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.") .. | 530,075 | 381,929 | 626,649 | 860,357 | 963,803 | 3,362,813 |
| 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 | 530,075 | 381,929 | 626,649 | 860,357 | 963,803 | 3,362,813 |
| 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) .. | 132,504 | |||||
| 6 | Public support. Subtract line 5 from line 4. | 3,230,309 | |||||
Calendar year
(or fiscal year beginning in)
![]() |
(a) 2019 | (b) 2020 | (c) 2021 | (d) 2022 | (e) 2023 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 530,075 | 381,929 | 626,649 | 860,357 | 963,803 | 3,362,813 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | 1,931 | 483 | 263 | 981 | 4,347 | 8,005 |
| 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.).. | -225 | 632 | 3,559 | 3,966 | ||
| 11 | Total support. Add lines 7 through 10 | 3,374,784 | |||||
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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| PART II, LINE 10 | 3,966 |
| Software ID: | |
| Software Version: |
| Return Reference | Explanation |
|---|---|
| FORM 990, PAGE 2, PART III, LINE 4B | HEALTH CAREERS EXPLORATION: CLASSROOM PRESENTATIONS AND LEARNING MODULES - INCLUDES DIDACTIC, HANDS-ON ACTIVITIES AND HEALTH PROFESSIONAL GUEST PRESENTATIONS TO HIGHLIGHT DIFFERENT HEALTH CAREER SECTORS (E.G. BEHAVIORAL HEALTH, CLINICAL AND PRIMARY CARE, PUBLIC HEALTH). CAREER AND TECHNICAL EDUCATION CENTERS AND HIGH SCHOOL CAREER EXPLORATORY PROGRAMS ARE TARGETED FOR OUTREACH. MEDQUEST AND ADVANCED MEDQUEST - SOUTHERN VERMONT AHEC'S SIGNATURE SUMMER PATHWAY PROGRAMS INVOLVE INTENSIVE, MULTI-DAY OPPORTUNITIES FOR HIGH SCHOOL STUDENTS WHERE THE STUDENTS HAVE THE OPTION TO EARN AN INDUSTRY-RECOGNIZED CREDENTIAL. MEDQUEST IS AN ON-SITE, 3-DAY, NON-RESIDENTIAL PROGRAM FOR HIGH SCHOOL STUDENTS TO EXPLORE A VARIETY OF HEALTH CAREERS IN A RICH LEARNING ENVIRONMENT WITH ENGAGING CLINICAL CONTENT AND GROUP DISCUSSIONS, SKILL- BUILDING ACTIVITIES, JOB SHADOWING, MENTORING, CAREER PLANNING AND REFLECTION, AND DIALOGUE WITH HEALTH PROFESSIONALS. FIRST-YEAR MEDICAL STUDENTS (AHEC SCHOLARS) SERVE AS MENTORS FOR THE PROGRAM. LEARNING OUTCOMES INVOLVE SKILLS AND KNOWLEDGE IN THE AREAS OF TEAMWORK, PATIENT CARE, HEALTH CAREERS EXPLORATION, SELF-REFLECTION, AND HEALTH EQUITY AND INCLUSION. ADVANCED MEDQUEST IS A 5-DAY NON-RESIDENTIAL ADVANCED PROGRAM FOR MEDQUEST ALUMNI THAT DELIVERS MORE IN-DEPTH CONTENT AND EXPLORATION OPPORTUNITIES, LONGER JOB SHADOWS, MORE PERSONALIZED MENTORING, AND A FULL DAY OF ACTIVITIES, INCLUDING SIMULATION LABS AND CAREER SUPPORT SERVICES, AT A LOCAL UNIVERSITY. HEALTH EDUCATION RESOURCES & OPPORTUNITIES (HERO) - CONSISTS OF AN AFTERSCHOOL PARTNERSHIP WITH AN ALTERNATIVE EDUCATION PROGRAM FOR HIGH SCHOOL STUDENTS WITH BARRIERS TO LEARNING AND EMPLOYMENT WHO ARE UNDERSERVED IN A TRADITIONAL SCHOOL SETTING. STUDENTS AND HEALTH PROFESSIONAL MENTORS MEET IN-PERSON AND COMPLETE A HEALTH CAREER EXPLORATION CURRICULUM TOGETHER AFTER SCHOOL DURING THE ACADEMIC YEAR. HERO INVOLVES EXPLORING PERSONAL INTERESTS, MATCHING INTERESTS TO A HEALTH CAREER PATHWAY, AND INCREASING GENERAL HEALTH SCIENCE VOCABULARY AND KNOWLEDGE. STUDENTS HAVE THE OPTION TO EARN A CPR/STOP THE BLEED CERTIFICATION, TOUR THE LOCAL HOSPITAL, MEET WITH HOSPITAL HUMAN RESOURCES ABOUT CAREER OPPORTUNITIES AND GUIDANCE, AND DESIGN A RESUME. |
