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 (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 | |||||
| (A)
HEALTH SERVICES FOR CHILDREN WITH SPECIAL NEEDS INC |
521862406 | 9 | Yes | 49,057 | 0 | |
| (B)
HOSPITAL FOR SICK CHILDREN |
530204670 | 3 | Yes | 0 | 0 | |
| Total 2 | 49,057 | 0 | ||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (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) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (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) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (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.) | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (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 VI.) .. | ||||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | ||||||
| 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 | ||||
| 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 2015 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-2015 |
(iii) Distributable Amount for 2015 |
|
|---|---|---|---|---|
|
1
Distributable amount for 2015 from Section C, line 6 |
||||
|
2
Underdistributions, if any, for years prior to 2015 (reasonable cause required--see instructions) |
||||
| 3 Excess distributions carryover, if any, to 2015: | ||||
| a | ||||
| b | ||||
| c | ||||
| d From 2013....... | ||||
| e From 2014....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2015 distributable amount | ||||
|
i
Carryover from 2010 not applied (see instructions) |
||||
| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | ||||
| 4Distributions for 2015 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2015 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from 4. | ||||
|
5
Remaining underdistributions for years prior to 2015, if any. Subtract lines 3g and 4a from line 2 (if amount greater than zero, see instructions) |
||||
|
6
Remaining underdistributions for 2015. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions) |
||||
|
7 Excess distributions carryover to 2016. Add lines 3j and 4c. |
||||
| 8 Breakdown of line 7: | ||||
| a | ||||
| b | ||||
| c Excess from 2013....... | ||||
| d From 2014....... | ||||
| e From 2015....... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|---|
| Schedule A, Part IV, Section A, Line 6 Support to other supported orgs | AS REPORTED IN SCHEDULE I, THE FOUNDATION PROVIDES A NUMBER OF GRANTS TO UNRELATED SECTION 501 (C)(3) ORGANIZATIONS TO FURTHER SUPPORT THE TAX-EXEMPT PURPOSES OF THE FOUNDATION AND ITS SUPPORTED ORGANIZATIONS OF SUPPORTING INDIVIDUALS WITH SPECIAL HEALTH NEEDS AND THEIR FAMILIES. THE GRANTS WERE RELATED TO COALITION BUILDING AND COMMUNITY HEALTH IMPROVEMENT ACTIVITIES, INCLUDING PROVIDING SPONSORSHIPS FOR MORE THAN 10 DISABILITY EVENTS. |
| Schedule A, Part IV, Section D, Line 3 Supp. Org. Have Significant Voice In Investment Policies | THE HSC FOUNDATION (FOUNDATION) IS THE PARENT ENTITY OF ITS TWO SUPPORTED ORGANIZATIONS: THE HSC PEDIATRIC CENTER (HSCPC) AND HEALTH SERVICES FOR CHILDREN WITH SPECIAL NEEDS (HSCSN). A MAJORITY OF THE HSCSN DIRECTORS ARE ALSO DIRECTORS OF THE FOUNDATION, AND 3 OUT OF 8 HSCPC DIRECTORS ARE ALSO DIRECTORS OF THE FOUNDATION. IN ADDITION, THERE IS IMPORTANT OVERLAP AMONG THE SENIOR LEADERSHIP OF THE FOUNDATION AND HSCPC AND HSCSN. AS A RESULT, HSCPC AND HSCSN HAVE A SIGNIFICANT VOICE IN THE FOUNDATION'S INVESTMENT POLICIES AND IN DIRECTING THE USE OF THE FOUNDATION'S INCOME AND ASSETS. IN PARTICULAR, THE OVERLAPPING DIRECTORS AND SENIOR LEADERSHIP ENSURE THAT THE FOUNDATION DIRECTS ITS RESOURCES IN A MANNER THAT DIRECTLY SUPPORTS THE TAX-EXEMPT PURPOSES OF HSCPC AND HSCSN. |
