ASSOCIATION OF MATERNAL AND CHILD HEALTH PROGRAMS: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization
ASSOCIATION OF MATERNAL AND CHILD HEALTH PROGRAMS (EIN 52-1529448)
Tax period
2015-10-01 to 2016-09-30
Filed
2017-05-15
IRS object ID
201721359349300247
Schema version
2015v3.0
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2017-05-15T07:36:11-05:00ReturnTs
Tax Period End2016-09-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN521392008PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1GELMAN ROSENBERG & FREEDMANBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line14550 MONTGOMERY AVE SUITE 650NAddressLine1Txt
CityBETHESDACityNm
State AbbreviationMDStateAbbreviationCd
ZIP208142930ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2015-10-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN521529448EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ASSOCIATION OF MATERNAL AND CHILD HEALTHBusinessNameLine1Txt
Business Name Line2PROGRAMSBusinessNameLine2Txt
FieldValueIRS element (for citing)
Business Name ControlASSOBusinessNameControlTxt
Phone2027750436PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11825 K STREET NW NO 250AddressLine1Txt
CityWASHINGTONCityNm
State AbbreviationDCStateAbbreviationCd
ZIP20006ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonLORI FREEMANPersonNm
Person TitleCHIEF EXECUTIVE OFFICERPersonTitleTxt
Phone2027750436PhoneNum
Signature2017-05-15SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Phone3019519090PhoneNum
FieldValueIRS element (for citing)
Tax2015TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Address ChangeYes (X)AddressChangeInd
Principal OfficerEILEEN FORLENZAPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11825 K STREET NW NO 250AddressLine1Txt
CityWASHINGTONCityNm
State AbbreviationDCStateAbbreviationCd
ZIP20006ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$6,947,341GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.AMCHP.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1987FormationYr
Legal Domicile StateDCLegalDomicileStateCd
Activity Or MissionSEE PART III, LINE 1.ActivityOrMissionDesc
Voting Members Governing Body19VotingMembersGoverningBodyCnt
Voting Members Independent19VotingMembersIndependentCnt
Total Employee47TotalEmployeeCnt
Total Volunteers100TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$5,597,370PYContributionsGrantsAmt
CY Contributions Grants$5,969,129CYContributionsGrantsAmt
PY Program Service Revenue$419,950PYProgramServiceRevenueAmt
CY Program Service Revenue$412,810CYProgramServiceRevenueAmt
PY Investment Income$37,385PYInvestmentIncomeAmt
CY Investment Income$90,685CYInvestmentIncomeAmt
PY Other Revenue$97,422PYOtherRevenueAmt
CY Other Revenue$363,216CYOtherRevenueAmt
PY Total Revenue$6,152,127PYTotalRevenueAmt
CY Total Revenue$6,835,840CYTotalRevenueAmt
