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 | |||||
| Total | ||||||
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.) .... | 1,071,087 | 589,472 | 882,261 | 1,032,690 | 1,009,653 | 4,585,163 |
| 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 | 1,071,087 | 589,472 | 882,261 | 1,032,690 | 1,009,653 | 4,585,163 |
| 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).. | 382,025 | |||||
| 6 | Public support. Subtract line 5 from line 4. | 4,203,138 | |||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 1,071,087 | 589,472 | 882,261 | 1,032,690 | 1,009,653 | 4,585,163 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | 157,960 | 167,161 | 156,075 | 81,730 | 82,155 | 645,081 |
| 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.).. | 10,997 | 10,997 | ||||
| 11 | Total support. Add lines 7 through 10. | 5,241,241 | |||||
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) |
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| 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): |
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| 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 |
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|
2
Underdistributions, if any, for years prior to 2015 (reasonable cause required--see instructions) |
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| 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) |
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| 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) |
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|
6
Remaining underdistributions for 2015. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions) |
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|
7 Excess distributions carryover to 2016. Add lines 3j and 4c. |
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| 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 II, LINE 10, EXPLANATION OF OTHER INCOME: | BAD DEBT RECOVERY |
| Software ID: | |
| Software Version: |
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 4A | HOME CARE SERVICE (HCS): - THE HOME CARE SERVICE (HCS) PROGRAM RECRUITS, SCREENS, TRAINS AND EMPLOYS HOME CARE SERVICE ASSISTANTS TO PROVIDE SERVICES FOR QUALIFIED ELDERLY AND PHYSICALLY DISABLED PERSONS THROUGH THE ARIZONA LONG TERM CARE SYSTEM (ALTCS) THAT HAVE POLICIES UNDER EVERCARE, MERCY CARE AND BRIDGEWAY HEALTHCARE PLANS. ABILITY360 ALSO PROVIDES HCS TO NATIVE AMERICANS LIVING OFF RESERVATION AND QUALIFY FOR SERVICES THROUGH AHCCCS/ALTCS AND THE NATIVE AMERICAN COMMUNITY HEALTH CENTERS. IN ADDITION, ABILITY360 PROVIDES HCS TO PERSONS WHO ARE DEVELOPMENTALLY DISABLED AND QUALIFY FOR LONG-TERM CARE SERVICES UNDER THE ARIZONA DEPARTMENT OF ECONOMIC SECURITY'S DIVISION OF DEVELOPMENTAL DISABILITIES (DDD). - PAS EMPLOYS OVER 2,455 PERSONAL ASSISTANTS THROUGHOUT MARICOPA, PIMA, PINAL AND GILA COUNTIES. - PERSONAL ASSISTANCE SERVICES WERE PROVIDED TO 1,995 CONSUMERS THROUGH THE PAS PROGRAM. |
| FORM 990, PART III, LINE 4B | HOME MODIFICATION PROGRAMS (HMP): - ABLITY360 INCREASES HOME ACCESSIBILITY, INDEPENDENCE, AND SAFETY FOR ALTCS MEMBERS LIVING WITH DISABILITIES. THE HMP PROVIDES LICENSED CONTRACTORS TO PREFORM MODIFICATIONS SUCH AS WIDENING DOORWAYS, ENTRANCE RAMPS, INSTALLING GRAB BARS, ELEVATED TOILETS, AND OTHER NEEDED STRUCTURAL MODIFICATIONS. - ABILITY360'S HMP COMPLETED 23 ACCESSIBILITY PROJECTS THROUGH COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) CONTRACTS WITH SEVERAL VALLEY CITIES THAT INCLUDED PHOENIX, GLENDALE, MESA, PEORIA, SCOTTSDALE AND SURPRISE. AN ADDITIONAL 107 HOME MODIFICATIONS WERE COMPLETED FOR CONSUMERS ELIGIBLE FOR THE ALTCS PROGRAM THROUGH HEALTHCARE PLAN MEMBERSHIP'S WITH MERCY CARE FOR A TOTAL OF 130 HOME MODIFICATIONS. - ABILITY360 REGULARLY PROVIDES PRESENTATIONS TO COMMUNITIES ON THE FAIR HOUSING ACT TO CONSUMERS, PROPERTY MANAGERS, AND CITY OFFICIALS. THIS EMPOWERS CONSUMERS TO UNDERSTAND THEIR RIGHTS WHICH MAKE A HUGE DIFFERENCE IN AVOIDING ISOLATION AND INSTITUTIONALIZATION. |
