Department of the Treasury Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
Attach to Form 990 or Form 990-EZ. See separate instructions.
OMB No. 1545-0047
2011
Open to Public Inspection
Name of the organization
NATIONAL ASSOCIATION OF HEALTH DATA ORGANIZATIONS
Employer identification number
52-1563768
Part I
Reason for Public Charity Status
(All organizations must complete this part.) See instructions
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).
f
If the organization received a written determination from the IRS that it is a Type I, Type II or Type III supporting organization, check this box
..................................................
g
Since August 17, 2006, has the organization accepted any gift or contribution from any of the following persons?
(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the the supported organization?
................
11g(i)
(ii)
a family member of a person described in (i) above?
......................
11g(ii)
(iii)
a 35% controlled entity of a person described in (i) or (ii) above?
................
11g(iii)
h
Provide the following information about the supported organization(s).
(i) Name of supported organization
(ii) EIN
(iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions))
(iv) Is the organization in col. (i) listed in your governing document?
(v) Did you notify the organization in col. (i) of your support?
(vi) Is the organization in col. (i) organized in the U.S.?
(vii) Amount of support?
Yes
No
Yes
No
Yes
No
Total
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2011
Schedule A (Form 990 or 990-EZ) 2011
Page 2
Part II
Support Schedule for Organizations Described in IRC 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi) (Complete only if you checked the box on line 5, 7, or 8 of Part I or if the
organization failed to qualify under Part III. If the organization fails to
qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year(or fiscal year beginning in)
(a) 2007
(b) 2008
(c) 2009
(d) 2010
(e) 2011
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
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..
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)..
6
Public Support. Subtract line 5 from line 4.
Section B. Total Support
Calendar year(or fiscal year beginning in)
(a) 2007
(b) 2008
(c) 2009
(d) 2010
(e) 2011
(f) Total
7
Amounts from line 4..
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
9
Net income from unrelated business activities, whether or not the business is regularly carried on..
10
Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..
11
Total support (Add lines 7 through 10).
12
Gross receipts from related activities, etc. (See instructions.)
..................
12
13
First Five Years
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here..........................................
Section C. Computation of Public Support Percentage
14
Public Support Percentage for 2010 (line 6 column (f) divided by line 11 column (f))
.........
14
15
Public Support Percentage for 2009 Schedule A, Part II, line 14
...............
15
16a
33 1/3% support test—2011.
If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization
......................
b
33 1/3% support test—2010.
If the organization did not check the box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization
.....................
17a
10%-facts-and-circumstances test—2011.
If the organization did not check a box on line 13, 16a, or 16b and line 14
is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported
organization
..................................................
b
10%-facts-and-circumstances test—2010.
If the organization did not check a box on line 13, 16a, 16b, or 17a and line
15 is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported organization
..............................................
18
Private Foundation
If the organization did not check a box on line 13, 16a, 16b, 17a or 17b, check this box and see
instructions
...................................................
Schedule A (Form 990 or 990-EZ) 2011
Schedule A (Form 990 or 990-EZ) 2011
Page 3
Part III
Support Schedule for Organizations Described in IRC 509(a)(2) (Complete only if you checked the box on line 9 of Part I or if the organization
failed to qualify under Part II. If the organization fails to qualify under
the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year(or fiscal year beginning in)
(a) 2007
(b) 2008
(c) 2009
(d) 2010
(e) 2011
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
641,252
446,183
439,687
583,086
363,556
2,473,764
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......
277,992
190,398
215,912
220,800
905,102
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.
641,252
724,175
630,085
798,998
584,356
3,378,866
7a
Amounts included on lines 1, 2, and 3 received from disqualified persons...
50,003
67,786
84,903
234,946
142,262
579,900
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..
50,003
67,786
84,903
234,946
142,262
579,900
8
Public Support (Subtract line 7c from line 6.)
2,798,966
Section B. Total Support
Calendar year (or fiscal year beginning in)
(a) 2007
(b) 2008
(c) 2009
(d) 2010
(e) 2011
(f) Total
9
Amounts from line 6...
641,252
724,175
630,085
798,998
584,356
3,378,866
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
5,159
1,509
675
436
318
8,097
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c
Add lines 10a and 10b.
5,159
1,509
675
436
318
8,097
11
Net income from unrelated business activities not included in 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 IV.)
13
Total support (Add lines 9, 10c, 11 and 12.).
646,411
725,684
630,760
799,434
584,674
3,386,963
14
First Five Years
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here.............................................
Section C. Computation of Public Support Percentage
15
Public Support Percentage for 2011 (line 8 column (f) divided by line 13 column (f))
.........
