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.") .. | 6,166,161 | 6,373,154 | 7,874,926 | 6,563,359 | 6,892,571 | 33,870,171 |
| 2 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf .... | 0 | |||||
| 3 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | 0 | |||||
| 4 | Total. Add lines 1 through 3 | 6,166,161 | 6,373,154 | 7,874,926 | 6,563,359 | 6,892,571 | 33,870,171 |
| 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) .. | 0 | |||||
| 6 | Public support. Subtract line 5 from line 4. | 33,870,171 | |||||
Calendar year
(or fiscal year beginning in)
![]() |
(a) 2019 | (b) 2020 | (c) 2021 | (d) 2022 | (e) 2023 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 6,166,161 | 6,373,154 | 7,874,926 | 6,563,359 | 6,892,571 | 33,870,171 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | 23,673 | 13,401 | 12,733 | 16,504 | 14,775 | 81,086 |
| 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.).. | 9,815 | 13,644 | 23,459 | |||
| 11 | Total support. Add lines 7 through 10 | 33,974,716 | |||||
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, PART III, LINE 4D, PROGRAM SERVICE ACCOMPLISHMENTS: | VOLUNTEER SERVICES ACTION WELLNESS HAS ALMOST 400 ACTIVE VOLUNTEERS. OTHER VOLUNTEER PROGRAMS INCLUDE IMMEDIATE SEATING VOLUNTEERS, DINING OUT FOR LIFE AMBASSADOR VOLUNTEERS, STUDENT SOCIAL WORK INTERN VOLUNTEERS, PRISON LINKAGE, FOOD DELIVERY AND OFFICE VOLUNTEERS. IMMEDIATE SEATING IS A VOLUNTEER RUN PROGRAM THAT PROVIDES COMPLIMENTARY TICKETS FOR CULTURAL AND SPORTING EVENTS TO CLIENTS. THIS PROGRAM IS MADE POSSIBLE BY THE GENEROSITY OF LOCAL CULTURAL AND SPORTING EVENTS TO CLIENTS AND LOCAL CULTURAL ORGANIZATIONS WHICH PROVIDE THOUSANDS OF FREE TICKETS EACH YEAR TO AREA EVENTS FOR PEOPLE LIVING WITH HIV AND OTHER CHRONIC ILLNESSES. POSITIVE ACTION EMPLOYMENT PROGRAM POSITIVE ACTION IS A COMPREHENSIVE CONSUMER-INVOLVED PROGRAM THAT ADDRESSES THE EMPLOYMENT NEEDS OF PEOPLE LIVING WITH HIV/AIDS. SPECIAL INITIATIVES AND ADVOCACY Consumer Feedback meetings are attended by over 100 people each quarter to provide clients with updates on medical care and available services and receive feedback. It serves as a forum to exchange ideas to improve Action Wellness' services and advocacy. There are emergency needs funds supported by foundation grants and individual donations. Action Wellness is the fiscal agent for the funds donated to the emergency needs, and funds are distributed to clients who are eligible for assistance. HEALTH CENTER ACTION WELLNESS PROVIDES A PRIMARY CARE CLINIC, ANNEX WEST HEALTH CENTER, IN COLLABORATION WITH FAMILY PRACTICE AND COUNSELING NETWORK ("FPCN"). FPCN NURSE PRACTITIONERS WORK WITH ACTION WELLNESS MEDICAL CASE MANAGERS TO PROVIDE COMPREHENSIVE SERVICES. REPRESENTATIVE PAYEE RROGRAM- ACTION WELLNESS IS CARRYING OUT THE REP PAYEE PROGRAM IN PARTNERSHIP WITH THE UNIVERSITY OF PITTSBURGH AS PART OF A DEMONSTRATION PROJECT FUNDED BY THE NATIONAL INSTITUTES OF HEALTH. THE 5-YEAR STRUCTURAL INTERVENTION ENTITILED "IMPACT OF REPRESENTATIVE PAYEE SERVICES ON ART ADHERENCE AMONG MARGINALIZED PEOPLE LIVING WITH HIV/AIDS", WILL ENABLE MORE THAN 150 VULNERABLE ACTION WELLNESS CLIENTS WHO ARE LIVING WITH HIV TO RECEIVE SUPPORTIVE FINANCIAL EDUCATION AND MANAGEMENT SERVICES AIMED AT ALLEVIATING HOUSING AND FINANCIAL INSTABILITY AS BARRIERS TO CARE. |
