) Pay compensation to, or pay or reimburse the expenses of, a disqualified person? ............
    1a(4)
    Yes
     
    (5) Transfer any income or assets to a disqualified person (or make any of either available
    for the benefit or use of a disqualified person)? ......................
    1a(5)
     
    No
    (6) Agree to pay money or property to a government official? (Exception. Check "No"
    if the foundation agreed to make a grant to or to employ the official for a period
    after termination of government service, if terminating within 90 days.) ...............
    1a(6)
     
    No
    b
    If any answer is "Yes" to 1a(1)–(6), did any of the acts fail to qualify under the exceptions described in Regulations
    section 53.4941(d)-3 or in a current notice regarding disaster assistance? See instructions ..........
    1b
     
    No
    c
    ........bullet
    d
    Did the foundation engage in a prior year in any of the acts described in 1a, other than excepted acts,
    that were not corrected before the first day of the tax year beginning in 2021? .............
    1d
     
    No
    2
    Taxes on failure to distribute income (section 4942) (does not apply for years the foundation was a private
    operating foundation defined in section 4942(j)(3) or 4942(j)(5)):
    a
    At the end of tax year 2021, did the foundation have any undistributed income (lines 6d
    and 6e, Part XII) for tax year(s) beginning before 2021?....................
    2a
     
    No
    If "Yes," list the years bullet20, 20, 20, 20
    b
    Are there any years listed in 2a for which the foundation is not applying the provisions of section 4942(a)(2)
    (relating to incorrect valuation of assets) to the year’s undistributed income? (If applying section 4942(a)(2)
    to all years listed, answer "No" and attach statement—see instructions.) ..............
    2b
     
     
    c
    If the provisions of section 4942(a)(2) are being applied to any of the years listed in 2a, list the years here.
    bullet20, 20, 20, 20
    3a
    Did the foundation hold more than a 2% direct or indirect interest in any business enterprise at
    any time during the year? ..............................
    3a
     
    No
    b
    If "Yes," did it have excess business holdings in 2021 as a result of (1) any purchase by the foundation
    or disqualified persons after May 26, 1969; (2) the lapse of the 5-year period (or longer period approved
    by the Commissioner under section 4943(c)(7)) to dispose of holdings acquired by gift or bequest; or (3)
    the lapse of the 10-, 15-, or 20-year first phase holding period? (Use Schedule C, Form 4720, to determine
    if the foundation had excess business holdings in 2021.) .....................
    3b
     
     
    4a
    Did the foundation invest during the year any amount in a manner that would jeopardize its charitable purposes?
    4a
     
    No
    b
    Did the foundation make any investment in a prior year (but after December 31, 1969) that could jeopardize its
    charitable purpose that had not been removed from jeopardy before the first day of the tax year beginning in 2021? ..
    4b
     
    No
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 6
    Part VI-B
    Statements Regarding Activities for Which Form 4720 May Be Required (continued)
    5a
    During the year did the foundation pay or incur any amount to:
    Yes
    No
    (1) Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))? ..........
    5a(1)
     
    No
    (2) Influence the outcome of any specific public election (see section 4955); or to carry
    on, directly or indirectly, any voter registration drive? ....................
    5a(2)
     
    No
    (3) Provide a grant to an individual for travel, study, or other similar purposes? .............
    5a(3)
     
    No
    (4) Provide a grant to an organization other than a charitable, etc., organization described
    in section 4945(d)(4)(A)? See instructions ........................
    5a(4)
     
    No
    (5) Provide for any purpose other than religious, charitable, scientific, literary, or
    educational purposes, or for the prevention of cruelty to children or animals? .............
    5a(5)
     
    No
    b
    If any answer is "Yes" to 5a(1)–(5), did any of the transactions fail to qualify under the exceptions described in
    Regulations section 53.4945 or in a current notice regarding disaster assistance? See instructions ........
    5b
     
     
    c
    .........bullet
    d
    If the answer is "Yes" to question 5a(4), does the foundation claim exemption from the
    tax because it maintained expenditure responsibility for the grant? .................
    5d
     
     
    If "Yes," attach the statement required by Regulations section 53.4945–5(d).
    6a
    Did the foundation, during the year, receive any funds, directly or indirectly, to pay premiums on
    a personal benefit contract? .............................
    6a
     
    No
    b
    Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ....
    6b
     
    No
    If "Yes" to 6b, file Form 8870.
    7a
    At any time during the tax year, was the foundation a party to a prohibited tax shelter transaction?
    7a
     
    No
    b
    If "Yes", did the foundation receive any proceeds or have any net income attributable to the transaction? .....
    7b
     
     
    8
    Is the foundation subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or
    excess parachute payment during the year? .........................
    8
     
