2017-07-10T15:25:33-05:00 2016-12-31 911123435 THE MYERS ASSOCIATES PC 520 PIKE ST STE 1040 SEATTLE WA 981012397 990 2016-01-01 910933802 ALPHA SUPPORTED LIVING SERVICES ALPH 2062849130 16030 JUANITA-WOODINVILLE WAY NE BOTHELL WA 98011 SCOTT LIVENGOOD CEO 2062849130 2017-07-10 1 MARK T LONG CPA P00047630 2066236116 2017-07-10 174.46.200.2 2017-07-10 13:25:25 PD P B1BCF3E98521E830F40F479F7EDF6BE3606F53D7 50CB343EB44C01A68A90EFC89846A7A6FC50AED5 2016 2021-01-29 14:40:06Z SCOTT LIVENGOOD 16030 JUANITA-WOODINVILLE WAY NE BOTHELL WA 98011 19720611 0 X WWW.ALPHASLS.ORG X 1974 WA RESIDENTIAL AND SUPPORT SERVICES FOR ADULTS WITH DEVELOPMENTAL DISABILITIES IN THE SEATTLE AREA 11 11 700 50 4500 -20083 835750 251024 13942454 18418661 188813 -42272 12819 4675 14979836 18632088 0 0 0 0 12788696 16728903 0 0 94230 1248240 1642252 14036936 18371155 942900 260933 6947858 7306987 2966955 2973703 3980903 4333284 TO SERVE INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES BY PROVIDING ACCESSIBLE RESIDENTIAL AND OTHER SUPPORT SERVICES THAT WILL MAXIMIZE EACH PERSON'S QUALITY OF LIFE. 0 0 16941548 18233496 PROVIDE RESIDENTIAL SUPPORT SERVICES TO INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES THROUGHOUT KING AND SNOHOMISH COUNTIES. THE PROGRAMS FOCUS ON RESPECTING RESIDENT'S CHOICES IN A CONTEXT OF DIGNITY, SAFETY, AND HEALTH. THE EXPENSES INCLUDED ABOVE ARE ONLY THE DIRECT PROGRAM EXPENSES, IN ADDITION ASLS INCURS SUBSTANTIAL MANAGEMENT AND GENERAL COSTS TO MANAGE THE OPERATIONS WHICH ARE REIMBURSED AS PART OF THE REVENUE ALSO REFLECTED ABOVE. 34287 27853 THE REPRESENTATIVE PAYEE PROGRAM PROVIDES FINANCIAL SERVICES AND COUNSEL FOR PEOPLE AT RISK OF HOMELESSNESS AND RECEIVING SOCIAL SECURITY. THE PAYEE PROGRAM HELPS CLIENTS MANAGE THEIR BENEFITS THROUGHOUT THE MONTH, AS WELL AS DEVELOP GOALS AND PLANS FOR LONG-TERM SAVINGS AND FINANCIAL STABILITY. THE PROGRAM CURRENTLY SERVES APPROXIMATELY 50 CLIENTS. 207195 183824 THE COMMUNITY ACCESS PROGRAM PROVIDES 1:1 SUPPORT FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES TO BE ENGAGED IN COMMUNITY ACTIVITIES. COMMUNITY ACCESS CREATES OPPORTUNITIES FOR PEOPLE WHO HAVE EITHER RETIRED FROM SUPPORTED EMPLOYMENT, OR WERE NOT ABLE TO BE PLACED IN A JOB, TO BE ENGAGED IN THE COMMUNITY AND BUILD RELATIONSHIPS. 17183030 1 1 0 1 0 0 0 0 1 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 1 5 0 1 700 1 1 1 0 0 0 0 1 1 0 0 0 0 X 11 11 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 WA X X SCOTT LIVENGOOD 2062849130 16030 JUANITA-WOODINVILLE WAY NE BOTHELL WA 98011 BOB ACTESON MEMBER 0.50 X 0 0 0 BOB BRESKOVICH VICE PRESIDENT 1.00 X X 0 0 0 DOUG COLEMAN TREASURER 1.00 X X 0 0 0 STACY GILLETT SECRETARY 1.00 X X 0 0 0 JANESSA HUNTER PRESIDENT 