Attach to Form 990 or Form 990-EZ.
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 listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
| Total | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (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) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (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 VI.).. | ||||||
| 11 | Total support Add lines 7 through 10. | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | 14,798,550 | 12,375,599 | 9,365,554 | 8,225,126 | 8,231,714 | 52,996,543 |
| 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...... | 88,081 | 36,701 | 37,933 | 28,547 | 25,555 | 216,817 |
| 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. | 14,886,631 | 12,412,300 | 9,403,487 | 8,253,673 | 8,257,269 | 53,213,360 |
| 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.. | 0 | |||||
| 8 | Public support (Subtract line 7c from line 6.) | 53,213,360 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 14,886,631 | 12,412,300 | 9,403,487 | 8,253,673 | 8,257,269 | 53,213,360 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 2,527 | 1,726 | 1,030 | 1,056 | 4,264 | 10,603 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | 2,527 | 1,726 | 1,030 | 1,056 | 4,264 | 10,603 |
| 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 VI.) .. | 1,893 | 6,287 | 2,578 | 1,075 | 1,515 | 13,348 |
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 14,891,051 | 12,420,313 | 9,407,095 | 8,255,804 | 8,263,048 | 53,237,311 |
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e | Discount claimed for blockage or other factors (explain in detail in Part VI): | |||||
| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). | 4 | ||||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | ||||
| 6 | Multiply line 5 by .035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| 7 | Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions) | |||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | ||
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
||
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | ||
| 4 Amounts paid to acquire exempt-use assets | ||
| 5 Qualified set-aside amounts (prior IRS approval required) | ||
| 6 Other distributions (describe in Part VI). See instructions | ||
| 7Total annual distributions. Add lines 1 through 6. | ||
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
||
| 9 Distributable amount for 2014 from Section C, line 6 | ||
| 10 Line 8 amount divided by Line 9 amount | ||
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2014 |
(iii) Distributable Amount for 2014 |
|
|---|---|---|---|---|
|
1
Distributable amount for 2014 from Section C, line 6 |
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|
2
Underdistributions, if any, for years prior to 2014 (reasonable cause required--see instructions) |
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| 3 Excess distributions carryover, if any, to 2014: | ||||
| a From 2009.......X | ||||
| b From 2010.......X | ||||
| c From 2011.......X | ||||
| d From 2012.......X | ||||
| e From 2013....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2014 distributable amount | ||||
|
i
Carryover from 2009 not applied (see instructions) |
||||
| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | ||||
| 4Distributions for 2014 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2014 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from 4. | ||||
|
5
Remaining underdistributions for years prior to 2014, if any. Subtract lines 3g and 4a from line 2 (if amount greater than zero, see instructions) |
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|
6
Remaining underdistributions for 2014. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions) |
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|
7 Excess distributions carryover to 2015. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a From 2010.......X | ||||
| b From 2011.......X | ||||
| c From 2012.......X | ||||
| d From 2013....... | ||||
| e From 2014....... | ||||
| Facts And Circumstances Test |
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| Return Reference | Explanation |