| FORM 990, PART III, LINE 4C | SOCIAL SECURITY ADMINISTRATION'S AZ BENEFITS TO WORK (AZB2W) & BENEFIT OFFSET NATIONAL DEMONSTRATION (BOND)AND AHCCCS'S WORK INCENTIVE INFORMATION NETWORK (WIIN): - BENEFITS TO WORK ARIZONA ENROLLED 1409 TOTAL BENEFICIARIES INTO WIPA DURING THIS REPORTING PERIOD (JUNE 2014 - JULY 2015). AT THE END OF THE REPORTING PERIOD 417 BENEFICIARIES WERE IN SERVICES 130 BENEFICIARIES REPORTED EMPLOYMENT. - WORK INCENTIVE INFORMATION NETWORK (WIIN) COMPLETED 184 CALCULATION SESSIONS THROUGH AZ DISABILITY BENEFITS 101 (DB101). WIIN COMPLETED 40 TRAINING SESSIONS EDUCATING 994 SERVICE PROVIDERS ON WORK INCENTIVES AND DB101. - ABILITY360 OPERATES A BENEFITS OFFSET NATIONAL DEMONSTRATION PROJECT (BOND), ONE OF ONLY TEN PROGRAMS NATIONALLY. OUR ADVOCACY UNIT PROVIDES WORK INCENTIVE COUNSELING (WIC) AND ABILITY360 EMPLOYMENT SERVICES (AES) PROVIDES ENHANCED WORK INCENTIVE COUNSELING (EWIC) THAT PROVIDES COMPREHENSIVE EMPLOYMENT SERVICES TO PEOPLE ON SSDI. UNDER THE BOND PROJECT, ABILITY360 HAS PROVIDED WORK INCENTIVE CONSULTATION TO 600 BENEFICIARIES ON SSDI WITH 269 REPORTING EMPLOYMENT AND 40 NEWLY EMPLOYED. |
| FORM 990, PART VI, SECTION A, LINE 1 | EXECUTIVE COMMITTEE : THE EXECUTIVE COMMITTEE SHALL CONSIST OF THE FIVE OFFICERS : CHAIR, VICE CHAIR, SECRETARY, TREASURER, AND PAST CHAIR. THE EXECUTIVE COMMITTEE SHALL BE RESPONSIBLE FOR REVIEWS OF THEIR PRESIDENT & CEO'S PERFORMANCE ANNUALLY, MAKES DECISIONS FOR THE ORGANIZATION IN EMERGENCY SITUATIONS, PERFORM STRATEGY PLANNING, PERFORMS ETHICAL OVERSIGHT, PERFORMS OTHER DUTIES AS ASSIGNED BY THE BOARD. |
| FORM 990, PART VI, SECTION B, LINE 11 | THE FORM 990 IS REVIEWED AND APPROVED BY THE FINANCE COMMITTEE. AFTER THIS REVIEW AND APPROVAL, A COPY OF THE FORM 990 IS DISTRIBUTED TO THE COMPLETE BOARD PRIOR TO FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | CONFLICTS OF INTEREST ARE INCONSISTENT WITH THE CORE VALUES OF ABILITY360. POTENTIAL CONFLICTS OF INTEREST INCLUDE, BUT ARE NOT LIMITED TO: THE EMPLOYEE PERFORMING SERVICES FOR MONEY OR OTHER PERSONAL GAIN FOR ANY SUPPLIER OR VENDOR TO ABILITY360; THE EMPLOYEE'S FAMILY MEMBER PERFORMING SERVICES FOR MONEY OR OTHER PERSONAL GAIN FOR ANY SUPPLIER OR VENDOR TO ABILITY360; THE EMPLOYEE HAVING OWNERSHIP INTERESTS (SUCH AS STOCK) IN A SUPPLIER OR VENDOR TO ABILITY360; OR THE EMPLOYEE OWING MONEY (SUCH AS A LOAN) TO A SUPPLIER OR VENDOR TO ABILITY360. ALL EMPLOYEES ARE TO BE AWARE OF POTENTIAL CONFLICTS OF INTEREST. ALL EMPLOYEES ARE EXPECTED TO DISCLOSE ANY CONFLICTS OF INTEREST TO THEIR SUPERVISOR. WHENEVER AN EMPLOYEE HAS A QUESTION ABOUT A CONFLICT OF INTEREST, IT IS EXPECTED THAT THE EMPLOYEE WILL RAISE THIS ISSUE IMMEDIATELY WITH HIS/HER SUPERVISOR. ALL EMPLOYEES ARE EXPECTED TO GRACIOUSLY DECLINE GIFTS AND TICKETS TO EVENTS THAT ARE NOT OF A NOMINAL VALUE. EMPLOYEES WHO DELIBERATELY ENGAGE IN CONFLICTS OF INTEREST MAY BE DISCIPLINED UP TO AND INCLUDING TERMINATION OF EMPLOYMENT. THIS CONFLICT OF INTEREST POLICY IS COVERED IN THE ABILITY360 PERSONNEL HANDBOOK AND IS ALSO APPLIED TO THE BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION B, LINE 15 | COMPENSATION FOR THE ORGANIZATION'S CEO, EXECUTIVE DIRECTOR, OR TOP MANAGEMENT OFFICIAL IS REVIEWED AND APPROVED BY THE BOARD OF DIRECTORS. COMPENSATION FOR OTHER OFFICERS OR KEY EMPLOYEES OF THE ORGANIZATION IS REVIEWED AND APPROVED BY THE EXECUTIVE DIRECTOR. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART IX, LINE 24E | TRAINING & TUITION: PROGRAM SERVICE EXPENSES 19,373. MANAGEMENT AND GENERAL EXPENSES 52,192. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 71,565. RECLASS RENTAL EXP TO PG 9: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES -25,963. FUNDRAISING EXPENSES 0. TOTAL EXPENSES -25,963. |
| FORM 990, PART XI, LINE 9: | CHANGE IN VALUE OF INTEREST RATE SWAP 224,764. |
| FORM 990, PART XII, LINE 2C | THE FINANCE COMMITTEE HAS RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF THE FINANCIAL STATEMENTS. THE FINANCE COMMITTEE CONSISTS OF THE EXECUTIVE DIRECTOR AND 5 BOARD MEMBERS, WHO REVIEW QUARTERLY FINANCIAL STATEMENTS, ANNUAL BUDGET, AND ANNUAL AUDIT BEFORE INFORMATION IS SUBMITTED TO THE BOARD. FINANCE COMMITTEE ALSO SELECTS AN INDEPENDENT ACCOUNTANT FOR THE ANNUAL FINANCIAL AUDIT. THE PROCESS OF OVERSIGHT OF THE FINANCIAL STATEMENTS, AUDIT AND SELECTION OF AN INDEPENDENT ACCOUNTANT HAS NOT CHANGED FROM THE PRIOR YEAR. |
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| Software Version: |