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)
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(a) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | 599,859 | 669,394 | 839,320 | 920,186 | 731,435 | 3,760,194 |
| 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 | 599,859 | 669,394 | 839,320 | 920,186 | 731,435 | 3,760,194 |
| 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) .. | 2,660,560 | |||||
| 6 | Public support. Subtract line 5 from line 4. | 1,099,634 | |||||
Calendar year
(or fiscal year beginning in)
![]() |
(a) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 599,859 | 669,394 | 839,320 | 920,186 | 731,435 | 3,760,194 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | 28 | 11 | 3 | 3 | 11 | 56 |
| 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 | 3,760,250 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (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) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (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 on 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 0.015 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 0.035 | 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 | 1 | |
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
2 | |
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | 3 | |
| 4 Amounts paid to acquire exempt-use assets | 4 | |
| 5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI) | 5 | |
| 6 Other distributions (describe in Part VI). See instructions | 6 | |
| 7Total annual distributions. Add lines 1 through 6. | 7 | |
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
8 | |
| 9 Distributable amount for 2021 from Section C, line 6 | 9 | |
| 10 Line 8 amount divided by Line 9 amount | 10 | |
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2021 |
(iii) Distributable Amount for 2021 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2021 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2021 (reasonable cause required-- explain in Part VI). See instructions. |
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| 3 Excess distributions carryover, if any, to 2021: | ||||
| a From 2016....... | ||||
| b From 2017....... | ||||
| c From 2018....... | ||||
| d From 2019....... | ||||
| e From 2020....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2021 distributable amount | ||||
|
i
Carryover from 2016 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from line 3f. | ||||
| 4Distributions for 2021 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2021 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from line 4. | ||||
|
5
Remaining underdistributions for years prior to 2021, 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 2021. 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 2022. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2017..... | ||||
| b Excess from 2018..... | ||||
| c Excess from 2019..... | ||||
| d Excess from 2020..... | ||||
| e Excess from 2021..... | ||||
| Facts And Circumstances Test |
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| Return Reference | Explanation |
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| 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, PAGE 1, PART I, LINE 6 | SIL'S BOARD OF DIRECTORS IS AN ALL-VOLUNTEER BOARD WHICH ACTIVELY SETS POLICY AND THE DIRECTION OF THE AGENCY. THERE ARE ALSO THOSE WHO VOLUNTEER GOODS AND SERVICES, INCLUDING INTERNS ASSISTING WITH PROGRAMS AND DEVELOPMENT OF WEBSITES AND NEWSLETTERS AND OTHER SERVICES. IN ADDITION, SIL IS ABLE TO CALL ON VOLUNTEERS TO ASSIST AT CONFERENCES AND EVENTS AS NEEDED, THEREBY FREEING UP STAFF TIME AND REDUCING COSTS. |