    No
    Part VII
    Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
    and Contractors
    1 List all officers, directors, trustees, foundation managers and their compensation. See instructions
    (a) Name and address (b) Title, and average
    hours per week
    devoted to position     		(c) Compensation
     (If not paid, enter
    -0-)     		(d) Contributions to employee benefit plans and deferred compensation (e) Expense account,
    other allowances
    CRYSTAL TOWNSEND PRESIDENT AND CEO
    40.00     		199,779 26,208 0
    12850 MIDDLEBROOK ROAD SUITE 400
    GERMANTOWN,MD20874
    ROBERT H MYERS JR CHAIR
    4.60     		0 0 0
    12850 MIDDLEBROOK ROAD SUITE 400
    GERMANTOWN,MD20874
    DAVID KRESSLER VICE CHAIR
    2.60     		0 0 0
    12850 MIDDLEBROOK ROAD SUITE 400
    GERMANTOWN,MD20874
    GEORGE DINES TREASURER
    1.60     		0 0 0
    12850 MIDDLEBROOK ROAD SUITE 400
    GERMANTOWN,MD20874
    DEBORAH FISHER SECRETARY
    1.50     		0 0 0
    12850 MIDDLEBROOK ROAD SUITE 400
    GERMANTOWN,MD20874
    MIKE KNAPP TRUSTEE
    0.70     		0 0 0
    12850 MIDDLEBROOK ROAD SUITE 400
    GERMANTOWN,MD20874
    MARTA BRITO PEREZ TRUSTEE
    1.50     		0 0 0
    12850 MIDDLEBROOK ROAD SUITE 400
    GERMANTOWN,MD20874
    KISHA DAVIS TRUSTEE
    0.10     		0 0 0
    12850 MIDDLEBROOK ROAD SUITE 400
    GERMANTOWN,MD20874
    2 Compensation of five highest-paid employees (other than those included on line 1—see instructions). If none, enter “NONE."
    (a) Name and address of each employee paid more than $50,000 (b) Title, and average
    hours per week
    devoted to position     		(c) Compensation (d) Contributions to
    employee benefit
    plans and deferred
    compensation     		(e) Expense account,
    other allowances
    JESSICA FUCHS GRANTS MANAGER
    40.00     		102,993 10,299 0
    12850 MIDDLEBROOK ROAD SUITE 400
    GERMANTOWN,MD20874
    FAYE D GREENE EXECUTIVE ASSITANT/O
    40.00     		69,426 6,943 0
    12850 MIDDLEBROOK ROAD SUITE 400
    GERMANTOWN,MD20874
    Total number of other employees paid over $50,000...................bullet 0
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 7
    Part VII
    Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
    and Contractors (continued)
    3 Five highest-paid independent contractors for professional services (see instructions). If none, enter "NONE".
    (a) Name and address of each person paid more than $50,000 (b) Type of service (c) Compensation
    COUNCILOR BUCHANAN & MITCHELL ACCOUNTING 57,722
    7910 WOODMONT AVE SUITE 500
    BETHESDA,MD20814
    Total number of others receiving over $50,000 for professional services.............bullet0
    Part VIII-A
    Summary of Direct Charitable Activities
    List the foundation’s four largest direct charitable activities during the tax year. Include relevant statistical information such as the number of organizations and other beneficiaries served, conferences convened, research papers produced, etc. Expenses
    1  
    2  
    3  
    4  
    Part VIII-B
    Summary of Program-Related Investments (see instructions)
    Describe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2. Amount
    1  
    2  
    All other program-related investments. See instructions.
    3  
    Total. Add lines 1 through 3.........................bullet0
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 8
    Part IX
    Minimum Investment Return (All domestic foundations must complete this part. Foreign foundations, see instructions.)
    1
    Fair market value of assets not used (or held for use) directly in carrying out charitable, etc.,
    purposes:
    a
    Average monthly fair market value of securities...................
    1a
    38,849,209
    b
    Average of monthly cash balances.......................
    1b
    572,621
    c
    Fair market value of all other assets (see instructions)................
    1c
    0
    d
    Total (add lines 1a, b, and c).........................
    1d
    39,421,830
    e
    Reduction claimed for blockage or other factors reported on lines 1a and
    1c (attach detailed explanation) .............
    1e
    0
    2
    Acquisition indebtedness applicable to line 1 assets..................
    2
    0
    3
    Subtract line 2 from line 1d.........................
    3
    39,421,830
    4
    Cash deemed held for charitable activities. Enter 1.5% (0.015) of line 3 (for greater amount, see
    instructions) .............................
    4
    591,327
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. .......
    5
    38,830,503
    6
    Minimum investment return. Enter 5% (0.05) of line 5................
    6
    1,941,525
    Part X
    Distributable Amount (see instructions) (Section 4942(j)(3) and (j)(5) private operating foundations and certain foreign organizations check here right arrow and do not complete this part.)
    1
    Minimum investment return from Part IX, line 6..................
    1
    1,941,525
    2a
    Tax on investment income for 2021 from Part V, line 5.......
    2a
    20,371
    b
    Income tax for 2021. (This does not include the tax from Part V.) ...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
    20,371
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    1,921,154
    4
    Recoveries of amounts treated as qualifying distributions................
    4
    0
    5
    Add lines 3 and 4............................
    5
    1,921,154
    6
    Deduction from distributable amount (see instructions).................
    6
    0
    7
    Distributable amount as adjusted. Subtract line 6 from line 5. Enter here and on Part XII, line 1 ...
    7
    1,921,154
    Part XI
    Qualifying Distributions (see instructions)
    1
    Amounts paid (including administrative expenses) to accomplish charitable, etc., purposes:
    a
    Expenses, contributions, gifts, etc.—total from Part I, column (d), line 26 ..........
    1a
     
    b
    Program-related investments—total from Part VIII-B..................
    1b
     
    2
    Amounts paid to acquire assets used (or held for use) directly in carrying out charitable, etc.,
    purposes...............................
    2
     
    3
    Amounts set aside for specific charitable projects that satisfy the:
    a
    Suitability test (prior IRS approval required)....................
    3a
     
    b
    Cash distribution test (attach the required schedule) .................
    3b
     
    4
    Qualifying distributions. Add lines 1a through 3b. Enter here and on Part XII, line 4.
    4
     
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 9
    Part XII
    Undistributed Income (see instructions)
    (a)
    Corpus     		(b)
    Years prior to 2020     		(c)
    2020     		(d)
    2021
    1 Distributable amount for 2021 from Part X, line 7 1,921,154
    2 Undistributed income, if any, as of the end of 2021:
    a Enter amount for 2020 only....... 0
    b Total for prior years:20, 20, 20 0
    3 Excess distributions carryover, if any, to 2021:
    a From 2016...... 276,344
    b From 2017...... 157,491
    c From 2018...... 658,773
    d From 2019......  
    e From 2020...... 458,582
    f Total of lines 3a through e ........ 1,551,190
    4Qualifying distributions for 2021 from Part
    XI, line 4: bullet$ 1,981,859
    a Applied to 2020, but not more than line 2a 0
    b Applied to undistributed income of prior years
    (Election required—see instructions).....     		0
    c Treated as distributions out of corpus (Election
    required—see instructions)........     		0
    d Applied to 2021 distributable amount..... 1,921,154
    e Remaining amount distributed out of corpus 60,705
    5 Excess distributions carryover applied to 2021. 0 0
    (If an amount appears in column (d), the
    same amount must be shown in column (a).)
    6Enter the net total of each column as
    indicated below:
    a Corpus. Add lines 3f, 4c, and 4e. Subtract line 5 1,611,895
    b Prior years’ undistributed income. Subtract
    line 4b from line 2b ..........     		0
    c Enter the amount of prior years’ undistributed
    income for which a notice of deficiency has
    been issued, or on which the section 4942(a)
    tax has been previously assessed......     		0
    d Subtract line 6c from line 6b. Taxable amount
    —see instructions ...........     		0
    e Undistributed income for 2019. Subtract line
    4a from line 2a. Taxable amount—see
    instructions .............     		0
    f Undistributed income for 2021. Subtract
    lines 4d and 5 from line 1. This amount must
    be distributed in 2022 ..........     		0
    7 Amounts treated as distributions out of
    corpus to satisfy requirements imposed by
    section 170(b)(1)(F) or 4942(g)(3) (Election may
    be required - see instructions) .......     		0
    8 Excess distributions carryover from 2016 not
    applied on line 5 or line 7 (see instructions) ...     		276,344
    9 Excess distributions carryover to 2022.
    Subtract lines 7 and 8 from line 6a ......     		1,335,551
    10 Analysis of line 9:
    a Excess from 2017.... 157,491
    b Excess from 2018.... 658,773
    c Excess from 2019....  
    d Excess from 2020.... 458,582
    e Excess from 2021.... 60,705
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 10
    Part XIII
    Private Operating Foundations (see instructions and Part VI-A, question 9)
    1a If the foundation has received a ruling or determination letter that it is a private operating
    foundation, and the ruling is effective for 2021, enter the date of the ruling ....... bullet
     
