Attach to Form 990 or Form 990-EZ.
See separate instructions.
Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
| (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 monetary support | |||
|---|---|---|---|---|---|---|---|---|---|
| Yes | No | Yes | No | Yes | No | ||||
| Total | |||||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2009 | (b) 2010 | (c) 2011 | (d) 2012 | (e) 2013 | (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. | ||||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2009 | (b) 2010 | (c) 2011 | (d) 2012 | (e) 2013 | (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. Do not include gain or loss from the sale of capital assets (Explain in Part IV.).. | ||||||
| 11 | Total support (Add lines 7 through 10). | ||||||






Calendar year (or fiscal year beginning in) ![]() |
(a) 2009 | (b) 2010 | (c) 2011 | (d) 2012 | (e) 2013 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | 619,177 | 684,272 | 622,808 | 45,275 | 419,542 | 2,391,074 |
| 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...... | 314,716 | 424,388 | 657,180 | 147,085 | 480,307 | 2,023,676 |
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513.. | 0 | |||||
| 4 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... | 0 | |||||
| 5 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | 0 | |||||
| 6 | Total. Add lines 1 through 5. | 933,893 | 1,108,660 | 1,279,988 | 192,360 | 899,849 | 4,414,750 |
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons... | 0 | |||||
| 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. | 0 | |||||
| c | Add lines 7a and 7b.. | ||||||
| 8 | Public support (Subtract line 7c from line 6.) | 4,414,750 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2009 | (b) 2010 | (c) 2011 | (d) 2012 | (e) 2013 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 933,893 | 1,108,660 | 1,279,988 | 192,360 | 899,849 | 4,414,750 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 1 | 2 | 2 | 3 | 8 | |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | 0 | |||||
| c | Add lines 10a and 10b. | 1 | 2 | 2 | 3 | 8 | |
| 11 | Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on. | 0 | |||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.) .. | 12,650 | 17,250 | 13,250 | 4,800 | 9,504 | 57,454 |
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 946,544 | 1,125,912 | 1,293,240 | 197,160 | 909,356 | 4,472,212 |




| Facts And Circumstances Test |
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| Explanation |
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| Software ID: | 13000170 |
| Software Version: | 2013v4.0 |
Attach to Form 990 or 990-EZ.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at| Return Reference | Explanation |
|---|---|
| Form 990, Part VI, Line 6: Explanation of Classes of Members or Shareholder | Gateway Healthcare, Inc. (Gateway) is the sole corporate member of AP. Lifespan Corporation is the sole corporate member of Gateway. |
| Form 990, Part VI, Line 7a: How Members or Shareholders Elect Governing Body | The bylaws of AP confer certain reserved powers on Gateway to provide it with the means of effective oversight, coordination, and support of the system. Powers reserved to Gateway include: to elect and remove trustees and to approve the election of and removal of certain officers. At each annual meeting of AP's Board of Trustees, a list is compiled of the names of those persons selected to serve as Trustees of AP so that it can be approved and submitted to Gateway for ratification and election. The Gateway Board is comprised on those persons serving as the directors of Lifespan Corporation. |
| Form 990, Part VI, Line 7b: Describe Decisions of Governing Body Approval by Members or Shareholders | Lifespan has the responsibility for planning, directing, and establishing policies to assure the development and delivery of quality health services on an integrated cost-effective basis. Powers reserved to Lifespan in addition to those noted above, include: to approve amendment of the Articles of Incorporation and Bylaws and other charter documents; strategic plans; to approve investment policies and any capital or operating budgets or material non-budgeted expenditures; and to authorize incurrence or guaranty of material indebtedness. Lifespan holds these powers with respect to Gateway; Gateway holds identical powers with respect to AP, which it may exercise with the authorization of Lifespan. |
| Form 990, Part VI, Line 11b: Form 990 Review Process | The preparation and filing of the Form 990 and supporting schedules is the responsibility of the Chief Financial Officer (CFO) and Finance Department of Gateway Healthcare, Inc. and Affiliates (Gateway). The Form 990 is prepared by the Gateway Finance Department staff upon completion of the annual independent financial statement audit. A draft of the Form 990 is then provided to the Lifespan Corporation Tax Compliance Manager for further review. Once the draft Form 990 is complete, the Gateway Director of Finance forwards it along with all supporting worksheets to KPMG, which then reviews the completed form in detail. The Lifespan Tax Compliance Manager and Gateway Director of Finance then answer questions as they arise and provide information as needed. KPMG provides the Lifespan Tax Compliance Manager with any recommended changes which are reviewed, and if agreed upon, are incorporated into the return.The draft Form 990 is then provided to the CFO for final management review. At this point, a copy of the Form 990 is provided to the Board prior to a scheduled Board of Directors meeting which occurs prior to filing Form 990 with the Internal Revenue Service. At this meeting, the CFO of Gateway reviews the form and discusses the highlights with the Board, as well as answers any questions or addresses any concerns. The Form 990 is then finalized to include any changes, if necessary, based on comments from the Board, and the Gateway CFO is then authorized to file the Form 990. |
| Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts | Lifespan Corporation has a Conflict of Interest Policy that is applicable to all affiliates, including AP, and administered by Lifespan's Corporate Compliance Department as follows: Each designated person subject to Lifespan's conflict of interest policy is required to provide Lifespan with an initial disclosure statement and thereafter an annual statement attesting that: (i) the designated person has read and is familiar with this policy, and (ii) the designated person and, to the best of his/her knowledge, family members, have not in the past engaged in, are not presently engaging in, or plan to engage in, any activity which contravenes this policy.If, at any time during the course of employment or association, a designated person has reason to believe that an existing or contemplated activity may contravene this policy, the person shall submit a full written description of the activity to the Lifespan Compliance Officer or the Office of the General Counsel to seek a determination as to whether the contemplated activity does or does not contravene this policy. This requirement shall be acknowledged as part of the annual performance evaluation process. If the activity in question involves either the Chief Executive Officer, the Senior Vice President and General Counsel, or a Trustee, a full written disclosure must be made to, and a determination sought from, the Chairman of the Board of Directors of Lifespan Corporation.Annually, the Lifespan Compliance Officer shall review and report to the Lifespan Executive Corporate Compliance Committee and to the Lifespan Audit and Compliance Committee on the administration of this policy.Failure on the part of any designated person to comply with this policy, including failure to submit in a timely fashion the conflict of interest disclosure statement, will be grounds for removal from his/her position and/or termination of his/her employment with Lifespan. |
| Form 990, Part VI, Line 15a: Compensation Review & Approval Process - CEO, Top Management | The compensation of CCCC's President/Executive Director and CEO is determined by the Gateway Board of Directors and is reviewed annually following the performance review process. The Executive Committee of the Board, who are independent of management and free of any conflicts of interest that would interfere with their exercise of independent judgment, serves as a compensation committee and approves the compensation decisions in advance of payment. The Committee reviews the current salary and compares it to available compensation data from local non-profit and regional behavioral health providers. The Committee adequately documents the basis for its determination concurrently upon making the compensation decision. |
| Form 990, Part VI, Line 19: Other Organization Documents Publicly Available | Lifespan and its affiliates organizations, including AP, whose activity is included in Gateway Healthcare, Inc. and Related Entities' audited consolidated financial statements, currently make their annual and quarterly consolidated financial statements available to the public via DAC (Digital Assurance Certification LLC), a disclosure dissemination agent for issues of tax-exempt bonds which electronically posts and transmits Lifespan's financial information to repositories and investors alike. In addition, copies of AP's governing documents, conflict of interest policies, financial statements, and Form 990 are available upon request. The organization will either provide copies to those who come to Gateway's administrative offices during normal business hours or provide copies upon request via U.S. mail. |
| Form 990, Part III, Line 4a: | Through these consultation services, during the fiscal year ended September 30, 2014, AP was able to reach over 2,000 students, professionals, and community members and provided parental support to more than 400 individuals through meetings and phone calls. AP also provided approximately 170 hours of consultation services during the fiscal year ended September 30, 2014. |
| Form 990, Part III, Line 4b: | Approximately 529 individuals participated in these groups during the fiscal year ended September 30, 2014. AP also operates an annual summer camp which hosted 115 campers during the summer of 2014. The goal of this camp is to provide a safe, supported, and fun experience for children, teens, and young adults with an Autism Spectrum Disorder. The camp is designed to provide campers with a chance for real life experiences and strives to enhance developmental skills such as language comprehension and prediction, offering sensory-based activities that increase a camper's ability to take advantage of language and communication opportunities, providing structure of daily living routines which are incorporated through camp activities, and supplying content that supports play skills, social skills, and participation in group activities. Each camper attends one week of camp which lasts approximately 27.5 hours. |
| Form 990, Part IV, Line 12a | AP changed its fiscal year from June 30 to September 30 effective July 1, 2013. As a result, AP obtained audited financial statements as of and for the fifteen month period ended September 30, 2014. |
