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
AIDS SERVICE ASSOCIATION OF PINELLAS INC
Employer identification number
59-2862537
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.") ....
1,841,703
754,746
1,827,198
1,796,459
688,567
6,908,673
2
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
0
3
The value of services or facilities furnished by a governmental unit to the organization without charge..
0
4
Total. Add lines 1 through 3..
1,841,703
754,746
1,827,198
1,796,459
688,567
6,908,673
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)..
122,659
6
Public Support. Subtract line 5 from line 4.
6,786,014
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..
1,841,703
754,746
1,827,198
1,796,459
688,567
6,908,673
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
1,494
413
6
0
0
1,913
9
Net income from unrelated business activities, whether or not the business is regularly carried on..
0
10
Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..
506
0
0
0
5,960
6,466
11
Total support (Add lines 7 through 10).
6,917,052
12
Gross receipts from related activities, etc. (See instructions.)
..................
12
210,238
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
98.100 %
15
Public Support Percentage for 2009 Schedule A, Part II, line 14
...............
15
98.580 %
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.") .
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.)
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...
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 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.).
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
16
Public support percentage from 2010 Schedule A, Part III, line 15
...............
16
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2011 (line 10c column (f) divided by line 13 column (f))
......
17
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
OTHER INCOME, SCHEDULE A, PART II, LINE 10, DESCRIPTION - OTHER INCOME, COLUMN A - 506, COLUMN B - 0, COLUMN C - 0, COLUMN D - 0, COLUMN E - 5960, COLUMN F - 6466;,
Schedule A (Form 990 or 990-EZ) 2011
Additional Data
Software ID:
11000230
Software Version:
v2011.1.0
-
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
AIDS SERVICE ASSOCIATION OF PINELLAS INC
Employer identification number
59-2862537
Identifier
Return Reference
Explanation
ORGANIZATION'S MISSION
FORM 990, PART III, LINE 1
(CONTINUED FROM PART III) DURING THE CURRENT FISCAL YEAR, ASAP SERVED OVER 10,300 CLIENTS AND TOUCHED THE LIVES OF OVER 269,000 PEOPLE THROUGH ITS MANY PROGRAMS.
Delegate broad authority to a committee
Form 990, Part VI, Section A, Line 1a
THE BOARD OF DIRECTORS HAS AN EXECUTIVE COMMITTEE, WHICH CONSISTS OF THE CHAIRMAN OF THE BOARD, THE VICE CHAIRMAN OF THE BOARD, THE PRESIDENT/CHIEF EXECUTIVE OFFICER, THE SECRETARY AND THE TREASURER. THE BOARD OF DIRECTORS MAY DESIGNATE FROM ITS MEMBERS UP TO TWO ADDITIONAL DIRECTORS TO SERVE AS MEMBERS OF THE EXECUTIVE COMMITTEE. WHEN THE BOARD OF DIRECTORS IS NOT IN SESSION, THE EXECUTIVE COMMITTEE HAS AND MAY EXERCISE ALL OF THE POWERS OF THE BOARD OF DIRECTORS, EXCEPT TO THE EXTENT, IF ANY, THAT SUCH AUTHORITY SHALL BE LIMITED BY A RESOLUTION ADOPTED BY A MAJORITY OF DIRECTORS IN OFFICE.
MARY LABYAK, BETTY OLDANIE, MICHAEL BELL AND SCOTT KISTLER SERVE ON THE BOARD OF HOSPICE SYSTEMS, INC. A RELATED, FOR-PROFIT COMPANY - BUSINESS RELATIONSHIP
Classes of members or stockholders
Form 990, Part VI, Section A, Line 6
PURSUANT TO THE ORGANIZATION'S GOVERNING DOCUMENTS, THE SOLE VOTING MEMBER OF AIDS SERVICE ASSOCIATION OF PINELLAS, INC (ASAP) SHALL BE SUNCOAST CARING COMMUNITY, INC. (SCCI), A RELATED TAX-EXEMPT ORGANIZATION. AS THE ORGANIZATION'S SOLE CORPORATE MEMBER, SCCI HAS THE RIGHT TO PARTICIPATE IN THE ORGANIZATION'S GOVERNANCE.
