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)
Alamance County Health Department |
566000271 | 6 | No | 0 | 0 | |
| (B)
Albemarle Regional Health Services |
566000798 | 6 | No | 0 | 0 | |
| (C)
Alexander County Health Department |
566000272 | 6 | No | 0 | 0 | |
| (D)
Alleghany County Health Department |
566001534 | 6 | No | 0 | 0 | |
| (E)
Anson County Health Department |
566000273 | 6 | No | 0 | 0 | |
| (F)
Ashe County Health Department |
566001534 | 6 | No | 0 | 0 | |
| (G)
Avery County Health Department |
561272202 | 6 | No | 0 | 0 | |
| (H)
Beaufort County Health Department |
566001521 | 6 | No | 0 | 0 | |
| (I)
Bertie County Health Department |
566000798 | 6 | No | 0 | 0 | |
| (J)
Bladen County Health Department |
566000277 | 6 | No | 0 | 0 | |
| (K)
Brunswick County Health Department |
566000278 | 6 | No | 0 | 0 | |
| (L)
Buncombe County Health Department |
566000279 | 6 | No | 0 | 0 | |
| (M)
Cabarrus County Health Department |
562016594 | 6 | No | 0 | 0 | |
| (N)
Caldwell County Health Department |
566001967 | 6 | No | 0 | 0 | |
| (O)
Camden County Health Department |
566000798 | 6 | No | 0 | 0 | |
| (P)
Carteret County Health Department |
566001522 | 6 | No | 0 | 0 | |
| (Q)
Caswell County Health Department |
566000283 | 6 | No | 0 | 0 | |
| (R)
Catawba County Health Department |
566001814 | 6 | No | 0 | 0 | |
| (S)
Chatham County Health Department |
566000284 | 6 | No | 0 | 0 | |
| (T)
Cherokee County Health Department |
566000285 | 6 | No | 0 | 0 | |
| (U)
Chowan County Health Department |
566000798 | 6 | No | 0 | 0 | |
| (V)
Clay County Health Department |
566000287 | 6 | No | 0 | 0 | |
| (W)
Cleveland County Health Department |
566000288 | 6 | No | 0 | 0 | |
| (X)
Columbus County Health Dept |
566000289 | 6 | No | 0 | 0 | |
| (Y)
Craven County Health Department |
566000290 | 6 | No | 0 | 0 | |
| (Z)
Cumberland County Health Department |
566000291 | 6 | No | 0 | 0 | |
| (AA)
Currituck County Health Department |
566000798 | 6 | No | 0 | 0 | |
| (AB)
Dare County Dept of Public Health |
566000293 | 6 | No | 0 | 0 | |
| (AC)
Davidson County Health Department |
566000294 | 6 | No | 0 | 0 | |
| (AD)
Davie County Health Department |
566000295 | 6 | No | 0 | 0 | |
| (AE)
Duplin County Health Department |
566000296 | 6 | No | 0 | 0 | |
| (AF)
Durham County Health Department |
566000297 | 6 | No | 0 | 0 | |
| (AG)
Edgecombe County Health Department |
566000298 | 6 | No | 0 | 0 | |
| (AH)
Forsyth County Health Department |
566000450 | 6 | No | 0 | 0 | |
| (AI)
Franklin County Health Department |
566000299 | 6 | No | 0 | 0 | |
| (AJ)
Gaston County Health Department |
566000300 | 6 | No | 0 | 0 | |
| (AK)
Gates County Health Department |
566000798 | 6 | No | 0 | 0 | |
| (AL)
Graham County Health Department |
566000302 | 6 | No | 0 | 0 | |
| (AM)
Granville County Health Department |
561060453 | 6 | No | 0 | 0 | |
| (AN)
Greene County Health Department |
566000304 | 6 | No | 0 | 0 | |
| (AO)
Guilford County Health Department |
566000305 | 6 | No | 0 | 0 | |
| (AP)
Halifax County Health Dept |
566001836 | 6 | No | 0 | 0 | |
| (AQ)
Harnett County Health Depatment |
566000306 | 6 | No | 0 | 0 | |
| (AR)
Haywood County Health Department |
566001524 | 6 | No | 0 | 0 | |
| (AS)
Henderson County Health Department |
566000307 | 6 | No | 0 | 0 | |
| (AT)
Hertford County Public Health Autho |
201073639 | 6 | No | 0 | 0 | |
| (AU)
Hoke County Health Department |
566001525 | 6 | No | 0 | 0 | |
| (AV)
Hyde County Health Department |
566000308 | 6 | No | 0 | 0 | |
| (AW)
Iredell County Health Department |
566000309 | 6 | No | 0 | 0 | |
| (AX)
Jackson County Health Department |
566000310 | 6 | No | 0 | 0 | |
| (AY)
Johnston County Health Department |
566000311 | 6 | No | 0 | 0 | |
| (AZ)
Jones County Health Department |
566000312 | 6 | No | 0 | 0 | |
| (BA)
Lee County Health Department |
566000313 | 6 | No | 0 | 0 | |
| (BB)
Lenoir County Health Department |
566000627 | 6 | No | 0 | 0 | |
| (BC)
Lincoln County Health Department |
566000315 | 6 | No | 0 | 0 | |
| (BD)
Macon County Health Department |
566000930 | 6 | No | 0 | 0 | |
| (BE)
Madison County Health Department |
566000316 | 6 | No | 0 | 0 | |
| (BF)
Martin County Health Department |
561066387 | 6 | No | 0 | 0 | |
| (BG)
McDowell County Health Department |
566000900 | 6 | No | 0 | 0 | |
| (BH)
Mecklenburg County Department of He |
566000319 | 6 | No | 0 | 0 | |
| (BI)
Montgomery County Health Department |
566000321 | 6 | No | 0 | 0 | |