| Form 990, Part VI, Lines 15a&b: | During calendar year 2013, the compensation of AP's President/Executive Director was determined by Gateway. The Human Resources Department used market/comparability data to support their recommendation to Gateway's President who had final approval authority. Compensation was reviewed annually following a performance evaluation process.The following applies to Lifespan and all of its affiliates, including AP as of January 1, 2014:EXECUTIVE COMPENSATIONLifespan's executive compensation philosophy balances appropriate stewardship of resources and the need to be competitive in recruiting and retaining talented individuals. It incorporates market-competitive and performance-related principles, and covers the President and CEO of Lifespan as well as other officers, senior management, and key employees. Lifespan's executive compensation program complies both with law and with contemporary ethical norms, and is administered consistent with the organization's tax-exempt status under Section 501(c)(3) of the Internal Revenue Code (IRC) and the avoidance of transactions subject to intermediate sanctions under Section 4958 of the IRC. Executive compensation is also administered consistent with Lifespan's Corporate Compliance Policy on Excess Benefit Transactions.The Compensation Committee of the Lifespan Corporation Board of Directors (the Committee), comprised of disinterested Lifespan and affiliate Board members, is responsible for diligent oversight of executive compensation to ensure compliance with IRC requirements. Its duties include:* Approving eligibility for participation in the executive compensation program * Approving changes in compensation for existing executive participants * Approving guidelines, such as salary ranges and contract terms, on appropriate levels of compensation for other key employees* Approving new, and modifying or terminating existing, executive compensation plans including, but not limited to, annual incentive and executive benefit plans* Approving performance objectives associated with Lifespan's annual incentive plan, including measuring points, and using audited actual performance relative to these objectives as a precondition to approving the payment of any awards under the plan* Authorizing periodic performance benchmark studies to be conducted for purposes of assessing Lifespan's performance within the healthcare industry and the degree to which total remuneration levels at Lifespan are generally commensurate with Lifespan performance relative to healthcare industry performance* Conducting an annual performance review of Lifespan's Chief Executive Officer. The Chair of the Committee conducts and documents this review, based on his/her observations and interpretation of feedback from members of the Board of Directors* Selecting and engaging qualified, independent, third-party compensation valuation consultants that the Committee charges with rendering opinions with respect to the reasonableness and comparability of compensation as well as the comparative organizations against which compensation is assessed, in accordance with relevant sections of the IRC and Lifespan's executive compensation philosophy. The independent consultants are not engaged by management to perform any services for Lifespan without prior approval by the Committee.Lifespan's Chief Executive Officer works closely with the Committee to make recommendations on the above topics and keep the Committee informed about contemplated compensation changes for executives and other key employees, as well as candidates for these roles. The CEO also provides periodic updates to the Committee regarding Lifespan's performance relative to compensation-related performance objectives. The Committee's deliberations and actions are documented in minutes prepared for each meeting.PROCESS FOR DETERMINING COMPENSATION Valuation of Total Cash and Total Remuneration: No less frequently than annually, the Committee receives and reviews a total cash compensation valuation of all existing executive compensation program participants prepared by its independent compensation consultant. Annually, the Committee also receives and reviews a total remuneration valuation of all existing executive compensation participants.Base Salary Actions: The CEO recommends any salary adjustments for participants in the executive compensation program, using the results of the valuation study and his/her assessment of individual performance or other pertinent information, for the Committee's consideration.New Participants in Executive Compensation Program: With respect to compensation offers for individuals expected to participate in the executive compensation program, the Office of the President works with the Committee's independent compensation consultant or relies on information previously provided by the consultant to establish a range of reasonable cash compensation within which recruitment is expected to conclude with acceptance of a reasonable compensation offer. |
| Form 990, Part XII, Line 2: | While AP did produce a separate audited financial statement as of and for the year ended September 30, 2014, it's activity was also included in the Gateway Healthcare, Inc. and Related Entities' audited consolidated financial statements, in which one column is used for AP individually. The Gateway Healthcare, Inc. and Related Entities' audited consolidated financial statements are included in the Lifespan audited consolidated financial statements. There are no regulatory or creditor stipulations which require the preparation of a separate audited financial statement for AP.The Lifespan Audit and Compliance Committee assumes responsibility for oversight of the audit of Lifespan Corporation's consolidated financial statements and the selection of Lifespan Corporation's independent accountant. |
| Software ID: | 13000170 |
| Software Version: | 2013v4.0 |