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)
![]() |
(a) 2019 | (b) 2020 | (c) 2021 | (d) 2022 | (e) 2023 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | 9,554,878 | 9,389,752 | 11,970,154 | 9,005,227 | 11,498,078 | 51,418,089 |
| 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 | 9,554,878 | 9,389,752 | 11,970,154 | 9,005,227 | 11,498,078 | 51,418,089 |
| 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) .. | 6,656,031 | |||||
| 6 | Public support. Subtract line 5 from line 4. | 44,762,058 | |||||
Calendar year
(or fiscal year beginning in)
![]() |
(a) 2019 | (b) 2020 | (c) 2021 | (d) 2022 | (e) 2023 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 9,554,878 | 9,389,752 | 11,970,154 | 9,005,227 | 11,498,078 | 51,418,089 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | 2,456 | 1,541 | 5,578 | 30,745 | 48,862 | 89,182 |
| 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 | 51,663,319 | |||||
Calendar year (or fiscal
year beginning in) ![]() |
(a) 2019 | (b) 2020 | (c) 2021 | (d) 2022 | (e) 2023 | (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) 2019 | (b) 2020 | (c) 2021 | (d) 2022 | (e) 2023 | (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 2023 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-2023 |
(iii) Distributable Amount for 2023 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2023 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2023 (reasonable cause required-- explain in Part VI).
See instructions. |
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| 3 Excess distributions carryover, if any, to 2023: | ||||
| a From 2018....... | ||||
| b From 2019....... | ||||
| c From 2020....... | ||||
| d From 2021....... | ||||
| e From 2022....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2023 distributable amount | ||||
|
i
Carryover from 2018 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from line 3f. | ||||
| 4Distributions for 2023 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2023 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from line 4. | ||||
|
5
Remaining underdistributions for years prior to 2023, 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 2023. 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 2024. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2019..... | ||||
| b Excess from 2020..... | ||||
| c Excess from 2021..... | ||||
| d Excess from 2022..... | ||||
| e Excess from 2023..... | ||||
| Facts And Circumstances Test |
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| Return Reference | Explanation |
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| Software ID: | |
| Software Version: |
| Return Reference | Explanation |
