2017-11-09T15:29:41-06:00 2016-12-31 Grant Thornton LLP 1000 WILSON BLVD SUITE 1400 ARLINGTON VA 22209 990 2016-01-01 521862406 Health Services for Children with Special Needs Inc % VICTOR FIELDS HEAL 2024672737 1101 VERMONT AVENUE NW Suite 1200 WASHINGTON DC 20005 VICTOR FIELDS SVP Fin. & CFO 2024672737 2017-11-07 true Mary Torretta P00847851 7038477500 38.69.39.117 54681420173135000004 2017-11-09 P AA918D8483008E32154F6CC583B06457B9AF9E42 AA918D8483008E32154F6CC583B06457B9AF9E42 2016 2018-03-14 21:41:22Z Nathaniel Beers 2013 H STREET NW STE 300 WASHINGTON DC 20005 179181659 false X http://www.hschealth.org/health-plan X 1994 DC TO PROVIDE COORDINATION OF HEALTHCARE, SOCIAL, AND EDUCATIONAL SERVICES TO PERSONS WHO HAVE DISABILITIES AND/OR COMPLEX MEDICAL AND/OR PSYCHOLOGICAL NEEDS. 6 5 215 278 0 56478 17320 164243362 179163090 764 1249 -56448 0 164244156 179181659 0 0 0 0 17139180 16550635 0 0 0 153954667 161039726 171093847 177590361 -6849691 1591298 53820178 58094018 42486529 45169071 11333649 12924947 X TO PROVIDE COORDINATION OF HEALTH CARE, SOCIAL, AND EDUCATIONAL SERVICES FOR INFANTS, CHILDREN, ADOLESCENTS, AND YOUNG ADULTS WHO HAVE DISABILITIES AND/OR COMPLEX MEDICAL AND/OR PSYCHOSOCIAL NEEDS. false false 160314357 179163090 HSCSN SERVED UP TO 5,924 MEMBERS DURING 2016 THROUGH INTENSE ONE ON ONE CARE MANAGEMENT SERVICES. THERE WERE 1,270 MEDICAL ACUTE HOSPITAL ADMISSIONS FOR A TOTAL OF 6,936 PATIENT DAYS, AND 202 BEHAVIORAL ACUTE HOSPITAL ADMISSIONS FOR A TOTAL OF 1,879 PATIENT DAYS COVERED DURING THE YEAR. THERE WERE ON AVERAGE 39 MEMBERS IN SUB-ACUTE AND LONG-TERM CARE FACILITIES COVERING 6,012 PATIENT DAYS DURING 2016. HSCSN ALSO COORDINATED 12,254 PRIMARY CARE AND 9,318 SPECIALTY CARE DOCTOR VISITS DURING 2016. OTHER SERVICES COORDINATED INCLUDE: TRANSPORTATION TO MEDICAL APPOINTMENTS, EMERGENCY ROOM VISITS, DENTAL CARE, LAB/RADIOLOGY SERVICES, DAY TREATMENT, HOME HEALTHCARE, MEDICAL DRUGS AND MEDICAL EQUIPMENT AND SUPPLIES. DURING 2016, HSCSN ALSO SPONSORED CME SEMINARS TO OUR PROVIDERS AND STAFF AND EDUCATIONAL PROGRAMS TO OUR MEMBERS. 160314357 true true false false false false false false false false true false false true true true true true false false false false false false false false false false false true false false false false false false false false false false false false false true false false false true 442 0 true 215 true false false false false false false false false false false X 6 5 false false false false true true true true true false false false true true true true true false false false X VICTOR FIELDS 2024541255 2013 H STREET NW SUITE 300 WASHINGTON DC 20006 X THOMAS W CHAPMAN PRES & CEO hscf, board