    b Check box to indicate whether the organization is a private operating foundation described in section or
    2a Enter the lesser of the adjusted net
    income from Part I or the minimum
    investment return from Part X for each
    year listed ..........     		Tax year Prior 3 years (e) Total
    (a) 2021 (b) 2020 (c) 2019 (d) 2018
             
    b 85% (0.85) of line 2a .........          
    c Qualifying distributions from Part XI,
    line 4 for each year listed .....     		         
    d Amounts included in line 2c not used directly
    for active conduct of exempt activities ..........     		         
    e Qualifying distributions made directly
    for active conduct of exempt activities.
    Subtract line 2d from line 2c ....     		         
    3 Complete 3a, b, or c for the
    alternative test relied upon:
    a “Assets" alternative test—enter:
    (1) Value of all assets ......          
    (2) Value of assets qualifying
    under section 4942(j)(3)(B)(i)    		          
    b “Endowment" alternative test— enter 2/3
    of minimum investment return shown in
    Part IX, line 6 for each year listed ..     		         
    c “Support" alternative test—enter:
    (1) Total support other than gross
    investment income (interest,
    dividends, rents, payments
    on securities loans (section
    512(a)(5)), or royalties) ....     		         
    (2) Support from general public
    and 5 or more exempt
    organizations as provided in
    section 4942(j)(3)(B)(iii)....     		         
    (3) Largest amount of support
    from an exempt organization    		          
    (4) Gross investment income          
    Part XIV
    Supplementary Information (Complete this part only if the foundation had $5,000 or more in
    assets at any time during the year—see instructions.)
    1Information Regarding Foundation Managers:
    aList any managers of the foundation who have contributed more than 2% of the total contributions received by the foundation
    before the close of any tax year (but only if they have contributed more than $5,000). (See section 507(d)(2).)
    bList any managers of the foundation who own 10% or more of the stock of a corporation (or an equally large portion of the
    ownership of a partnership or other entity) of which the foundation has a 10% or greater interest.
    2Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
    Check here bullet
    aThe name, address, and telephone number or e-mail address of the person to whom applications should be addressed:
    CRYSTAL CARR TOWNSEND
    12850 MIDDLEBROOK ROAD SUITE 400
    GERMANTOWN,MD20874
    (301) 907-9144
    bThe form in which applications should be submitted and information and materials they should include:
    THE FOUNDATION DOES NOT ACCEPT APPLICATION BY MAIL, EMAIL OR FAX, BUT VIA ITS GRANT INTERFACE WEB-BASED SYSTEM (WWW.GRANTINTERFACE.COM/HEALTHCAREINITIATIVE/COMMON/LOGIN.ASPX). GRANT APPLICATIONS AND REPORTS MUST BE SUBMITTED VIA HIF'S ONLINE SYSTEM (SEE ABOVE LINK). GRANT APPLICATIONS ARE AVAILABLE ONLINE APPROXIMATELY SIX WEEKS BEFORE THEY ARE DUE. GRANT APPLICATION ROUNDS (E.G., MULTI-YEAR STRATEGIC SUSTAINABILITY, GENERAL OPERATING SUPPORT, CAPACITY BUILDING, AND SMALL GRANT ROUNDS) ARE ADVERTISED ON THE FOUNDATION'S WEBSITE ALONG WITH THE GRANT CALENDER. THE FOUDNATION ALSO REVIEWS EMERGING NEEDS APPLICATIONS ON A ROLLING BASIS. THESE REQUESTS ARE SUBMITTED VIA THE FOUNDATION'S ONLINE SYSTEM AS WELL.
    cAny submission deadlines:
    GRANT DEADLINES ARE POSTED ON THE ORGANIZATION'S WEBSITE AND BASED ON VARIOUS CRITERIA.
    dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
    factors:
    THE FOUNDATION CONSIDERS GRANTS TO 501(C)(3) HEALTHCARE NONPROFITS THAT ARE BASED IN MONTGOMERY COUNTY, MARYLAND, OR TO NONPROFITS THAT HAVE COUNTY-BASED HEALTH PROGRAMS OR ACTIVITIES. WITHIN ITS GEOGRAPHIC AND FOCUS AREA, IT CONSIDERS EFFORTS TO: -IMPROVE THE QUALITY AND DELIVERY OF HEALTHCARE; -EXPAND THE AVAILABILITY OF COMPREHENSIVE HEALTHCARE; -BUILD APPROPRIATE CAPACITY IN THE HEALTHCARE NETWORK; AND -GROW THE HEALTHCARE WORKFORCE.
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 11
    Part XIV
    Supplementary Information (continued)
    3 Grants and Contributions Paid During the Year or Approved for Future Payment
    Recipient If recipient is an individual,
    show any relationship to
