Department of the Treasury Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
Attach to Form 990 or Form 990-EZ. See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
Daughters of Charity Services of San Antonio
Employer identification number
74-6106876
Part I
Reason for Public Charity Status
(All organizations must complete this part.) See instructions
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).
f
If the organization received a written determination from the IRS that it is a Type I, Type II or Type III supporting organization, check this box
..................................................
g
Since August 17, 2006, has the organization accepted any gift or contribution from any of the following persons?
(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the the supported organization?
................
11g(i)
(ii)
a family member of a person described in (i) above?
......................
11g(ii)
(iii)
a 35% controlled entity of a person described in (i) or (ii) above?
................
11g(iii)
h
Provide the following information about the supported organization(s).
(i) Name of supported organization
(ii) EIN
(iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions))
(iv) Is the organization in col. (i) listed in your governing document?
(v) Did you notify the organization in col. (i) of your support?
(vi) Is the organization in col. (i) organized in the U.S.?
(vii) Amount of support?
Yes
No
Yes
No
Yes
No
Total
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 2
Part II
Support Schedule for Organizations Described in IRC 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi) (Complete only if you checked the box on line 5, 7, or 8 of Part I or if the
organization failed to qualify under Part III. If the organization fails to
qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year(or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
3,506,423
5,617,932
4,379,101
3,068,317
3,788,918
20,360,691
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..
3,506,423
5,617,932
4,379,101
3,068,317
3,788,918
20,360,691
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)..
7,387,748
6
Public Support. Subtract line 5 from line 4.
12,972,943
Section B. Total Support
Calendar year(or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(f) Total
7
Amounts from line 4..
3,506,423
5,617,932
4,379,101
3,068,317
3,788,918
20,360,691
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
127,056
88,998
8,011
1,977
226,042
9
Net income from unrelated business activities, whether or not the business is regularly carried on..
10
Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..
809,527
966,359
1,045,224
1,105,905
1,307,111
5,234,126
11
Total support (Add lines 7 through 10).
25,820,859
12
Gross receipts from related activities, etc. (See instructions.)
..................
12
5,218,438
13
First Five Years
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here..........................................
Section C. Computation of Public Support Percentage
14
Public Support Percentage for 2010 (line 6 column (f) divided by line 11 column (f))
.........
14
50.242 %
15
Public Support Percentage for 2009 Schedule A, Part II, line 14
...............
15
70.890 %
16a
33 1/3% support test—2010.
If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization
......................
b
33 1/3% support test—2009.
If the organization did not check the box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization
.....................
17a
10%-facts-and-circumstances test—2010.
If the organization did not check a box on line 13, 16a, or 16b and line 14
is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported
organization
..................................................
b
10%-facts-and-circumstances test—2009.
If the organization did not check a box on line 13, 16a, 16b, or 17a and line
15 is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported organization
..............................................
18
Private Foundation
If the organization did not check a box on line 13, 16a, 16b, 17a or 17b, check this box and see
instructions
...................................................
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 3
Part III
Support Schedule for Organizations Described in IRC 509(a)(2) (Complete only if you checked the box on line 9 of Part I or if the organization
failed to qualify under Part II. If the organization fails to qualify under
the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year(or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(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.)
Section B. Total Support
Calendar year (or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(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 in 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 IV.)
13
Total support (Add lines 9, 10c, 11 and 12.).
14
First Five Years
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here.............................................
Section C. Computation of Public Support Percentage
15
Public Support Percentage for 2010 (line 8 column (f) divided by line 13 column (f))
.........
15
16
Public support percentage from 2009 Schedule A, Part III, line 15
...............
16
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2010 (line 10c column (f) divided by line 13 column (f))
......
17
18
Investment income percentage from 2009 Schedule A, Part III, line 17
.............
18
19a
33 1/3% support tests—2010.
If the organization did not check the box on line 14, and line 15 is more than 33 1/3% and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
..........
b
33 1/3% support tests—2009.