member 4.0 36.0 X X 0 685979 40674 ANA PILSKAYA CHAIRPERSON 1.0 0.0 X X 0 0 0 WILLIAM CLYBURN BOARD MEMBER 1.0 1.0 X 0 0 0 ELAINE A CRIDER BOARD MEMBER 1.0 1.0 X 0 0 0 MARIA IVONNE RIVERA SECRETARY 1.0 1.0 X X 0 0 0 THOMAS WALSH BOARD MEMBER 1.0 0.0 X 0 0 0 KHALIL BOUHAROUN COO HSCSN; Former Cio 10.0 30.0 X 0 256575 28814 RAYMOND VICKS JR SVP Fin & CFO, to 7/31/2017 10.0 30.0 X 0 353165 24092 JOHN MATHEWSON HSCF EXECUTIVE VP, to 3/31/16 8.0 32.0 X 0 368586 33087 DANIEL BELLAMY VP, Bus Dev't; Fmr COO, HSCSN 36.0 4.0 X 0 300995 39095 RHONIQUE SHIELDS CHIEF MEDICAL OFFICER 40.0 0.0 X 304010 0 24498 LYNNE HOSTETTER PIPER Chief Comp Officer & VP, HR 8.0 32.0 X 0 257050 35068 FRANCES P CHRISTMON VP Fin/Plan/Anlys, to 4/30/16 20.0 20.0 X 0 197860 12726 Kimberly Brown Corp Controller & VP Corp Fin 10.0 30.0 X 0 181965 3914 304010 2602175 241968 1 false true false CAREMARK 2211 SANDERS RD NORTHBROOK IL 60062 PHARMACY SERVICES 15504878 SOUTHEASTRANS INC 4751 BEST ROAD SUITE 210 ATLANTA GA 30337 TRANSPORTATION SVCS 3799418 QUALITY PLAN ADMINISTRATORS 7824 EASTERN AVE NW SUITE 100 WASHINGTON DC 20012 CAPITATION 2627437 URBAN BEHAVIORAL ASSOCIATES 3029 MARTIN LUTHER KING AVE SE WASHINGTON DC 20032 BEHAVIORAL HEALTH 1969662 TRIZETTO DEPT 2140 PO BOX 122140 DALLAS TX 75312 CLAIMS PROCESSING 1262070 14 11970 5350 17320 MANAGED CARE REVENUE 621400 179163090 179163090 179163090 1249 1249 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 179181659 179163090 1249 0 0 0 0 0 0 14244792 12820313 1424479 488523 488523 806964 806964 1010356 1010356 0 303071 303071 57177 57177 0 0 0 6204824 1654757 4550067 35962 35962 288667 45899 242768 20407 20407 0 2554233 38253 2515980 488107 212609 275498 0 38446 11273 27173 0 0 1283785 1283785 151817 151817 HEALTHCARE SERVICE COST 145336600 145336600 PREMIUM TAXES 3654282 3654282 SPECIAL EVENTS 156365 9499 146866 FOOD 59043 8292 50751 406940 176862 230078 177590361 160314357 17276004 0 253589 0 0 254430 0 0 790 29355 0 0 0 0 0 0 0 0 0 204936 7349968 4497598 3149022 2852370 0 0 0 0 0 0 0 0 50416777 54752927 53820178 58094018 35554204 35315980 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6932325 9853091 42486529 45169071 X 11297638 12924947 36011 0 0 0 11333649 12924947 53820178 58094018 1591298 X false true X true false X 131863 103287 29550 56478 17320 338498 127983433 155049589 154769081 164243362 179163090 781208555 0 0 0 128115296 155152876 154798631 164299840 179180410 781547053 0 0 0 781547053 427 645 271 764 1249 3356 0 427 645 271 764 1249 3356 0 375 29382 283741 204700 518198 128116098 155182903 155082643 164505304 179181659 782068607 0.99933 0.99930 0.00000 0.00000 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 