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.") .. | 29,745 | 129,440 | 149,495 | 215,297 | 523,977 | |
| 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 | 29,745 | 129,440 | 149,495 | 215,297 | 523,977 | |
| 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. | 523,977 | |||||
Calendar year
(or fiscal year beginning in)
![]() |
(a) 2019 | (b) 2020 | (c) 2021 | (d) 2022 | (e) 2023 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 29,745 | 129,440 | 149,495 | 215,297 | 523,977 | |
| 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.).. | 2,517 | 1,089 | 123 | 3,729 | ||
| 11 | Total support. Add lines 7 through 10 | 527,706 | |||||
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 |
|---|
| Return Reference | Explanation |
|---|---|
| PART II, LINE 10 | 3,729 |
| Software ID: | |
| Software Version: |
| Return Reference | Explanation |
|---|---|
| FORM 990 - ORGANIZATION'S MISSION | MISSION: TO PROMOTE WELLNESS IN THE NELSON COMMUNITY BY DEVELOPING AND IMPLEMENTING STRATEGIES TO REDUCE SUBSTANCE USE AMONG YOUTH AND THEIR FAMILIES. VISION: TO CREATE A COMMUNITY THAT IS TRAUMA INFORMED, ENGAGED, AND ACTIVELY WORKING TO REDUCE THE STIGMA ASSOCIATED WITH ADDICTION, TRAUMA, SUBSTANCE ABUSE, AND BEHAVIORAL HEALTH CONDITIONS BY PROVIDING EDUCATION RELATED TO PREVENTION, TREATMENT, AND RECOVERY. |
| FORM 990, PAGE 2, PART III, LINE 4A | THE NELSON COMMUNITY WELLNESS ALLIANCE (NCWA) IS BASED IN NELSON COUNTY, VIRGINIA. NELSON IS A DESIGNATED RURAL HEALTH AREA BY THE HEALTH RESOURCES AND SERVICES ADMINISTRATION (HRSA). IT IS LOCATED BETWEEN THE CITIES OF CHARLOTTESVILLE, 40 MINUTES TO THE NORTH, AND LYNCHBURG, 35 MINUTES TO THE SOUTH. GEOGRAPHICALLY, NELSON COUNTY IS NEAR THE CENTER OF THE STATE, BORDERED BY THE BLUE RIDGE MOUNTAINS ON THE NORTHWEST AND THE JAMES RIVER TO THE SOUTHEAST. NELSON COUNTY IS PART OF HEALTH PLANNING DISTRICT (HPD) 10, ALSO KNOWN AS THE BLUE RIDGE HEALTH PLANNING DISTRICT; HOWEVER DUE TO THE COUNTIES UNIQUE DIAMOND SHAPE, IT SITS ON THE EDGE OF THREE DIFFERENT HEALTH PLANNING DISTRICT'S. THE NORTHERN TIP OF NELSON COUNTY MEETS AUGUSTA COUNTY IN HPD 6, TO THE NORTHEAST IT JOINS WITH ALBEMARLE COUNTY WHICH IS ALSO PART OF HPD 10. TO THE SOUTHEAST IT IS BORDERED BY BUCKINGHAM COUNTY IN HPD 14 (ALSO A RURAL HEALTH AREA). TO THE SOUTHWEST NELSON MEETS WITH AMHERST COUNTY IN HPD 11 (ALSO A RURAL HEALTH AREA), AND TO THE WEST IT IS BORDERED BY ROCKBRIDGE COUNTY IN HPD 6 (ALSO A RURAL HEALTH AREA). DUE TO THE RURAL LOCATION OF NELSON COUNTY AND LACK OF RESOURCES WITHIN THE COUNTY MANY RESIDENTS TRAVEL TO OTHER LOCALITIES TO ACCESS ESSENTIAL SERVICES. THE TARGET POPULATION FOR THE ALLIANCE ACTIVITIES AND EVENTS INCLUDES ALL RESIDENTS IN NELSON COUNTY, WITH A SPECIAL EMPHASIS ON THE 6,819 PEOPLE RESIDING IN CENSUS TRACT: 51125950300 (INCLUDING THE COMMUNITIES OF ARRINGTON, PINEY RIVER, TYRO, MONTEBELLO, AND GLADSTONE), MANY OF WHOM ARE LOW-INCOME INDIVIDUALS AND/OR ISOLATED ECONOMICALLY, SOCIALLY, AND GEOGRAPHICALLY. CURRENT PROGRAMS "STAMP OUT STIGMA (SOS): PEOPLE WITH MENTAL HEALTH PROBLEMS SAY THAT THE SOCIAL STIGMA ATTACHED TO THEIR CONDITION AND THE DISCRIMINATION THEY EXPERIENCE CAN MAKE THEIR DIFFICULTIES WORSE AND MAKE IT HARDER TO RECOVER. SOS IS A PROGRAM DESIGNED BY NCWA TO HELP REDUCE THIS STIGMA, PROVIDING OPPORTUNITIES FOR PEOPLE OF ALL AGES TO LEARN HOW TO CARE FOR THEIR MENTAL HEALTH. THE ALLIANCE CONNECTS NATIONALLY KNOWN SPEAKERS AND EXPERTS IN MENTAL HEALTH, ADDICTION, AND RECOVERY TO NELSON COUNTY CITIZENS INCLUDING YOUTH, PARENTS, AND ALLIED PROFESSIONALS. "FIRST RESPONDERS' APPRECIATION DAY (FRAD): ANNUAL PROGRAM RECOGNIZING THE EMS, FIRE & RESCUE, POLICE, SHERIFF, SOCIAL SERVICES, MEDICAL STAFF, AND CRISIS WORKERS WHO SERVE NELSON COUNTY. STUDIES HAVE SHOWN THAT FIRST RESPONDERS ARE AT HIGHER RISK FOR ANXIETY DISORDERS, POST-TRAUMATIC STRESS DISORDER, SEVERE DEPRESSION, AND DEATH BY SUICIDE. FRAD SERVES TO RAISE AWARENESS ABOUT THE IMPORTANCE OF CARING FOR MENTAL HEALTH TO REDUCE THE LONG-TERM IMPACTS OF EXPOSURE TO TRAUMA, TO THANK OUR FIRST RESPONDERS, AND TO ENCOURAGE ANYONE STRUGGLING AFTER A TRAUMATIC EVENT TO SEEK OUT RESOURCES FOR RECOVERY. "NELSON COMMUNITY TEXT-LINE: A COORDINATED PLATFORM TO HELP MEET THE MENTAL HEALTH AND WELLNESS NEEDS OF NELSON COUNTY RESIDENTS, DEVELOP PARTNERSHIPS WITH KEY COMMUNITY STAKEHOLDERS (CITIZENS, ALLIED PROFESSIONALS, AND COMMUNITY GROUPS), AND ENHANCE OUR ABILITY TO PROVIDE A COORDINATED RESPONSE FOR NELSON COUNTY RESIDENTS DURING COVID-19. "POSITIVE BEHAVIORAL INTERVENTIONS AND SUPPORTS (PBIS) REWARDS: PBIS SEEKS TO REDUCE OR ELIMINATE POOR BEHAVIOR IN SCHOOLS THROUGH THE ENCOURAGEMENT OF POSITIVE BEHAVIORS. IT IMPLEMENTS AN EVIDENCE-BASED FRAMEWORK TO IMPROVE SCHOOL CULTURE AND STUDENT BEHAVIOR, PROMOTING A SAFE ENVIRONMENT FOR LEARNING. PBIS IS BASED ON SEVERAL DECADES OF RESEARCH BY MAJOR UNIVERSITIES ACROSS THE COUNTRY, FOCUSING ON MORE POSITIVE BEHAVIORS AND LESS ON NEGATIVE BEHAVIORS. "PATHWAYS COMMUNITY HUB MODEL: TOWARDS OUR GOAL OF REDUCING MORBIDITY AND MORTALITY OF SUBSTANCE USE DISORDER (SUD) AND OPIOID USE DISORDER (OUD) IN NELSON COUNTY, THE ALLIANCE WILL WORK ACROSS SYSTEMS TO CONNECT VULNERABLE POPULATIONS TO SUD/OUD PREVENTION, TREATMENT, AND RECOVERY SUPPORTS BY ESTABLISHING A PATHWAYS COMMUNITY HUB. THE HUB WILL FACILITATE HEALTHCARE COORDINATION, OUTREACH, AND EDUCATION, AS WELL AS INCREASE ACCESS TO BEHAVIORAL HEALTH SERVICES TO A POPULATION OTHERWISE UNABLE TO ACCESS THESE SERVICES. TO SUPPORT THE EXPANSION AND STRENGTHENING OF AFFORDABLE TREATMENT AND CARE OPTIONS, THE HUB WILL ALSO SERVE AS A REFERRAL RESOURCE FOR THE LOCAL COURT SYSTEM, PROVIDING AN ALTERNATIVE TO INCARCERATION WHICH WILL RESULT IN VASTLY IMPROVED OUTCOMES FOR ITS VOLUNTARY PARTICIPANTS. |