1.00 X X 0 0 0 LINDA JOHNSON MEMBER 0.50 X 0 0 0 MARK JOHNSON MEMBER 0.50 X 0 0 0 JAN JOHNSTON MEMBER 0.50 X 0 0 0 JIM KURESMAN MEMBER 0.50 X 0 0 0 PENNY MARTIN MEMBER 0.50 X 0 0 0 KRIS MORIMOTO MEMBER 0.50 X 0 0 0 SCOTT LIVENGOOD CEO 42.00 X 289625 0 36448 AMANDA REINHARD FINANCE DIRECTOR 40.00 X 111574 0 6654 ROBERT BURMASTER DIRECTOR OF OPERATIONS 40.00 X 103833 0 7006 505032 0 50108 3 0 1 0 0 1715 96613 152696 251024 SUPPORTED LIVING 623990 17775211 17775211 PARTICIPATION/RENT 623990 274837 274837 COMMUNITY ACCESS 623990 183824 183824 PRIVATE CARE PAYMENTS 623990 149256 149256 REP PAYEE PROGRAM 623990 27853 27853 7680 7680 18418661 21234 21234 986030 1049536 -63506 -63506 -63506 12650 96613 38987 -26337 -26337 CONSULTING & TRAINING 623990 26512 26512 BOOKKEEPING SERVICES 541200 4500 4500 31012 18632088 18445173 4500 -68609 555140 539580 15560 13723037 13366129 287996 68912 143661 138383 3687 1591 863755 847787 13826 2142 1443310 1395179 42206 5925 24925 24925 19502 19502 138908 113322 25586 88928 70653 18175 100 98847 95652 3195 243316 214147 29169 157810 149055 8755 49133 49133 VEHICLE LEASE EXPENSES 563123 556801 6322 EQUIP LEASE & MNTNCE 131479 117926 13553 PROGRAM SUPPLIES & FEES 90669 90669 STAFF DEVELOPMNT & EDUC 35612 27327 8285 18371155 17183030 1093895 94230 1449622 1208372 89732 89759 20152 22394 328704 913991 46536 155879 4467547 1042988 3556235 3424559 1389358 1418997 67519 73036 6947858 7306987 1334099 1388440 1117621 1083479 447716 428748 67519 73036 2966955 2973703 X 3980903 4333284 3980903 4333284 6947858 7306987 260933 91448 0 X X 0 1 X 1 0 X 168649 219863 240150 835750 251024 1715436 9747125 10630722 11600269 13976753 18445173 64400042 9915774 10850585 11840419 14812503 18696197 66115478 0 0 0 66115478 47636 64298 54258 25788 21234 213214 47636 64298 54258 25788 21234 213214 6760 -48364 -51664 -23689 -23535 -140492 31258 39478 60939 131675 10001428 10905997 11903952 14814602 18693896 66319875 0.99690 0.99540 0.00320 0.00400 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 0 0 1 3460 1 16890 0 0 20350 0 PART II-B, LINE 1: THE ORGANIZATION ENGAGES IN LOBBYING ACTIVITIES TO PROTECT THE INTERESTS OF AND ENCOURAGE FUNDING FOR INDIVIDUALS WITH DISABILITIES IN THE STATE OF WASHINGTON. 1 597077 2271716 2337459 531334 0 1456000 1456000 2297789 625607 1672182 47336 28474 18862 326013 218389 107624 340409 170518 169891 3424559 457 PLAN FUNDING 73036 73036 18704034 91448 91448 18612586 19502 19502 18632088 18351653 0 18351653 19502 19502 18371155 PART IV, LINE 1B: ASLS MANAGES CUSTODIAL ACCOUNTS FOR MANY OF ITS SUPPORTED LIVING CLIENTS AS WELL AS MISSION-RELATED NON-CLIENTS IN NEED OF CUSTODIAL ARRANGEMENTS. GIVING THROUGH SONG 109263 96613 12650 5000 18929 5900 