PY Grants And Similar Paid$522,065PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$1,142,697CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$2,912,697PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$2,972,564CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$20,276CYTotalFundraisingExpenseAmt
PY Other Expenses$2,453,881PYOtherExpensesAmt
CY Other Expenses$2,422,546CYOtherExpensesAmt
PY Total Expenses$5,888,643PYTotalExpensesAmt
CY Total Expenses$6,537,807CYTotalExpensesAmt
PY Revenues Less Expenses$263,484PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$298,033CYRevenuesLessExpensesAmt
Total Assets BOY$2,553,316TotalAssetsBOYAmt
Total Assets EOY$2,524,223TotalAssetsEOYAmt
Total Liabilities BOY$1,691,118TotalLiabilitiesBOYAmt
Total Liabilities EOY$1,400,682TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$862,198NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$1,123,541NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTHE MISSION OF THE ASSOCIATION OF MATERNAL & CHILD HEALTH PROGRAMS IS TO PROTECT AND PROMOTE THE OPTIMAL HEALTH OF WOMEN, CHILDREN, AND FAMILIES.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$5,573,459ExpenseAmt
Grant$1,142,697GrantAmt
DescMATERNAL AND CHILD HEALTH PROGRAMS AND POLICY: THE RESEARCH AND EDUCATION PROGRAMS ARE INTENDED TO STRENGTHEN AND SUPPORT LEADERSHIP, CAPACITY, AND ACCOUNTABILITY IN STATE MATERNAL AND CHILD HEALTH PROGRAMS. AMCHP PARTNERED WITH FEDERAL AGENCIES, NATIONAL ORGANIZATIONS AND OTHER KEY STAKEHOLDERS AND STAFF TO: ENHANCE LEADERSHIP AND BUILD CAPACITY FOR MCH POPULATIONS; AND STRENGTHEN THE CAPACITY OF STATE MCH PROGRAMS IN CARRYING OUT THE CORE FUNCTIONS OF PUBLIC HEALTH PRACTICE TO IMPROVE MATERNAL CHILD HEALTH OUTCOMES.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$355,693ExpenseAmt
Revenue$412,810RevenueAmt
DescANNUAL CONFERENCE: THE ANNUAL CONFERENCE DIRECTLY DELIVERED EDUCATIONAL FORUMS ON MCH ISSUES; FOSTERED EXCHANGE OF IDEAS AND EXPERIENCES AMONG MEMBERS AND THEIR PARTNERS; AND DISTRIBUTED INFORMATION ON STATE AND NATIONAL MCH ACTIVITIES AND STATE APPROACHES TO ADDRESS MCH PROBLEMS. IT WAS ALSO A FORUM FOR NUMEROUS TECHNICAL ASSISTANCE SESSIONS THAT PROMOTE EFFECTIVE PRACTICES FOR STATE MCH PROGRAMS.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$367,661ExpenseAmt
DescLEGISLATIVE ACTIVITIES: THE ASSOCIATION OF MATERNAL & CHILD HEALTH PROGRAMS PROVIDES REGULAR INFORMATION TO ITS MEMBERSHIP AND STAKEHOLDERS ON PUBLIC POLICY ISSUES AFFECTING THE FIELD OF MATERNAL AND CHILD HEALTH. THESE ISSUES INCLUDE FEDERAL BUDGET ALLOCATIONS INCLUDING SEQUESTRATION, CHANGES IN PROGRAMS PROVIDING HEALTH INSURANCE COVERAGE TO MCH POPULATIONS, AND THE STATUS OF A RANGE OF PROGRAMS ADMINISTERED AT THE STATE LEVEL IN PARTNERSHIP WITH THE DEPARTMENT OF HEALTH AND HUMAN SERVICES. ACTIVITIES INCLUDE PUBLICATION OF NEWSLETTERS, DEVELOPMENT OF POLICY ANALYSIS, LEARNING OPPORTUNITIES FOR STATES TO SHARE THEIR PERSPECTIVES WITH EACH OTHER, AND ALLOWABLE ACTIVITIES TO EDUCATE POLICYMAKERS AND ASSURE THEY HAVE INFORMATION TO SUPPORT DECISIONS AFFECTING MCH POPULATIONS AND PROGRAMS.Desc

Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp

FieldValueIRS element (for citing)
Expense$67,119ExpenseAmt
DescMEMBERSHIP, COMMUNICATIONS AND OTHER PROGRAMSDesc
FieldValueIRS element (for citing)
Total Other Prog Srvc Expense$67,119TotalOtherProgSrvcExpenseAmt
Total Program Service Expenses$6,363,932TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To IndividualsYes (1)GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related Entity0RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document53IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee47EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members19GoverningBodyVotingMembersCnt
Independent Voting Member19IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonWENDY WENPersonNm
Phone2027750436PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11825 K STREET NW SUITE 250AddressLine1Txt
CityWASHINGTONCityNm
State AbbreviationDCStateAbbreviationCd
ZIP20006ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (22 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeInd
EILEEN FORLENZA
PRESIDENT2.00Yes (X)Yes (X)$0$0$0
SAM COOPER
PAST PRESIDENT2.00Yes (X)Yes (X)$0$0$0
MICHAEL WARREN
PRESIDENT-ELECT2.00Yes (X)Yes (X)$0$0$0
VALERIE RICKER
TREASURER2.00Yes (X)Yes (X)$0$0$0
SUSAN COLBURN
SECRETARY2.00Yes (X)Yes (X)$0$0$0
KARIN DOWNS
DIRECTOR2.00Yes (X)$0$0$0
RODNEY FARLEY
DIRECTOR-AT-LARGE2.00Yes (X)$0$0$0
DONNA YADRICH
FAMILY REPRESENTATIVE2.00Yes (X)$0$0$0
MARILYN KACICA
DIRECTOR2.00Yes (X)$0$0$0
MARY FRANCES KORNAK
DIRECTOR2.00Yes (X)$0$0$0
BELINDA PETTIFORD
DIRECTOR2.00Yes (X)$0$0$0
SUSAN CHACON
DIRECTOR2.00Yes (X)$0$0$0
HEATHER SMITH
DIRECTOR2.00Yes (X)$0$0$0
LINDA MCELWAIN
DIRECTOR2.00Yes (X)$0$0$0
MARY ELLEN CUNNINGHAM
DIRECTOR2.00Yes (X)$0$0$0
SHIRLEY PAYNE
DIRECTOR2.00Yes (X)$0$0$0
CATE WILCOX
DIRECTOR2.00Yes (X)$0$0$0
DONNA JOHNSON
DIRECTOR-AT-LARGE2.00Yes (X)$0$0$0
GINA POLA-MONEY
FAMILY REPRESENTATIVE2.00Yes (X)$0$0$0
LORI FREEMAN
CEO40.00Yes (X)$209,818$0$35,515
CAROLINE STAMPFEL
DIRECTOR OF PROGRAM TEAM35.00$107,850$0$15,344Yes (X)
BRENT EWIG
DIR., PUBLIC POL. & GOV'T35.00$146,685$0$13,291Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$464,353TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$64,150TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K3IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
Membership Dues$472,025MembershipDuesAmt
Government Grants$2,239,292GovernmentGrantsAmt
All Other Contributions$3,257,812AllOtherContributionsAmt
Total Contributions$5,969,129TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescREGISTRATION/EXHIBITDesc
Business900099BusinessCd
Total Revenue Column$412,810TotalRevenueColumnAmt
Related Or Exempt Func Income$412,810RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$412,810TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$63,253TotalRevenueColumnAmt
Exclusion$63,253ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$138,933SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$111,501SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$27,432SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$27,432TotalRevenueColumnAmt
Exclusion$27,432ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmt
LEASE TERM. INCENTIVE900099$292,840$292,840
REGISTRATION REFUND900099$61,496$61,496
OTHER REVENUE900099$8,880$8,880
FieldValueIRS element (for citing)
Other Revenue Total$363,216OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$6,835,840TotalRevenueColumnAmt
Related Or Exempt Func Income$412,810RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$453,901ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$1,116,048TotalAmt
Program Services$1,116,048ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$26,649TotalAmt
Program Services$26,649ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$249,738TotalAmt
Program Services$213,687ProgramServicesAmt
Management And General$34,808ManagementAndGeneralAmt
Fundraising$1,243FundraisingAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$2,137,685TotalAmt
Program Services$1,829,076ProgramServicesAmt
Management And General$297,971ManagementAndGeneralAmt
Fundraising$10,638FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$111,178TotalAmt
Program Services$95,149ProgramServicesAmt
Management And General$15,476ManagementAndGeneralAmt
Fundraising$553FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$307,101TotalAmt
Program Services$262,827ProgramServicesAmt
Management And General$42,747ManagementAndGeneralAmt
Fundraising$1,527FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$166,862TotalAmt
Program Services$142,804ProgramServicesAmt
Management And General$23,228ManagementAndGeneralAmt
Fundraising$830FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$30,469TotalAmt
Management And General$30,469ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$34,086TotalAmt
Management And General$34,086ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$307,688TotalAmt
Program Services$226,204ProgramServicesAmt
Management And General$81,484ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$1,500TotalAmt
Management And General$1,500ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$146,327TotalAmt
Program Services$106,193ProgramServicesAmt
Management And General$40,134ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$182,516TotalAmt
Program Services$19,641ProgramServicesAmt
Management And General$162,875ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$277,077TotalAmt
Program Services$17,619ProgramServicesAmt
Management And General$259,458ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$839,763TotalAmt
Program Services$831,202ProgramServicesAmt
Management And General$8,561ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$501,633TotalAmt
Program Services$493,921ProgramServicesAmt
Management And General$7,712ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$30,870TotalAmt
Management And General$30,870ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$14,763TotalAmt
Program Services$2,671ProgramServicesAmt
Management And General$12,092ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
ALLOCATION OF M&G$0$943,168-$948,653$5,485
SUBS. & PUBLICATIONS$26,010$25,711$299
EQUIPMENT$17,586$1,540$16,046
DUES TO ORGANIZATIONS$6,752$5,433$1,319

