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        <PersonNm>Lauren Schadt Baker</PersonNm>
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        <PersonNm>Scott Ransom</PersonNm>
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        <PersonNm>Donella Rapier</PersonNm>
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        <PersonNm>Krishna White</PersonNm>
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        <PersonNm>Jack Markell</PersonNm>
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        <PersonNm>Melanie Bell-Mayeda</PersonNm>
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        <PersonNm>Anita Bekenstein</PersonNm>
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        <ExplanationTxt>Schedule A Part II Lines 1 and 5f are presented using the accrual basis of accounting net of discounts as presented in our audited financial statements.</ExplanationTxt>
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      <Form990ScheduleAPartVIGrp>
        <FormAndLineReferenceDesc>Part II Line 5</FormAndLineReferenceDesc>
        <ExplanationTxt>Schedule A Part II Lines 1 and 5f are presented using the accrual basis of accounting net of discounts as presented in our audited financial statements.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part IV</FormAndLineReferenceDesc>
        <ExplanationTxt>| PartandLinenumber:,Explanation:| Part II-A Line 2,Upstream made its first 501h election in the tax year ending December 31 2020. The election has not been revoked.|</ExplanationTxt>
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    </IRS990ScheduleC>
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      <FootnoteTextInd>X</FootnoteTextInd>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part X, line 2</FormAndLineReferenceDesc>
        <ExplanationTxt>Upstream accounts for uncertainty in income taxes in accordance with ASC Topic Income Taxes. This standard clarifies the accounting for uncertainty in tax positions and prescribes a recognition threshold and measurement attribute for the financial statements regarding a tax position taken or expected to be taken in a tax return. Upstream has determined that there are no uncertain tax positions which qualify for either recognition or disclosure in the financial statements at December 31 2025 and 2024.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part XI, line 4b</FormAndLineReferenceDesc>
        <ExplanationTxt>This reconciling item is the rental expense included in Part VIII line 4b that is associated with the sublease of Upstream office space. Expenses include rent operating expenses and the legal expenses for the sublease</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part XII, line 2d</FormAndLineReferenceDesc>
        <ExplanationTxt>This reconciling item is the rental expense included in Part VIII line 4b that is associated with the sublease of Upstream office space. Expenses include rent operating expenses and the legal expenses for the sublease</ExplanationTxt>
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    </IRS990ScheduleD>
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          <AddressLine2Txt>PO Box 660</AddressLine2Txt>
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          <StateAbbreviationCd>MD</StateAbbreviationCd>
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          <StateAbbreviationCd>TX</StateAbbreviationCd>
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          <AddressLine1Txt>212 E Columbus Ave Ste 1</AddressLine1Txt>
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          <StateAbbreviationCd>OH</StateAbbreviationCd>
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          <StateAbbreviationCd>NY</StateAbbreviationCd>
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          <AddressLine1Txt>1419 Mermaid Avenue</AddressLine1Txt>
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          <StateAbbreviationCd>NY</StateAbbreviationCd>
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          <StateAbbreviationCd>WA</StateAbbreviationCd>
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          <StateAbbreviationCd>MA</StateAbbreviationCd>
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          <StateAbbreviationCd>MA</StateAbbreviationCd>
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          <AddressLine1Txt>PO Box 1490</AddressLine1Txt>
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          <StateAbbreviationCd>NC</StateAbbreviationCd>
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          <StateAbbreviationCd>MA</StateAbbreviationCd>
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          <StateAbbreviationCd>CO</StateAbbreviationCd>
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          <StateAbbreviationCd>MA</StateAbbreviationCd>
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          <StateAbbreviationCd>MA</StateAbbreviationCd>
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          <BusinessNameLine1Txt>North End Community Health Committee Inc dba NEW Health</BusinessNameLine1Txt>
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          <StateAbbreviationCd>MA</StateAbbreviationCd>
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          <StateAbbreviationCd>CO</StateAbbreviationCd>
          <ZIPCd>80487</ZIPCd>
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          <AddressLine1Txt>10767 E Traverse Hwy</AddressLine1Txt>
