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) 2020 | (b) 2021 | (c) 2022 | (d) 2023 | (e) 2024 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | 131,950 | 160,811 | 161,141 | 196,274 | 163,998 | 814,174 |
| 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 | 131,950 | 160,811 | 161,141 | 196,274 | 163,998 | 814,174 |
| 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) .. | 152,834 | |||||
| 6 | Public support. Subtract line 5 from line 4. | 661,340 | |||||
Calendar year
(or fiscal year beginning in)
![]() |
(a) 2020 | (b) 2021 | (c) 2022 | (d) 2023 | (e) 2024 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 131,950 | 160,811 | 161,141 | 196,274 | 163,998 | 814,174 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | 27 | 19 | 143 | 2,232 | 4,945 | 7,366 |
| 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.).. | 4,291 | 6,028 | 3,360 | 13,679 | ||
| 11 | Total support. Add lines 7 through 10 | 836,089 | |||||
Calendar year (or fiscal
year beginning in) ![]() |
(a) 2020 | (b) 2021 | (c) 2022 | (d) 2023 | (e) 2024 | (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) 2020 | (b) 2021 | (c) 2022 | (d) 2023 | (e) 2024 | (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 2024 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-2024 |
(iii) Distributable Amount for 2024 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2024 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2024 (reasonable cause required-- explain in Part VI).
See instructions. |
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| 3 Excess distributions carryover, if any, to 2024: | ||||
| a From 2019....... | ||||
| b From 2020....... | ||||
| c From 2021....... | ||||
| d From 2022....... | ||||
| e From 2023....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2024 distributable amount | ||||
|
i
Carryover from 2019 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from line 3f. | ||||
| 4Distributions for 2024 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2024 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from line 4. | ||||
|
5
Remaining underdistributions for years prior to 2024, 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 2024. 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 2025. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2020..... | ||||
| b Excess from 2021..... | ||||
| c Excess from 2022..... | ||||
| d Excess from 2023..... | ||||
| e Excess from 2024..... | ||||
| Facts And Circumstances Test |
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| Return Reference | Explanation |
|---|---|
| PART II, LINE 10 | SOUPER BOWL FUNDRAISING 7,724 CHILI SUPPER 1,085 J3 & ME FUNDRAISER 1,510 |
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| Return Reference | Explanation |
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| FORM 990-EZ, PART I, LINE 8 | 8500 CASH BACK REWARDS 125 TOTAL 125 |