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$5,506TotalAmt
Program Services$4,389ProgramServicesAmt
Management And General$1,117ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$6,537,807TotalAmt
Program Services$6,363,932ProgramServicesAmt
Management And General$153,599ManagementAndGeneralAmt
Fundraising$20,276FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$303,897BOYAmt
EOY$32,933EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$253,953BOYAmt
EOY$243,876EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$1,010,607BOYAmt
EOY$765,735EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$6,512BOYAmt
EOY$573,422EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$64,983BOYAmt
EOY$117,003EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$4,671LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$0LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$30,870BOYAmt
EOY$4,671EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$804,967BOYAmt
EOY$669,744EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$77,527BOYAmt
EOY$116,839EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$2,553,316BOYAmt
EOY$2,524,223EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$549,794BOYAmt
EOY$773,478EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$95,285BOYAmt
EOY$196,305EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,046,039BOYAmt
EOY$430,899EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,691,118BOYAmt
EOY$1,400,682EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$862,198BOYAmt
EOY$1,123,541EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$862,198BOYAmt
EOY$1,123,541EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$2,553,316BOYAmt
EOY$2,524,223EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$298,033ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$36,690NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit RequiredYes (1)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (1)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Public Organization170Yes (X)PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$3,927,249CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$4,074,300CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$4,394,037CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$5,597,370CurrentTaxYearMinus1YearAmt
Current Tax Year$5,969,129CurrentTaxYearAmt
Total$23,962,085TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$3,927,249CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$4,074,300CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$4,394,037CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$5,597,370CurrentTaxYearMinus1YearAmt
Current Tax Year$5,969,129CurrentTaxYearAmt
Total$23,962,085TotalAmt
FieldValueIRS element (for citing)
Substantial Contributors Tot$1,783,536SubstantialContributorsTotAmt
Public Support Total170$22,178,549PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$39,807CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$23,428CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$30,768CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$37,989CurrentTaxYearMinus1YearAmt
Current Tax Year$63,253CurrentTaxYearAmt
Total$195,245TotalAmt

Other Income170 OtherIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$3,368CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,895CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$8,097CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$96,818CurrentTaxYearMinus1YearAmt
Current Tax Year$363,216CurrentTaxYearAmt
Total$473,394TotalAmt
FieldValueIRS element (for citing)
Total Support$24,630,724TotalSupportAmt
Gross Receipts Rltd Activities$1,826,006GrossReceiptsRltdActivitiesAmt
Public Support CY1700.90040PublicSupportCY170Pct
Public Support PY1700.94010PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

Total Grassroots Lobbying TotalGrassrootsLobbyingGrp

FieldValueIRS element (for citing)
Filing Organizations Total$0FilingOrganizationsTotalAmt

Total Direct Lobbying TotalDirectLobbyingGrp

FieldValueIRS element (for citing)
Filing Organizations Total$18,249FilingOrganizationsTotalAmt

Total Lobbying Expend TotalLobbyingExpendGrp

FieldValueIRS element (for citing)
Filing Organizations Total$18,249FilingOrganizationsTotalAmt

Other Exempt Purpose Expend OtherExemptPurposeExpendGrp

FieldValueIRS element (for citing)
Filing Organizations Total$6,519,558FilingOrganizationsTotalAmt

Total Exempt Purpose Expend TotalExemptPurposeExpendGrp

FieldValueIRS element (for citing)
Filing Organizations Total$6,537,807FilingOrganizationsTotalAmt

Lobbying Nontaxable Amount LobbyingNontaxableAmountGrp

FieldValueIRS element (for citing)
Filing Organizations Total$476,890FilingOrganizationsTotalAmt

Grassroots Nontaxable GrassrootsNontaxableGrp

FieldValueIRS element (for citing)
Filing Organizations Total$119,223FilingOrganizationsTotalAmt

Tot Lbbyng Grassroot Mns Non Tx TotLbbyngGrassrootMnsNonTxGrp

FieldValueIRS element (for citing)
Filing Organizations Total$0FilingOrganizationsTotalAmt

Tot Lbby Expend Mns Lbbyng Non Tx TotLbbyExpendMnsLbbyngNonTxGrp

FieldValueIRS element (for citing)
Filing Organizations Total$0FilingOrganizationsTotalAmt

Avg Lobbying Nontaxable Amount AvgLobbyingNontaxableAmountGrp

FieldValueIRS element (for citing)
Current Year Minus3$382,279CurrentYearMinus3Amt
Current Year Minus2$395,490CurrentYearMinus2Amt
Current Year Minus1$438,043CurrentYearMinus1Amt
Current Year$476,890CurrentYearAmt
Total$1,692,702TotalAmt
FieldValueIRS element (for citing)
Lobbying Ceiling$2,539,053LobbyingCeilingAmt

Avg Total Lobbying Expend AvgTotalLobbyingExpendGrp

FieldValueIRS element (for citing)
Current Year Minus3$36,506CurrentYearMinus3Amt
Current Year Minus2$17,214CurrentYearMinus2Amt
Current Year Minus1$15,899CurrentYearMinus1Amt
Current Year$18,249CurrentYearAmt
Total$87,868TotalAmt