    any foundation manager
    or substantial contributor
    		 Foundation
    status of
    recipient     		Purpose of grant or
    contribution     		Amount
    Name and address (home or business)
    aPaid during the year
    COLUMBIA LIGHTHOUSE FOR THE BLIND
    8757 GEORGIA AVENUE SUITE 805
    SILVER SPRING,MD20910     		NONE PUBLIC CHARITY CLB DIABETIC RETINOTHERAPY SCREENINGS 25,000
    IDENTITY INC
    15800 CRABBS BRANCH WAY SUITE 300
    C/O NONPROFIT VILLAGE
    ROCKVILLE,MD20855     		NONE PUBLIC CHARITY NON-TRADITIONAL COMMUNITY MENTAL HEALTH INITIATIVE 25,000
    GREATER WASHINGTON COMMUNITY FOUNDATION
    8720 GEORGIA AVE
    SILVER SPRING,MD20910     		NONE PUBLIC CHARITY NEIGHBORS IN DIRE NEED MONTGOMERY 20,000
    GREATER WASHINGTON COMMUNITY FOUNDATION
    8720 GEORGIA AVE
    SILVER SPRING,MD20910     		NONE PUBLIC CHARITY FOOD FOR MONTGOMERY FUND 20,000
    FAMILY SERVICES INC
    610 E DIAMOND AVE
    GAITHERSBURG,MD20877     		NONE PUBLIC CHARITY HEALTHY MOTHERS, HEALTHY BABIES (HMHB) 22,500
    AYUDA
    1990 K STREET NW STE 500
    WASHINGTON,DC20006     		NONE PUBLIC CHARITY TRAUMA INFORMED BEHAVIORAL HEALTH & WELLNESS PROGRAM 18,000
    MUSLIM COMMUNITY CENTER MEDICAL CLINIC
    15200 NEW HAMPSHIRE AVENUE
    SILVER SPRING,MD20905     		NONE PUBLIC CHARITY BUILDING SUSTAINABLE TELEHEALTH PROGRAM 22,500
    MOBILE MEDICAL CARE
    9309 OLD GEORGETOWN RD
    BETHESDA,MD20814     		NONE PUBLIC CHARITY ENHANCING OUR COMMUNITY ENGAGEMENT FOR PRIMARY CARE 22,500
    CHINESE CULTURE AND COMMUNITY SERVICE CENTER INC
    9318 GAITHER ROAD
    GAITHERSBURG,MD20877     		NONE PUBLIC CHARITY IMPROVE HEALTHCARE ACCESS FOR VULNERABLE SENIOR POPULATIONS. 22,500
    THE TREE HOUSE CHILD ADVOCACY CENTER OF MONTGOMERY COUNTY MD INC
    7300 CALHOUN PLACE
    ROCKVILLE,MD20855     		NONE PUBLIC CHARITY PEDIATRIC HOLISTIC MEDICAL CARE FOR SUSPECTED ABUSED & NEGLECTED CHILDREN OF MONTGOMERY COUNTY, MD 22,500
    FAMILY SERVICES INC
    610 E DIAMOND AVE
    GAITHERSBURG,MD20877     		NONE PUBLIC CHARITY THRIVING GERMANTOWN COMMUNITY HUB (TG). CARE COORDINATION. 22,500
    AMERICAN MUSLIM SENIOR SOCIETY (AMSS)
    15800 CRABBS BRANCH WAY SUITE 300
    ROCKVILLE,MD20855     		NONE PUBLIC CHARITY HALAL MEALS ON WHEELS A COMPREHENSIVE SOCIAL OUTREACH PROGRAM FOR FOOD SECURITY. 12,500
    JSSA (JEWISH SOCIAL SERVICE AGENCY)
    200 WOOD HILL ROAD
    ROCKVILLE,MD20850     		NONE PUBLIC CHARITY JSSA EXPANSION OF THE PARTNERS IN CARE (PIC) PROGRAM. CARE COORDINATION FOR SENIORS. 22,000
    VIETNAMESE AMERICANS SERVICES INC
    12621 OLD COLUMBIA PIKE
    SILVER SPRING,MD20904     		NONE PUBLIC CHARITY CARE COORDINATION FOR BETTER HEALTH IN VIETNAMESE COMMUNITY 22,500
    IDENTITY INC
    15800 CRABBS BRANCH WAY SUITE 300
    C/O NONPROFIT VILLAGE
    ROCKVILLE,MD20855     		NONE PUBLIC CHARITY COVID HEALTH AND SAFETY AMBASSADOR PROGRAM 22,500
    COMMUNITY BRIDGES
    8757 GEORGIA AVENUE SUITE 540
    SILVER SPRING,MD20910     		NONE PUBLIC CHARITY COMMUNITY BRIDGES GIRLS MENTORING TO IMPROVE BEHAVIORAL HEALTH AND RESILIENCY. 9,000
    CASA
    8151 15TH AVENUE
    LANGLEY PARK,MD20783     		NONE PUBLIC CHARITY CASA HEALTH AND SOCIAL SERVICES - IMMIGRANT ACCESS TO CARE 22,500
    REBUILDING TOGETHER MONTGOMERY COUNTY
    18225-A FLOWER HILL WAY
    GAITHERSBURG,MD20879     		NONE PUBLIC CHARITY HEALTHY VILLAGES. HELPING SENIORS AGE IN PLACE SAFELY. 12,500
    CRITTENTON SERVICES OF GREATER WASHINGTON
    815 SILVER SPRING AVENUE
    SILVER SPRING,MD20910     		NONE PUBLIC CHARITY EXPANDING CAPACITY TO ADDRESS THE BEHAVIORAL HEALTH NEEDS OF GIRLS OF COLOR FROM LOW-INCOME FAMILIES 15,750
    CARINGMATTERS
    518 SOUTH FREDERICK AVENUE
    GAITHERSBURG,MD20877     		NONE PUBLIC CHARITY THE WHOLE YOU - SUPPORTING LIFE'S NEEDS DURING CANCER 15,000
    CARE FOR YOUR HEALTH INC
    12140 FLOWING WATER TRAIL
    CLARKSVILLE,MD21029     		NONE PUBLIC CHARITY HOSPITAL AT HOME WITH REMOTE MONITORING: ENHANCING QOL FOR THE ELDERLY 22,500
    GERMANTOWN CULTURAL ARTS CENTER BLACKROCK CENTER FOR THE ARTS
    12901 TOWN COMMONS DRIVE
    GERMANTOWN,MD20874     		NONE PUBLIC CHARITY UPCOUNTY CONSOLIDATION HUB: TRANSITION TO A PERMANENT FULL SERVICE DISTRIBUTION MODEL 22,500
    GREATER WASHINGTON JEWISH COALITION AGAINST DOMESTIC ABUSE
    PO BOX 2266
    ROCKVILLE,MD20847     		NONE PUBLIC CHARITY FOOD DISTRIBUTION MODEL EXPANDING CAPACITY OF THE DV HELPLINE. 17,500