60628 39958 20670 6974140 4457640 2516500 315200 315200 2852370 DEPOSITS 404175 DUE FROM AFFILIATES 48903345 DUE FROM THIRD PARTIES 5445407 54752927 0 DUE TO AFFILIATES 4247975 DUE TO THIRD PARTIES 5364145 SELF INSURANCE PROFESSIONAL LIABILITY 240971 9853091 X 179181659 179181659 179181659 177590361 177590361 177590361 LIABILITY FOR UNCERTAIN TAX POSITION (ASC 740) Schedule D, part X Line 2 HSCSN WAS RECOGNIZED AS A PUBLIC CHARITY GENERALLY EXEMPT FROM FEDERAL INCOME TAXATION UNDER 501(C)(3) OF THE INTERNAL REVENUE CODE PURSUANT TO A DETERMINATION LETTER ISSUED BY THE INTERNAL REVENUE SERVICE (IRS) ON AUGUST 30, 1999. HSCSN IS ENTITLED TO RELY ON THIS DETERMINATION AS LONG AS THERE ARE NO SUBSTANTIAL CHANGES IN ITS CHARACTER, PURPOSES, OR METHODS OF OPERATION. MANAGEMENT HAS CONCLUDED THAT THERE HAVE BEEN NO SUCH CHANGES AND THEREFORE HSCSNS STATUS AS A PUBLIC CHARITY EXEMPT FROM FEDERAL INCOME TAXATION REMAINS IN EFFECT. THE STATES IN WHICH HSCSN OPERATES ALSO PROVIDE GENERAL EXEMPTION FROM STATE INCOME TAXATION FOR ORGANIZATIONS THAT ARE EXEMPT FROM FEDERAL INCOME TAXATION. HOWEVER, HSCSN IS SUBJECT TO BOTH FEDERAL AND STATE INCOME TAXATION AT CORPORATE TAX RATES ON ITS UNRELATED BUSINESS INCOME. EXEMPTION FROM OTHER STATE TAXES, SUCH AS REAL AND PERSONAL PROPERTY TAXES, IS SEPARATELY DETERMINED. HSCSN HAD NO UNRECOGNIZED TAX BENEFITS OR SUCH AMOUNTS WERE IMMATERIAL DURING THE PERIODS PRESENTED. FOR TAX PERIODS WITH RESPECT TO WHICH NO UNRELATED BUSINESS INCOME WAS RECOGNIZED, NO TAX RETURN WAS REQUIRED. TAX PERIODS FOR WHICH NO RETURN IS FILED REMAIN OPEN FOR EXAMINATION INDEFINITELY. INFORMATION RETURNS (FORM 990) AND TAX RETURNS(FORM 990-T) FOR THE YEAR ENDED DECEMBER 31, 2016 ARE DUE ON MAY 15, 2017. MANAGEMENT FILED AN EXTENSION THROUGH AUGUST 15, 2017. HSCSN HAS FILED INFORMATION RETURNS AND TAX RETURNS FOR ALL YEARS THROUGH 2015. HSCSN MUST RECOGNIZE THE TAX BENEFIT FROM AN UNCERTAIN TAX POSITION ONLY IF IT IS "MORE-LIKELY-THAN-NOT" THAT THE TAX POSITION WILL BE SUSTAINED ON EXAMINATION BY THE APPLICABLE TAXING AUTHORITIES BASED ON THE TECHNICAL MERITS OF THE POSITION. THERE WERE NO UNCERTAIN TAX POSITIONS IDENTIFIED AS OF DECEMBER 31, 2016 AND 2015. TAX RETURNS FILED BY HSCSN ARE SUBJECT TO EXAMINATION BY THE IRS UP TO THREE YEARS FROM THE DATE THE RETURN WAS FILED. TAX RETURNS FILED BY HSCSN ARE NO LONGER SUBJECT TO EXAMINATION FOR THE YEAR ENDED DECEMBER 31, 2012 AND PRIOR. true true false false false false false false false THOMAS W CHAPMAN PRES & CEO hscf, board member 0 625742 0 150 0 60087 0 23216 0 17458 0 726653 0 0 JOHN MATHEWSON HSCF EXECUTIVE VP, to 3/31/16 0 92507 0 0 0 276079 0 10286 0 22801 0 401673 0 0 