Avg Grassroots Nontaxable AvgGrassrootsNontaxableGrp

FieldValueIRS element (for citing)
Current Year Minus3$95,570CurrentYearMinus3Amt
Current Year Minus2$98,873CurrentYearMinus2Amt
Current Year Minus1$109,511CurrentYearMinus1Amt
Current Year$119,223CurrentYearAmt
Total$423,177TotalAmt
FieldValueIRS element (for citing)
Grassroots Ceiling$634,766GrassrootsCeilingAmt

Avg Grassroots Lobbying Expend AvgGrassrootsLobbyingExpendGrp

FieldValueIRS element (for citing)
Current Year Minus3$2,500CurrentYearMinus3Amt
Total$2,500TotalAmt

Schedule D IRS990ScheduleD

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$4,671OtherCostOrOtherBasisAmt
Book Value$4,671BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$4,671TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescREFUNDABLE ADVANCESDesc
Amt$430,899Amt
FieldValueIRS element (for citing)
Total Liability$430,899TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$6,799,150TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst-$36,690NetUnrealizedGainsInvstAmt
Revenue Not Reported-$36,690RevenueNotReportedAmt
Revenue Subtotal$6,835,840RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$6,835,840TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$6,537,807TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$6,537,807ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$6,537,807TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationFOR THE YEAR ENDED SEPTEMBER 30, 2016, AMCHP HAS DOCUMENTED ITS CONSIDERATION OF FASB ASC 740-10, INCOME TAXES, THAT PROVIDES GUIDANCE FOR REPORTING UNCERTAINTY IN INCOME TAXES AND HAS DETERMINED THAT NO MATERIAL UNCERTAIN TAX POSITIONS QUALIFY FOR EITHER RECOGNITION OR DISCLOSURE IN THE FINANCIAL STATEMENTS.ExplanationTxt

