2015-06-11T13:01:34-05:00 2015-01-31 350905983 K B PARRISH & CO LLP 6840 EAGLE HIGHLANDS WAY INDIANAPOLIS IN 46254 990 2014-02-01 352029321 THE INDIANA CHAPTER OF THE ALS ASSOCIATION INC INDI 3179159888 6525 E 82ND STREET NO 115 INDIANAPOLIS IN 46250 CYNTHIA WISE EXECUTIVE DIRECTOR 3179159888 2015-06-10 1 REBEKAH PAYNE CPA P00841956 3173475200 2014 2016-02-25 16:41:14Z CYNTHIA WISE 6525 E 82ND STREET NO 115 INDIANAPOLIS IN 46250 1244961 0 4119 X WEBIN.ALSA.ORG X 1997 IN MOST COMPREHENSIVE PROVIDER OF CARE, SUPPORT SERVICES, AND EDUCATIONAL RESOURCES FOR ALS PATIENTS AND FAMILIES IN INDIANA. LEADING ADVOCATE AND VOICE FOR ALS COMMUNITY. FUNDS AND PROMOTES ALS RESEARCH. 14 14 9 182 0 0 772102 1172908 0 0 10035 12034 -61607 -70325 720530 1114617 23650 33019 0 0 259779 293761 0 0 107491 316509 290409 599938 617189 120592 497428 489821 968007 18982 5394 470839 962613 X MOST COMPREHENSIVE PROVIDER OF CARE, SUPPORT SERVICES, AND EDUCATIONAL RESOURCES FOR ALS PATIENTS AND FAMILIES IN INDIANA. LEADING ADVOCATE AND VOICE FOR ALS COMMUNITY. FUNDS AND PROMOTES ALS RESEARCH. 0 0 383118 25000 PATIENT AND CAREGIVER SERVICES - THE INDIANA CHAPTER'S PATIENT SERVICES INCLUDES SUPPORT GROUPS, NUTRITION ASSISTANCE, LENDING OF MEDICAL EQUIPMENT AND SUPPLIES, AND PROVIDING MULTI-DISCIPLINARY CLINICS.SUPPORT GROUPS PROVIDE SOCIAL AND EMOTIONAL SUPPORT AS WELL AS INFORMATION ABOUT MANAGING THE DISEASE TO PATIENTS AND THEIR FAMILIES. THE CHAPTER HAS OPERATED SEVERAL SUPPORT GROUPS IN THE PAST. THE GROUPS ARE GEOGRAPHICALLY-BASED AND MEET MONTHLY. THE GROUPS ARE ATTENDED BY THOSE IMPACTED IN SOME WAY BY ALS AND ALL ARE WELCOME TO ATTEND. THERE IS A SPEAKER PROVIDING TECHNICAL EXPERTISE OF SOME KIND AT SOME OF THE GROUP MEETINGS AND AT OTHERS GROUP MEMBERS SHARE THOUGHTS, FEELINGS, ISSUES, CONCERNS AND QUESTIONS. ON AN AVERAGE MONTHLY ATTENDANCE IS 80 PATIENTS AND CAREGIVERS STATEWIDE.THE INDIANA CHAPTER ACCEPTS DONATIONS OF MEDICAL EQUIPMENT AND SUPPLIES THAT THEY MAKE AVAILABLE TO ALS PATIENTS AT NO CHARGE THROUGH A LOAN CLOSET.MULTI-DISCIPLINARY CLINICS EXIST TO HELP PEOPLE WITH ALS GET THE BEST POSSIBLE CARE FOR THEIR CONDITION BY PROVIDING A MULTITUDE OF SERVICES AND A BROAD RANGE OF EXPERTISE IN A SINGLE LOCATION. THE ALSA-CERTIFIED CENTER OF EXCELLENCE, ALS MULTI-DISCIPLINARY CLINIC, SCHEDULES PATIENTS EVERY TUESDAY AND THE LAST THURSDAY OF EACH MONTH IN THE I.U. NEUROSCIENCE CENTER. WHILE THERE, PATIENTS SEE THEIR NEUROLOGIST, PHYSICAL THERAPIST, SPEECH THERAPIST, RESPIRATORY THERAPIST, NUTRITIONIST, CLINICAL TRIALS NURSE, SOCIALWORKER/CASE MANAGER, AND, IF APPROPRIATE, A HOSPICE REPRESENTATIVE. AFTER