    CROSS COMMUNITY
    8300 HELGERMAN CT
    GAITHERSBURG,MD20877     		NONE PUBLIC CHARITY THE EQUITY CENTER AT LAKE FOREST MALL - COVID TESTING, VACCINES AND FOOD ACCESS. 10,000
    BETHESDA CARES
    7728 WOODMONT AVE
    BETHESDA,MD20814     		NONE PUBLIC CHARITY HOUSING IS HEALTHCARE. PRIORITIZING HOUSING RESOURCES FOR THE MEDICALLY VULNERABLE HOMELESS POPULATION. 15,000
    THE UNIVERSITIES AT SHADY GROVE
    9631 GUDELSKY DR
    ROCKVILLE,MD20850     		NONE PUBLIC CHARITY ENHANCING HEALTHCARE CAREER PATHWAYS THROUGH MONTGOMERY COLLEGE AND THE UNIVERSITIES AT SHADY GROVE 200,000
    METROPOLITAN WASHINGTON COUNCIL OF GOVERNMENTS
    777 NORTH CAPITOL STREET NE
    WASHINGTON,DC20002     		NONE PUBLIC CHARITY REGIONAL VARIANT PROJECT 2,750
    CARE FOR YOUR HEALTH INC
    12140 FLOWING WATER TRAIL
    CLARKSVILLE,MD21029     		NONE PUBLIC CHARITY VACCINES TO CHILDREN (FALL 2021) 100,000
    GLOBAL SUSTAINABLE PARTNERSHIPS (GSP)
    9101 1ST AVENUE
    SILVER SPRING,MD20910     		NONE PUBLIC CHARITY COVID VACCINE EDUCATION, OUTREACH, AND ACCESS. 25,000
    LEADERSHIP MONTGOMERY
    6010 EXECUTIVE BOULEVARD SUITE 200
    ROCKVILLE,MD20852     		NONE PUBLIC CHARITY CORE HEALTH AND SAFETY SESSION (CONNECTING OUR REGION'S EXECUTIVES) PROGRAM 5,000
    FAMILY SERVICES INC
    610 E DIAMOND AVE
    GAITHERSBURG,MD20877     		NONE PUBLIC CHARITY THRIVING GERMANTOWN COMMUNITY HUB (TG) - CARE COORDINATION. 15,000
    AMERICAN MUSLIM SENIOR SOCIETY (AMSS)
    15800 CRABBS BRANCH WAY SUITE 300
    ROCKVILLE,MD20855     		NONE PUBLIC CHARITY AMSS HALAL MEALS ON WHEELS AND HEALTH AND WELLNESS CULTURALLY COMPETENT OUTREACH CAMPAIGN EXPANSION 10,000
    COMMUNITY FARMSHARE
    14975 SUGARLAND RD
    POOLESVILLE,MD20837     		NONE PUBLIC CHARITY FARM TO FAMILY - DIRECT HEALTHY PRODUCE TO FAMILIES EXPERIENCING FOOD INSECURITY IN POOLESVILLE 15,000
    JSSA (JEWISH SOCIAL SERVICE AGENCY)
    200 WOOD HILL ROAD
    ROCKVILLE,MD20850     		NONE PUBLIC CHARITY PARTNERS IN CARE (PIC) PROGRAM FOR SENIORS AT AFFORDABLE HOUSING SITES 15,000
    REGINALD S LOURIE CENTER FOR INFANTS AND YOUNG CHILDREN
    12301 ACADEMY WAY
    ROCKVILLE,MD20852     		NONE PUBLIC CHARITY FOSTERING CHILDHOOD RESILIENCY AND LINGUISTICALLY RESPONSIVE EARLY CHILDHOOD MENTAL HEALTH CARE 20,000
    COMMUNITY BRIDGES
    8757 GEORGIA AVENUE SUITE 540
    SILVER SPRING,MD20910     		NONE PUBLIC CHARITY COMMUNITY BRIDGES GIRLS MENTORING PROGRAM 7,000
    GERMANTOWN CULTURAL ARTS CENTER BLACKROCK CENTER FOR THE ARTS
    12901 TOWN COMMONS DRIVE
    GERMANTOWN,MD20874     		NONE PUBLIC CHARITY UPCOUNTY HUB: PROVIDING EFFICIENCY AND COST SAVINGS FOR SUSTAINABLE FOOD SERVICE DELIVERY SYSTEM 15,000
    AMERICAN KIDNEY FUND
    11921 ROCKVILLE PIKE
    ROCKVILLE,MD20852     		NONE PUBLIC CHARITY AMERICAN KIDNEY FUNDS PATIENT ASSISTANCE FOR MONTGOMERY COUNTY AREA 10,000
    CARE FOR YOUR HEALTH INC
    12140 FLOWING WATER TRAIL
    CLARKSVILLE,MD21029     		NONE PUBLIC CHARITY KEEPING THE HOUSE IN ORDER: BASIC ADMIN AND HOME ASSISTANCE TO ENABLE AGING IN PLACE 20,000
    WE CARE INCORPORATED DBA FEED THE FRIDGE
    6901 RADNOR ROAD
    BETHESDA,MD20817     		NONE PUBLIC CHARITY FEED THE FRIDGE AT THE HUB - FOOD ACCESS 20,000
    VIETNAMESE AMERICANS SERVICES INC
    12621 OLD COLUMBIA PIKE
    SILVER SPRING,MD20904     		NONE PUBLIC CHARITY IMPROVE HEALTH OUTCOMES FOR VIETNAMESE COMMUNITY BY SOCIAL DETERMINANTS OF HEALTH 20,000
    CRITTENTON SERVICES OF GREATER WASHINGTON
    815 SILVER SPRING AVENUE
    SILVER SPRING,MD20910     		NONE PUBLIC CHARITY PROMOTING THE HEALTHY DEVELOPMENT AND MENTAL WELL-BEING OF GIRLS OF COLOR FROM LOW-INCOME FAMILIES 20,000
    MONTGOMERY COMMUNITY TELEVISION DBA MONTGOMERY COMMUNITY MEDIA
    7548 STANDISH PLACE
    ROCKVILLE,MD20855     		NONE PUBLIC CHARITY HEALTH CONNECT - HEALTH LITERACY FOR MONTGOMERY COUNTY 7,500
    MANNA FOOD CENTER
    9311 GAITHER ROAD
    GAITHERSBURG,MD20877     		NONE PUBLIC CHARITY MANNA FOOD CENTER FOOD FOR FAMILIES 20,000
    WUMCO HELP INC
    PO BOX 247
    POOLESVILLE,MD20837     		NONE PUBLIC CHARITY WESTERN MONTGOMERY COUNTY IMPROVED ACCESS TO HEALTH CARE INITIATIVE 20,000
    CARINGMATTERS
    518 SOUTH FREDERICK AVENUE
    GAITHERSBURG,MD20877     		NONE PUBLIC CHARITY THE WHOLE YOU - SUPPORTING LIFE'S NEEDS DURING CANCER 15,000