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Recipient Table RecipientTable (36 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtPurpose Of GrantPurposeOfGrantTxtAddress Line2USAddress/AddressLine2Txt
ALABAMA DEPT OF PUBLIC HEALTH FAMILY HEALTH SERVICES BUREAU
201 MONROE STREET SUITE 1350MONTGOMERYAL36104736017987GOVERNMENT$44,764BIRTH OUTCOME COLLABORATIVE
ARKANSAS BREASTFEEDING COALITION
P O BOX 251592LITTLE ROCKAR72225396006492501(C)(3)$12,602IMPLEMENTATION OF ROI ANALYTIC ALC COHORT
ARKANSAS DEPARTMENT OF HEALTH
4815 WEST MARKHAM STREET MS-16LITTLE ROCKAR72205716007358GOVERNMENT$22,899BIRTH OUTCOME COLLABORATIVE
REACHUP INC
2902 N ARMENIA AVE SUITE 100TAMPAFL33607208437749OTHER$26,977EVERY MOTHER INITIATIVE
ROBERTSON CONSULTING GROUP INC
P O BOX 51688SARASOTAFL34232450480862OTHER$33,250BIRTH OUTCOME COLLABORATIVE
GEORGIA DEPARTMENT OF PUBLIC HEALTH
2 PEACHTREE STATLANTAGA30303900676388GOVERNMENT$31,8361, BIRTH OUTCOME COLLABORATIVE; 2, RETURN ON INVESTMENT ANALYSIS OF A TOPIC RELATED TO CHILD AND ADOLESCENT HEALTH
OFFICE OF SPONSORED RESEARCH UNIVERSITY OF NORTH CAROLINA
PO BOX 402420ATLANTAGA30384566001393501(C)(3)$78,8401, EVERY WOMAN SOUTHEAST COALITION, 2, EVERY MOTHER INITIATIVE; 3,RETURN ON INVESTMENT ANALYSIS OF A TOPIC RELATED TO CHILD AND ADOLESCENT HEALTH
IOWA DEPT OF PUBLIC HEALTH
321 E 12TH STREETDES MOINESIA50319GOVERNMENT$14,827ADOLESCENT & YOUNG ADULT NATIONAL RESOURCES CENTER
ILLINOIS DEPARTMENT OF PUBLIC HEALTH
535 W JEFFERSON 1ST FLOORSPRINGFIELDIL62761GOVERNMENT$20,000EVERY MOTHER INITIATIVE
UNIVERSITY OF ILLINOIS
28395 NETWORK PLACECHICAGOIL60673376000511501(C)(3)$20,000EVERY MOTHER INITIATIVE
WESTERN KENTUCKY UNIVERSITY
1906 COLLEGE HEIGHTS BLVDBOWLING GREENKY42101616055628501(C)(3)$34,553BIRTH OUTCOME COLLABORATIVE
LOUISIANA OFFICE OF PUBLIC HEALTH
1450 POYDRAS ST STE 1552NEW ORLEANSLA70112726000821GOVERNMENT$26,760EVERY MOTHER INITIATIVE
THE RIPPLES GROUP
3 SCHOOL STREET FL4BOSTONMA02478263286164OTHER$8,039IMPLEMENTATION OF ROL ANALYTIC ALC COHORT
NATIONAL INSTITUTE FOR CHILDREN'S HEALTH QUALITY
30 WINTER STREET 6TH FLOORBOSTONMA02108010647374501(C)(3)$33,904BIRTH OUTCOME COLLABORATIVE
BOSTON UNIVERSITY
881 COOMONWEALTH AVE 4TH FLBOSTONMA02215042103547501(C)(3)$69,423ACCESS TO CARE CORE
NATIONAL ASSOCIATION FOR PUBLIC HEALTH STATS AND INFO SYSTEMS
962 WAYNE AVE SUITE 701SILVER SPRINGMD20910522265888501(C)(3)$63,2641, BUILDING CAPACITY IN MATERNAL AND CHILD HEALTH EPIDEMIOLOGY, PROGRAMS AND POLICIES; 2, MATERNAL AND CHILD HEALTH EPIDEMIOLOGY, NATIONAL AND STATE COALITION CAPACITY BUILDING TO IMPROVE OUTCOMES
NATIONAL ACADEMY FOR STATE HEALTH POLICY
10 FREE STREET 2ND FLOORPORTLANDME04101521576801501(C)(3)$55,0001, NATIONAL CONSENSUS FRAMEWORK FOR IMPROVING QUALITY SYSTEMS OF CARE FOR CYSHCN, PHASE III; 2,ACCESS TO CARE CORE
REGENTS OF THE UNIVERSITY OF MINNESOTA