PATIENT VISITS ARE OVER THE TEAM DEBRIEFS ON EACH PATIENT'S ISSUES AND CONCERNS. SIX TO EIGHT PATIENTS ARE SEEN DURING THE AVERAGE CLINIC DAY AND MORE THAN 300 PATIENT VISITS TO THE CLINIC WERE SCHEDULED IN THE PAST YEAR. WHILE SOME OF THOSE VISITS MAY BE REPEAT VISITS BY THE SAME PATIENT WITHIN THE SAME YEAR, USUALLY 200 OR MORE INDIVIDUAL PATIENTS ARE SEEN IN THE CLINIC OVER THE COURSE OF THE YEAR. THE CHAPTER PROVIDES FINANCIAL SUPPORT TO THE CLINIC WHICH IS USED FOR MULTI-DISCIPLINARY AND RESEARCH CLINICAL TRIALS, STAFF AND GENERAL SUPPORT AND MAINTENANCE OF THE CLINIC. THE CHAPTER'S DIRECTOR OF PATIENT SERVICES IS A MEMBER OF THE CLINIC'S MULTI-DISCIPLINARY TEAM. THE TEAM ALSO ATTENDS THE VA HOSPITAL ALS CLINIC.OTHER PROGRAMS INCLUDE CAREGIVER DAY, WHICH IS AN ANNUAL EVENT WHERE CAREGIVERS AND CAREGIVER/VOLUNTEERS COME TOGETHER FOR SUPPORT, ENCOURAGEMENT, EDUCATION AND FUN. A VARIETY OF OTHER MISCELLANEOUS PROGRAMS ARE OFFERED AS NEEDED FROM TIME TO TIME. 62135 PUBLIC AND PROFESSIONAL EDUCATION - THE ALS ASSOCIATION INDIANA CHAPTER RAISES FUNDS TO SUPPORT RESEARCH INTO CAUSES, TREATMENTS, AND A CURE FOR ALS. RESEARCH DOLLARS ARE USED TO UNDERSTAND THE DISEASE PROCESS OF ALS AND HOW AXON STRUCTURE AND DYNAMICS, CELL DEATH, COGNITIVE CHANGES, GLUTAMATES, INFLAMMATION, MITOCHONDRIA AND SOD 1 ARE INVOLVED. MONIES RAISED FUND CLINICAL TRIALS, THE INVESTIGATION AND LINKAGE OF POSSIBLE ENVIRONMENTAL FACTORS, TO BETTER UNDERSTAND THE GENETICS OF ALS AND TO CREATE LABORATORY MODELS OF ALS. THE CHAPTER ADVOCATES AND EDUCATES THE PUBLIC THROUGH NEWSLETTERS AND OUTREACH PROGRAMS. 8019 8019 REVENUE SHARE - AS AN OFFICIAL CHARTER CHAPTER OF THE NATIONAL ALS ASSOCIATION, THE INDIANA CHAPTER PROVIDES 17 PERCENT OF ITS REVENUES RAISED WITH THE NATIONAL ASSOCIATION. FUNDS ARE FORWARDED FROM LOCAL CHAPTERS TO THE NATIONAL ASSOCIATION IN ORDER TO POOL RESOURCES TO RESEARCH ALS AND TEST NEW TREATMENTS TO BATTLE THE PROGRESSION OF ALS IN PATIENTS. FUNDS ARE ALSO USED BY THE NATIONAL ASSOCIATION TO RAISE AWARENESS OF THE DISEASE AT A NATIONAL LEVEL AND SUPPORT THE OPERATIONS AND EFFORTS OF OTHER LOCAL CHAPTERS AND NATIONAL PROGRAMS. DUE TO A GRANT FROM THE NATIONAL ASSOCIATION, REVENUE SHARE WAS NOT PAID IN THE CURRENT YEAR. THE REMAINING PROGRAM EXPENSE REPRESENTS THE RESEARCH DISTRIBUTION TO THE NATIONAL ASSOCIATION. 