| (BJ)
Moore County Health Department |
566000322 | 6 | No | 0 | 0 | |
| (BK)
Nash County Health Department |
566000323 | 6 | No | 0 | 0 | |
| (BL)
New Hanover County Health Departmen |
566000324 | 6 | No | 0 | 0 | |
| (BM)
Northampton County Health Departmen |
566000325 | 6 | No | 0 | 0 | |
| (BN)
Onslow County Health Department |
566000326 | 6 | No | 0 | 0 | |
| (BO)
Orange County Health Department |
566000327 | 6 | No | 0 | 0 | |
| (BP)
Pamlico County Health Department |
566000949 | 6 | No | 0 | 0 | |
| (BQ)
Pasquotank County Health Dept |
566000798 | 6 | No | 0 | 0 | |
| (BR)
Pender County Health Dept |
566000329 | 6 | No | 0 | 0 | |
| (BS)
Perquimans County Health Dept |
566000798 | 6 | No | 0 | 0 | |
| (BT)
Person County Health Department |
566000331 | 6 | No | 0 | 0 | |
| (BU)
Pitt County Health Department |
566000332 | 6 | No | 0 | 0 | |
| (BV)
Polk County Health Department |
566000900 | 6 | No | 0 | 0 | |
| (BW)
Randolph County Health Dept |
566001526 | 6 | No | 0 | 0 | |
| (BX)
Richmond County Health Dept |
566000334 | 6 | No | 0 | 0 | |
| (BY)
Robeson County Health Department |
566000335 | 6 | No | 0 | 0 | |
| (BZ)
Rockingham County Health Department |
566001527 | 6 | No | 0 | 0 | |
| (CA)
Rowan County Health Dept |
566000336 | 6 | No | 0 | 0 | |
| (CB)
Rutherford County Health Dept |
566000900 | 6 | No | 0 | 0 | |
| (CC)
Sampson County Health Department |
566000338 | 6 | No | 0 | 0 | |
| (CD)
Scotland County Health Department |
566000339 | 6 | No | 0 | 0 | |
| (CE)
Stanly County Health Department |
566001537 | 6 | No | 0 | 0 | |
| (CF)
Stokes County Health Department |
566000340 | 6 | No | 0 | 0 | |
| (CG)
Surry County Health & Nutrition Cen |
566000341 | 6 | No | 0 | 0 | |
| (CH)
Swain County Health Dept |
561829153 | 6 | No | 0 | 0 | |
| (CI)
Transylvania County Health Dept |
566000343 | 6 | No | 0 | 0 | |
| (CJ)
Tyrrell County Health Dept |
561066387 | 6 | No | 0 | 0 | |
| (CK)
Union County Health Department |
566000345 | 6 | No | 0 | 0 | |
| (CL)
Vance County Health Department |
561060453 | 6 | No | 0 | 0 | |
| (CM)
Wake County Health Department |
566000347 | 6 | No | 0 | 0 | |
| (CN)
Warren County Health Department |
566000348 | 6 | No | 0 | 0 | |
| (CO)
Washington County Health Department |
561066387 | 6 | No | 0 | 0 | |
| (CP)
Watauga County Health Department |
566001534 | 6 | No | 0 | 0 | |
| (CQ)
Wayne County Health Department |
566001520 | 6 | No | 0 | 0 | |
| (CR)
Wilkes County Health Department |
566000350 | 6 | No | 0 | 0 | |
| (CS)
Wilson County Health Department |
566000351 | 6 | No | 0 | 0 | |
| (CT)
Yadkin County Health Department |
566000352 | 6 | No | 0 | 0 | |
| (CU)
Yancey County Health Department |
561272202 | 6 | No | 0 | 0 | |
| (CV)
NC Dept of Health & Human Services |
561636462 | 6 | No | 0 | 0 | |
| Total 100 | 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 |
|---|---|
| Part I: Additional Information | Form 990, Schedule A, Part I, Line 11g(v): During the tax year, NCAPHA provided staffing agency services valued at $5,655,588 to the supported organizations listed in Schedule A, Part VI. |
| Part IV, Section A, Line 1: Description Of How Supported Organizations Are Desigated | Form 990, Schedule A, Part I, Line 11h(iv): North Carolina Alliance for Public Health Agencies (NCAPHA) is not required to specify in its articles of incorporation those publicly supported organizations for which it is organized and operated exclusively to support or benefit in order for it to qualify as a Type I supporting organization because (1) pursuant to NCAPHAs articles, it is controlled by its members, who are a designated class of publicly supported organizations, and (2) NCAPHAs articles require it to be operated to support its members. That class of publicly supported organizations is defined in NCAPHAs articles as: the North Carolina Division of Public Health, those North Carolina county home health agencies, those North Carolina county health departments, those North Carolina multi-county district health departments, those North Carolina public health authorities, and those North Carolina public hospitals and hospital authorities established and existing as instrumentalities of the State under Article 2 of Chapter 130A of the North Carolina General Statutes, as amended, or under their successor statutes, (1) that provide Medicare certified home health agency services, or that provide clinical health services, or that provide other essential public health services under authority of N.C. General Statutes Section 130A-1-1(b), or other state law or regulation, and (2) that pay any membership fee that may be established by the NCAPHAs Board of Directors. |