DANIEL BELLAMY VP, Bus Dev't; Fmr COO, HSCSN 0 263257 0 150 0 37588 0 23850 0 15245 0 340090 0 0 KHALIL BOUHAROUN COO HSCSN; Former Cio 0 238810 0 150 0 17615 0 27130 0 1684 0 285389 0 0 RAYMOND VICKS JR SVP Fin & CFO, to 7/31/2017 0 303355 0 150 0 49660 0 23216 0 876 0 377257 0 0 RHONIQUE SHIELDS CHIEF MEDICAL OFFICER 271014 0 150 0 32846 0 13585 0 10913 0 328508 0 0 0 LYNNE HOSTETTER PIPER Chief Comp Officer & VP, HR 0 234562 0 150 0 22338 0 27464 0 7604 0 292118 0 0 FRANCES P CHRISTMON VP Fin/Plan/Anlys, to 4/30/16 0 65344 0 0 0 132516 0 4647 0 8079 0 210586 0 0 Kimberly Brown Corp Controller & VP Corp Fin 0 171389 0 150 0 10426 0 3165 0 749 0 185879 0 0 ARRANGEMENT USED TO ESTABLISH THE TOP MANAGEMENT OFFICIAL'S COMPENSATION SCHEDULE J. PART 1, LINE 3 THE ORGANIZATION RELIED ON A RELATED ORGANIZATION AND THAT RELATED ORGANIZATION USED THE FOLLOWING METHODS TO ESTABLISH THE CEO/PRESIDENT'S COMPENSATION: 1) INDEPENDENT COMPENSATION CONSULTANT; 2) COMPENSATION SURVEY OR STUDY; AND 3) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. SEVERANCE OR CHANGE-OF-CONTROL PAYMENT SCHEDULE J, PART I, LINE 4A During the year ended December 30, 2016, certain individuals received severance payments. These amounts are reported as taxable compensation and reported on schedule J, part ii, line b(iii), other reportable compensation. The individuals and amounts are listed below: Frances P. Christmon $102,308 John Mathewson $254,678 SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN SCHEDULE J, PART 1, LINE 4B A RELATED ORGANIZATION MAINTAINS A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) AS PART OF THE TOTAL COMPENSATION ARRANGEMENT FOR THE ORGANIZATION'S CEO, THOMAS CHAPMAN. THE SERP PLAN IS MEANT TO PROVIDE THOMAS CHAPMAN WITH A RETIREMENT BENEFIT FOR OVER 15 YEARS OF SERVICE PROVIDED TO THE RELATED ORGANIZATION. THE RELATED ORGANIZATION'S COMPENSATION COMMITTEE HAS CAREFULLY REVIEWED AND APPROVED THE SERP PLAN FOR THOMAS CHAPMAN AND CONCLUDED THAT THOMAS CHAPMAN'S ENTIRE COMPENSATION PACKAGE, INCLUDING THE BENEFITS PROVIDED BY THE SERP PLAN, IS REASONABLE WHEN COMPARED TO MARKET DATA. NO SERP DISTRIBUTIONS WERE MADE IN 2016. DELEGATE BOARD AUTHORITY TO A COMMITTEE FORM 990, PART VI, LINE 1A THE EXECUTIVE COMMITTEE OF THE HSC FOUNDATION, THE SOLE CORPORATE MEMBER OF THE ORGANIZATION, HAS THE POWER TO EXERCISE EACH AND ALL OF THE POWERS OF THE BOARD OF DIRECTORS IN THE SAME MANNER AND TO THE SAME EXTENT AS IF THE COMMITTEE WERE IN FACT THE BOARD OF DIRECTORS, PROVIDED THAT ANY ACTION TAKEN SHALL NOT CONFLICT WITH PREVIOUSLY ESTABLISHED POLICIES OR DIRECTIVES OF THE BOARD. HOWEVER, NOTHING CONTAINED IN THESE BYLAWS SHALL CONSTITUTE A DELEGATION