Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for 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 | |||||
| (A)
CONNECTICUT CHILDREN'S MEDICAL CENTER |
060646755 | 3 | Yes | 10,000 | 0 | |
| (B)
CHILD HEALTH AND DEVELOPMENT OF CONNECTICUT INC |
061504725 | 7 | No | 1,210,495 | 0 | |
|
Total 2
|
1,220,495 | 0 | ||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2014 | (b) 2015 | (c) 2016 | (d) 2017 | (e) 2018 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | ||||||
| 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) 2014 | (b) 2015 | (c) 2016 | (d) 2017 | (e) 2018 | (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) 2014 | (b) 2015 | (c) 2016 | (d) 2017 | (e) 2018 | (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) 2014 | (b) 2015 | (c) 2016 | (d) 2017 | (e) 2018 | (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 2018 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-2018 |
(iii) Distributable Amount for 2018 |
|
|---|---|---|---|---|
|
1
Distributable amount for 2018 from Section C, line 6 |
||||
|
2
Underdistributions, if any, for years prior to 2018 (reasonable cause required-- explain in Part VI). See instructions. |
||||
| 3 Excess distributions carryover, if any, to 2018: | ||||
| a From 2013....... | ||||
| b From 2014....... | ||||
| c From 2015....... | ||||
| d From 2016....... | ||||
| e From 2017....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2018 distributable amount | ||||
|
i
Carryover from 2013 not applied (see instructions) |
||||
| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | ||||
| 4Distributions for 2018 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2018 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from 4. | ||||
|
5
Remaining underdistributions for years prior to 2018, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions. |
||||
|
6
Remaining underdistributions for 2018. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions. |
||||
|
7 Excess distributions carryover to 2019. Add lines 3j and 4c. |
||||
| 8 Breakdown of line 7: | ||||
| a Excess from 2014...... | ||||
| b Excess from 2015..... | ||||
| c Excess from 2016..... | ||||
| d Excess from 2017..... | ||||
| e Excess from 2018..... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|---|
| PART IV, SECTION B, LINE 1: | CONNECTICUT CHILDREN'S MEDICAL CENTER (THE "MEMBER"), ACTING THROUGH ITS BOARD OF DIRECTORS ELECTS THE BOARD OF THE CHILDREN'S FUND OF CONNECTICUT, INC. ( THE "CORPORATION"). THE CHILDREN'S FUND OF CONNECTICUT, INC. ELECTS THE BOARD OF CHILD HEALTH AND DEVELOPMENT INSTITUTE OF CONNECTICUT, INC. (THE "CORPORATION"). |
| PART IV, SECTION B, LINE 2: | CHILDREN'S FUND OF CONNECTICUT ("CFC") IS THE SOLE MEMBER OF CHILD HEALTH & DEVELOPMENT INSTITUTE OF CONNECTICUT ("CHDI"). CFC PROVIDED SUPPORT FOR THE OPERATIONS AND PROGRAMS OF CHDI TO ENHANCE CHILDREN'S HEALTH AND MENTAL HEALTH. |
| 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 VI, SECTION A, LINE 3 | THE CHILD HEALTH AND DEVELOPMENT INSTITUTE OF CONNECTICUT, INC., A 501(C)(3) ORGANIZATION, PERFORMS MANAGEMENT DUTIES FOR THE CHILDREN'S FUND OF CONNECTICUT, INC. AS DIRECTED BY THE BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION A, LINE 6 | CONNECTICUT CHILDREN'S MEDICAL CENTER (THE "MEMBER"), ACTING THROUGH ITS BOARD OF DIRECTORS, SHALL BE THE SOLE MEMBER OF THE CHILDREN'S FUND OF CONNECTICUT, INC. ( THE "CORPORATION"). |