NW 5957 PO BOX 1450MINNEAPOLISMN55485416007513501(C)(3)$7,920ACT EARLY SYSTEMS GRANT
MISSOURI DEPARTMENT OF HEALTH
920 WILDWOOD DRIVE P O BOX 570JEFFERSON CITYMO65102446000987GOVERNMENT$30,957EVERY MOTHER INITIATIVE
MISSISSIPPI DEPT OF HEALTH
570 E WOODROW WILSON DRIVE OSBORNEJACKSONMS39215646000775GOVERNMENT$63,3241, IMPLEMENTATION OF ROI ANALYTIC ALC COHORT 2, STATE ADOLESCENT AND YOUNG ADULT HEALTH CAPACITY BUILDING PROGRAM; 3,BIRTH OUTCOME COLLABORATIVE200
THE UNIVERSITY OF MONTANA
32 CAMPUS DRIVEMISSOULAMT59812816001713501(C)(3)$10,207ACT EARLY SYSTEMS GRANT
NORTH CAROLINA PUBLIC HEALTH FOUNDATION
PO BOX 18763RALEIGHNC27169470921425501(C)(3)$46,6791, IMPLEMENTATION OF ROI ANALYTIC ALC COHORT; 2, BIRTH OUTCOME COLLABORATIVE
RUTGERS THE STATE UNIVERSITY OF NEW JERSEY
ASB III 3 RUTGERS PLAZANEW BRUNSWICKNJ08901462354111GOVERNMENT$9,232ACT EARLY SYSTEMS GRANT
UNIVERSITY OF NEW MEXICO HEALTH SCIENCES CENTER
MSC09 5222 1 UNIVERSITY OF NEWALBUQUERQUENM87131856000642501(C)(3)$6,107ACT EARLY SYSTEMS GRANTMEXICO
NEW MEXICO DEPARTMENT OF HEALTH PUBLIC HEALTH DIVISION
PO BOX 25307ALBUQUERQUENM87125GOVERNMENT$9,154BIRTH OUTCOME COLLABORATIVE
NEW MEXICO FORUM FOR YOUTH IN THE COMMUNITY
924 PARK AVENUE SW SUITE EALBUQUERQUENM87102201650827501(C)(3)$15,000ADOLESCENT & YOUNG ADULT NATIONAL RESOURCES CENTER
FAMILY VOICES
PO BOX 37188ALBUQUERQUENM87176850430800501(C)(3)$30,711PARTNERSHIP FOR STATE TITLE V MCH LEADERSHIP COMMUNITY COOPERATIVE AGREEMENT
CENTER FOR HEALTH POLICY DEVELOPMENT
PO BOX 10571ALBANYNY12201521576801501(C)(3)$40,0001, NATIONAL CONSENSUS FRAMEWORK FOR IMPROVING QUALITY SYSTEMS OF CARE FOR CHILDREN AND YOUTH WITH SPECIAL HEALTH CARE NEEDS, PHASE III; 2, ACCESS TO CARE CORE
UNIVERSITY OF OKLAHOMA HEALTH SCIENCE CENTER
1000 STANTON L YOUNG BLVD LIB-121OKLAHOMA CITYOK73117736017987501(C)(3)$7,938ACT EARLY SYSTEMS GRANT
OKLAHOMA STATE DEPARTMENT OF HEALTH
1000 NE 10TH STOKLAHOMA CITYOK73117GOVERNMENT$84,2381, BIRTH OUTCOME COLLABORATIVE
UNIVERSITY OF SOUTH CAROLINA GRANTS AND CONTRACTING
1600 HAMPTON STREET ROOM 612COLUMBIASC29208576001153501(C)(3)$36,533BIRTH OUTCOME COLLABORATIVE
SIGNAL CENTERS INC
109 N GERMANTOWN RDCHATTANOOGATN37411620587285501(C)(3)$8,280ACT EARLY SYSTEMS GRANT
THE UNIVERSITY OF TENNESSEE HEALTH SCIENCE CENTER
62 DUNLAP STREETMEMPHISTN38163626001636501(C)(3)$39,224BIRTH OUTCOME COLLABORATIVE
UTAH DEPARTMENT OF HEALTH
POBOX 142002SALT LAKE CITYUT84114876000545GOVERNMENT$40,000EVERY MOTHER INITIATIVE
AMERICAN ACADEMY OF PEDIATRICS - VERMONT CHAPTER
134 MAIN STREETMONTPELIERVT05601030316774501(C)(3)$15,000STATE ADOLESCENT AND YOUNG ADULT HEALTH CAPACITY BUILDING PROGRAM
BOARD OF REGENTS OF THE UNIVERSITY OF WISCONSIN SYSTEM
21 N PARK STREET SUITE 6401MADISONWI53715396006492501(C)(3)$7,008ACT EARLY 2014 SYSTEMS GRANT
FieldValueIRS element (for citing)
Total501c3 Org33Total501c3OrgCnt
Total Other Org3TotalOtherOrgCnt