Members or stockholders electing members of governing body
Form 990, Part VI, Section A, Line 7a
PURSUANT TO THE ORGANIZATION'S GOVERNING DOCUMENTS, THE SOLE CORPORATE MEMBER, SCCI, HAS THE RIGHT TO ELECT, APPOINT, OR REMOVE ANY BOARD OF DIRECTOR OF ASAP WITHOUT CAUSE AT ANY TIME.
Decisions requiring approval by members or stockholders
Form 990, Part VI, Section A, Line 7b
THE SOLE CORPORATE MEMBER, SCCI, HAS THE RIGHT TO APPROVE OR RATIFY SIGNIFICANT DECISIONS OF THE ORGANIZATION'S GOVERNING BODY. THE BOARD OF DIRECTORS OF ASAP SHALL NOT HAVE THE AUTHORITY TO MAKE SIGNIFICANT DECISIONS WITHOUT THE APPROVAL OF THE SCCI BOARD. SIGNIFICANT DECISIONS INCLUDE BUT ARE NOT LIMITED TO: THE RIGHT TO AMEND, REPEAL OR ALTER THEIR GOVERNING DOCUMENTS; SELL, LEASE OR OTHERWISE DISPOSE OF SUBSTANTIALLY ALL OF THE ORGANIZATION'S ASSETS; AND MERGE OR CONSOLIDATE THE ORGANIZATION WITH ANOTHER ORGANIZATION.
Review of form 990 by governing body
Form 990, Part VI, Section B, Line 11b
THE ORGANIZATION RETAINS THE EXPERTISE OF AN INDEPENDENT TAX ADVISOR TO ASSIST IN THE PREPARATION AND REVIEW OF ITS IRS FORM 990. PRIOR TO FILING THE IRS FORM 990, MANAGEMENT AND THE INDEPENDENT TAX ADVISOR REVIEW THE TAX RETURN AND ALL REQUIRED DISCLOSURES. THE FORM 990 IS THEN REVIEWED BY THE AUDIT COMMITTEE, CONSISTING OF INDEPENDENT DIRECTORS OF THE ORGANIZATION. THE AUDIT COMMITTEE MAKES A RECOMMENDATION TO THE BOARD OF DIRECTORS. THE FORM 990 IS THEN PROVIDED TO THE FULL BOARD OF DIRECTORS FOR THEIR REVIEW PRIOR TO FILING WITH THE IRS.
Conflict of interest policy
Form 990, Part VI, Section B, Line 12c
ALL OFFICERS, DIRECTORS, TRUSTEES, KEY EMPLOYEES AND HIGHEST PAID EMPLOYEES (INTERESTED PERSONS) OF THE ORGANIZATION HAVE A DUTY TO AVOID CONFLICTS OF INTEREST, BOTH REAL AND PERCEIVED, WHICH MAY NEGATIVELY IMPACT THE ORGANIZATION OR THOSE IT SERVES. THE ORGANIZATION'S INTERESTED PERSONS ARE TO BE GUIDED BY THE ORGANIZATION'S MISSION, VISION AND VALUES AND TO SERVE PATIENTS, FAMILIES AND THE GENERAL PUBLIC WITHOUT NEED FOR ANY PERSONAL FAVOR OR GAIN. THE ORGANIZATION'S ETHICS AND COMPLIANCE PLAN EMPHASIZES THE DUTY INTERESTED PERSONS HAVE TO DISCLOSE ANY ACTUAL OR POTENTIAL CONFLICTS OF INTEREST THAT MAY BENEFIT THEIR PRIVATE INTERESTS OR RESULT IN A POSSIBLE EXCESS BENEFIT TRANSACTION. CONFLICTS ARE DISCLOSED ANNUALLY ON A CONFLICT OF INTEREST QUESTIONNAIRE THAT IS DISTRIBUTED TO THE OFFICERS, DIRECTORS, KEY EMPLOYEES, AND HIGHEST COMPENSATED EMPLOYEES. IN THE EVENT OF ANY ACTUAL OR POTENTIAL CONFLICTS OF INTEREST, INTERESTED PERSONS MUST DISCLOSE THE EXISTENCE OF THEIR FINANCIAL INTEREST AND DISCLOSE ALL MATERIAL FACTS TO THE BOARD CHAIR, CEO OR OTHER DESIGNATED PERSONS. IF IT IS DETERMINED AN ACTUAL CONFLICT OF INTEREST EXISTS BETWEEN THE ORGANIZATION AND AN INTERESTED PERSON, THE PARTY WITH A CONFLICT OF INTEREST MUST ABSTAIN FROM ANY DISCUSSION OR VOTING ON THE TRANSACTION OR ARRANGEMENT INVOLVING THE CONFLICT OF INTEREST.