| FORM 990, PART VI, SECTION A, LINE 7A | AT THE ANNUAL MEETING, THE MEMBER MAY ELECT DIRECTORS, IN ACCORDANCE WITH THE CORPORATION'S CERTIFICATE OF INCORPORATION AND THEIR BYLAWS, AND SHALL TRANSACT SUCH OTHER BUSINESS RELATING TO THE AFFAIRS OF THE CORPORATION AS MAY PROPERLY COME BEFORE THE MEETING. A MAJORITY OF THE DIRECTORS SHALL BE NOMINATED BY THE MEMBER, THE BALANCE OF THE ELECTED DIRECTORS SHALL BE NOMINATED BY THE BOARD DEVELOPMENT COMMITTEE. THE MEMBER AND THE BOARD DEVELOPMENT COMMITTEE WILL COLLABORATIVELY DESIGN A BOARD OF DIRECTORS WITH APPROPRIATE GEOGRAPHIC, ETHNIC, AND SKILL-SET DIVERSITY. |
| FORM 990, PART VI, SECTION A, LINE 7B | SUBJECT TO THE APPROVAL OF THE MEMBER, THE BOARD OF DIRECTORS AT A MEETING DULY WARNED AND HELD, BY A VOTE OF AT LEAST TWO-THIRDS OF ALL DIRECTORS THEN SERVING, MAY REMOVE ANY DIRECTOR WITH OR WITHOUT CAUSE, PROVIDED THE NOTICE OF SUCH MEETING SHALL INCLUDE NOTICE OF PROPOSED REMOVAL. THE DIRECTOR SOUGHT TO BE REMOVED SHALL HAVE NO RIGHT TO VOTE WITH RESPECT TO ANY SUCH ACTION. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 (TAX RETURN) WILL BE PREPARED ANNUALLY. COPIES OF THE FORM 990, WITH SUPPORTING SCHEDULES, WILL BE DISTRIBUTED BY THE VP FOR FINANCE AND OPERATIONS TO THE PRESIDENT AND CEO FOR REVIEW AND APPROVAL. ANY CORRECTIONS OR CHANGES WILL BE NOTED AND ADDRESSED. ONCE APPROVED BY THE PRESIDENT AND CEO, THE VP FOR FINANCE AND OPERATIONS WILL PROVIDE THE FORM 990 WITH SUPPORTING SCHEDULES TO THE BOARD OF DIRECTORS. ONCE THE BOARD OF DIRECTORS HAS HAD A REASONABLE OPPORTUNITY TO REVIEW THE FORM 990, ANY CORRECTIONS OR CHANGES WILL BE NOTED AND ADDRESSED. THE VP OF FINANCE AND OPERATIONS WILL THEN PROCESS THE FILING OF THE FORM 990 USING E-FILE RETURN PROCEDURES. |
| FORM 990, PART VI, SECTION B, LINE 12C | TO PROMOTE THE SOUND ADMINISTRATION OF THE CONFLICT OF INTEREST POLICY, ALL DIRECTORS AND OFFICERS OF THE CORPORATION COMPLETE ANNUALLY (AND UPDATED AS APPROPRIATE), A DISCLOSURE STATEMENT THAT DESCRIBES A TRANSACTION OR ARRANGEMENT THAT COULD REASONABLY GIVE RISE TO A CONFLICT OF INTEREST. THE STATEMENT INCLUDES A ITEMIZATION AND DESCRIPTION OF THE NATURE OF ANY ACTUAL OR POTENTIAL CONFLICT OF INTEREST AND ALL MATERIAL FACTS RELATED THERETO. DIRECTORS AND OFFICERS ARE URGED TO BE INCLUSIVE IN THIS DISCLOSURE SINCE THE DISCLOSURE OF POTENTIAL CONFLICTS IS ESSENTIAL TO ENSURING APPROPRIATE, OPEN DISCUSSION, EVEN IF A CONFLICT OF INTEREST IS EVENTUALLY DETERMINED NOT TO EXIST. IF, AFTER SUBMITTING AN ANNUAL DISCLOSURE STATEMENT, AN APPARENT OR POTENTIAL CONFLICT ARISES WITHIN THE SPIRIT OF THIS POLICY, DIRECTORS AND OFFICERS IMMEDIATELY DISCLOSE THE SITUATION IN WRITING TO THE PRESIDENT. DISCLOSURE STATEMENTS ARE PROVIDED BY AND RETURNED TO THE PRESIDENT. IF A POTENTIAL CONFLICT OF INTEREST SITUATION INVOLVES A PENDING TRANSACTION OR ARRANGEMENT ON THE PART OF THE CORPORATION, SUCH POTENTIAL CONFLICT IS BROUGHT TO THE ATTENTION OF THE PRESIDENT PRIOR TO ANY ACTION ON THE PART OF THE CORPORATION. THE PRESIDENT CONSULTS WITH THE DIRECTOR OR OFFICER WITH THE POTENTIAL CONFLICT AND OBTAINS INFORMATION NECESSARY FOR AN ORDINARY PRUDENT PERSON TO MAKE JUDGMENT AS TO WHETHER A CONFLICT EXISTS. THE PRESIDENT EXERCISES A GOOD FAITH JUDGMENT IN DETERMINING WHETHER AN ACTUAL CONFLICT OF INTEREST EXISTS, AND PROVIDES GUIDANCE TO THE DIRECTOR OR OFFICER WITH THE POTENTIAL CONFLICT AND/OR TO THE BOARD, AS APPLICABLE, AS TO THE APPROPRIATE COURSE OF ACTION. IF A CONFLICT EXISTS OR IF THE PRESIDENT DETERMINES THAT FURTHER REVIEW WOULD BE PRUDENT, HE OR SHE SHALL SEEK THE ADVICE AND APPROVAL OF THE BOARD IN DETERMING WHETHER THE SITUATION OR TRANSACTION IS FAIR AND SERVES THE CORPORATION'S BEST INTERESTS. DIRECTORS AND OFFICERS WHO HAVE DECLARED OR HAVE BEEN DEEMED TO HAVE A CONFLICT OF INTEREST ("INTERESTED PERSON") REFRAIN FROM CONSIDERATION OF PROPOSED TRANSACTIONS OR