    CENTER FOR ADOPTION SUPPORT AND EDUCATION INC
    3919 NATIONAL DRIVE SUITE 200
    BURTONSVILLE,MD20866     		NONE PUBLIC CHARITY TRAINING DIVERSE WORKFORCE TO MEET MENTAL HEALTH NEEDS OF ADOPTIVE, FOSTER, AND KINSHIP FAMILIES 20,000
    NATIONAL CENTER FOR CHILDREN AND FAMILIES
    6301 GREENTREE RD BLDG 1
    BETHESDA,MD20817     		NONE PUBLIC CHARITY BLACK PHYSICIAN AND HEALTHCARE NETWORK (BPHN) 15,000
    NONPROFIT MONTGOMERY
    6010 EXECUTIVE BOULEVARD
    ROCKVILLE,MD20852     		NONE PUBLIC CHARITY HEALTHCARE NONPROFIT CAPACITY BUILDING PILOT 20,000
    FAMILY SERVICES INC
    610 E DIAMOND AVE
    GAITHERSBURG,MD20877     		NONE PUBLIC CHARITY HEALTHY MOTHERS, HEALTHY BABIES 15,000
    IDENTITY INC
    15800 CRABBS BRANCH WAY SUITE 300
    C/O NONPROFIT VILLAGE
    ROCKVILLE,MD20855     		NONE PUBLIC CHARITY NON-CLINICAL COMMUNITY MENTAL HEALTH (CMH) EMOTIONAL SUPPORT GROUPS MODULE II 20,000
    CORNERSTONE MONTGOMERY
    2 TAFT
    ROCKVILLE,MD20850     		NONE PUBLIC CHARITY INTEGRATING PRIMARY CARE AND BEHAVIORAL HEALTH SERVICES AND IMPROVING OUTCOMES DURING COVID-19 4,500
    AMERICAN RED CROSS SERVING MONTGOMERY HOWARD AND FREDERICK COUNTIES
    2020 EAST WEST HIGHWAY
    SILVER SPRING,MD20910     		NONE PUBLIC CHARITY SICKLE CELL INITIATIVE IN MONTGOMERY COUNTY - SUPPORTING A DIVERSE BLOOD SUPPLY 6,000
    COLUMBIA LIGHTHOUSE FOR THE BLIND
    8757 GEORGIA AVENUE SUITE 805
    SILVER SPRING,MD20910     		NONE PUBLIC CHARITY FY22 CLB DIABETIC RETINOPATHY SCREENINGS/SCHOOL EXAMS 20,000
    AYUDA
    1990 K STREET NW STE 500
    WASHINGTON,DC20006     		NONE PUBLIC CHARITY TRAUMA INFORMED BEHAVIORAL HEALTH & WELLNESS PROGRAM 20,000
    CASA RUBEN INC
    1700 ELTON ROAD SUITE 200
    SILVER SPRING,MD20903     		NONE PUBLIC CHARITY ENHANCE PEDIATRIC ACCESS. 10,000
    MARYLAND FOUNDATION OF DENTISTRY FOR THE HANDICAPPED
    8901 HERRMANN DRIVE
    COLUMBIA,MD21045     		NONE PUBLIC CHARITY THE MARYLAND FOUNDATION OF DENTISTRY/DONATED DENTAL SERVICES 4,000
    NAMI MONTGOMERY COUNTY (MD) INC
    9210 CORPORATE BOULEVARD
    ROCKVILLE,MD20850     		NONE PUBLIC CHARITY STRENGTHENING MENTAL HEALTH SUPPORT FOR OUR MONTGOMERY COUNTY COMMUNITY 20,000
    AMERICAN DIVERSITY GROUP
    8815 CENTRE PARK DRIVE
    COLUMBIA,MD21045     		NONE PUBLIC CHARITY HEALTHY SMILE - EXPANDING DENTAL ACCESS 20,000
    WARRIOR CANINE CONNECTION
    14934 SCHAEFFER ROAD
    BOYDS,MD20841     		NONE PUBLIC CHARITY WARRIOR CANINE CONNECTION COHEN CENTER MBTR PROGRAM FOR VETERANS 10,000
    THE UNIVERSITIES AT SHADY GROVE
    9631 GUDELSKY DR
    ROCKVILLE,MD20850     		NONE PUBLIC CHARITY EXPANDING THE HIF PATHWAY TO MSW STUDENTS TO DIVERSIFY AND IMPROVE BEHAVIORAL HEALTH SERVICES 18,000
    CASA
    8151 15TH AVENUE
    LANGLEY PARK,MD20783     		NONE PUBLIC CHARITY CASA CANCER EDUCATION AND ACCESS PROGRAM 10,000
    OUR MINDS MATTER
    1300 CARPERS FARM WAY
    VIENNA,VA22182     		NONE PUBLIC CHARITY EXPANDING AND DEEPENING THE IMPACT OF A PROVEN STUDENT-LED MENTAL HEALTH PROGRAM IN MCPS 10,000
    GLOBAL SUSTAINABLE PARTNERSHIPS (GSP)
    9101 1ST AVENUE
    SILVER SPRING,MD20910     		NONE PUBLIC CHARITY "IT TAKES A VILLAGE" - EXPANDED COMMUNITY HEALTH OUTREACH 5,000
    CASA RUBEN INC
    1700 ELTON ROAD SUITE 200
    SILVER SPRING,MD20903     		NONE PUBLIC CHARITY PEDS AT UPCOUNTY NON PROFIT SERVICE HUB 5,000
    NONPROFIT MONTGOMERY
    6010 EXECUTIVE BOULEVARD
    ROCKVILLE,MD20852     		NONE PUBLIC CHARITY IMPROVING CHILD HEALTH AND WELLNESS WITH CREATION OF AN EARLY CARE AND EDUCATION COORDINATING ENTITY FOR MONTGOMERY COUNTY 3,300
    FUTURE LINK
    15 WEST GUDE DRIVE
    ROCKVILLE,MD20850     		NONE PUBLIC CHARITY HEALTHCARE WORKFORCE PIPELINE PROGRAMMING 5,000
    480 CARES
    10003 WEDGE WAY
    MONTGOMERY VILLAGE,MD20886     		NONE PUBLIC CHARITY SUMMER FRIDAY NIGHT MENTORING AND SAFE ACTIVITIES FOR YOUTH IN MONTGOMERY VILLAGE. 5,000
    IDENTITY INC
    15800 CRABBS BRANCH WAY SUITE 300
    C/O NONPROFIT VILLAGE
    ROCKVILLE,MD20855     		NONE PUBLIC CHARITY IDENTITY HIGH SCHOOL MINDFULNESS PROGRAM AT SENECA VALLEY HIGH SCHOOL 5,000
    STORY TAPESTRIES INC
    19301 HEMPSTONE AVE
    POOLESVILLE,MD20837     		NONE PUBLIC CHARITY WRITE YOUR STORY (WYS) - TRAUMA INFORMED STORY TELLING IN AN EARLY CARE SETTING. 5,000
    EVERYMIND (FORMERLY MHA OF MOCO)
    1000 TWINBROOK PARKWAY