| FORM 990, PART VI, SECTION B, LINE 11B: | GOVERNING BODY REVIEW OF FORM 990 AN ELECTRONIC COPY OF THE FORM 990 AS ULTIMATELY FILED IS SENT VIA EMAIL TO THE BOARD OF DIRECTORS PRIOR TO BEING FILED. |
| FORM 990, PART VI, SECTION B, LINE 12C: | ENFORCEMENT OF CONFLICT OF INTEREST POLICY THE CONFLICT OF INTEREST POLICIES ARE CONTAINED IN THE BYLAWS AND IN THE EMPLOYEE HANDBOOK. BOARD MEMBERS AND MANAGEMENT ARE REQUIRED TO DISCLOSE ANY POTENTIAL CONFLICT OF INTEREST THAT MAY ARISE IN THE COURSE OF THEIR RESPONSIBILITIES AS MEMBERS OF THE BOARD AND ARE REQUIRED TO ABSTAIN FROM VOTING IN SUCH SITUATIONS. |
| FORM 990, PART VI, SECTION B, LINE 15: | PROCESS FOR DETERMINING COMPENSATION THE PRESIDENT OF THE BOARD OF DIRECTORS AND THE CHAIR OF THE HUMANRE SOURCES COMMITTEE ARE RESPONSIBLE FOR AN ANNUAL EVALUATION OF THE PERFORMANCE OF THE EXECUTIVE DIRECTOR. THE EVALUATION INCLUDES A REVIEW OF COMPENSATION LEVELS OF OTHER EXECUTIVE DIRECTORS AT SIMILAR ORGANIZATIONS ACROSS THE REGION AND NATIONALLY THROUGH GUIDESTAR. ONCE COMPLETED THE EVALUATION IS REVIEWED BY THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS AND IS THEN GIVEN TO THE EXECUTIVE DIRECTOR AND DISCUSSED. THE EXECUTIVE DIRECTOR IS RESPONSIBLE FOR THE EVALUATION OF ALL STAFF DIRECTORS. ALL SALARY SCALES ARE REVIEWED AND APPROVED BY THE HUMAN RESOURCE COMMITTEE AND THE BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION C, LINE 19: | PUBLIC AVAILABILITY OF OTHER DOCUMENTS COPIES OF ACTION WELLNESS' GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICIES, FINANCIAL STATEMENTS AND FORM 990 WILL BE PROVIDED ON REQUEST. THEY ARE ALSO AVAILABLE FOR INSPECTION AT ITS OFFICE. |
| FORM 990, PART III, LINE 4A, PROGRAM SERVICE ACCOMPLISHMENTS: | CASE MANAGEMENT PROGRAM CASE MANAGERS ARE PROFESSIONALS WITH DEGREES AND EXPERTISE IN SOCIAL WORK, NURSING, MENTAL HEALTH, DRUG AND ALCOHOL ADDICTION, THE PRISON SYSTEM, FAMILY AND PRENATAL SERVICES, ADOLESCENTS, TRANSGENDER COMMUNITIES AND THE DEAF AND HARD OF HEARING COMMUNITY. CASE MANAGERS OFFER CONFIDENTIAL INDIVIDUALIZED CARE COORDINATION AND ADVOCACY TO HIV INFECTED AND OTHER CHRONICALLY ILL INDIVIDUALS AND THEIR FAMILIES REQUIRING HELP WITH HOUSING,SUBSTANCE ABUSE AND MENTAL HEALTH ISSUES. THEY INSURE THAT CLIENTS AND THEIR FAMILIES RECEIVE THE HIGHEST LEVEL OF CARE AND BENEFITS AVAILABLE THROUGH APPROPRIATE COORDINATION WITH SOCIAL SERVICE, MEDICAL ENTITLEMENT AND OTHER RELATED SYSTEMS. ACTION WELLNESS' HOME HOUSING SPECIALISTS PROVIDE PRACTICAL AND EMOTIONAL SUPPORT TO HIV INFECTED FAMILIES. CASE MANAGERS ESTABLISH CONSISTENT AND ONGOING RELATIONSHIPS WITH FAMILIES AND PROVIDE THESE SERVICES IN CLIENTS' HOMES AND THE NEIGHBORHOODS IN WHICH THEY LIVE. CARE OUTREACH WORKERS PROVIDE ASSISTANCE TO REENGAGE CLIENTS WHO ARE LOST TO CARE. THE BUDDY PROGRAM IS AN INTEGRAL PART OF OUR CASE MANAGEMENT SERVICES. ALL CLIENTS WHO ARE ASSIGNED TO A VOLUNTEER BUDDY ARE REQUIRED TO BE RECEIVING CASE MANAGEMENT SERVICES. IT IS MADE UP OF OVER 200 MEN AND WOMEN WHO PROVIDE EMOTIONAL SUPPORT, COMPANIONSHIP AND PRACTICAL ASSISTANCE TO PEOPLE WITH AIDS, HIV DISEASE AND OTHER CHRONIC ILLNESSES. ALSO, THE 340B PHARMACY PROGRAM HAS BECOME AN INCREASINGLY IMPORTANT PART OF THE CASE MANAGEMENT PROGRAM. |
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