Process used to establish compensation of top management official
Form 990, Part VI, Section B, Line 15a
THE COMPENSATION OF THE EXECUTIVE DIRECTOR OF AIDS SERVICE ASSOCIATION OF PINELLAS, INC. IS DETERMINED BY SUNCOAST CARING COMMUNITY, INC. (SCCI), A RELATED ORGANIZATION. THE COMPENSATION IS REVIEWED AND APPROVED BY THE EXECUTIVE COMMITTEE OF SCCI. THIS REVIEW WILL INCLUDE ANY INFORMATION RECEIVED FROM THE CAREER CENTER WHEN AN EXTERNAL REVIEW HAS BEEN PERFORMED PER THE PROCESS BELOW. EVERY 3-5 YEARS THE CAREER CENTER WILL EMPLOY A WELL-RECOGNIZED, INDEPENDENT COMPENSATION CONSULTANT TO REVIEW THE MARKET RANGES FOR THE OFFICERS OF SCCI AND AFFILIATES. THE REVIEW WILL INCLUDE A NATIONAL COMPARISON OF SIMILAR JOBS AT SIMILARLY SITUATED COMPANIES IN ORDER TO MAKE CERTAIN THAT THESE KEY EMPLOYEES ARE PAID WITHIN A REASONABLE AND APPROPRIATE RANGE. THE RESULTING RECOMMENDATIONS WILL BE REVIEWED AS IS APPROPRIATE TO RECOMMEND ANY MARKET-BASED CHANGES OR POSSIBLY JUST ASSURE OURSELVES OF THE CURRENT CORRECT POSITIONING OF COMPENSATION FOR THESE INDIVIDUALS. THIS PROCESS WAS LAST UNDERTAKEN IN THE YEAR ENDED SEPTEMBER 30, 2012. THE PROCESS AND DECISIONS ARE DOCUMENTED IN THE EXECUTIVE COMMITTEE MINUTES.