    ROCKVILLE,MD20851     		NONE PUBLIC CHARITY PROVIDING HEALTHY SUPPORT SYSTEMS TO OUR LGBTQ+ YOUTH 5,000
    REGINALD S LOURIE CENTER FOR INFANTS AND YOUNG CHILDREN
    12301 ACADEMY WAY
    ROCKVILLE,MD20852     		NONE PUBLIC CHARITY FOSTERING CHILDHOOD RESILIENCY AND LINGUISTICALLY RESPONSIVE EARLY CHILDHOOD MENTAL HEALTH CARE 5,000
    4MONTGOMERYS KIDS
    PO BOX 34864
    BETHESDA,MD20817     		NONE PUBLIC CHARITY SUMMER CAMP FOR SPECIAL NEEDS FOSTER CHILDREN 3,350
    FAMILY SERVICE FOUNDATION INC
    5301 76TH AVENUE
    LANDOVER HILLS,MD20784     		NONE PUBLIC CHARITY SKILLS ENHANCEMENT FOR STAFF TO SUPPORT BEHAVIORAL HEALTH OF STUDENTS. 5,000
    COLLEGETRACKS INC
    8737 COLESVILLE ROAD SUITE 1010
    SILVER SPRING,MD20910     		NONE PUBLIC CHARITY COLLEGETRACKS PATHWAYS TO HEALTHCARE CAREERS 5,000
    RAINBOW YOUTH ALLIANCE
    100 WELSH PARK DRIVE
    ROCKVILLE,MD20850     		NONE PUBLIC CHARITY RAINBOW YOUTH ALLIANCE - SUPPORTING BEHAVIORAL HEALTH AND WELLNESS. 5,000
    SHARED HORIZONS INC
    4301 CONNECTICUT AVENUE NW
    WASHINGTON,DC20008     		NONE PUBLIC CHARITY SHARED HORIZONS CHARITABLE HEALTH SERVICES 5,000
    MADISON HOUSE AUTISM FOUNDATION
    611 ROCKVILLE PIKE
    ROCKVILLE,MD20852     		NONE PUBLIC CHARITY FUND JOB READINESS PROGRAM IMPROVING FOOD SECURITY AT MADISON FIELDS FOR INDIVIDUALS WITH VARYING ABILITIES. 3,350
    ISLAMIC CENTER OF MARYLAND
    19411 WOODFIELD ROAD
    GAITHERSBURG,MD20879     		NONE PUBLIC CHARITY ICMCARES - IMPROVING FOOD ACCESS FOR SENIORS. 12,500
    Total .................................bullet 3a 1,392,000
    bApproved for future payment
    GURU GOBIND SINGH FOUNDATION
    13814 TRAVILAH ROAD
    ROCKVILLE,MD20850     		NONE PUBLIC CHARITY FOOD DISTRIBUTION 2,500
    A PLACE OF HOPE INC
    12002 COOK COURT
    SILVER SPRING,MD20902     		NONE PUBLIC CHARITY FOOD DISTRIBUTION AND VACCINE DISTRIBUTION 2,500
    Total .................................bullet 3b 5,000
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 12
    Part XV-A
    Analysis of Income-Producing Activities
    Enter gross amounts unless otherwise indicated. Unrelated business income Excluded by section 512, 513, or 514 (e)
    Related or exempt
    function income
    (See instructions.)
    1Program service revenue: (a)
    Business code     		(b)
    Amount     		(c)
    Exclusion code     		(d)
    Amount
    a
    b
    c
    d
    e
    f
    gFees and contracts from government agencies          
    2 Membership dues and assessments ....          
    3 Interest on savings and temporary cash
    investments ...........     		    14 165  
    4 Dividends and interest from securities ....          
    5 Net rental income or (loss) from real estate:
    aDebt-financed property......          
    bNot debt-financed property.....          
    6 Net rental income or (loss) from personal property          
    7 Other investment income .....          
    8 Gain or (loss) from sales of assets other than
    inventory ............     		    18 640,390  
    9 Net income or (loss) from special events:          
    10 Gross profit or (loss) from sales of inventory          
    11 Other revenue:
    aMISCELLANEOUS     		    01 45  
    b
    c
    d
    e
    12 Subtotal. Add columns (b), (d), and (e) .. 0 1,519,003 0
    13Total. Add line 12, columns (b), (d), and (e)..................
    13
    1,519,003
    (See worksheet in line 13 instructions to verify calculations.)
    Part XV-B
    Relationship of Activities to the Accomplishment of Exempt Purposes
    Line No.
    DownArrow     		Explain below how each activity for which income is reported in column (e) of Part XV-A contributed importantly to
    the accomplishment of the foundation’s exempt purposes (other than by providing funds for such purposes). (See
    instructions.)
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 13
    Part XVI
    Information Regarding Transfers To and Transactions and Relationships With Noncharitable Exempt Organizations
    1
    Did the organization directly or indirectly engage in any of the following with any other organization described in section 501(c) (other than section 501(c)(3) organizations) or in section 527, relating to political organizations?
    Yes
    No
    a
    Transfers from the reporting foundation to a noncharitable exempt organization of:
    (1) Cash...................................
    1a(1)
     
