HEALTH NET OF WEST MICHIGAN: Form 990, tax year 2018
View the entire original 990 at ProPublica ↗
- Organization
- HEALTH NET OF WEST MICHIGAN (EIN 38-3609504)
- Tax period
- 2018-10-01 to 2019-09-30
- Filed
- 2020-07-23
- IRS object ID
- 202042059349300904
- Schema version
- 2018v3.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2020-07-23T06:43:28-07:00 | ReturnTs |
| Tax Period End | 2019-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | VREDEVELD HAEFNER LLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4001 GRANADA CT NW | AddressLine1Txt |
| City | GRAND RAPIDS | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49534 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2018-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 383609504 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Health Net of West Michigan | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | HEAL | BusinessNameControlTxt |
| Phone | 6167268204 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 620 Century Ave SW Suite 210 | AddressLine1Txt |
| City | Grand Rapids | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49503 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Maureen Kirkwood | PersonNm |
| Person Title | Executive Director | PersonTitleTxt |
| Phone | 6167268204 | PhoneNum |
| Signature | 2020-07-10 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Peter Haefner CPA | PreparerPersonNm |
| PTIN | P01420387 | PTIN |
| Phone | 6164609388 | PhoneNum |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 154.27.55.67 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2020-07-23 | IPDt |
| IP Tm | 06:43:21 | IPTm |
| IP Timezone | PD | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 11FFE0C74E3FC08D6D8A8A42EACDCD40980DBA19 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | DFFEF886FBCDB3ACF7C5485D4A435F56B0303AD8 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2018 | TaxYr |
| Build TS | 2020-09-23 17:36:50Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Maureen Kirkwood | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 620 Century Ave SW Suite 210 | AddressLine1Txt |
| City | Grand Rapids | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49503 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $2,485,307 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.healthnetwm.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2001 | FormationYr |
| Legal Domicile State | MI | LegalDomicileStateCd |
| Activity Or Mission | To improve the health of children and adults, particularly vulnerable populations, through education and connections to health care and support services. | ActivityOrMissionDesc |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 12 | VotingMembersIndependentCnt |
| Total Employee | 40 | TotalEmployeeCnt |
| Total Volunteers | 93 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,482,242 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,984,961 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $826,744 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $485,539 | CYProgramServiceRevenueAmt |
| PY Investment Income | $22,767 | PYInvestmentIncomeAmt |
| CY Investment Income | $9,807 | CYInvestmentIncomeAmt |
| PY Other Revenue | $15,041 | PYOtherRevenueAmt |
| CY Other Revenue | $5,000 | CYOtherRevenueAmt |
| PY Total Revenue | $2,346,794 | PYTotalRevenueAmt |
| CY Total Revenue | $2,485,307 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $230,475 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $275,326 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $1,494,915 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $1,788,304 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $13,706 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $615,870 | PYOtherExpensesAmt |
| CY Other Expenses | $589,901 | CYOtherExpensesAmt |
| PY Total Expenses | $2,341,260 | PYTotalExpensesAmt |
| CY Total Expenses | $2,653,531 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $5,534 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$168,224 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $1,890,021 | TotalAssetsBOYAmt |
| Total Assets EOY | $823,596 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $137,872 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $184,773 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $1,752,149 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $638,823 | NetAssetsOrFundBalancesEOYAmt |
| Mission | To improve the health of children and adults, particularly vulnerable populations, through education and connections to health care and support services. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $1,414,339 | ExpenseAmt |
| Grant | $244,231 | GrantAmt |
| Revenue | $0 | RevenueAmt |
| Desc | CHAP - CHAP program assists adults and children to maintain their health and understand how to navigate the healthcare system, thus reducing costs and improving health outcomes. The program provides educational resources, case management for chronic illnesses, and addresses social determinants of health. 5,408 clients were served this year. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $741,522 | ExpenseAmt |
| Grant | $31,095 | GrantAmt |
| Revenue | $0 | RevenueAmt |
| Desc | Other programs - Through its other programs, the Organization works to address the social determinants of health activities include assesting clients in navigating the healthcare system, working to reduce pediatric obesity and improving access to affordable dental care. 355 clients were served this year. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $2,155,861 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | false | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | Yes (true) | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | false | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | false | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 14 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 40 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Form8899 Filedind | false | Form8899Filedind |
| Form1098 C Filed | false | Form1098CFiledInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 12 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Kristi Kam | PersonNm |