TO THE EXECUTIVE COMMITTEE OF THE FOLLOWING POWERS OF THE BOARD OF DIRECTORS: TO INCREASE OR DECREASE THE NUMBER OF DIRECTORS; TO FILL VACANCIES ON OR REMOVE DIRECTORS FROM THE BOARD; TO ELECT OFFICERS; TO FILL OFFICERS VACANCIES; TO REMOVE OFFICERS; TO SELL, ENCUMBER OR OTHERWISE DISPOSE OF ALL OR ANY MATERIAL PART OF THE ASSETS OF THE CORPORATION; TO MERGE OR CONSOLIDATE THE CORPORATION WITH ANOTHER ENTITY; OR TO AMEND THESE BYLAWS. ALL EXECUTIVE COMMITTEE MINUTES WILL BE PROVIDED TO ALL MEMBERS OF THE BOARD OF DIRECTORS PRIOR TO THE NEXT MEETING OF THE BOARD OF DIRECTORS. THE EXECUTIVE COMMITTEE SHALL CONSIST OF THE CHAIRMAN, VICE CHAIRMAN, SECRETARY AND TREASURER OF THE HSC FOUNDATION AND UP TO FOUR (4) ADDITIONAL AT-LARGE MEMBERS WHO MAY BE APPOINTED BY THE CHAIRMAN OF THE BOARD, IN HIS OR HER DISCRETION. THE PRESIDENT SHALL BE AN EX OFFICIO MEMBER OF THE COMMITTEE. Members or Stockholders Form 990, Part VI, Line 6 The HSC Foundation is the sole member of Health Services for Children with Special Needs, Inc. Election of Members Form 990, Part VI, lines 7a & 7b The sole member shall have all of the powers specified in the Articles of Incorporation and Bylaws, including the power to: (a) Establish the Corporations policies and goals; (b) Appoint and remove the Corporations Board of Directors; (c) Monitor the decisions of the Corporations Boards of Directors; and (d) Approve the Corporations budget. REVIEW OF FORM 990 BY GOVERNING BODY FORM 990, PART VI, LINE 11B THE FORM 990 IS PREPARED BY AN ACCOUNTING FIRM AND THEN REVIEWED BY THE VPS FINANCE and CFO. ONCE COMMENTS FROM VPS FINANCE and CFO HAVE BEEN INCORPORATED INTO THE FORM 990, THE FORM 990 IS MADE AVAILABLE TO THE AUDIT COMMITTEE FOLLOWED BY A MEETING IN WHICH THE FORM 990 IS PRESENTED. THE FULL BOARD OF DIRECTORS HAS DELEGATED THE REVIEW OF THE FORM 990 TO THE AUDIT COMMITTEE. THE AUDIT COMMITTEE IS A PART OF THE FULL VOTING BOARD OF DIRECTORS. A COPY OF THE FORM 990 IS PROVIDED TO ANY OTHER BOARD MEMBERS UPON REQUEST. CONFLICTS OF INTEREST POLICY FORM 990, PART VI, LINE 12C THE HSC FOUNDATION HAS A WRITTEN CONFLICT OF INTEREST POLICY THAT COVERS ITSELF AND ALL OF ITS DIRECT AND INDIRECT SUBSIDIARIES (INCLUDING HEALTH SERVICES FOR CHILDREN WITH SPECIAL NEEDS INC.) UNDER THAT POLICY, WHENEVER A POTENTIAL CONFLICT ARISES FOR HEALTH SERVICES FOR CHILDREN WITH SPECIAL NEEDS, INC. BOARD OF DIRECTORS AND OFFICERS, IT IS BROUGHT TO THE ATTENTION OF THE PRESIDENT AND EXECUTIVE COMMITTEE OF THE HSC FOUNDATION BOARD, WHICH ANALYZES THE SITUATION AND MAKES A DETERMINATION OF WHETHER OR NOT AN ACTUAL CONFLICT EXISTS. IF IT IS DETERMINED THAT AN ACTUAL CONFLICT EXISTS, THE PRESIDENT AND