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          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49684</ZIPCd>
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          <BusinessNameLine1Txt>Oakland Integrated Healthcare Network dba Honor Community Health</BusinessNameLine1Txt>
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          <AddressLine1Txt>PO Box 430150</AddressLine1Txt>
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          <StateAbbreviationCd>MI</StateAbbreviationCd>
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          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>02720</ZIPCd>
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          <BusinessNameLine1Txt>State of Maryland dba Harford County Health Department</BusinessNameLine1Txt>
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          <StateAbbreviationCd>MD</StateAbbreviationCd>
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          <CityNm>Yuma</CityNm>
          <StateAbbreviationCd>AZ</StateAbbreviationCd>
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          <StateAbbreviationCd>NY</StateAbbreviationCd>
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          <StateAbbreviationCd>OH</StateAbbreviationCd>
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          <CityNm>Conowingo</CityNm>
          <StateAbbreviationCd>MD</StateAbbreviationCd>
          <ZIPCd>21918</ZIPCd>
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          <BusinessNameLine1Txt>The William F Ryan Community Health Center dba Ryan Health</BusinessNameLine1Txt>
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          <CityNm>New York</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
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          <CityNm>Hillman</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
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          <BusinessNameLine1Txt>Cornerstone Family Healthcare</BusinessNameLine1Txt>
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          <AddressLine1Txt>2570 Route 9W</AddressLine1Txt>
          <CityNm>Cornwall</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>12518</ZIPCd>
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          <BusinessNameLine1Txt>Housing Works Health Services III Inc</BusinessNameLine1Txt>
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          <AddressLine1Txt>57 Willoughby Street 2nd Fl</AddressLine1Txt>
          <CityNm>Brooklyn</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
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          <AddressLine1Txt>PO Box 590</AddressLine1Txt>
          <CityNm>Union</CityNm>
          <StateAbbreviationCd>WV</StateAbbreviationCd>
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          <CityNm>Columbus</CityNm>
          <StateAbbreviationCd>GA</StateAbbreviationCd>
          <ZIPCd>31903</ZIPCd>
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        <RecipientEIN>581999205</RecipientEIN>
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          <AddressLine1Txt>39 East Avenue</AddressLine1Txt>
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          <StateAbbreviationCd>RI</StateAbbreviationCd>
          <ZIPCd>02860</ZIPCd>
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        <RecipientEIN>510183476</RecipientEIN>
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          <BusinessNameLine1Txt>MQVN Community Development Corp Inc</BusinessNameLine1Txt>
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          <AddressLine1Txt>13085 Chef Menteur Highway</AddressLine1Txt>
          <CityNm>New Orleans</CityNm>
          <StateAbbreviationCd>LA</StateAbbreviationCd>
          <ZIPCd>70129</ZIPCd>
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        <RecipientEIN>204929600</RecipientEIN>
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          <BusinessNameLine1Txt>Berks Community Health Center</BusinessNameLine1Txt>
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          <AddressLine1Txt>838 Penn ST</AddressLine1Txt>
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          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>19602</ZIPCd>
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        <RecipientEIN>273795179</RecipientEIN>
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          <BusinessNameLine1Txt>East Bay Community Action Program</BusinessNameLine1Txt>
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          <AddressLine1Txt>19 Broadway</AddressLine1Txt>
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          <StateAbbreviationCd>RI</StateAbbreviationCd>
          <ZIPCd>02840</ZIPCd>
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        <RecipientEIN>050310024</RecipientEIN>
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          <BusinessNameLine1Txt>Telluride Hospital District dba Telluride Regional Medical Center</BusinessNameLine1Txt>
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          <AddressLine1Txt>500 W Pacific Box 1229</AddressLine1Txt>
          <CityNm>Telluride</CityNm>
          <StateAbbreviationCd>CO</StateAbbreviationCd>
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        <RecipientEIN>840738052</RecipientEIN>
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          <AddressLine1Txt>794 Eastland Dr</AddressLine1Txt>