15
82.640 %
16
Public support percentage from 2010 Schedule A, Part III, line 15
...............
16
79.460 %
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2011 (line 10c column (f) divided by line 13 column (f))
......
17
0 %
18
Investment income percentage from 2010 Schedule A, Part III, line 17
.............
18
19a
33 1/3% support tests—2011.
If the organization did not check the box on line 14, and line 15 is more than 33 1/3% and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
..........
b
33 1/3% support tests—2010.
If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
....
20
Private Foundation
If the organization did not check a box on line 14, 19a or 19b, check this box and see instructions
.....
Schedule A (Form 990 or 990-EZ) 2011
Schedule A (Form 990 or 990-EZ) 2011
Page 4
Part IV
Supplemental Information.
Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
Explanation
Schedule A (Form 990 or 990-EZ) 2011
Additional Data
Software ID:
Software Version:
-
TIN:
SCHEDULE O (Form 990 or 990-EZ)
Department of the Treasury Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ
Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2011
Open to Public Inspection
Name of the organization
NATIONAL ASSOCIATION OF HEALTH DATA ORGANIZATIONS
Employer identification number
52-1563768
Identifier
Return Reference
Explanation
ORGANIZATION'S MISSION
FORM 990 - ORGANIZATION'S MISSION
NAHDO WORKS TO STRENGTHEN STATE HEALTH DATA AGENCIES BY: 1. DEVELOPING CLOSE WORKING RELATIONSHIPS WITH PUBLIC AND PRIVATE STATE HEALTH AGENCIES IN ORDER TO BE IN A POSITION WHEN OPPORTUNITY ARISES TO HELP THEM INCREASE CAPACITY. 2. WORKING WITH PRIVATE AND FEDERAL PARTNERS TO NURTURE AND STRENGTHEN STATE HEALTH DATA AGENCY INFRASTRUCTURE. 3. BRINGING GROUPS TOGETHER TO LEARN FROM EACH OTHER AND/OR TO WORK TOGETHER. 4. SPONSORING AND SUPPORTING WORK TO INCREASE THE CONSISTENCY AND PREDICTABILITY OF STATEWIDE HEALTH DATA. 5. PROMOTING STANDARDIZATION IN DATA ELEMENTS AND METHODS OF COLLECTING, ANALYZING, AND DISSEMINATION DATA. 6. IDENTIFYING THE GAPS IN PUBLICLY AVAILABLE DATA AND PROMOTING THE CLOSURE OF THESE GAPS. ADVOCATING FOR THE STATE HEALTH DATA AGENCY AND NATIONAL HEALTH POLICY DEVELOPMENT.
FIRST ACCOMPLISHMENT DESCRIPTION
FORM 990, PAGE 2, PART III, LINE 4A
IMPLEMENTATION, HOSPITAL DISCHARGE DATA IMPROVEMENTS, AND STAKEHOLDER SUPPORT. APCD CONVENING AGENCY FOR HEALTHCARE RESEARCH AND QUALITY, SMALL CONFERENCE GRANT, 2011: EXPANDING AND ENHANCING ALL PAYER CLAIMS DATA BASE SYSTEM CAPACITY IN STATES AGENCY FOR HEALTHCARE RESEARCH AND QUALITY, SMALL CONFERENCE GRANT, 2012: LAYING THE GROUNDWORK FOR CONSUMER REPORTING ON COST AND QUALITY: PUTTING APCD SYSTEMS TO WORK DHHS MULTI-PAYER CLAIMS DATABASE (MCDB) NAHDO IS A SUBCONTRACTOR TO OPTUM HEALTH FOR THE DHHS MULTIPAYER CLAIMS DATABASE INITIATIVE PROGRAMS STATE TECHNICAL ASSISTANCE AND SUPPORT O LOUISIANA DEPARTMENT OF HEALTH AND HOSPITALS CONTRACTED WITH NAHDO TO ALIGN HOSPITAL DISCHARGE DATA REPORTING WITH NATIONAL STANDARDS O CONSULTING SERVICES FOR IMPLEMENTATION OF UTAH'S HOUSE BILL 9 PROVISIONS RELATED TO ALL-PAYER CLAIMS DATABASE ANALYTICS NAHDO-CDC ENVIRONMENTAL PUBLIC HEALTH TRACKING NETWORK NAHDO FACILITATES THE ACCESS TO AND USE OF HOSPITAL DISCHARGE AND CLAIMS DATABASES FOR CREATING STANDARDIZED HEALTH INDICATORS MEASURING MORBIDITY AND HEALTH OUTCOMES RELATED TO ENVIRONMENTAL EXPOSURES. TWO INITIATIVES INCLUDED