ARRANGEMENTS, UNLESS FOR SPECIAL REASON THE BOARD REQUESTS INFORMATION OR INTERPRETATIONS. THE CORPORATION MAKES ITS DECISION AS TO WHETHER TO ENTER INTO A TRANSACTION OR ARRANGEMENT IN CONFORMITY WITH THE FOLLOWING PROCESS: A) AN INTERESTED PERSON MAY UPON INVITATION MAKE A PRESENTATION AT THE BOARD MEETING, BUT AFTER THE PRESENTATION, HE/SHE SHALL LEAVE THE MEETING DURING THE DISCUSSION OF, AND THE VOTE ON, THE TRANSACTION OR ARRANGEMENT INVOLVING POSSIBLE CONFLICT OF INTEREST. B) IN THE CONTEXT OF A TRANSACTION OR ARRANGEMENT, THE PRESIDENT SHALL, IF APPROPRIATE, APPOINT A DISINTERESTED DIRECTOR OR COMMITTEE OF DISINTERESTED DIRECTORS TO INVESTIGATE ALERNATIVES TO PROPOSED TRANSACTION OR ARRANGEMENT. C) AFTER EXERCISING DUE DILIGENCE, THE BOARD SHALL DETERMINE, IF APPROPRIATE, WHETHER THE CORPORATION CAN OBTAIN WITH REASONABLE EFFORTS A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT FROM A PERSON OR ENTITIY THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST. D) IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY POSSIBLE OR APPROPRIATE UNDER CIRCUMSTANCES NOT PRODUCING A CONFLICT OF INTEREST, THE BOARD SHALL DETERMINE BY A MAJORITY VOTE, BUT NOT FEWER THAN TWO, OF THE DISINTERESTED DIRECTORS, OR AS OTHERWISE PERMITTED BY LAW, WHETHER THE TRANSACTION OR ARRANGEMENT IS IN THE CORPORATION'S BEST INTEREST AND IS FAIR AND REASONABLE, PROVIDED, HOWEVER, IF SUCH CONFLICTING INTEREST TRANSACTION OR ARRANGEMENT IS APPROVED BY DISINTERESTED DIRECTORS WHO DO NOT SATISFY A QUORUM OR VOTING REQUIREMENT APPLICABLE TO THE AUTHORIZATION OF THE ACTION BY REASON OF THE CORPORATION'S CERTIFICATE OF INCORPORATION, BYLAWS OR A PROVISION OF LAW, THE ACTION MUST BE INDEPENDENTLY APPROVED BY SUCH INTERESTED AND DISINTERESTED DIRECTORS AS SATISFYING THE APPLICABLE QUORUM OR VOTING REQUIREMENT. THE BOARD WILL RETAIN DETAILED MINUTES OF ANY PROCEEDINGS INVOLVING A POTENTIAL CONFLICT OF INTEREST TRANSACTION. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE CHILDREN'S FUND OF CONNECTICUT DOES NOT HAVE EMPLOYEES BUT DOES HAVE A COMPENSATION POLICY IN THE EVENT THAT EMPLOYEES ARE HIRED. THIS POLICY APPLIES TO THE PROCESS FOR DETERMINING COMPENSATION IN COMPLIANCE WITH IRS INSTRUCTIONS FOR THE CFC'S CEO, TOP MANAGEMENT OFFICIALS, AND OTHER OFFICERS OR KEY EMPLOYEES. THE PROCESS INCLUDES ALL OF THESE ELEMENTS: (1) REVIEW AND APPROVAL BY THE BOARD OF DIRECTORS OR EXECUTIVE COMMITTEE OF THE CHILDREN'S FUND OF CONNECTICUT (CFC), (2) USE OF DATA AS TO COMPARABLE COMPENSATION, AND (3) CONTEMPORANEOUS DOCUMENTATION AND RECORDKEEPING. 1) REVIEW AND APPROVAL: THE COMPENSATION OF THE PERSON IS REVIEWED AND APPROVED BY THE BOARD OF DIRECTORS OR EXECUTIVE COMMITTEE OF CFC, PROVIDED THAT PERSONS WITH CONFLICTS OF INTEREST WITH RESPECT TO THE COMPENSATION ARRANGEMENT AT ISSUE ARE NOT INVOLVED IN THIS REVIEW AND APPROVAL. 2) USE OF DATA AS TO COMPARABLE COMPENSATION: THE COMPENSATION OF THE PERSON IS REVIEWED AND APPROVED USING DATA AS TO COMPARABLE COMPENSATION FOR SIMILARLY QUALIFIED PERSONS IN FUNCTIONALLY COMPARABLE POSITIONS AT SIMILARLY SITUATED ORGANIZATIONS. 3) CONTEMPORANEOUS DOCUMENTATION AND RECORDKEEPING: THERE IS CONTEMPORANEOUS DOCUMENTATION AND RECORDKEEPING WITH RESPECT TO THE DELIBERATIONS AND DECISIONS REGARDING THE COMPENSATION ARRANGEMENT. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE CHILDREN'S FUND OF CONNECTICUT, INC. (CFC) MAKES ITS GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. COPIES ARE PROVIDED TO THE PUBLIC OR THE PUBLIC MAY INSPECT THE DOCUMENTS AT CFC'S OFFICE LOCATED AT 270 FARMINGTON AVENUE, SUITE 367, FARMINGTON, CT 06032. |
| Software ID: | |
| Software Version: |