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          <StateAbbreviationCd>ID</StateAbbreviationCd>
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          <BusinessNameLine1Txt>Henry J Austin Health Center Inc</BusinessNameLine1Txt>
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          <StateAbbreviationCd>NJ</StateAbbreviationCd>
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          <CityNm>Delhi</CityNm>
          <StateAbbreviationCd>LA</StateAbbreviationCd>
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        <PurposeOfGrantTxt>Reproductive Health Program Training</PurposeOfGrantTxt>
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        <RecipientBusinessName>
          <BusinessNameLine1Txt>South Plains Public Health District</BusinessNameLine1Txt>
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          <AddressLine1Txt>919 E Main St</AddressLine1Txt>
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          <StateAbbreviationCd>TX</StateAbbreviationCd>
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        <RecipientBusinessName>
          <BusinessNameLine1Txt>Spectrum Health Services Inc</BusinessNameLine1Txt>
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          <StateAbbreviationCd>PA</StateAbbreviationCd>
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          <BusinessNameLine1Txt>Tyler Family Circle of Care dba Family Circle of Care</BusinessNameLine1Txt>
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          <StateAbbreviationCd>TX</StateAbbreviationCd>
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          <StateAbbreviationCd>IN</StateAbbreviationCd>
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          <AddressLine2Txt>Suite 409</AddressLine2Txt>
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          <StateAbbreviationCd>CA</StateAbbreviationCd>
          <ZIPCd>33435</ZIPCd>
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          <BusinessNameLine1Txt>Arapahoe County Government</BusinessNameLine1Txt>
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          <StateAbbreviationCd>CO</StateAbbreviationCd>
          <ZIPCd>80120</ZIPCd>
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        <RecipientBusinessName>
          <BusinessNameLine1Txt>Healing Hands Ministries Inc dba HHM Health</BusinessNameLine1Txt>
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          <AddressLine2Txt>Suite 300</AddressLine2Txt>
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          <StateAbbreviationCd>TX</StateAbbreviationCd>
          <ZIPCd>75231</ZIPCd>
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          <BusinessNameLine1Txt>Jane Pauley Community Health Center Inc</BusinessNameLine1Txt>
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          <CityNm>Indianapolis</CityNm>
          <StateAbbreviationCd>IN</StateAbbreviationCd>
          <ZIPCd>46229</ZIPCd>
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          <BusinessNameLine1Txt>LifeSpring Inc dba LifeSpring Health Systems</BusinessNameLine1Txt>
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          <CityNm>Jeffersonville</CityNm>
          <StateAbbreviationCd>IN</StateAbbreviationCd>
          <ZIPCd>47130</ZIPCd>
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          <BusinessNameLine1Txt>Public Health Management Corporation</BusinessNameLine1Txt>
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          <AddressLine1Txt>Center Square East</AddressLine1Txt>
          <AddressLine2Txt>1500 Market St LM500</AddressLine2Txt>
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          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>19102</ZIPCd>
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          <BusinessNameLine1Txt>Adams County Colorado dba Adams County Health Department</BusinessNameLine1Txt>
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          <AddressLine1Txt>4430 South Adams County Parkway</AddressLine1Txt>
          <AddressLine2Txt>STE C4000A</AddressLine2Txt>
          <CityNm>Brighton</CityNm>
          <StateAbbreviationCd>CO</StateAbbreviationCd>
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          <BusinessNameLine1Txt>Finger Lakes Migrant Health Care Project Inc dba Finger Lakes Community</BusinessNameLine1Txt>
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          <AddressLine2Txt>14 Maiden Lane</AddressLine2Txt>
          <CityNm>Penn Yan</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>14527</ZIPCd>
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          <BusinessNameLine1Txt>Rockbrige Area Free Clinic dba Rockbridge Area Health Center</BusinessNameLine1Txt>
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          <CityNm>Lexington</CityNm>
          <StateAbbreviationCd>VA</StateAbbreviationCd>
          <ZIPCd>24450</ZIPCd>
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          <BusinessNameLine1Txt>CareArc Inc</BusinessNameLine1Txt>
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          <CityNm>Emporia</CityNm>
          <StateAbbreviationCd>KS</StateAbbreviationCd>
          <ZIPCd>66801</ZIPCd>
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          <BusinessNameLine1Txt>Inner City Health Center</BusinessNameLine1Txt>
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          <StateAbbreviationCd>CO</StateAbbreviationCd>