IN THIS PROJECT ARE: ---CROSS-BORDER EXCHANGE OF HOSPITAL DISCHARGE DATABASES FOR SURVEILLANCE ---ALL PAYER CLAIMS DATABASE INDICATORS FOR CHRONIC DISEASE SURVEILLANCE MEDICAID AND PUBLIC HEALTH DATA PARTNERSHIPS A THREE-STATE STUDY OF MODEL DATA PARTNERSHIPS BETWEEN STATE MEDICAID AGENCIES AND PUBLIC HEALTH---FUNDED BY THE GLOBAL TASK FORCE FOR PUBLIC HEALTH CDC AND CANCER SURVEILLANCE HARMONIZING KEY DATA ELEMENTS BETWEEN CANCER REGISTRIES AND DISCHARGE DATA BASES TO REDUCE PROVIDER REPORTING BURDEN AND ENHANCE/FACILITATE LINKAGE STANDARDS DEVELOPMENT ALL-PAYER CLAIMS DATABASES (APCD) CORE STANDARDS AS A PART OF THE APCD COUNCIL, NAHDO WITH FUNDING FROM A TASK ORDER FROM AHRQ, ESTABLISHED A TECHNICAL ADVISORY PANEL (TAP) INCLUDING MEMBERS FROM ORGANIZATIONS LIKE AHIP, AHRQ, NCSL, NAIC, NGA, UNITEDHEALTH, WELLPOINT, KAISER PERMANENTE, AND AETNA. ALSO, DURING JANUARY, THE APCD STANDARDS EFFORT WAS ANNOUNCED AT THE ASC X12 STANDING MEETING; IN RESPONSE, IT WAS DISCOVERED THAT MEDICAID AND MEDICARE MAY HAVE SIMILAR REPORTING NEEDS. X12N POST ADJUDICATED CLAIMS DATA REPORTING GUIDE (PACDR) NAHDO AND THE APCD COUNCIL ARE ACTIVELY PARTICIPATING IN THIS FORUM TO DEVELOP A UNIFORM MEDICAL CLAIMS PAYER REPORTING STANDARD. CONTINUED REPRESENTATION ON NATIONAL UNIFORM BILLING AND NATIONAL UNIFORM CLAIMS COMMITTEES (NUBC/NUCC) NATIONAL ADVOCACY FOR APCDS PROPOSED RULE FOR PATIENT PROTECTION AND AFFORDABLE CARE ACT; STANDARDS RELATED TO REINSURANCE, RISK CORRIDORS AND RISK ADJUSTMENT (CMS-9975-P) TO CMS ON WEDNESDAY, SEPTEMBER 28, 2011. NAHDO AND THE APCD COUNCIL WORKED WITH THE CENTERS FOR MEDICARE AND MEDICAID SERVICES AND STATES TO PROMOTE ACCESS TO MEDICARE DATA FOR STATE APCDS. BUILDING VALUE: KNOWLEDGE TRANSFER HIGHLIGHTS NAHDO IS KNOWN FOR ITS HIGH-QUALITY MEETINGS AND WORKSHOPS. NAHDO'S GRANTS AND PROJECTS ARE DESIGNED TO PROMOTE AND STRENGTHEN HEALTH CARE DATA USE ACROSS THE SYSTEM. NAHDO'S 26TH ANNUAL MEETING: ANALYTICS, ACCOUNTABILITY, AND ACTION ALEXANDRIA, VIRGINIA OCTOBER 2011 170 ATTENDEES FROM STATE, FEDERAL, AND PRIVATE SECTOR AGENCIES. FIFTH NATIONAL ALL PAYER CLAIMS DATABASES CONFERENCE ALEXANDRIA, VIRGINIA 106 ATTENDEES MEMBERSHIP WEBINARS: O DECEMBER 7TH 2011: SOURCE OF PAYMENT TYPOLOGY: A NEW NATIONAL STANDARD O DECEMBER 13TH, 2011: A PATHWAY TO SUCCESS: DATA INTEGRATION O DECEMBER 16TH, 2011: ENHANCEMENT OF CANCER REGISTRY DATABASES WITH TWO KEY HOSPITAL DISCHARGE DATA ELEMENTS: POA AND DISCHARGE STATUS O MARCH 12, 2012: NAHDO WEBINAR TO PRESENT GUIDANCE DOCUMENT ON CREATING AND RELEASING HOSPITAL AND FACILITY DISCHARGE DATA PUBLIC USE FILES O JULY 12, 2012 COLLECTION AND USE OF RACE AND ETHNICITY DATA FOR DISCHARGE DATA REPORTING SYSTEMS O SEPTEMBER 6 2012, PREPARING FOR ICD -10 - STATE DATA AGENCY DISCUSSION GUIDANCE DOCUMENT ON CREATING AND RELEASING HOSPITAL AND FACILITY DISCHARGE DATA PUBLIC USE FILES AVAILABLE TO NAHDO MEMBERS AT: HTTPS://WWW.NAHDO.ORG/PUBLICATIONS APCD COST STUDY THIS REPORT PRESENTS A SUMMARY OF THE COSTS TO STATES ASSOCIATED WITH THE DEVELOPMENT OF APCDS. AVAILABLE TO NAHDO MEMBERS AT: HTTPS://WWW.NAHDO.ORG/PUBLICATIONS
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990
FORM 990, PAGE 6, PART VI, LINE 11B
A COPY OF THE 990 IS PROVIDED TO ALL BOARD MEMBERS, TO ACCOUNTING MANAGEMENT, AND TO THE EXECUTIVE DIRECTOR. THESE INDIVIDUALS REVIEW THE FORM. QUESTIONS AND CONCERNS ARE ADDRESSED AND CORRECTIONS ARE MADE, AS NEEDED.