| FORM 990, PAGE 2, PART III, LINE 4A | ILST/PEER SUPPORT - THESE TWO CORE SERVICES OFTEN GO HAND-IN-HAND WITH EACH OTHER. INDEPENDENT LIVING SKILLS TRAINING (ILST) HELPS INDIVIDUALS DEVELOP SKILLS NEEDED TO LIVE IN THE COMMUNITY OF CHOICE AND/OR BECOME MORE INDEPENDENT. EXAMPLES OF TOPICS COVERED UNDER ILST INCLUDE BUDGETING, USING THE COMPUTER/INTERNET, INTERNET SAFETY, BULLYING, SELF-ADVOCACY, COOKING, LAUNDRY, WASHING DISHES, SAFETY IN THE HOME AND COMMUNITY, DEVELOPING PERSONAL EMERGENCY PLANS AND MANAGING A PERSONAL CARE ATTENDANT. PEER SUPPORT SERVICES ARE PROVIDED TO INDIVIDUALS BY SOMEONE WHO HAS A DISABILITY, EITHER STAFF OR TRAINED VOLUNTEERS. THE SUPPORT PERSON IS ABLE TO HELP WITH THE PERSON RECEIVING SERVICES FROM A PLACE OF PERSONAL EXPERIENCE. ISSUES COVERED IN PEER SUPPORTS MAY INCLUDE: SUPPORTED DECISION MAKING, PROBLEM SOLVING, ACCEPTING DISABILITY, IDENTIFYING ACCOMMODATIONS, SETTING AND ACHIEVING LIFE GOALS, AND GENERAL SHARING OF EXPERIENCES TO ENSURE THE PERSON INVOLVED DOES NOT FEEL ALONE. |
| FORM 990, PAGE 2, PART III, LINE 4B | PERSONAL CARE ASSISTANCE PROGRAM: OPPORTUNITIES FOR OHIOANS WITH DISABILITIES, OHIO'S REHABILITATION SERVICES AGENCY, CONTRACTS WITH SIL TO PROVIDE ADMINISTRATIVE AND PROGRAMMATIC SUPPORT TO 62 INDIVIDUALS WITH DISABILITIES ACROSS THE MAJORITY OF NORTHERN OHIO COUNTIES. THIS PROGRAM ASSISTS INDIVIDUALS WHO ARE WORKING, LOOKING FOR WORK OR ARE PURSUING POST- SECONDARY EDUCATIONAL OPPORTUNITIES WITH FUNDING TO HIRE PERSONAL ASSISTANTS. THIS PROGRAM WAS OHIO'S FIRST PUBLICLY FUNDED CONSUMER- DIRECTED PERSONAL ASSISTANCE PROGRAM. THE ROLE OF SIL STAFF IS TO PROMOTE THE PROGRAM TO THE COMMUNITY, PROVIDE OPTIONS COUNSELING TO POTENTIAL PARTICIPANTS, ORIENT NEW PARTICIPANTS TO THE PROGRAM, PROVIDE TECHNICAL ASSISTANCE ON PERSONAL ASSISTANCE MANAGEMENT ISSUES, TROUBLESHOOT ANY OTHER ISSUES THAT ARISE, AND ENTER BILLINGS INTO THE STATE DATABASE FOR PROCESSING. |
| FORM 990, PAGE 2, PART III, LINE 4D | COMMUNITY EDUCATION: SIL STAFF ARE OFTEN CALLED UPON TO PRESENT AT LOCAL, STATE AND NATIONAL TRAINING VENUES ON A VARIETY OF TOPICS INCLUDING: DIRECT CARE WORKFORCE CRISIS, DISABILITY BASICS, ADDRESSING BARRIERS TO COMMUNITY LIVING, PERSON-CENTERED-PLANNING, SOCIAL SECURITY AND WORK INCENTIVES, MANAGING YOUR PERSONAL ASSISTANT, AND THE AMERICANS WITH DISABILITY ACT. SIL TRAINED OVER 1,500 COMMUNITY MEMBERS, ON ADDRESSING BARRIERS TO COMMUNITY LIVING. SIL ALSO MAINTAINS AN ACTIVE FACEBOOK SITE AND CONTINUES TO INCREASE THEIR PRESENCE ON TWITTER. YOUTH ABILITIES AND PRE-EMPLOYMENT TRANSITION SERVICES: A YOUTH TRANSITION PROGRAM PROVIDES SUPPORTS TO YOUTHS WITH DISABILITIES. THE PROGRAM CURRENTLY SERVES 85 YOUTHS AND FOCUSES ON SKILL BUILDING SELF-ADVOCACY, PRE-EMPLOYMENT AND OTHER INDEPENDENT LIVING SKILLS. YOUTHS ARE INDIVIDUALS THAT ARE CURRENTLY ENROLLED IN SCHOOL AND INDIVIDUALS WHO HAVE LEFT SECONDARY EDUCATION VIA GRADUATION OR WITHDRAWAL. OHIO DEPARTMENT OF MEDICAID HOME CHOICE PROGRAM - SIL'S INVOLVEMENT IS AT THE BEGINNING OF THIS THREE-STEP PROCESS. SIL CONDUCTS COMMUNITY LIVING INTERVIEWS TO GAUGE INTEREST FROM INDIVIDUALS IF THEY ARE GOING TO TRANSITION IN THE FUTURE. IF SO, RESOURCES ARE GIVEN TO THE INDIVIDUAL REGARDING