| FORM 990-EZ, PART I, LINE 10 | CLASS OF ACTIVITY: MEDICAL TRANSPORT CASH CONTRIBUTION: 11,862 RELATIONSHIP: NONE |
| FORM 990-EZ, PART I, LINE 16 | EXPENSES 6100 ADVERTISING & MARKETING 637 6700 SOFTWARE & APPLICATIONS 405 7232 LODGING EXPENSE 182 7233 TRANSPORTATION EXP 430 7234 MILEAGE REIMBURSEMENT 1,211 7231 CONFERENCE EXPENSE 218 7250 PERSONNEL INSURANCE 127 7251 D&O INSURANCE 753 7252 WORKERS COMP INSURANCE 859 6550 BANK & CC FEES 40 6600 GENERAL OPER SUPPL 1,602 6600 GENERAL OPER SUPPL 32 6690 DUES & SUBSCRIPTIONS 25 6850 LICENSES & PERMITS 89 6950 DONATIONS EXPENSE 1,650 7105 FIXED ASSETS <2500 1,938 7130 REPAIRS & MNTNCE 45 7240 GIFTS & APPRECIATION 400 7242 VOLUNTEER APPREC. 504 7270 HIRING EXPENSES 135 7310 MEALS & FOOD PURCH 11,635 7310 MEALS & FOOD PURCH 5,320 7310 MEALS & FOOD PURCH 633 7315 PROGRAM SUPPLIES 1,647 7315 PROGRAM SUPPLIES 107 7315 PROGRAM SUPPLIES 274 7500 EVENT EXPENSE 722 7700 DISCRETIONARY FUND 2,126 ROUNDING -2 NON-INVESTMENT DEPRECIATION 207 TOTAL 33,951 |
| FORM 990-EZ, PART II, LINE 24 | ACCOUNTS RECEIVABLE 25,711 399 INVENTORIES FOR SALE OR USE 306 273 1500 FIXED ASSETS 8,573 8,046 LESS ACCUMULATED DEPRECIATION 561 241 TOTAL 34,029 8,477 |
| FORM 990-EZ, PART II, LINE 26 | ACCOUNTS PAYABLE AND ACCRUED EXPENSES 1,656 768 2020 NICOLET CREDIT CARD 466 11 |
| FORM 990-EZ, PART III | THE WASHINGTON ISLAND COMMUNITY HEALTH PROGRAM (WICHP) SEEKS TO EMPOWER AND SUPPORT WASHINGTON ISLAND RESIDENTS ACROSS GENERATIONS TO MAKE INFORMED CHOICES FOR A SUCCESSFUL, HEALTHY, SAFE AND INDEPENDENT LIFESTYLE. WICHP ESTABLISHES LINKS BETWEEN ISLAND RESIDENTS AND SERVICE PROVIDERS NOT AVAILABLE ON WASHINGTON ISLAND. |
| FORM 990-EZ, PART III, LINE 28 | WICHP PROVIDES ASSISTANCE TO ISLAND RESIDENTS, PRIMARILY ELDERLY AND THEIR CAREGIVERS,PROVIDING INFORMATION ABOUT THEIR OPTIONS. WICHP HELPS BRING PROVIDERS TO THE ISLAND, AND HELPS ISLAND RESIDENTS CONNECT WITH OFF-ISLAND SERVICE PROVIDERS.OUR PRIMARY FOCUS OF SERVICES FALLS WITHIN OUR 6 KEY IN- HOME SUPPORTIVE CARE AREAS. 1)IN HOME SUPPORTIVE CARE--THIS AREA INCLUDES HOME AND OFFICE VISITS PROVIDED TO RESIDENTS TO DISCUSS AND/OR PROVIDE DIRECT SERVICES. IN 2024, WICHP PERFORMED 54 HOME VISITS & 390 OFFICE VISITS FOR A TOTAL OF 444 VISITS SERVICING 400+ RESIDENTS/SENIORS & 120+ FAMILY UNITS WITH COMMUNITY HEALTH SUPPORTIVE SERVICES OR INFORMATION. 2)HOME DELIVERED MEALS (AKA MEALS ON WHEELS)--THIS PROGRAM IS RUN IN CONJUNCTION WITH THE DOOR COUNTY AGING & DISABILITY RESOURCE CENTER (ADRC) SENIOR MEAL PROGRAM. IN 2024 MOWS PROVIDED 3,074 MEALS TO 34 HOMEBOUND RESIDENTS/CAREGIVERS. 3)MEDICAL EQUIPMENT LOAN CLOSET-THIS IS RUN IN CONJUNCTION WITH NEIGHBOR TO NEIGHBOR OF DOOR COUNTY. IN 2024, A TOTAL OF 68 RESIDENTS (SEASONAL & YEAR ROUND) WERE SERVED AND BORROWED 152 PIECES OF MEDICAL EQUIPMENT. 