| Phone | 6167268204 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 620 Century Ave SW Suite 210 | AddressLine1Txt |
| City | Grand Rapids | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49503 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (14 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|
| Kenneth Fawcett | ||||||
| Chair | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| Shannon Wilson | ||||||
| Vice Chair | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| Margo Schlewitz | ||||||
| Secretary | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| Christopher Slater | ||||||
| Treasurer | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| David Smith | ||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | |
| Larry Robson | ||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | |
| Carl VerBeek | ||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | |
| Nirali Bora | ||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | |
| Richard Clanton | ||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | |
| Dede Esque | ||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | |
| Kathy Howard | ||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | |
| Julie Tatko | ||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | |
| Maureen Kirkwood | ||||||
| Executive Director | 40.00 | Yes (X) | $93,653 | $0 | $11,458 | |
| Kristi Kam | ||||||
| Director of Finance and Compliance | 40.00 | Yes (X) | $53,059 | $0 | $0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $146,712 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $11,458 | TotalOtherCompensationAmt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | false | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
| Government Grants | $1,519,347 | GovernmentGrantsAmt |
| All Other Contributions | $465,614 | AllOtherContributionsAmt |
| Total Contributions | $1,984,961 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Program revenue | Desc |
| Business | 813219 | BusinessCd |
| Total Revenue Column | $485,539 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $485,539 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $9,807 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $9,807 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Miscellaneous | Desc |
| Business | 813219 | BusinessCd |
| Total Revenue Column | $5,000 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $5,000 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $5,000 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,485,307 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $490,539 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $9,807 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $275,326 | TotalAmt |
| Program Services | $275,326 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $158,170 | TotalAmt |
| Program Services | $127,017 | ProgramServicesAmt |
| Management And General | $30,062 | ManagementAndGeneralAmt |
| Fundraising | $1,091 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,330,128 | TotalAmt |
| Program Services | $1,068,149 | ProgramServicesAmt |
| Management And General | $252,803 | ManagementAndGeneralAmt |
| Fundraising | $9,176 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $194,206 | TotalAmt |
| Program Services | $145,986 | ProgramServicesAmt |
| Management And General | $46,521 | ManagementAndGeneralAmt |
| Fundraising | $1,699 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $105,800 | TotalAmt |
| Program Services | $84,825 | ProgramServicesAmt |
| Management And General | $20,247 | ManagementAndGeneralAmt |
| Fundraising | $728 | FundraisingAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $83,584 | TotalAmt |
| Program Services | $46,382 | ProgramServicesAmt |
| Management And General | $37,195 | ManagementAndGeneralAmt |
| Fundraising | $7 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,566 | TotalAmt |
| Program Services | $12,414 | ProgramServicesAmt |
| Management And General | $3,112 | ManagementAndGeneralAmt |
| Fundraising | $40 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $126,088 | TotalAmt |
| Program Services | $113,225 | ProgramServicesAmt |
| Management And General | $12,622 | ManagementAndGeneralAmt |
| Fundraising | $241 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $166,002 | TotalAmt |
| Program Services | $138,945 | ProgramServicesAmt |
| Management And General | $26,390 | ManagementAndGeneralAmt |
| Fundraising | $667 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,950 | TotalAmt |
| Program Services | $13,550 | ProgramServicesAmt |
| Management And General | $1,400 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,797 | TotalAmt |
| Program Services | $9,460 | ProgramServicesAmt |
| Management And General | $4,337 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $29,721 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $29,721 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,746 | TotalAmt |
| Program Services | $9,031 | ProgramServicesAmt |
| Management And General | $1,677 | ManagementAndGeneralAmt |
| Fundraising | $38 | FundraisingAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| Printing, publication and promotion | $63,255 | $59,676 | $3,579 | $0 |
| Client expenses | $39,864 | $39,864 | $0 | $0 |
| Minor equipment purchases and rentals | $15,474 | $9,202 | $6,253 | $19 |
| Miscellaneous | $10,854 | $2,809 | $8,045 | $0 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,653,531 | TotalAmt |
| Program Services | $2,155,861 | ProgramServicesAmt |
| Management And General | $483,964 | ManagementAndGeneralAmt |
| Fundraising | $13,706 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $68,002 | BOYAmt |
| EOY | $23,737 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $249,663 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,333,573 | BOYAmt |
| EOY | $68,620 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,850 | BOYAmt |
| EOY | $33,921 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $306,845 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $286,222 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $50,342 | BOYAmt |
| EOY | $20,623 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $417,254 | BOYAmt |
| EOY | $427,032 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,890,021 | BOYAmt |