PROCESS OF DETERMINING COMPENSATION OF OTHER OFFICERS
FORM 990, PART VI, LINE 15B
BELOW IS THE PROCESS USED BY SUNCOAST CARING COMMUNITY, INC. (SCCI) FOR DETERMINING COMPENSATION OF THE OTHER OFFICERS. THE COMPENSATION OF THE OTHER OFFICERS OF THE FAMILY OF PROGRAMS WILL BE REVIEWED ON AN ANNUAL BASIS BY THE EXECUTIVE COMMITTEE OF SCCI. THIS REVIEW WILL INCLUDE ANY INFORMATION RECEIVED FROM THE CAREER CENTER WHEN AN EXTERNAL REVIEW HAS BEEN PERFORMED PER THE PROCESS BELOW. EVERY 3-5 YEARS THE CAREER CENTER WILL EMPLOY A WELL-RECOGNIZED, INDEPENDENT COMPENSATION CONSULTANT TO REVIEW THE MARKET RANGES FOR THE CEO OF SCCI AND THE OTHER OFFICERS. THE REVIEW WILL INCLUDE A NATIONAL COMPARISON OF SIMILAR JOBS AT SIMILARLY SITUATED COMPANIES IN ORDER TO MAKE CERTAIN THAT THESE KEY EMPLOYEES ARE PAID WITHIN A REASONABLE AND APPROPRIATE RANGE. THE RESULTING RECOMMENDATIONS WILL BE REVIEWED AS IS APPROPRIATE TO RECOMMEND ANY MARKET-BASED CHANGES OR POSSIBLY JUST ASSURE OURSELVES OF THE CURRENT CORRECT POSITIONING OF COMPENSATION FOR THESE INDIVIDUALS. THIS PROCESS WAS LAST UNDERTAKEN IN THE YEAR ENDED SEPTEMBER 30, 2012. THE PROCESS AND DECISIONS ARE DOCUMENTED IN THE EXECUTIVE COMMITTEE MINUTES.
Governing documents, conflict of interest policy and financial statements available to the public
Form 990, Part VI, Section C, Line 19
FINANCIAL STATEMENTS, GOVERNING DOCUMENTS, AND CONFLICT OF INTEREST POLICIES ARE NOT REQUIRED DISCLOSURES PURSUANT TO INTERNAL REVENUE CODE (IRC) SECTION 6104. THESE DOCUMENTS ARE NOT AVAILABLE TO THE PUBLIC AT THIS TIME.
Average number of hours devoted per week to related organization
Form 990, Part VII, Section A, Column B
BETTY OLDANIE:THE HOSPICE OF THE FLORIDA SUNCOAST, INC.- 1.0001.000, SUNCOAST CARING COMMUNITY, INC.- 40.00040.000, PROJECT GRACE, INC.- 1.0001.000, SUNCOAST PACE- 1.0001.000, THE HOSPICE FOUNDATION OF THE FLORIDA SUNCOAST- 1.0001.000, THE HOSPICE INSTITUTE OF THE FLORIDA SUNCOAST, INC.- 1.0001.000, HOSPICE SYSTEMS, INC.- 1.000;MARY LABYAK, MSSW, LCSW:SUNCOAST CARING COMMUNITY, INC.- 40.00040.000, THE HOSPICE OF THE FLORIDA SUNCOAST, INC.- 1.0001.000, PROJECT GRACE, INC.- 1.0001.000, SUNCOAST PACE- 1.0001.000, THE HOSPICE FOUNDATION OF THE FLORIDA SUNCOAST- 1.0001.000, THE HOSPICE INSTITUTE OF THE FLORIDA SUNCOAST, INC.- 1.0001.000, HOSPICE SYSTEMS, INC.- 1.000;MICHAEL BELL:THE HOSPICE FOUNDATION OF THE FLORIDA SUNCOAST- 40.00040.000, HOSPICE SYSTEMS, INC.- 1.000;DR. DAVID BUBY:THE HOSPICE OF THE FLORIDA SUNCOAST, INC.- 1.000;SCOTT KISTLER:SUNCOAST CARING COMMUNITY, INC.- 40.00040.000, HOSPICE SYSTEMS, INC.- 1.000;ANNE HOCHSPRUNG:SUNCOAST CARING COMMUNITY, INC.- 40.00040.000, THE HOSPICE OF THE FLORIDA SUNCOAST, INC.- 1.0001.000, THE HOSPICE INSTITUTE OF THE FLORIDA SUNCOAST, INC.- 1.0001.000, THE HOSPICE FOUNDATION OF THE FLORIDA SUNCOAST- 1.0001.000, SUNCOAST PACE- 1.0001.000, PROJECT GRACE, INC.- 1.0001.000, HOSPICE SYSTEMS, INC.- 1.000;
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.