| Schedule A, Part IV, Section E, Line 3a Power To Appoint/Elect Majority of Officer/Director/Trustee | PURSUANT TO THE ORGANIZING DOCUMENTS OF HSCSN AND THE HSC PEDIATRIC CENTER, THE HSC FOUNDATION HAS THE RIGHT TO APPOINT THE BOARD MEMBERS OF HSCSN AND THE HSC PEDIATRIC CENTER. |
| Schedule A, Part IV, Section E, Line 3b Substantial Direction Over Policies/Programs/Activities | THE FOUNDATION IS THE PARENT ENTITY OF ITS TWO SUPPORTED ORGANIZATIONS: HSCPC AND HSCSN. THE FOUNDATION APPOINTS AND REMOVES THE BOARD MEMBERS OF HSCPC AND HSCSN. IN ADDITION, THERE IS IMPORTANT OVERLAP AMONG THE SENIOR LEADERSHIP OF THE FOUNDATION AND HSCPC AND HSCSN. THE FOUNDATION, AS SOLE CORPORATE MEMBER OF HSCPC AND HSCSN, ALSO POSSESSES CERTAIN RESERVED POWERS OVER THOSE ENTITIES, INCLUDING THE POWER TO ESTABLISH THE POLICIES AND GOALS OF EACH ORGANIZATION AND APPROVE AMENDMENTS TO GOVERNING DOCUMENTS AND ORGANIZATIONAL BUDGETS. THUS, AS A TYPICAL PARENT ORGANIZATION IN AN INTEGRATED HEALTHCARE SYSTEM, THE FOUNDATION EXERCISES A SUBSTANTIAL DEGREE OF DIRECTION OVER THE POLICIES, PROGRAMS, AND ACTIVITIES OF HSCPC AND HSCSN, AND HAS A DIRECT ROLE IN GUIDING THE FINANCIAL, OPERATIONAL, AND STRATEGIC DECISION-MAKING OF HSCPC AND HSCSN. |
| Software ID: | 15000238 |
| Software Version: | 2015v2.1 |
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 III, Line 4d Description of other program services | (Expenses $ 20,557 including grants of $ 20,557)(Revenue $ 0) - Therapeutic Recreation Fund: Provided grant support for nine (9) therapeutic recreation programs offered by Health Services for Children with Special Needs, Inc. and The HSC Pediatric Center. These programs provide children/youth with disabilities an opportunity to learn and participate in group sports and therapeutic recreation activities. |
| Form 990, Part VI, Line 1a Delegate broad authority to a committee | The Executive Committee shall have the power to exercise each and all of the powers of the Board of Directors in the same manner and to the same extent as if the Committee were in fact the Board of Directors, provided that any action taken shall not conflict with previously established policies or directives of the Board. However, nothing contained in these Bylaws shall constitute a delegation to the Executive Committee of the following powers of the Board of Directors: to increase or decrease the number of Directors; to fill vacancies on or remove Directors from the Board; to elect officers; to fill officers' vacancies; to remove officers; to sell, encumber or otherwise dispose of all or any material part of the assets of the Corporation; to merge or consolidate the Corporation with another entity; or to amend these Bylaws. All Executive Committee minutes will be provided to all members of the Board of Directors prior to the next meeting of the Board of Directors. The Executive Committee shall consist of the Chairman, Vice Chairman, Secretary and Treasurer of the Corporation and up to four (4) additional at-large members who may be appointed by the Chairman of the Board, in his or her discretion. The President shall be an ex officio member of the Committee. |