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| FORM 990, PAGE 2, PART III, LINE 4A | MEDICAL/DENTAL SERVICES AND PRESCRIPTION MEDICATIONS PROVIDED AT NO COST TO THE SICK, UNINSURED AND UNDER-INSURED POOR, AND HOMELESS THROUGH HEALTH CLINICS STAFFED PRIMARILY BY VOLUNTEER, LICENSED HEALTHCARE PROFESSIONALS. BETWEEN JULY 1, 2023 AND JUNE 30, 2024 WE DISPENSED 39,562 PRESCRIPTIONS AND HAD 19,842 PATIENT VISITS AT 13 CLINIC SITES IN 4 STATES. THE ORGANIZATION RECEIVES SUBSTANTIAL DONATED RESOURCES TO SUPPORT OUR PATIENT CARE, INCLUDING 6,354,430 OF MEDICATION AND MEDICAL SUPPLIES, 2,309,006 OF DONATED LAB AND DIAGNOSTIC IMAGING SERVICES, USE OF DONATED FACILITIES OF 483,106, 1,033,530 OF DONATED SERVICES FROM LICENSED HEALTHCARE PROFESSIONALS THAT PROVIDE THE MEDICAL, DENTAL, AND OPHTHALMIC SERVICES, AND 8,100 OF DONATED SERVICES FROM ACCOUNTANTS, ATTORNEYS, AND OTHER PROFESSIONAL SERVICES. AN ADDITIONAL 11,262 VOLUNTEER HOURS WERE DONATED FOR ADMINISTRATIVE, FUNDRAISING, AND OTHER PURPOSES THAT HAVE NOT HAD A VALUE ASSIGNED TO THEM. |
| FORM 990, PAGE 2, PART III, LINE 4B | IN ADDITION TO DIRECT HEALTHCARE SERVICES PROVIDED FREE TO PATIENTS, THE COMMUNITY CONNECTIONS PROGRAM AT OUR CLINICS CONNECTS PATIENTS WITH ADDITIONAL RESOURCES FROM OTHER PARTNER ORGANIZATIONS, HELPING TO PROMOTE HEALTH LITERACY, DISEASE MANAGEMENT AND PREVENTION EDUCATION, NUTRITION AND EXERCISE. WE CONTINUE TO SERVE OUR PATIENTS NEEDS AS POSSIBLE/PRACTICAL. FOR EXAMPLE, ACTIVITIES DURING THE YEAR ENDED JUNE 30, 2024 INCLUDE: MARYLAND/PENNSYLVANIA PROGRAM -108,780 POUNDS OF FOOD, (75% FRESH FRUIT AND VEGETABLES, 25% HEALTHY NON- PERISHABLES) DISTRIBUTED TO 860 FAMILIES (3,650 INDIVIDUALS) -PROVIDED FREE COVID-19 TESTING FOR PATIENTS -FREDERICK COUNTY HEALTH DEPARTMENT PROVIDED OPIOID ABUSE EDUCATION TO PATIENTS AND VOLUNTEERS. DISPENSED NARCAN TO PATIENTS AND VOLUNTEERS UPON SUCCESSFUL COMPLETION OF TRAINING. -FREDERICK HEALTH PROVIDED FREE ON-SITE BONE DENSITY TESTING. -FREDERICK HEALTH PROVIDED ON-SITE HIV TESTING. ARIZONA PROGRAM -PARTNERED WITH ALBERTSONS/SAFEWAY PHARMACIES TO EXPAND VACCINE ACCESS TO INCLUDE INFLUENZA, PNEUMONIA, SHINGLES AND HEP B TO PATIENTS OF NORTH PHOENIX BAPTIST CLINIC. -PARTNERED WITH DIGNITY HEALTH EAST VALLEY TO ADMINISTER FREE FLU VACCINES TO 111 PATIENTS OF CHANDLER AND MESA CLINICS. -COLLABORATED WITH HELPING FAMILIES IN NEED TO PROVIDE COMMUNITY RESOURCES AND REFERRALS - 1,632 RESOURCE CONTACTS WERE MADE ON BEHALF OF AVONDALE CLINIC PATIENTS. -CONDUCTED COMPREHENSIVE DIABETES MANAGEMENT, INCLUDING 826 HEALTH EDUCATION AND NUTRITION SESSIONS, AND DISTRIBUTED 9,350 LBS OF FRESH PRODUCE TO PATIENTS AND FAMILIES. FUNDING AND SERVICE PARTNERS INCLUDED DIGNITY HEALTH, BLUE CROSS BLUE SHIELD OF ARIZONA, BHHS LEGACY FOUNDATION, KEMPER & ETHEL MARLEY FOUNDATION, GREGORY'S FRESH MARKET AND AZCEND. -LAUNCHED A VISION PROGRAM AT OUR MESA CLINIC TO SERVE PATIENTS WITH DIABETES - 106 PATIENTS WERE SERVED FROM JAN-JUN. -CONDUCTED TWO FREE MOBILE MAMMOGRAM EVENTS SERVING 37 WOMEN TEXAS PROGRAM -INCREASED THE NUMBER OF PATIENTS AND PATIENT VISITS. -EXPANDED