    No
    (2) Other assets.................................
    1a(2)
     
    No
    b
    Other transactions:
    (1) Sales of assets to a noncharitable exempt organization....................
    1b(1)
     
    No
    (2) Purchases of assets from a noncharitable exempt organization..................
    1b(2)
     
    No
    (3) Rental of facilities, equipment, or other assets.......................
    1b(3)
     
    No
    (4) Reimbursement arrangements...........................
    1b(4)
     
    No
    (5) Loans or loan guarantees.............................
    1b(5)
     
    No
    (6) Performance of services or membership or fundraising solicitations................
    1b(6)
     
    No
    c
    Sharing of facilities, equipment, mailing lists, other assets, or paid employees..............
    1c
     
    No
    d
    If the answer to any of the above is "Yes," complete the following schedule. Column (b) should always show the fair market value
    of the goods, other assets, or services given by the reporting foundation. If the foundation received less than fair market value
    in any transaction or sharing arrangement, show in column (d) the value of the goods, other assets, or services received.
    (a) Line No. (b) Amount involved (c) Name of noncharitable exempt organization (d) Description of transfers, transactions, and sharing arrangements
    2a
    Is the foundation directly or indirectly affiliated with, or related to, one or more tax-exempt organizations
    described in section 501(c) (other than section 501(c)(3)) or in section 527? ...........
    b
    If "Yes," complete the following schedule.

    (a) Name of organization (b) Type of organization (c) Description of relationship
    Sign Here
    Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
    Bullet Bullet
    May the IRS discuss this return
    with the preparer shown below?
    See instructions.
    Signature of officer or trustee Date Title
    Paid Preparer Use Only Print/Type preparer's name Preparer's Signature Date PTIN
    Firm's name SmallBullet
    		 Firm's EIN SmallBullet
    Firm's address SmallBullet


    		 Phone no.
    Form 990-PF (2021)
    Additional Data


    Software ID:  
    Software Version:  


    Form 990PF - Special Condition Description:
    Special Condition Description

    TY 2021 AccountingFeesSchedule
    Name:
    HEALTHCARE INITIATIVE FOUNDATION
    EIN:
    23-7324576
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    ACCOUNTING FEES 82,722 3,750   85,620

    TY 2021 InvestmentsOtherSchedule2
    Name:
    HEALTHCARE INITIATIVE FOUNDATION
    EIN:
    23-7324576
    Category/ Item Listed at Cost or FMV Book Value End of Year Fair Market Value
    VANGUARD MONEY MARKET AT COST 482,314 482,314
    VANGUARD TOTAL INTERNATIONAL BOND INDEX AT COST 3,135,208 2,818,700
    VANGUARD TOTAL INTERNATIONAL STOCK INDEX AT COST 10,802,355 11,335,534
    VANGUARD TOTAL STOCK MARKET INDEX AT COST 7,056,727 12,358,493
    VANGUARD TOTAL BOND MARKET INDEX FUND AT COST 7,126,306 6,475,746

    TY 2021 OtherAssetsSchedule
    Name:
    HEALTHCARE INITIATIVE FOUNDATION
    EIN:
    23-7324576
    Description Beginning of Year - Book Value End of Year - Book Value End of Year - Fair Market Value
    ASSETS HELD IN CHARITABLE REMAINDER TRUST 76,579 76,579 191,247


    TY 2021 OtherExpensesSchedule
    Name:
    HEALTHCARE INITIATIVE FOUNDATION
    EIN:
    23-7324576
    Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    OFFICE EXPENSES 21,985 0   18,272
    MEMBERSHIP DUES 17,515 0   17,515
    INSURANCE 13,506 0   11,985
    PAYROLL EXPENSES 8,575 0   8,575
    PENSION ADMINISTRATION EXPENSE 2,605 0   2,605


    TY 2021 OtherIncomeSchedule2
    Name:
    HEALTHCARE INITIATIVE FOUNDATION
    EIN:
    23-7324576
    Description Revenue And Expenses Per Books Net Investment Income Adjusted Net Income
    MISCELLANEOUS 45   45


    TY 2021 OtherIncreasesSchedule
    Name:
    HEALTHCARE INITIATIVE FOUNDATION
    EIN:
    23-7324576
    Description Amount
    CHANGE IN ACCRUAL FOR DEFERRED INCOME TAXES 101,645


    TY 2021 OtherLiabilitiesSchedule
    Name:
    HEALTHCARE INITIATIVE FOUNDATION
    EIN:
    23-7324576
    Description Beginning of Year - Book Value End of Year - Book Value
    DEFERRED FEDERAL EXCISE TAX LIABILITY 169,308 67,663


    TY 2021 OtherProfessionalFeesSchedule
    Name:
    HEALTHCARE INITIATIVE FOUNDATION
    EIN:
    23-7324576
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    CONSULTING 1,000 0   1,000
    INVESTMENT FEES 47,234 47,234   0


    TY 2021 TaxesSchedule
    Name:
    HEALTHCARE INITIATIVE FOUNDATION
    EIN:
    23-7324576
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    FEDERAL EXCISE TAX EXPENSE 20,207 0   0