| Form 990, Part VI, Line 11b Review of form 990 by governing body | THE FORM 990 IS PREPARED BY AN ACCOUNTING FIRM AND THEN REVIEWED BY THE VP'S FINANCE. ONCE COMMENTS FROM VP'S FINANCE HAVE BEEN INCORPORATED INTO THE FORM 990, THE FORM 990 IS MADE AVAILABLE TO THE AUDIT COMMITTEE FOLLOWED BY A MEETING IN WHICH THE FORM 990 IS PRESENTED. THE FULL BOARD OF DIRECTORS HAS DELEGATED THE REVIEW OF THE FORM 990 TO THE AUDIT COMMITTEE. THE AUDIT COMMITTEE IS A PART OF THE FULL VOTING BOARD OF DIRECTORS. A COPY OF THE FORM 990 IS DISTRIBUTED TO THE BOARD OF DIRECTORS PRIOR TO FILING. |
| Form 990, Part VI, Line 12c Conflict of interest policy | THE HSC FOUNDATION HAS A WRITTEN CONFLICT OF INTEREST POLICY THAT COVERS ITSELF AND ALL OF ITS DIRECT AND INDIRECT SUBSIDIARIES. UNDER THAT POLICY, WHENEVER A POTENTIAL CONFLICT ARISES FOR THE HSC FOUNDATION BOARD OF DIRECTORS AND OFFICERS, IT IS BROUGHT TO THE ATTENTION OF THE PRESIDENT AND EXECUTIVE COMMITTEE OF THE HSC FOUNDATION BOARD, WHICH ANALYZES THE SITUATION AND MAKES A DETERMINATION OF WHETHER OR NOT AN ACTUAL CONFLICT EXISTS. IF IT IS DETERMINED THAT AN ACTUAL CONFLICT EXISTS , THE PRESIDENT AND EXECUTIVE COMMITTEE REPORTS TO THE HSC FOUNDATION BOARD OF DIRECTORS REGARDING THE NATURE OF THE CONFLICT AND THAT PERSON IS THEREAFTER RECUSED FROM ANY DISCUSSION AND VOTE REGARDING THE MATTER. WHENEVER A POTENTIAL CONFLICT ARISES FOR EMPLOYEES OF THE HSC FOUNDATION MANAGEMENT TEAM, IT WILL BE BROUGHT TO THE BOARD CHAIR BY THE PRESIDENT WHICH ANALYZES THE SITUATION AND MAKES A DETERMINATION OF WHETHER OR NOT AN ACTUAL CONFLICT EXISTS. IF IT IS DETERMINED THAT AN ACTUAL CONFLICT EXISTS, STEPS WILL BE TAKEN TO ELIMINATE THE CONFLICT AND COMMUNICATED TO THE EMPLOYEE INVOLVED. THE BOARD CHAIR AND PRESIDENT WILL REPORT ALL CONFLICTS TO THE EXECUTIVE COMMITTEE FOUNDATION. |
| Form 990, Part VI, Line 15a Process to establish compensation of top management official | ON AN ANNUAL BASIS, THE HSC FOUNDATION USES A FOUR STEP APPROACH TO EXECUTIVE COMPENSATION OF ITS TOP MANAGEMENT OFFICIAL AND THE FOUNDATION'S OTHER OFFICERS AND KEY EMPLOYEES: 1. THE EXECUTIVE COMMITTEE IS MADE UP OF INDEPENDENT BOARD MEMBERS WITHOUT A CONFLICT OF INTEREST, TO ESTABLISH AND DETERMINE THE REASONABLENESS OF TOTAL COMPENSATION FOR THE SYSTEM'S DISQUALIFIED EXECUTIVES AND FORWARDS TO THE FULL BOARD FOR APPROVAL. 2. PERIODICALLY, THE EXECUTIVE COMMITTEE WILL ENGAGE AN INDEPENDENT CONSULTANT TO PREPARE A DETAILED WRITTEN REPORT ON APPROPRIATE COMPARABILITY DATA FOR COMPARABLE POSITIONS. 3. THE EXECUTIVE COMMITTEE REVIEWS AND RELIES UPON THE REPORT OF THE INDEPENDENT CONSULTANT, ALONG WITH OTHER INDIVIDUAL AND MARKET DATA, THEN DEBATES AND FULLY DOCUMENTS ITS DECISION ABOUT WHAT IS REASONABLE COMPENSATION FOR DISQUALIFIED EXECUTIVES. 4. ONCE THE EXECUTIVE COMMITTEE DEVELOPS EXECUTIVE COMPENSATION RECOMMENDATIONS, THEY ARE PRESENTED TO THE SYSTEM'S FULL BOARD FOR RATIFICATION. |
| Form 990, Part VI, Line 15b Process to establish compensation of other employees | PLEASE REFER TO THE NARRATIVE RESPONSE FOR LINE 15A FOR THE COMPENSATION PROCESS UNDERTAKEN FOR THE FOUNDATION'S OTHER OFFICERS AND KEY EMPLOYEES. |
| Form 990, Part VI, Line 19 Required documents available to the public | THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE ALL AVAILABLE TO THE PUBLIC UPON REQUEST. |
| Form 990, Part XI, Line 9 Other changes in net assets or fund balances | NET ASSETS RELEASED FROM RESTRICTION - -99576; |
| Software ID: | 15000238 |
| Software Version: | 2015v2.1 |