ENFORCEMENT OF CONFLICTS POLICY
FORM 990, PAGE 6, PART VI, LINE 12C
THE ORGANIZATION HAS A WRITTEN CONFLICT OF INTEREST POLICY. A COPY OF THIS CONFLICT OF INTEREST STATEMENT SHALL BE FURNISHED TO EACH DIRECTOR OR OFFICER WHO IS PRESENTLY SERVING THE CORPORATION, OR WHO MAY HEREAFTER BECOME ASSOCIATED WITH THE CORPORATION. THIS POLICY SHALL BE REVIEWED ANNUALLY FOR THE INFORMATION AND GUIDANCE OF DIRECTORS AND OFFICERS, AND ANY NEW OFFICERS AND DIRECTORS SHALL BE ADVISED OF THE POLICY UPON UNDERTAKING THE DUTIES OF THEIR OFFICES. ALL POTENTIAL CONFLICTS OF INTEREST AND ALL SPEAKING ARRANGEMENTS (FOR THE ANNUAL MEETING) MUST BE SUBMITTED IN WRITING TO THE EXECUTIVE DIRECTOR. THE EXECUTIVE DIRECTOR IS RESPONSIBLE FOR REVIEWING THESE TO DETERMINE WHETHER A CONFLICT ACTUALLY EXISTS. WHEN THERE IS DOUBT AS TO WHETHER ANY CONFLICT OF INTEREST EXISTS, THE MATTER SHALL BE RESOLVED BY A VOTE OF THE BOARD OF DIRECOTRS, EXCLUDING THE PERSON WHO IS THE SUBJECT OF THE POSSIBLE CONFLICT OF INTEREST. IF ANY SUCH CONFLICT OF INTEREST ARISES WITH REGARD TO A MATTER REQUIRING ACTION BY THE BOARD OF DIRECTORS, THE INTERESTED PERSON SHALL CALL IT TO THE ATTENTION OF THE BOARD OF DIRECTORS AND SUCH PERSON SHALL NOT VOTE ON THE MATTER. THE MINUTES OF THE MEETING OF THE BOARD SHALL REFLECT THAT THE CONFLICT WAS DISCLOSED AND THAT THE INTERESTED PERSON WAS NOT PRESENT DURING THE FINAL DISCUSSION OR VOTE AND DID NOT VOTE ON THE MATTER.
COMPENSATION PROCESS FOR TOP OFFICIAL
FORM 990, PAGE 6, PART VI, LINE 15A
COMPENSATION FOR THE EXECUTIVE DIRECTOR IS DETERMINED BY THE BOARD OF DIRECTORS. MARKET COMPARABILITY DATA FOR SIMILAR POSITIONS AT SIMILAR NONPROFITS IS REVIEWED DURING THIS PROCESS TO DETERMINE A REASONABLE LEVEL OF COMPENSATION. COMPENSATION FOR THE EXECUTIVE DIRECTOR IS APPROVED ANNUALLY BY THE BOARD OF DIRECTORS DURING THE BUDGETING PROCESS AT THE BEGINNING OF EACH FISCAL YEAR.
GOVERNING DOCUMENTS DISCLOSURE EXPLANATION
FORM 990, PAGE 6, PART VI, LINE 19
THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST STATEMENT, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST AT THE ORGANIZATION'S OFFICES DURING NORMAL BUSINESS HOURS.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.