| Part IV, Section A, Line 6: Description Of Grants Or Provided Benefits To Others | The filing organization ("the Alliance") provided support to another 501(c)(3) organization that is operated in connection with the Alliance's beneficiaries. Reg. Section 1.509(a)-4(e)(1)states that in such a circumstance, the filing organization "will be considered as operated exclusively to support S within the meaning of Code Section 509(a)(3)(A)."In addition, the Alliance provided support to a 501(c)(6) organization that is also operated in connection with the organization's beneficiaries. That organization would meet the 509(a)(2) support test if it were a 501(c)(3) organization. Per the flush language after Code Section 509(a)(4), for purposes of Code Section 509(a)(3), such a 501(c)(6) organization shall be deemed to be described in Code Section 509(a)(2). Accordingly, the support to these organizations does not disqualify the Alliance as a Type I supporting organization. |
| Software ID: | 15000324 |
| Software Version: | 2015v3.0 |
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 III, Line 2: New Services | The organization began providing consulting services related to Medicaid to local health departments. See program accomplishments in Part III, Line 4c. |
| Form 990, Part VI, Line 6: Explanation of Classes of Members or Shareholder | The members of the organization consist of the North Carolina Division of Public Health and those North Carolina county home health agencies, those North Carolina county health departments, those North Carolina multi-county district health departments, and those North Carolina public hospitals and hospital authorities (1) that provide Medicare certified home health services, or that provide clinical health services, or that provide other essential public health services and (2) that pay the membership fee as established by the organization's Board of Directors. No private person, private corporation, private party or entity that is or may be liable for income tax may be a member of the organization. |
| Form 990, Part VI, Line 7a: How Members or Shareholders Elect Governing Body | Except for the initial directors, election to the Board of Directors is by plurality vote of a quorum of the members of the organization. The presence in person or by proxy of one-third of the members of record entitled to vote on the matter before the meeting shall constitute a quorum. |
| Form 990, Part VI, Line 7b: Describe Decisions of Governing Body Approval by Members or Shareholders | Except for the initial directors, election to the Board of Directors is by plurality vote of a quorum of the members of the organization. The presence in person or by proxy of one-third of the members of record entitled to vote on the matter before the meeting shall constitute a quorum. The Board of Directors alone, without approval of the members, has the power to make, adopt, alter, amend and repeal from time to time bylaws of the organization. |
| Form 990, Part VI, Line 11b: Form 990 Review Process | Prior to filing, the Form 990 will be reviewed by the bookkeeper, Finance Director and Executive Director. It will then be e-mailed to the Board Members for review. |
| Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts | Conflicts of interest are monitored and documented in the meeting minutes. If there is a conflict, the person recuses themselves from the discussion and vote. |
| Form 990, Part VI, Line 15a: Compensation Review & Approval Process - CEO, Top Management | The Executive Director's compensation was reviewed and approved by a committee of the Board of Directors. The amount of the salary increase was determined after careful consideration of salary data found in multiple salary surveys. Other increases are approved by the Board of Directors and implemented on the employee's service anniversary date. All discussions are documented in the meeting minutes. |
| Form 990, Part VI, Line 19: Other Organization Documents Publicly Available | The organization's governing documents and three most recent Forms 990 (including financial information) are available to the public upon request. |
| Software ID: | 15000324 |
| Software Version: | 2015v3.0 |