Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for instructions and the latest information.
| (i) Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 10 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 |
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Calendar year (or fiscal year beginning in) ![]() |
(a) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | 882,261 | 1,032,690 | 1,009,653 | 1,456,735 | 1,859,696 | 6,241,035 |
| 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 | 882,261 | 1,032,690 | 1,009,653 | 1,456,735 | 1,859,696 | 6,241,035 |
| 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).. | 575,362 | |||||
| 6 | Public support. Subtract line 5 from line 4. | 5,665,673 | |||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 882,261 | 1,032,690 | 1,009,653 | 1,456,735 | 1,859,696 | 6,241,035 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | 156,075 | 81,730 | 82,155 | 90,726 | 103,221 | 513,907 |
| 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 | 6,765,939 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (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) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (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) |
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| 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 2019 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-2019 |
(iii) Distributable Amount for 2019 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2019 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI). See instructions. |
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| 3 Excess distributions carryover, if any, to 2019: | ||||
| a From 2014....... | ||||
| b From 2015....... | ||||
| c From 2016....... | ||||
| d From 2017....... | ||||
| e From 2018....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2019 distributable amount | ||||
|
i
Carryover from 2014 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | ||||
| 4Distributions for 2019 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2019 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from 4. | ||||
|
5
Remaining underdistributions for years prior to 2019, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
6
Remaining underdistributions for 2019. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
7 Excess distributions carryover to 2020. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2015..... | ||||
| b Excess from 2016..... | ||||
| c Excess from 2017..... | ||||
| d Excess from 2018..... | ||||
| e Excess from 2019..... | ||||
| 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.
Go to www.irs.gov/Form990 for the latest information.
| 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). HCS EMPLOYS OVER 2,326 HOME CARE SERVICE ASSISTANTS THROUGHOUT MARICOPA, PIMA, PINAL, YAVAPAI AND GILA COUNTIES. HOME CARE SERVICES WERE PROVIDED TO 1,907 CONSUMERS THROUGH THE HCS 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 HOME MODIFICATION PROGRAM PROVIDES LICENSED CONTRACTORS TO PERFORM MODIFICATIONS SUCH AS WIDENING DOORWAYS, ENTRANCE RAMPS, INSTALLING GRAB BARS, ELEVATED TOILETS, AND OTHER NEEDED STRUCTURAL MODIFICATIONS. ABILITY360'S HOME MODIFICATION COMPLETED 33 ACCESSIBILITY PROJECTS THROUGH COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) CONTRACTS WITH SEVERAL VALLEY CITIES THAT INCLUDED PHOENIX, MESA, PEORIA, SCOTTSDALE, SURPRISE AND TEMPE. AN ADDITIONAL 89 HOME MODIFICATIONS WERE COMPLETED FOR CONSUMERS ELIGIBLE FOR THE ALTCS PROGRAM THROUGH HEALTHCARE PLAN MEMBERSHIPS WITH MERCY CARE FOR A TOTAL OF 122 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 | TITLE VII PART C: THE SOCIALIZATION THROUGH RECREATION PROGRAM PROVIDED PROGRAMS AND ACTIVITIES FOR 920 CONSUMERS INCLUDING 59 NEW CONSUMERS. VOLUNTEERS CONTRIBUTED 146 VOLUNTEER HOURS. THE REINTEGRATION PROGRAM ASSISTED 8 CONSUMERS IN LEAVING NURSING HOMES TO EXPERIENCE LESS RESTRICTIVE, MORE INDEPENDENT LIVING ARRANGEMENTS. OUR EARLY INTERVENTION COORDINATOR CONTACTED 308 CONSUMERS THROUGH OUTREACH TO REHAB AND OTHER FACILITIES FOR THOSE WITH NEW INJURIES OR DISABILITIES AND ATTENDED 69 COMMUNITY OUTREACH MEETINGS, IMPACTING 854 PARTICIPANTS. PEER MENTOR MATCHES WERE MADE FOR 34 NEWLY INJURED CONSUMERS, AND 226 VOLUNTEER HOURS WERE CONTRIBUTED TO THIS PROGRAM. ABILITY360 TRAINS AND SUPERVISES PEER MENTOR VOLUNTEERS TO ACT AS COACHES, AND PROVIDE SUPPORT TO OTHERS WITH DISABILITIES WORKING ON THEIR OWN INDEPENDENT LIVING GOALS. PEER MENTORS CONTRIBUTED 1,723 HOURS OF ONE-ON-ONE MENTORING AND ADVOCACY SUPPORT TO PERSONS WITH A VARIETY OF DISABILITIES. ABILITY360 FACILITATED 11 GROUP MENTORING SESSIONS FOR 126 DUPLICATED/51 UNDUPLICATED PARTICIPANTS TO PROVIDE SUPPORT, AND RESOURCE INFORMATION FOR MENTORS, MENTEES, AND CONSUMER PARTICIPANTS. ABILITY360 MAINTAINED A POOL OF 47 TRAINED PEER MENTORS THROUGHOUT THE YEAR, TRAINED 17 NEW PEER MENTOR VOLUNTEERS AND 07 NEW MENTEES WERE MATCHED WITH PEER MENTOR VOLUNTEERS. ABILITY360 USES TRAINED VOLUNTEERS TO ASSIST WITH CLERICAL PROJECTS AND AT EVENTS AND COMMUNITY FAIRS. GENERAL VOLUNTEERS DONATED 8,260 HOURS OF SERVICE TO ABILITY360. ABILITY360 PROVIDES ONE-ON-ONE ADVOCACY SUPPORT TO CONSUMERS AND THE COMMUNITY ON INDIVIDUAL ADVOCACY CONCERNS, PUBLIC TRANSPORTATION, FINANCIAL PLANNING, HEALTHCARE, AND DISABILITY CIVIL RIGHTS ETC. OUR ADVOCACY SPECIALIST PROVIDED SERVICES TO 289 UNDUPLICATED INDIVIDUALS. ABILITY360 ALSO OFFERED 24 EDUCATIONAL AND ADVOCACY RELATED WORKSHOPS FOR 296 PARTICIPANTS. |
| 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 11B | 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. THIS PROCESS WAS LAST PERFORMED IN APRIL/MAY 2018. COMPENSATION FOR OTHER OFFICERS OR KEY EMPLOYEES OF THE ORGANIZATION IS REVIEWED AND APPROVED BY THE EXECUTIVE DIRECTOR. THIS PROCESS WAS LAST PERFORMED IN JULY 2018. |
| 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 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. |
| Software ID: | |
| Software Version: |