HOUSING, TRANSPORTATION, OR ANY OTHER ADDITIONAL FUNDING THEY ASK FOR. SIL CONDUCTED 21 INTERVIEWS THIS YEAR. FOR THE SECOND STEP, SIL CONDUCTS COMMUNITY LIVING ASSESSMENTS IN THE INSTITUTION TO RESIDENTS WHO ARE DEEMED ELIGIBLE TO MOVE, BUT NEED THE ASSESSMENT COMPLETED TO DETERMINE SAFETY IN THE COMMUNITY. THIS STEP MUST BE CONDUCTED BY A STAFF MEMBER WHO IS AN RN, LSW, OR LISW. SIL CONDUCTED 51 ASSESSMENTS IN THE LAST YEAR. EQUIPMENT LOAN PROGRAM: SIL MAINTAINS AN EQUIPMENT LOAN CLOSET THAT ALSO INCLUDES SOFT SUPPLIES SUCH AS ADULT DIAPERS AND PADS. THE PROGRAM IS FREE TO RECIPIENTS AND RELIES UPON EQUIPMENT DONATIONS FROM INDIVIDUALS AND MEDICAL SUPPLY COMPANIES. DURING THIS REPORTING PERIOD, SIL PROVIDED OVER 100 PIECES OF DURABLE MEDICAL EQUIPMENT AND SUPPLIES TO 62 INDIVIDUALS. INFORMATION AND REFERRAL: SIL SERVES AS A RESOURCE TO THE COMMUNITY WITH REGARDS TO INFORMATION. IN ADDITION TO HELPING INDIVIDUALS WITH DISABILITIES ACCESS SERVICES/SUPPORTS AND INFORMATION, SIL STAFF ANSWERED 1,113 CALLS FROM COMMUNITY STAKEHOLDERS ON ISSUES RANGING FROM HOUSING, EMPLOYMENT, TRANSPORTATION AND BENEFITS TO HOW TO ACCESS WAIVER SUPPORTS OR HELP TO RID THEIR HOME OF BED BUGS. LEADERSHIP ACADEMY: THE PREMISE IS THAT PEOPLE WITH DISABILITIES SHOULD BE INVOLVED IN THE DECISION-MAKING PROCESS AS LAWS AND RULES ARE BEING DEVELOPED IMPACTING THEIR LIVES. THIS 8-WEEK COURSE HELPS PERSONS WITH DISABILITIES GAIN SKILLS TO EFFECTIVELY PARTICIPATE IN LEADERSHIP BOARDS OF DIRECTORS AND COMMUNITY COMMITTEES, COALITIONS AND TASKFORCES. THIS PAST FISCAL YEAR, 17 PEOPLE PARTICIPATED. YOUNG ADULT COUNCIL: THIS IS A STATEWIDE COMMUNITY LED COUNCIL, HANDS- ON/INTERNSHIP APPROACH THAT WILL PROVIDE YOUNG ADULTS THE OPPORTUNITY TO PARTICIPATE IN A REALISTIC POLICYMAKING ENVIRONMENT. THIS IS AN INTERACTIVE PROGRAM IN WHICH PARTICIPANTS EXPLORE DIFFERENT ADVOCACY INITIATIVES, NETWORK WITH LEGISLATORS, TRAVEL TO CITY COUNCIL MEETINGS AND MAYOR'S OFFICES, AND VISIT THE OHIO STATE HOUSE. THIS PAST FISCAL YEAR, 6 YOUNG ADULTS PARTICIPATED. OHIO BENEFITS LONG-TERM SERVICES AND SUPPORTS: THE OBLTSS PROGRAM IS AVAILABLE FOR INDIVIDUALS, THEIR FAMILY MEMBERS, AND PROFESSIONALS SEEKING INFORMATION ABOUT HOME AND COMMUNITY-BASED LONG-TERM SERVICES AND SUPPORTS. INDIVIDUALS CAN SPEAK WITH SOMEONE WHO WILL ANSWER QUESTIONS ABOUT SERVICES AND CONNECT THEM TO COMMUNITY PROGRAMS AND RESOURCES BASED ON THEIR NEEDS. IN THIS REPORTING PERIOD, SIL PROVIDED VALUABLE INFORMATION AND REFERRAL SERVICES TO 506 INDIVIDUALS. |
| FORM 990, PAGE 6, PART VI, LINE 11B | FEDERAL FORM 990 WAS PRESENTED TO THE BOARD OF DIRECTORS PRIOR TO FILING. |
| FORM 990, PAGE 6, PART VI, LINE 12C | ON AN ANNUAL BASIS, EACH BOARD MEMBER AND ALL MANAGEMENT PERSONNEL ARE REQUIRED TO READ THE ORGANIZATION'S CONFILCT OF INTEREST POLICY AND DISCLOSE ANY POSSIBLE CONFLICTS. |
| FORM 990, PAGE 6, PART VI, LINE 15A | EXECUTIVE DIRECTOR'S SALARY WAS DETERMINED BY THE EXECUTIVE COMMITTEE, WHICH USED OTHER NPO'S FEDERAL FORMS 990 AND INDUSTRY STANDARDS AND CONSIDERED THE LIMITED RESOURCES OF THE ORGANIZATION. |
| FORM 990, PAGE 6, PART VI, LINE 19 | CONSISTENT WITH THE REQUIREMENTS OF SECTION 6104 (D) OF THE IRC AND THE REGULATIONS THEREUNDER, COPIES OF THE ORGANIZATION'S FORM 990 AND GOVERNING DOCUMENTS WILL BE MADE AVAILABLE UPON REQUEST, IN A TIMELY MANNER, AND SUBJECT TO CHARGES PERMITTED BY LAW TO ANY INDIVIDUAL WHO REQUESTS THEM. |
| Software ID: | |
| Software Version: |