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp

FieldValueIRS element (for citing)
Grant TypeGRANTS TO RECIPIENTSGrantTypeTxt
Recipient43RecipientCnt
Cash Grant$26,649CashGrantAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 2:FormAndLineReferenceDesc
ExplanationTHE ORGANIZATION REQUIRES PROGRESS REPORTS, FINAL REPORTS, FINANCIAL STATUS REPORTS, AND CONFERENCE CALLS TO MONITOR THE USE OF GRANT FUNDS.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (1)AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (2 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
LORI FREEMAN
CEO$209,818$0$0$0$0$0$16,549$0$18,966$0$245,333$0$0$0
BRENT EWIG
DIR., PUBLIC POL. & GOV'T$145,485$0$1,200$0$0$0$11,281$0$2,010$0$159,976$0$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 7FormAndLineReferenceDesc
ExplanationBRENT EWIG RECEIVED A BONUS PAYMENT OF $1,200.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 6THE MEMBERSHIP OF THE ASSOCIATION IS COMPRISED OF TITLE V PROGRAM (STATE AND TERRITORY MCH/CYSHCN PROGRAM), REGULAR, AND ASSOCIATE MEMBERS. EACH TITLE V PROGRAM IS ENTITLED TO APPOINT UP TO FIVE (5) DELEGATES, WHO SHALL HAVE THE SOLE VOTING AUTHORITY ON BEHALF OF THE TITLE V PROGRAM MEMBERS. ONLY DELEGATES SHALL BE ELIGIBLE TO VOTE IN THE ELECTION OF ASSOCIATION OFFICERS AND DIRECTORS, AND ONLY DELEGATES SHALL BE ELIGIBLE FOR ELECTION AS OFFICERS AND DIRECTORS, EXCEPT FOR THE TWO FAMILY REPRESENTATIVE POSITIONS ON THE BOARD OF DIRECTORS. REGULAR MEMBERS SHALL BE STAFF OF TITLE V PROGRAMS OR INDIVIDUALS WHO WORK IN PARTNERSHIP WITH TITLE V PROGRAMS, INCLUDING FAMILY LIAISONS WORKING IN CONNECTION WITH STATE TITLE V PROGRAMS. REGULAR MEMBERS SHALL BE ELIGIBLE TO VOTE ON ALL MATTERS BEFORE THE ASSOCIATION, EXCEPT ELECTION OF OFFICERS AND DIRECTORS. ASSOCIATE MEMBERSHIP IS OPEN TO BOTH INDIVIDUALS AND ORGANIZATIONS INTERESTED IN MATERNAL AND CHILD HEALTH. ASSOCIATE MEMBERS ARE NOT ELIGIBLE TO VOTE ON ANY MATTER OR TO HOLD AN OFFICE OR BOARD OF DIRECTOR POSITION.
FORM 990, PART VI, SECTION A, LINE 7AMEMBERS ARE ALLOWED TO VOTE IN ELECTIONS.
FORM 990, PART VI, SECTION B, LINE 11THE DRAFT 990 WAS PREPARED BY THE OUTSIDE ACCOUNTANTS AND REVIEWED BY SENIOR MANAGEMENT. THE DRAFT WAS PROVIDED TO THE EXECUTIVE/FINANCE COMMITTEE FOR REVIEW AND COMMENT. A FINAL COPY OF 990 WAS SENT TO THE ENTIRE BOARD BEFORE IT WAS FILED WITH IRS.
FORM 990, PART VI, SECTION B, LINE 12CALL AMCHP DIRECTORS MUST ANNUALLY COMPLETE A CONFLICT OF INTEREST STATEMENT THAT DISCLOSES ANY EXISTING OR POTENTIAL RELATIONSHIPS THAT MAY LEAD TO AN ACTUAL OR PERCEIVED CONFLICT OF INTEREST. BOARD MEMBERS ARE RESPONSIBLE FOR INFORMING THE GOVERNANCE COMMITTEE CHAIR OF ANY SUBSEQUENT CHANGES IN A TIMELY MANNER. THE GOVERNANCE COMMITTEE CHAIR REVIEWS ALL CONFLICT OF INTEREST STATEMENTS. THESE STATEMENTS MAY BE DISTRIBUTED TO THE BOARD OF DIRECTORS AND CHIEF EXECUTIVE OFFICER AND ALSO MAY BE DISCLOSED PUBLICLY ON REQUEST. AN INTERESTED BOARD MEMBER, OFFICER, OR STAFF MEMBER DOES NOT PARTICIPATE IN ANY DISCUSSION OR DEBATE OF THE BOARD OF DIRECTORS, OR OF ANY COMMITTEE OR SUBCOMMITTEE THEREOF IN WHICH THE SUBJECT OF DISCUSSION IS A CONTRACT, TRANSACTION, OR SITUATION IN WHICH THERE MAY BE A PERCEIVED OR ACTUAL CONFLICT OF INTEREST. HOWEVER, THEY MAY BE PRESENT TO PROVIDE CLARIFYING INFORMATION IN SUCH A DISCUSSION OR DEBATE UNLESS OBJECTED TO BY ANY PRESENT BOARD OR COMMITTEE MEMBER. FOLLOWING FULL DISCLOSURE OF A POSSIBLE CONFLICT OF INTEREST OR ANY CONDITION LISTED ABOVE, THE BOARD OF DIRECTORS DETERMINES WHETHER A CONFLICT OF INTEREST EXISTS AND, IF SO, THE BOARD VOTES TO AUTHORIZE OR REJECT THE TRANSACTION OR TAKES ANY OTHER ACTION DEEMED NECESSARY TO ADDRESS THE CONFLICT AND PROTECT AMCHP'S BEST INTERESTS. VOTES ARE BY A MAJORITY VOTE WITHOUT COUNTING THE VOTE OF ANY INTERESTED DIRECTOR, EVEN IF THE DISINTERESTED DIRECTORS ARE LESS THAN A QUORUM PROVIDED THAT AT LEAST ONE CONSENTING DIRECTOR IS DISINTERESTED.
FORM 990, PART VI, SECTION B, LINE 15ATHE CEO'S SALARY IS REVIEWED AND APPROVED BY THE BOARD. THE BOARD USES MARKET SURVEYS OF OTHER NGOS AND DOCUMENTS THE PROCESS AND DECISION IN WRITTEN FORM IN THE PERSONNEL FILES. THE REVIEW IS CONDUCTED ANNUALLY. THE CEO DETERMINES THE SALARIES OF THE OTHER EMPLOYEES. THE LAST COMPENSATION REVIEW TOOK PLACE IN MARCH 2016.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, FINANCIAL STATEMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC UPON REQUEST.

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