9158 109263 96613 12650 5000 18929 5900 9158 38987 -26337 X X X X X X 0 1 0 1 0 1 0 1 0 SCOTT LIVENGOOD CEO 241646 0 24822 0 23157 0 21684 0 14764 0 326073 0 17994 0 PART I, LINE 4B CEO- 457 PLAN: $23,157 DISTRIBUTED TO EMPLOYEE IN 2016; $21,684 OF EMPLOYER CONTRIBUTIONS FUNDED TO THE PLAN FOR 2016. PART I, LINE 5 CEO BONUS COMPENSATION IS DETERMINED BASED ON PRE-SET BOARD-ESTABLISHED TARGETS ADVANCING ASLS'S STRATEGIC GOALS. THESE TARGETS INCLUDE FUNDRAISING REVENUE IN ADDITION TO NON-FINANCIAL MEASURES. PART I, LINE 6 CEO BONUS COMPENSATION IS DETERMINED BASED ON PRE-SET BOARD-ESTABLISHED TARGETS ADVANCING ASLS'S STRATEGIC GOALS. THESE TARGETS INCLUDE EXCESS OF REVENUES OVER EXPENSES IN ADDITION TO NON-FINANCIAL MEASURES. PART I, LINE 7 CEO RECEIVED A YEAR END BONUS AS A RESULT OF MEETING PERFORMANCE METRICS WHICH INCLUDE BOTH FINANCIAL AND NON-FINANCIAL MEASURES. A WASHINGTON STATE HOUSING FINANCE COMMISSION 911220968 2013-01-29 1336000 FACILITY REMODEL AND ACQUISITION 0 0 0 A 1336000 18846 1205778 111376 2013 0 0 1 1 A 0 0 0 0 0 0 0 A 0 0 0 0 0 0 0 0 0 A 0 FORM 990, PART I, LINE 8 THE DECREASE IN CONTRIBUTED REVENUE DURING 2016 RESULTS FROM A ONE-TIME GIFT OF A FACILITY FROM A WASHINGTON STATE AGENCY IN 2015. FORM 990, PART VI, SECTION A, LINE 2 MARRIED COUPLE ON THE BOARD OF DIRECTORS: MARK AND LINDA JOHNSON. FORM 990, PART VI, SECTION B, LINE 11B THE DRAFT FORM 990 IS PRESENTED TOGETHER WITH THE DRAFT AUDITED FINANCIAL STATEMENTS TO THE EXECUTIVE COMMITTEE. ANY UNUSUAL OR CHANGED ITEMS ARE HIGHLIGHTED IN DISCUSSION. THE BOARD OF DIRECTORS RECEIVES A COPY OF THE FULL FORM 990 PRIOR TO SIGNING BY THE CEO AND SUBMISSION TO THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD OF DIRECTORS DECLARES ANY CONFLICTS OF INTEREST AT LEAST ANNUALLY. IF THERE IS A SPECIFIC BOARD MATTER THAT PRESENTS A CONFLICT OF INTEREST FOR A BOARD MEMBER, THEY ARE RECUSED FROM THE DISCUSSION AND ANY RELATED VOTE. FORM 990, PART VI, SECTION B, LINE 15 ASLS PERIODICALLY HIRES A COMPENSATION CONSULTANT TO REVIEW THE CEO'S SALARY AND COMPARE IT TO INDUSTRY AND REGIONAL STANDARDS. THIS RECOMMENDATION IS DISCUSSED AND COMPENSATION INCREASES ARE APPROVED BY THE FULL BOARD OF DIRECTORS. FORM 990, PART VI, SECTION C, LINE 19 ANNUAL AUDITED FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. OTHER POLICY DOCUMENTS ARE NOT MADE AVAILABLE TO THE PUBLIC. FORM 990, PART XII, LINE 2C, REVIEW OF AUDITED FINANCIAL STATEMENTS: THE AUDITED FINANCIAL STATEMENTS ARE REVIEWED BY THE EXECUTIVE COMMITTEE PRIOR TO ISSUANCE. INCLUSION HOUSING LLC 16030 JUANITA-WOODINVILLE WAY NE BOTHELL WA 98011 910933802 HOUSING FOR INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES WA 20566 424425 ALPHA SUPPORTED LIVING SERVICES