| EOY | $823,596 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $137,872 | BOYAmt |
| EOY | $183,273 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $1,500 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $137,872 | BOYAmt |
| EOY | $184,773 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $657,145 | BOYAmt |
| EOY | $564,594 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,095,004 | BOYAmt |
| EOY | $74,229 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,752,149 | BOYAmt |
| EOY | $638,823 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,890,021 | BOYAmt |
| EOY | $823,596 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$168,224 | ReconcilationRevenueExpnssAmt |
| Prior Period Adjustments | -$945,102 | PriorPeriodAdjustmentsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
| Other Support Sum | $0 | OtherSupportSumAmt |
| Public Support CY170 | 0 | PublicSupportCY170Pct |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,342,336 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,021,263 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,343,032 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,482,242 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,984,961 | CurrentTaxYearAmt |
| Total | $7,173,834 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,949,509 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,527,305 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,218,907 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $841,785 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $490,539 | CurrentTaxYearAmt |
| Total | $6,028,045 | TotalAmt |
Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Tax Rev Levied Orgnztnl Bnft509 TaxRevLeviedOrgnztnlBnft509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $3,291,845 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,548,568 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,561,939 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,324,027 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,475,500 | CurrentTaxYearAmt |
| Total | $13,201,879 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $13,201,879 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $47,293 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $29,611 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $29,672 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $15,102 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $9,807 | CurrentTaxYearAmt |
| Total | $131,485 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $47,293 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $29,611 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $29,672 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $15,102 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $9,807 | CurrentTaxYearAmt |
| Total | $131,485 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,333,364 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99010 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99200 | PublicSupportPY509Pct |
| Investment Income CY | 0.00990 | InvestmentIncomeCYPct |
| Investment Income PY | 0.01000 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $0 | InvestmentCostOrOtherBasisAmt |
| Book Value | $0 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $67,966 | OtherCostOrOtherBasisAmt |
| Depreciation | $67,966 | DepreciationAmt |
| Book Value | $0 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $238,879 | OtherCostOrOtherBasisAmt |
| Depreciation | $218,256 | DepreciationAmt |
| Book Value | $20,623 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $20,623 | TotalBookValueLandBuildingsAmt |
| Total Rev Etc Audited Fincl Stmt | $2,485,307 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Subtotal | $2,485,307 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $2,485,307 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $2,653,531 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $2,653,531 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $2,653,531 | TotalExpensesPerForm990Amt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | false | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (6 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|
| Arbor Circle Corporation | |||||||
| 1115 Ball Ave NE | Grand Rapids | MI | 49505 | 383263853 | 501c3 | $22,653 | Service agreement |
| Family Outreach Center Inc | |||||||
| 1939 South Division | Grand Rapids | MI | 49507 | 382272711 | 501c3 | $25,410 | Service agreement |
| Healthy Homes Coalition of West MI | |||||||
| 1545 Buchanan Ave SW Suite 2 | Grand Rapids | MI | 49507 | 205326650 | 501c3 | $5,906 | Service agreement |
| Cherry Health | |||||||
| 100 Cherry St SE | Grand Rapids | MI | 49503 | 382853534 | 501c3 | $99,616 | Service agreement |
| Kent County Health Dept | |||||||
| 700 Fuller NE | Grand Rapids | MI | 49503 | 386004862 | 501c3 | $18,000 | Service agreement |
| Catholic Charities West Michigan | |||||||
| 360 S Division Suite 3A | Grand Rapids | MI | 49503 | 383012473 | 501c3 | $5,705 | Service agreement |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Pt I Line 2 | The Organization has a review with each agency and reviews their reported spending upon the services supported in the grant. In each case the agency's spending on the services is significantly higher than the amount of the grant. |
| Other | Part II, Column H - Purpose of grant or assistance service agreement - Provided working capital for Organization to pursue its tax exempt mission. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Pt VI, Line 11b | The Finance Committee is responsible for reviewing and giving initial approval of the Form 990. The Finance Committee is also responsible for presenting the Form 990 to the Board of Directors for final approval. |
| Pt VI, Line 12c | Conflicts of interest are monitored by a review of all financial transactions by top management. Board members are required to recuse themselves from voting on matters that relate to contracts between Health Net and their employer. Annual conflict of interest disclosures are required of all board members and each employee is required to disclose any possible conflict of interest. |
| Pt VI, Line 15a | c |
| Pt VI, Line 15b | d |
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