          <ZIPCd>80205</ZIPCd>
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          <BusinessNameLine1Txt>La Clinica Tepeyac Inc dba Tepeyac Community Health Center</BusinessNameLine1Txt>
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          <AddressLine1Txt>2101 E 48th Avenue</AddressLine1Txt>
          <CityNm>Denver</CityNm>
          <StateAbbreviationCd>CO</StateAbbreviationCd>
          <ZIPCd>80216</ZIPCd>
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          <BusinessNameLine1Txt>Mississippi Delta Family Medicine Residency Foundation Inc</BusinessNameLine1Txt>
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          <StateAbbreviationCd>MS</StateAbbreviationCd>
          <ZIPCd>38701</ZIPCd>
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        <RecipientEIN>333916075</RecipientEIN>
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        <PurposeOfGrantTxt>Reproductive Health Program Training</PurposeOfGrantTxt>
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        <RecipientBusinessName>
          <BusinessNameLine1Txt>Sun Life Family Health Center Inc</BusinessNameLine1Txt>
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          <AddressLine1Txt>865 N Arizola Rd</AddressLine1Txt>
          <CityNm>Casa Grande</CityNm>
          <StateAbbreviationCd>AZ</StateAbbreviationCd>
          <ZIPCd>85122</ZIPCd>
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        <RecipientEIN>860296211</RecipientEIN>
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        <ValuationMethodUsedDesc>Cash</ValuationMethodUsedDesc>
        <NonCashAssistanceDesc>0</NonCashAssistanceDesc>
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      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>United Health Centers</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
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          <CityNm>Winston Salem</CityNm>
          <StateAbbreviationCd>NC</StateAbbreviationCd>
          <ZIPCd>27127</ZIPCd>
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        <RecipientEIN>050589120</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
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        <ValuationMethodUsedDesc>Cash</ValuationMethodUsedDesc>
        <NonCashAssistanceDesc>0</NonCashAssistanceDesc>
        <PurposeOfGrantTxt>Reproductive Health Program Training</PurposeOfGrantTxt>
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      <RecipientTable>
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        </RecipientBusinessName>
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        <RecipientEIN>460341255</RecipientEIN>
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      <RecipientTable>
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      <RecipientTable>
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          <BusinessNameLine1Txt>Rocking Horse Children s Health Center dba Rocking Horse Community Health</BusinessNameLine1Txt>
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          <StateAbbreviationCd>OH</StateAbbreviationCd>
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        <NonCashAssistanceDesc>0</NonCashAssistanceDesc>
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      <RecipientTable>
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          <BusinessNameLine1Txt>Wayne Community Health Centers Inc</BusinessNameLine1Txt>
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          <StateAbbreviationCd>UT</StateAbbreviationCd>
          <ZIPCd>84715</ZIPCd>
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        <RecipientEIN>870342259</RecipientEIN>
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        <CashGrantAmt>6250</CashGrantAmt>
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        <ValuationMethodUsedDesc>Cash</ValuationMethodUsedDesc>
        <NonCashAssistanceDesc>0</NonCashAssistanceDesc>
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      <RecipientTable>
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          <BusinessNameLine1Txt>United Community Health Center Maria Auxiliadora Inc</BusinessNameLine1Txt>
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        <ValuationMethodUsedDesc>Cash</ValuationMethodUsedDesc>
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        <FormAndLineReferenceDesc>Part I Line 2</FormAndLineReferenceDesc>
        <ExplanationTxt>Upstream works in partnership with organizations receiving grants to determine the recipient organizations progress toward the grant agreement goals. Upstream holds regular discussions with grant recipients for a formal update on the project and to review the organizations progress. For grant agreements that include milestones payments are initiated once the milestones are met. These milestones are documented and agreed to in a memorandum of understanding between Upstream and the organization receiving the grant. When a milestone is reached Upstream reviews and verifies supporting documentation before issuing the grant payment.</ExplanationTxt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Sarah Pierson</PersonNm>
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        <PersonNm>Kelleen Kaye</PersonNm>
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        <FormAndLineReferenceDesc>Part I</FormAndLineReferenceDesc>