| FORM 990, PAGE 6, PART VI, LINE 6 | ALL PERSONS EIGHTEEN (18) YEARS OF AGE OR OLDER ARE ELIGIBLE TO APPLY FOR MEMBERSHIP. APPLICATIONS ARE FILED WITH THE SECRETARY OF THE BOARD OF DIRECTORS AND READ AT FIRST MEMBERSHIP MEETING FOLLOWING RECEIPT. AFFIRMATIVE VOTE OF 3/4 OF THE MEMBERSHIP IN GOOD STANDING PRESENT AND VOTING IS REQUIRED TO ELECT THE APPLICANT. BLUE RIDGE MEDICAL CENTER, REGION TEN, UNITY & COMMUNITY OUTREACH MINISTRIES, INC., THE NELSON COUNTY DEPARTMENT OF SOCIAL SERVICES, AND THE NELSON COUNTY SHERIFF'S OFFICE ARE ENTITLED, WITHOUT APPLICATION, TO HAVE ONE STANDING MEMBER WHO MAY BE APPOINTED BY THE REPRESENTATIVE ORGANIZATION. |
| FORM 990, PAGE 6, PART VI, LINE 7A | THE BOARD OF DIRECTORS AND OFFICERS ARE ELECTED FOR TERMS OF 3 YEARS AT THE ANNUAL MEMBERSHIP MEETING BY THE MEMBERS. |
| FORM 990, PAGE 6, PART VI, LINE 7B | ARTICLE FIVE OF BYLAWS: THE CORPORATION MAY BE DISSOLVED AT ANY TIME BY RECOMMENDATION OF THE BOARD OF DIRECTORS APPROVED IN WRITING BY MORE THAN TWO-THIRDS (2/3) OF THE MEMBERS IN GOOD STANDING. |
| FORM 990, PAGE 6, PART VI, LINE 11B | COPY OF THE FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS FOR APPROVAL. ONCE APPROVED, BOARD PRESIDENT PROVIDES SIGNATURE FOR FILING. |
| FORM 990, PAGE 6, PART VI, LINE 12C | PER THE CONFLICT OF INTEREST POLICY: ANNUAL STATEMENTS EACH DIRECTOR, PRINCIPAL OFFICER, AND MEMBER OF A COMMITTEE WITH GOVERNING BOARD DELEGATED POWERS SHALL ANNUALLY SIGN A STATEMENT WHICH AFFIRMS SUCH PERSON: A. HAS RECEIVED A COPY OF THE CONFLICT OF INTEREST POLICY, B. HAS READ AND UNDERSTANDS THE POLICY, C. HAS AGREED TO COMPLY WITH THE POLICY, AND D. UNDERSTANDS THE ORGANIZATION IS CHARITABLE AND IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION IT MUST ENGAGE PRIMARILY IN ACTIVITIES THAT ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. PERIODIC REVIEWS TO ENSURE THE ORGANIZATION OPERATES IN A MANNER CONSISTENT WITH CHARITABLE PURPOSES, AND DOESN'T ENGAGE IN ACTIVITIES THAT COULD JEOPARDIZE ITS TAX- EXEMPT STATUS, PERIODIC REVIEWS SHALL BE CONDUCTED. THE PERIODIC REVIEWS SHALL, AT A MINIMUM, INCLUDE THE FOLLOWING SUBJECTS: A. WHETHER COMPENSATION ARRANGEMENTS AND BENEFITS ARE REASONABLE, BASED ON COMPETENT SURVEY INFORMATION, AND THE RESULT OF ARM'S LENGTH BARGAINING. B. WHETHER PARTNERSHIPS, JOINT VENTURES, AND ARRANGEMENTS WITH MANAGEMENT ORGANIZATIONS CONFORM TO THE ORGANIZATION'S WRITTEN POLICIES, ARE PROPERLY RECORDED, REFLECT REASONABLE INVESTMENT OR PAYMENTS FOR GOODS AND SERVICES, FURTHER CHARITABLE PURPOSES AND DON'T RESULT IN INUREMENT, IMPERMISSIBLE PRIVATE BENEFIT, OR IN AN EXCESS BENEFIT TRANSACTION. |
| FORM 990, PAGE 6, PART VI, LINE 15A | COMPENSATION IS BASED ON COMPARABLE DATA OF SIMILAR JOB RESPONSIBILITIES IN THE REGION. BOARD OF DIRECTORS APPROVES SALARY FOR EXECUTIVE DIRECTOR. EXECUTIVE DIRECTOR APPROVES SALARY FOR ALL OTHER STAFF MEMBERS. |
| FORM 990, PAGE 6, PART VI, LINE 15B | COMPENSATION IS BASED ON COMPARABLE DATA OF SIMILAR JOB RESPONSIBILITIES IN THE REGION. BOARD OF DIRECTORS APPROVES SALARY FOR EXECUTIVE DIRECTOR. EXECUTIVE DIRECTOR APPROVES SALARY FOR ALL OTHER STAFF MEMBERS. |
| FORM 990, PAGE 6, PART VI, LINE 19 | THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC BY REQUEST. |
| Software ID: | |
| Software Version: |