EXECUTIVE COMMITTEE REPORTS TO THE HEALTH SERVICES FOR CHILDREN WITH SPECIAL NEEDS, INC. BOARD OF DIRECTORS REGARDING THE NATURE OF THE CONFLICT AND THAT PERSON IS THEREAFTER RECUSED FROM ANY DISCUSSION AND VOTE REGARDING THE MATTER. WHENEVER A POTENTIAL CONFLICT ARISES FOR EMPLOYEES OF HEALTH SERVICES FOR CHILDREN WITH SPECIAL NEEDS, INC. MANAGEMENT TEAM IT WILL BE BROUGHT TO THE BOARD CHAIR BY THE PRESIDENT WHICH ANALYZES THE SITUATION AND MAKES A DETERMINATION OF WHETHER OR NOT AN ACTUAL CONFLICT EXISTS. IF IT IS DETERMINED THAT AN ACTUAL CONFLICT EXISTS, STEPS WILL BE TAKEN TO ELIMINATE THE CONFLICT AND COMMUNICATED TO THE EMPLOYEE INVOLVED. THE BOARD CHAIR AND PRESIDENT WILL REPORT ALL COI TO THE EXECUTIVE COMMITTEE FOUNDATION. PROCESS TO ESTABLISH COMPENSATION OF CEO, OTHER OFFICERS AND KEY EMPLOYEES FORM 990, PART VI, LINE 15 THE ORGANIZATION RELIED ON A RELATED ORGANIZATION, HSC FOUNDATION, TO DETERMINE COMPENSATION OF THE ORGANIZATION'S CEO. IN ADDITION, THE ORGANIZATION DETERMINES THE COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION, AS DISCUSSED BELOW. THE ORGANIZATION AND HSC FOUNDATION BOTH USE A FOUR STEP APPROACH TO EXECUTIVE COMPENSATION: 1. THE EXECUTIVE COMMITTEE IS MADE UP OF INDEPENDENT BOARD MEMBERS WITHOUT A CONFLICT OF INTEREST, TO ESTABLISH AND DETERMINE THE REASONABLENESS OF TOTAL COMPENSATION FOR THE SYSTEM'S DISQUALIFIED EXECUTIVES AND FORWARDS TO THE FULL BOARD FOR APPROVAL. 2. PERIODICALLY, THE EXECUTIVE COMMITTEE WILL ENGAGE AN INDEPENDENT CONSULTANT TO PREPARE A DETAILED WRITTEN REPORT ON APPROPRIATE COMPARABILITY DATA FOR COMPARABLE POSITIONS. 3.THE EXECUTIVE COMMITTEE REVIEWS AND RELIES UPON THE REPORT OF THE INDEPENDENT CONSULTANT, ALONG WITH OTHER INDIVIDUAL AND MARKET DATA, THEN DEBATES AND FULLY DOCUMENTS ITS DECISION ABOUT WHAT IS REASONABLE COMPENSATION FOR DISQUALIFIED EXECUTIVES. 4.ONCE THE EXECUTIVE COMMITTEE DEVELOPS EXECUTIVE COMPENSATION RECOMMENDATIONS,THEY ARE PRESENTED TO THE SYSTEM'S FULL BOARD FOR APPROVAL. REQUIRED DOCUMENTS AVAILABLE TO THE PUBLIC FORM 990, PART VI, LINE 19 THIS ORGANIZATION MAKES ITS CONFLICT OF INTEREST POLICY, FINANCIAL STATEMENTS AND ORGANIZATIONAL DOCUMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. THE HOSPITAL FOR SICK CHILDREN 1731 BUNKER HILL ROAD NE WASHINGTON DC 20017 530204670 hospital DC 501(c)(3) 3 HSC FNDN false THE HSC FOUNDATION 2013 H STREET NW SUITE 300 WASHINGTON DC 20006 521346603 healthcare DC 501(c)(3) 12-III-FI na false 2013 HOLDINGS INC 2013 H STREET NW WASHINGTON DC 20006 272882469 holding co. DC 501(c)(2) n/a HSC FNDN false false false true false false false false false false false false false false false true true true false false