4)ADVOCACY SERVICES-THIS IS A UNIQUE SERVICE TO WICHP AND IS AVAILABLE TO ALL ISLAND RESIDENTS, INCLUDING SENIORS. IT PROVIDES SUPPORT AND GUIDANCE TO ASSIST IN THE EVALUATION AND SELECTION OF APPROPRIATE HEALTH AND SUPPORTIVE LIVING SERVICES. THIS CAN INCLUDE ATTENDING MEDICAL APPOINTMENTS,SPEAKING WITH HEALTHCARE PROFESSIONALS ON BEHALF OF A CLIENT WITH THEIR CONSENT, ATTENDING PATIENT CARE CONFERENCES TO SUPPORT SMOOTH TRANSITIONS FROM HOSPITAL OR REHAB TO HOME AND CAN HELP REVIEW/ADVISE ON MEDICAL BILLS AND INSURANCE DOCUMENTS. IN 2024 WE SERVED 115 RESIDENTS & 34 FAMILY UNITS (FOR A TOTAL OF 149)IN THIS CAPACITY . 5)LIFEASSIST SERVICES-THE STAFF INSTALLS AND MAINTAINS IN-HOME 24 HOUR MONITORING AS AN EXTENSION OF THIS PROGRAM WITH DOOR COUNTY MEDICAL CENTER IN STURGEON BAY. IN 2024 THERE WERE 18 RESIDENTS WHO UTILIZED THIS SERVICE IN THEIR HOMES WITH A TOTAL OF 17 UNITS. 6)MEDICAL TRAVEL FUND~THE STAFF ADMINISTERS THIS PROGRAM AND WORKS CLOSELY WITH THE WASHINGTON ISLAND FERRY LINE TO ASSURE RESIDENTS WHO NEED TO TRAVEL FOR PHYSICIAN ORDERED THERAPY AND/OR CANCER TREATMENT HAVE REDUCED PASSAGE COST. DOOR-TRAN & DOOR CANCER ALSO COLLABORATED WITH WICHP ON THIS PROGRAM. IN 2024 WE SERVICED 116 RESIDENTS AND 73 FAMILY UNITS FOR A TOTAL OF 1,001 ONE WAY PASSENGER TRIPS AND 515 ONE WAY AUTO TRIPS. ADDITIONAL KEY SERVICE AREAS: 7)CONNECTION TO COUNTY WIDE RESOURCES--IN 2024 WE SAW 200+ RESIDENTS SERVED BY OFF ISLAND PROVIDERS SUCH AS ADVOCATES IN HOME CARE, UNITY (DEPERE), MEMORY CARE WITH DOOR COUNTY MEDICAL CENTER (DCMC), NEIGHBOR TO NEIGHBOR CAREGIVER RESPITE PROGRAMS, CURATIVE CONNECTIONS (GREEN BAY),DCMC SISTER BAY, OPTIONS FOR INDEPENDENT LIVING (GREEN BAY),DOOR COUNTY DEPT. OF HUMAN SERVICES, DOOR COUNTY PUBLIC HEALTH DEPT., HELP OF DOOR COUNTY, DCMC SENIOR LIFE SOLUTIONS, DOOR-TRAN AND DOOR CANCER. IN ADDITION A TOTAL OF 20+ CONTACTS WERE MADE (PHONE/IN PERSON) THROUGH ADRC SERVICES WHICH INCLUDES INFORMATION & ASSISTANT SPECIALISTS AND DISABILITY & ELDERLY BENEFITS SPECIALISTS CONTACTS PLUS FUNCTIONAL SCREEN ASSESSMENTS. (NOTE: THE ARDC NUMBER IS HIGHER THAN REPORTED. ADRC CHANGED THEIR STAT TRACKING SYSTEM AND THEY WERE UNABLE TO BACK TO PULL ALL THE 2024 NUMBERS.) 8)OUTREACH-THIS INCLUDES OUR BLOOD PRESSURE (BP) CLINICS, MONTHLY CAREGIVER SUPPORT GROUPS VIA ADRC, ANNUAL OPEN HOUSE/RESOURCE FAIR,AND WORKSHOPS/CLINICS (FOOT CARE & FLUORIDE CLINICS), MASON DINNERS, WELL STUDY, NICOLET BANK FRAUD/SCAM PRESENTATION, SOUPER BOWL FUNDRAISER AND OUR COFFEE, COOKIES & CONVERSATION PROGRAM. TOTAL NUMBER OF RESIDENTS SERVED THROUGH THESE SERVICES = 841. |
| FORM 990-EZ, PART III, LINE 29 | WICHP LUNCHEON (FORMERLY FACTS OF LIFE LUNCHEON) - THIS PROGRAM MET MONTHLY 8 TIMES(SEPTEMBER TO NOVEMBER AND JANUARY TO MAY) IN 2024 FOR LUNCH WITH A SPEAKER OR ACTIVITY PLANNED FOR EACH EVENT. OUR ATTENDANCE RANGED FROM 21 TO 60 RESIDENTS. WE ALSO HELD 3 INTERGENERATIONAL EVENTS WITH THE END OF THE SCHOOL YEAR PICNIC IN JUNE,THE PACKER PARTY WITH THE SCHOOL STUDENTS AND A HOLIDAY BREAKFAST WITH THESCHOOL. THE ATTENDANCE OF THESE EVENTS RANGED FROM 28-100+ RESIDENTS (ADULTS AND CHILDREN). |
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