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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, SECTION A, LINE 6 | THERE ARE ACTIVE MEMBERS AND ASSOCIATE MEMBERS WITH THE FOLLOWING QUALIFICATIONS AND RIGHTS: ACTIVE MEMBERS SHALL BE THE OFFICIALLY DESIGNATED DIRECTORS OF THE SPECIALIZED PUBLIC MENTAL HEALTH PROGRAMS FOR THE STATES, TERRITORIES, AND THE DISTRICT OF COLUMBIA. ACTIVE MEMBERS VOTE TO ELECT MEMBERS AND OFFICERS OF THE NASMHPD BOARD OF DIRECTORS. ASSOCIATE MEMBERS SHALL BE PUBLIC MENTAL HEALTH AGENCY EXECUTIVES, CENTRAL OFFICE AND/OR FACILITY STAFF DESIGNATED OR APPOINTED BY THE ACTIVE MEMBERS TO PARTICIPATE IN THE ASSOCIATION IN SPECIFIC AREAS IDENTIFIED BY THE BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION A, LINE 7A | ACTIVE MEMBERS VOTE TO ELECT MEMBERS AND OFFICERS OF THE NASMHPD BOARD OF DIRECTORS. EACH ASSOCIATE MEMBER MAY SERVE ON COMMITTEES, BUT MAY NOT HOLD OFFICE AND SHALL NOT HAVE THE RIGHT TO VOTE UNLESS A SIGNED PROXY BY THE ACTIVE MEMBER IS SUBMITTED PRIOR TO THE ACTUAL VOTE TAKING PLACE. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE ACTIVE MEMBER SHALL BE THE DESIGNATED "POLICY-MAKING MEMBER" FOR DEVELOPMENT OF ANY COLLECTIVE POSITION OR STRATEGY BY NASMHPD THAT WOULD BE SUBJECT TO REVIEW BY THE NATIONAL GOVERNORS' ASSOCIATION. ONLY ONE ACTIVE MEMBER PER JURISDICTION SHALL BE RECOGNIZED BY THE ASSOCIATION. WHERE THERE IS DISPUTE AS TO WHO IS THE "ACTIVE MEMBER," THE ASSOCIATION SHALL CONTACT THE GOVERNOR OR APPOINTING AUTHORITY OF THE JURISDICTION IN QUESTION AND REQUEST AN OFFICIAL DESIGNATION. |
| FORM 990, PART VI, SECTION A, LINE 8B | THERE ARE NO COMMITTEES THAT HAVE THE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY; THEREFORE THERE WERE NO MEETINGS HELD OR WRITTEN ACTIONS UNDERTAKEN. |
| FORM 990, PART VI, SECTION B, LINE 11 | NASMHPD'S POLICY IS TO PRESENT THE FORM 990 TO THE BOARD OF DIRECTORS INCLUDING ALL APPLICABLE SCHEDULES. EACH MEMBER OF THE BOARD OF DIRECTORS WILL RECEIVE A COPY OF THE FORM 990 PRIOR TO THE SUBMISSION OF THE FORM TO THE INTERNAL REVENUE SERVICE. QUESTIONS FROM BOARD MEMBERS WILL BE DIRECTED TO THE NASMHPD CHIEF FINANCIAL OFFICER (CFO) FOR CLARIFICATION PRIOR TO THE SUBMISSION OF THE FORM 990. |
| FORM 990, PART VI, SECTION B, LINE 12C | NASMHPD REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. ON AN ANNUAL BASIS, THE BOARD OF DIRECTORS (BOD'S) AND KEY EMPLOYEES (EXECUTIVE DIRECTOR) RECEIVE A COPY OF THE CONFLICT OF INTEREST POLICY, AND SIGN AN ACKNOWLEDGEMENT OF RECEIPT FORM. IN ADDITION, ON THE FORM THEY ARE REQUIRED TO DISCLOSE IN WRITING IF THEY DO OR DO NOT HAVE A CONFLICT OF INTEREST AS OUTLINED IN THE POLICY. DURING A SUBSEQUENT BOARD MEETING, THE DIRECTOR OF HUMAN RESOURCES REVIEWS THE ACKNOWLEDGEMENT FORMS RECEIVED BY THE BOD MEMBERS AND THE NASMHPD EXECUTIVE DIRECTOR AND CONFIRMS THAT THERE ARE NO CONFLICTS DISCLOSED. THE BOD REVIEWS AND DISCUSSES THE POLICY AND DOCUMENTS THE REVIEW IN THE BOARD MEETING MINUTES. FOLLOWING FULL DISCLOSURE OF A POSSIBLE CONFLICT OF INTEREST, THE BOARD OF DIRECTORS SHALL DETERMINE WHETHER A CONFLICT OF INTEREST EXISTS AND, IF SO THE BOARD SHALL VOTE TO AUTHORIZE OR REJECT THE TRANSACTION OR TAKE ANY OTHER ACTION DEEMED NECESSARY TO ADDRESS THE CONFLICT. AN INTERESTED BOARD MEMBER, OFFICER, OR EMPLOYEE MEMBER SHALL NOT PARTICIPATE IN ANY DISCUSSION OR DEBATE OF THE BOARD OF DIRECTORS, OR OF ANY COMMITTEE OR SUBCOMMITTEE THEREOF IN WHICH THE SUBJECT OF DISCUSSION IS A CONTRACT, TRANSACTION, OR SITUATION IN WHICH THERE MAY BE A PERCEIVED OR ACTUAL CONFLICT OF INTEREST. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE PROCESS FOR DETERMINING COMPENSATION FOR THE ORGANIZATION'S CEO, EXECUTIVE DIRECTOR, TOP MANAGEMENT OFFICIAL, OTHER OFFICERS OR KEY EMPLOYEES OF THE ORGANIZATION DOES INCLUDE A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. ANNUALLY, THE DIRECTOR OF HUMAN RESOURCES SUBMITS A COMPENSATION SURVEY TO THE BOD THAT INCLUDES A REVIEW OF EXECUTIVE DIRECTOR SALARIES FROM FORMS 990 OF SIMILAR ORGANIZATIONS, AND OTHER SURVEYS. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. THE FORM 990, IRS DETERMINATION LETTER, FORM 1023 TAX EXEMPTION APPLICATION ARE AVAILABLE FOR PUBLIC INSPECTION. THE FORM 990 AND IRS DETERMINATION LETTER ARE AVAILABLE ON NASMHPD'S WEBSITE. THE FINANCIAL STATEMENTS ARE AVAILABLE ON THE ORGANIZATION'S WEBSITE AND UPON REQUEST. |
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