453272 1 0 0 1 0 0 0 0 0 0 1 1 0 0 1 1 1 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 15 0 1 9 1 0 0 0 0 0 0 0 0 0 0 X 14 14 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 IN X X CYNTHIA WISE 3179159888 6525 EAST 82ND STREET SUITE 115 INDIANAPOLIS IN 46250 MICHAEL E MILLIKAN PAST PRESIDENT 1.00 X 0 0 0 JEANNE MANNELLA VICE PRESIDENT 2.00 X X 0 0 0 ADAM TERNET SECRETARY 2.00 X X 0 0 0 STEVEN CHMIELEWSKI PRESIDENT 2.00 X X 0 0 0 SARAH HELGESON TRUSTEE 1.00 X 0 0 0 KRISTIN WROBLESKI TRUSTEE 1.00 X 0 0 0 LINDA STURGES TRUSTEE 1.00 X 0 0 0 CHERYL WHITE TRUSTEE 1.00 X 0 0 0 DEREK FRENCH TREASURER 3.00 X X 0 0 0 MONA EULER TRUSTEE 1.00 X 0 0 0 GEOFFREY DAVIS TRUSTEE 1.00 X 0 0 0 CELINA ANNABLE TRUSTEE 1.00 X 0 0 0 CHRISTOPHER DILWORTH TRUSTEE 1.00 X 0 0 0 CHRISTY SHEPARD TRUSTEE 1.00 X 0 0 0 CYNTHIA WISE EXECUTIVE DIRECTOR 40.00 X 69859 0 2393 69859 0 2393 0 0 0 0 0 780771 392137 12090 1172908 13136 13136 58427 57729 1800 698 -1800 -1102 -1102 0 780771 70815 -70815 -70815 MISCELLANEOUS 900099 490 490 490 1114617 490 0 -58781 33019 33019 72252 54189 7225 10838 192168 143956 19608 28604 6874 5135 642 1097 22467 17021 2316 3130 500 500 9113 9113 1906 1906 5394 5020 152 222 44932 41182 3750 36915 20486 1958 14471 29399 3594 4902 20903 33498 24930 3343 5225 13097 8547 114 4436 1893 1222 41 630 3059 1346 183 1530 1606 1193 161 252 LOAN CLOSET EXPENSE 83979 83979 OTHER MISCELLANEOUS 9294 3197 2260 3837 BANK FEES 7971 779 1751 5441 PROFESSIONAL DEVELOPMEN 5530 3355 2175 2323 622 751 950 617189 453272 56426 107491 X 116502 192886 133992 245840 6743 61998 1727 813 580 626 17453 8459 10917 8994 124952 84885 335357 94408 36608 489821 968007 13406 713 5576 4681 18982 5394 X 457284 937732 13555 24881 470839 962613 489821 968007 497428 -5654 0 X X 0 1 X 1 0 X 429301 602068 663849 772102 1172908 3640228 429301 602068 663849 772102 1172908 3640228 3640228 280 826 3544 5394 13136 23180 269 310 356 2783 490 4208 3667616 0.99250 0.98600 X 1 1 0 0 0 0 1 1883 0 0 1883 0 PART II-B, LINE 1: REGISTRATION COSTS, MATERIALS PRINTING, TRAVEL, LODGING, AND MEALS FOR THE EXECUTIVE DIRECTOR TO ADVOCATE TO CONGRESS ABOUT ALS AND ENCOURAGE CONGRESSIONAL APPROPRIATIONS TO FUND RESEARCH AND SUPPORT OF THE ALS REGISTRY. COMPENSATION IS NOT INCLUDED AS ALLOCATED PORTION OF EMPLOYEE SALARIES WOULD NOT BE MATERIAL FOR THIS EVENT (LESS THAN $1,000). 17453 8459 8994 8994 CORPORATE BONDS 299161 F MUNICIPAL BONDS 36196 F 335357 CAPITAL LEASE 1944 DEFERRED RENT 2737 4681 X 1324632 -5654 217575 211921 1112711 1906 1906 1114617 832858 217575 217575 615283 1906 1906 617189 PART X, LINE 2: THE ASSOCIATION HAS EVALUATED TAX POSITIONS TAKEN IN THE TAX RETURNS FILED AND HAS DETERMINED THAT THERE ARE NO UNCERTAIN TAX POSITIONS AS DEFINED BY GENERALLY ACCEPTED ACCOUNTING STANDARDS. UNDER A THREE-YEAR STATUTE OF LIMITATIONS, THE ASSOCIATION REMAINS SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE FOR THE YEARS ENDED JANUARY 31, 2012 THROUGH JANUARY 31, 2014. PART XI, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EVENT EXPENSES 70,815. IN-KIND GRANT 146,760. PART XII, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EVENT EXPENSES 70,815. IN-KIND GRANT 146,760. WALKS AND OTHER EVENTS 780771 780771 28055 23068 3846 15846 780771 780771 28055 23068 3846 15846 70815 -70815 1 IU ALS CENTER OF EXCELLENCE AT IU NEUROSCIENCE CENTER 355 W 16TH INDIANAPOLIS IN 46202 264529479 501(C)(3) 25000 SUPPORT FOR CLINIC AMYOTROPHIC LATERAL SCLEROSIS ASSOCIATION - NATIONAL OFFICE 1275 K STREET NW NO 1050 WASHINGTON DC 20005 133271855 501(C)(3) 8019 RESEARCH GRANT SHARE WITH NATIONAL AFFILIATED ORGANIZATION 2 2 PART I, LINE 2: CONTRIBUTIONS TO SUPPORT CLINIC AND RESEARCH GRANT SHARE PAID TO NATIONAL ALS ASSOCIATION. THE CHAPTER'S DIRECTOR OF PATIENT SERVICES IS A MEMBER OF THE CLINIC'S MULT-DISCIPLINARY TEAM AND MONITORS HOW THE FUNDS ARE SPENT. FORM 990, PART VI, SECTION B, LINE 11 A DRAFT COPY OF THE FORM 990 WILL BE PROVIDED TO ALL BOARD MEMBERS FOR REVIEW PRIOR TO FILING IT WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C ENFORCEMENT OF THE CONFLICT OF INTEREST POLICY IS MONITORED REGULARLY. ALL EXEMPT AND NON-EXEMPT EMPLOYEES ARE COVERED AS ARE MEMBERS OF THE BOARD OF TRUSTEES. ALL NEW EMPLOYEES AND BOARD MEMBERS MUST SIGN A CONFLICT OF INTEREST POLICY. BOARD MEMBERS ARE REQUIRED TO SIGN A NEW CONFLICT OF INTEREST POLICY EVERY YEAR. THE EXECUTIVE DIRECTOR DETERMINES AND REVIEWS ALL CONFLICTS WITH STAFF THAT HAVE THE POTENTIAL TO NEGATIVELY AFFECT PERFORMANCE OR DECISION MAKING. THE BOARD PRESIDENT DETERMINES AND REVIEWS ANY CONFLICTS WITH BOARD MEMBERS. BOARD MEMBERS MUST RECUSE THEMSELVES FROM ANY DISCUSSION OR VOTE THAT INVOLVES A CONFLICT OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15A GOALS ARE ESTABLISHED AND APPROVED BY THE EXECUTIVE COMMITTEE. THEN IN THE FOLLOWING YEAR, A REVIEW IS DONE BY THE EXECUTIVE COMMITTEE TO DETERMINE IF GOALS WERE MET. SALARY AND BONUSES IF ANY ARE DETERMINED BASED ON THIS ANNUAL REVIEW. FORM 990, PART VI, SECTION C, LINE 18 THE CHAPTER MAKES ITS FORM 1023 AND FORM 990 AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST. ANNUAL FORM 990S CAN ALSO BE ATTAINED THROUGH THIRD PARTY WEBSITES SUCH AS WWW.GUIDESTAR.COM. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC IN THE CHAPTER OFFICE UPON REQUEST. FORM 990, PART XII, LINE 2C THE TREASURER AND BOARD OF DIRECTORS ASSUME RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT AND ITS FINANCIAL STATEMENTS AS WELL AS THE SELECTION OF AN INDEPENDENT ACCOUNTANT.