        <ExplanationTxt>| PartandLinenumber:,Explanation:|Part I Line 7,The Compensation Committee of the Board of Directors, none of whom have a conflict of interest, is charged with overseeing Upstreams management compensation policies and practices including reviewing the CEOs compensation on an annual basis, and notifying the independent members of the Board of Directors with respect to compensation of the CEO. The CEOs 360 performance evaluations as well as comparability data for similarly qualified persons are reviewed by the Committee. In addition, in situations where an employees (other than the CEO) compensation has reached the top of their salary range, additional base salary increases may be limited. In recognition of strong performance and contributions, a merit bonus may be considered as an alternative form of compensation.|</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I Line 4a</FormAndLineReferenceDesc>
        <ExplanationTxt>| Name :, Amount:| Elizabeth Kaltman severance, 29737|</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleM documentId="IRS990ScheduleM1" documentName="IRS990ScheduleM">
      <SecuritiesPubliclyTradedGrp>
        <NonCashCheckboxInd>X</NonCashCheckboxInd>
        <ContributionCnt>5</ContributionCnt>
        <NoncashContributionsRptF990Amt>108232</NoncashContributionsRptF990Amt>
        <MethodOfDeterminingRevenuesTxt>FMV</MethodOfDeterminingRevenuesTxt>
      </SecuritiesPubliclyTradedGrp>
      <Form8283ReceivedCnt>0</Form8283ReceivedCnt>
      <AnyPropertyThatMustBeHeldInd>false</AnyPropertyThatMustBeHeldInd>
      <ReviewProcessUnusualNCGiftsInd>true</ReviewProcessUnusualNCGiftsInd>
      <ThirdPartiesUsedInd>false</ThirdPartiesUsedInd>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I and II</FormAndLineReferenceDesc>
        <ExplanationTxt>| PartandLinenumber:,Explanation:| Part I Line 9,In column b Upstream is reporting the number of stock donations received in 2025.|</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleM>
    <IRS990ScheduleO documentId="IRS990ScheduleO1" documentName="IRS990ScheduleO">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI, Line 6</FormAndLineReferenceDesc>
        <ExplanationTxt>As a non-stock non-profit Delaware corporation Upstream has members but the governing documents state that the members shall consist of those persons serving as directors. Members have no right to vote on any matter other than the election and removal of directors.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI, Line 11a</FormAndLineReferenceDesc>
        <ExplanationTxt>The Form 990 is prepared by the Upstream accounting team and then reviewed closely by AAFCPAs Upstreams tax advisor and Upstreams Treasurer. This draft is then provided to the Audit Committee of the Board for their review and approval. Finally the Form 990 is provided to the Board of Directors prior to filing. All questions and comments are addressed by management.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI, Line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>The Board authorizes and oversees an annual review of the administration of Upstreams conflict of interest policy. The review may be written or oral. The review shall consider the level of compliance with the policy the continuing suitability of the policy and whether the policy should be modified and improved. The process occurs each year during a scheduled meeting of the Upstream Boards Governance and Nominating Committee.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI, Line 15</FormAndLineReferenceDesc>
        <ExplanationTxt>The Compensation Committee of the Board of Directors none of whom have a conflict of interest is charged with overseeing Upstreams management compensation policies and practices including reviewing the compensation of the CEO on an annual basis notifying the independent members of the Board of Directors regarding CEO compensation reviewing the compensation of the Organizations other officers managers and employees who have substantial influence over the affairs of the organization on an annual basis of which the CFO and President and COO is qualified under this category in the Committees most recent review. The Committee meets at least one time per year and additionally as circumstances dictate. Comparability data for similarly qualified persons in functionally comparable positions at similarly situated organizations are prepared by a compensation consultant on a regular basis. This data was last compiled in January 2026 for the CEO President and COO and CFO roles. The CEOs 360 performance evaluations and the comparability data are reviewed by the Committee before it forms and approves changes in compensation for the CEO. The Committee also reviews and approves recommended compensation changes for the President and COO and CFO roles. These deliberations and decisions are documented in the minutes contemporaneously. This recommendation review and vote occur annually and were completed in 2025 and again in early 2026.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI, Line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>Upstreams governing documents conflict of interest policy and financial statements are available to the public upon request.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part XII, Line 2c</FormAndLineReferenceDesc>
        <ExplanationTxt>The process has not changed from the prior year.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>