| FORM 990, PAGE 2, PART III, LINE 4C | HEALTH CAREERS PREPARATION: COLLEGE STUDENT HEALTH INTERNSHIP PROGRAM (CSHIP) - INCLUDES PART-TIME, WORK-BASED LEARNING EXPERIENCE FOR 10 - 15 STUDENTS ENROLLED IN A POST- SECONDARY PROGRAM IN A HEALTH SCIENCE MAJOR OR CONCENTRATION. INTERNSHIPS ARE 50 OR 100 HOURS AND MAY BE PERFORMED ON-SITE OR REMOTELY, DEPENDING ON THE PROJECT OR SITE REQUIREMENTS OF OUR PARTNER ORGANIZATIONS, AND CAN BE FOCUSED ON HEALTH IMPROVEMENT PROJECTS IN AREAS SUCH AS MEDICINE, MENTAL OR BEHAVIORAL HEALTH, PREVENTION, AND COMMUNITY AND PUBLIC HEALTH. INTERNS ACQUIRE AT LEAST TWO OF THE CAREER COMPETENCIES LISTED BY THE NATIONAL ASSOCIATION OF COLLEGES AND EMPLOYEES (NACE) AND ADDRESS AT LEAST ONE OF THE AHEC SCHOLARS FOCUS AREAS. COLLEGE-READINESS PROGRAMMING - CONSISTS OF A SUMMER PROGRAM IN PARTNERSHIP WITH A LOCAL UNIVERSITY, TO PROVIDE HEALTH CAREER EXPLORATION AND SUPPORT ACTIVITIES TO UPWARD BOUND STUDENTS (FIRST GENERATION COLLEGE AND/OR LOW- INCOME HIGH SCHOOL STUDENTS). SKILL-BUILDING WORKSHOPS FOR COLLEGE STUDENTS - INCLUDES A PARTNERSHIP WITH A LOCAL UNIVERSITY TO OFFER CLINICAL AND MEDICAL SKILLS WORKSHOPS TO THEIR UNDERGRADUATE STUDENTS. WORKSHOPS DESIGNED FOR STUDENTS INTERESTED IN HEALTH PROFESSIONS REQUIRING GRADUATE STUDY (INCLUDING PHYSICIANS, PHYSICIANS ASSISTANTS, PHYSICAL THERAPY, ETC.) AND WANT TO GAIN NEW SKILLS. PROGRAMMING IS A COLLABORATION WITH ACADEMIC DEPARTMENTS, PRE-MEDICINE STUDENT CLUBS, MEDICAL RESERVE CORPS VOLUNTEERS, AND A U.S. ARMY MEDICAL RECRUITER. |
| FORM 990, PAGE 2, PART III, LINE 4D | PRACTITIONER SUPPORT: PROFESSIONAL SUPPORT AND DEVELOPMENT - SUPPORTS THE CONTINUING EDUCATION AND PROFESSIONAL DEVELOPMENT FOR HEALTH PROFESSIONALS IN VERMONT BY PROVIDING TRAINING AND EDUCATIONAL RESOURCES AND OTHER SUPPORT. FOR RECRUITMENT, SOUTHERN VERMONT AHEC IDENTIFIES WORKFORCE SHORTAGES THROUGH AN ANNUAL PRIMARY CARE SURVEY AND BY COLLABORATING WITH THE UNIVERSITY OF VERMONT OFFICE OF PRIMARY CARE IN TARGETED WORKFORCE RECRUITMENT IN SOUTHERN VERMONT. ADDITIONALLY, THE ORGANIZATION ADMINISTERS THE VERMONT EDUCATION LOAN REPAYMENT PROGRAM FOR PRIMARY CARE PROVIDERS TO ENSURE A STABLE SUPPLY OF PRIMARY CARE PROVIDERS. COLLEGE OF MEDICINE STUDENT SUPPORT - ENGAGES STUDENTS IN FAMILY MEDICINE CLINICAL ROTATIONS IN SOUTHERN VERMONT AND IN SPECIAL SUMMER EDUCATION AND MENTORING OR RESEARCH AND QUALITY INITIATIVE PROJECTS TO EXPLORE THE OPPORTUNITIES AND CHALLENGES OF DELIVERING QUALITY HEALTHCARE IN RURAL VERMONT. ALSO, PROVIDES HOUSING SUPPORT FOR MEDICAL RESIDENTS AND FELLOWS COMPLETING TRAINING IN SOUTHERN VERMONT. |
| FORM 990, PAGE 6, PART VI, LINE 11B | THE FORM 990 IS PRESENTED TO THE BOARD, EITHER IN PERSON OR BY EMAIL, BEFORE FILING AND A VOTE TO APPROVE IS CONDUCTED AT THE NEXT SCHEDULED BOARD MEETING. |
| FORM 990, PAGE 6, PART VI, LINE 12C | SERVICE ON THE EDUCATIONAL LOAN REPAYMENT PROGRAM REQUIRES COMMITTEE MEMBERS TO PROVIDE DISCLOSURE ON CONFLICT OF INTEREST/CONFIDENTIALITY FORMS. |
| FORM 990, PAGE 6, PART VI, LINE 15A | UPON HIRE, THE EXECUTIVE DIRECTOR'S COMPENSATION IS DETERMINED BY THE BOARD OF DIRECTORS BASED ON PRIOR SALARY RANGE AND CANDIDATE EXPERIENCE. RAISES FOR THE EXECUTIVE DIRECTOR ARE INCLUDED IN THE ANNUAL BUDGET THAT IS PRESENTED TO THE FULL BOARD AND VOTED ON IN JUNE. |
| FORM 990, PAGE 6, PART VI, LINE 19 | UPON REQUEST |
| Software ID: | |
| Software Version: |