OUR SERVICES AND OPERATING HOURS TO PATIENTS BY OFFERING SCHEDULED APPOINTMENT DAYS, WALK-IN CLINIC DAYS, AND EVENING CLINIC DAYS. -INCREASED OUR HEALTHCARE VOLUNTEERS TO 34 IN THE MEDICAL CLINIC, 9 IN THE VISION CLINIC, AND 4 IN THE DENTAL CLINIC. -IMPLEMENTED AN ELECTRONIC HEALTH RECORDS SOFTWARE DONATED BY ATHENAHEALTH THAT ALLOWS US TO GO FROM PAPER PATIENT FILES TO CLOUD BASED TECHNOLOGY. -INCREASED THE NUMBER OF TEXAS UNIVERSITY STUDENTS WANTING TO FINISH THEIR PRECEPTORS. -EXPANDED OUR PARTNERSHIPS TO INCLUDE EXERCISE AND EDUCATION CLASSES FOR YOUTH AGES 7 AND UP TO 13. -IMPLEMENTED OUR COMMUNITY WELLNESS EVENTS IN GREGORY AND KINGSVILLE. -HELD THE 2ND ANNUAL "HEALTHY HEART FESTIVAL", THE 3RD ANNUAL "PULL FOR MISSION OF MERCY CLAY SHOOT- AND THE 9TH ANNUAL "CAMO & COUNTRY" SPECIAL EVENTS. -HELD THE 3RD ANNUAL "OPERATION HEALTH & WELLNESS" COMMUNITY PARTNERSHIP EVENT IN OUR VISION CLINIC. WE WERE 1 OF 3 LOCATIONS AND THE ONLY ONE PROVIDING VISION CARE. |
| FORM 990, PAGE 6, PART VI, LINE 11B | THE FINANCE COMMITTEE IS PROVIDED WITH COPIES OF THE DRAFT AUDITED FINANCIAL STATEMENTS AND DRAFT FORM 990. ALL MEMBERS OF THE EXECUTIVE COMMITTEE REVIEW THE AMOUNTS AND DISCLOSURES IN DETAIL AND COMPARE THE DRAFT AUDITED FINANCIAL STATEMENTS TO THE DRAFT FORM 990. THE BOARD OF DIRECTORS RECEIVES AND APPROVES THE AUDIT AND 990 AT THE NEXT REGULARLY SCHEDULED BOARD MEETING. ANY QUESTIONS OR CONCERNS ARE COMMUNICATED TO THE INDEPENDENT ACCOUNTANTS AND RESOLVED. THE EXECUTIVE COMMITTEE WILL APPROVE THE AUDITED FINANCIAL STATEMENTS AND FORM 990 WHEN ALL CONCERNS HAVE BEEN ADDRESSED. |
| FORM 990, PAGE 6, PART VI, LINE 12C | THE CFO CIRCULATES THE CONFLICT OF INTEREST POLICY AMONG BOARD MEMBERS ANNUALLY AND REQUIRES A SIGNED RESPONSE REGARDING ANY CONFLICTS FROM EACH. |
| FORM 990, PAGE 6, PART VI, LINE 15A | A BOARD COMMITTEE (EXECUTIVE COMMITTEE) ESTABLISHES JOB DESCRIPTION AND COMPENSATION LEVELS FOR THE CHIEF MEDICAL DIRECTOR, CFO, AND EXECUTIVE DIRECTORS. THE SAME BOARD COMMITTEE ALSO REVIEWS JOB DESCRIPTIONS AND COMPENSATION LEVELS ANNUALLY. |
| FORM 990, PAGE 6, PART VI, LINE 15B | A BOARD COMMITTEE (EXECUTIVE COMMITTEE) ESTABLISHES AND REVIEWS THE JOB DESCRIPTION AND COMPENSATION LEVEL FOR THE CHIEF MEDICAL DIRECTOR, CFO, AND EXECUTIVE DIRECTORS. ALL COMPENSATION LEVELS OF ALL POSITIONS IN THE ORGANIZATION ARE COMPARED TO SIMILAR POSITIONS IN THE GEOGRAPHICAL AREA BY THE CFO. THE ORGANIZATION USES THIRD PARTY RESOURCES WHERE AVAILABLE (IE, THE PAYROLL SERVICE PROVIDER WILL PROVIDE THIRD PARTY SALARY COMPARISONS). |
| FORM 990, PAGE 6, PART VI, LINE 19 | COPIES OF FORM 990 AND AUDITED FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST, AND AN ELECTRONIC COPY IN PDF FORMAT IS AVAILABLE FOR REVIEW AND PRINTING ON THE ORGANIZATION'S WEBSITE. CONFLICT OF INTEREST POLICY IS ALSO AVAILABLE UPON REQUEST. |
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