If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
....
20
Private Foundation
If the organization did not check a box on line 14, 19a or 19b, check this box and see instructions
.....
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 4
Part IV
Supplemental Information.
Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
Explanation
Schedule A (Form 990 or 990-EZ) 2010
Additional Data
Software ID:
Software Version:
-
TIN:
SCHEDULE O (Form 990 or 990-EZ)
Department of the Treasury Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ
Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
Daughters of Charity Services of San Antonio
Employer identification number
74-6106876
Identifier
Return Reference
Explanation
ORGANIZATION'S MISSION
FORM 990, PART I, QUESTION 1
FAITHFUL TO THE VINCENTIAN TRADITION, THE DAUGHTERS OF CHARITY SERVICES OF SAN ANTONIO WILL ESTABLISH AND MAINTAIN NEIGHBORHOOD-BASED PROGRAMS TO INCREASE ACCESSIBILITY TO PRIMARY HEALTH CARE AND HUMAN SERVICES ON THE PART OF THE POOR. THESE PROGRAMS WILL HAVE A STRONG HOLISTIC ORIENTATION AND CONSIDER PARTICIPATION AND EMPOWERMENT AS AN INTEGRAL DIMENSION OF THE DELIVERY OF SERVICE. WHILE SERVICES WILL BE RENDERED WITH PREFERENTIAL OPTION FOR THE POOR, IT IS NOT TO THE EXCLUSION OF OTHERS.
PROCESS TO REVIEW THE FORM 990
FORM 990, PART VI, QUESTION 11B
DRAFT OF 990 IS REVIEWED BY CEO AND CFO, FORWARDED TO FINANCE COMMITTEE FOR REVIEW, THEN IT IS ALSO FORWARDED TO ASCENSION HEALTH'S (CORPORATE SPONSOR) TAX ACCOUNTANTS FOR REVIEW, PRIOR TO FILING. A COPY OF THE 990 IS PROVIDED TO ALL THE GOVERNING BODY BEFORE FILING.
PROCESS FOR MONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICY
FORM 990, PART VI, QUESTION 12C
CONFLICT OF INTEREST QUESTION IS ASKED AT EVERY BOARD MEETING AND WRITTEN CONFLICT OF INTEREST STATEMENTS ARE SIGNED BY ALL BOARD MEMBERS AND SENIOR MANAGEMENT ANNUALLY.
REVIEW OF CEO OR TOP MANAGEMENT OFFICIAL COMPENSATION
FORM 990, PART VI, QUESTION 15A
A REVIEW IS DONE BY THE ENTIRE BOARD OF DIRECTORS IN EXECUTIVE SESSION AFTER THE AUDITED FINANCIAL STATEMENTS ARE PRESENTED. A COMPENSATION REVIEW IS DONE PERIODICALLY BY AN INDEPENDENT CONSULTANT.
REVIEW OF OTHER OFFICER OR KEY EMPLOYEES COMPENSATION
FORM 990, PART VI, QUESTION 15B
DIRECTORS' SALARIES ARE REVIEWED BY IMMEDIATE SUPERVISORS AND A FINAL REVIEW AND APPROVED BY THE CEO. ALL EVALUATIONS ARE BASED ON ESTABLISHED GOALS IN THE PRECEDING YEAR. A COMPENSATION REVIEW IS DONE PERIODICALLY BY AN INDEPENDENT CONSULTANT.
DESCRIBE HOW DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC
FORM 990, PART VI, QUESTION 19
AVAILABLE UPON REQUEST
DOES THE ORGANIZATION HAVE MEMBERS OR STOCKHOLDERS
FORM 990, PART VI, LINE 6
THE ORGANIZATION HAS ONE MEMBER, ASCENSION HEALTH.
MEMBER WHO MAY ELECT ONE OR MORE MEMBERS OF THE GOVERNING BODY
FORM 990, PART VI, QUESTION 7A
THE ORGANIZATION HAS ONE MEMBER, ASCENSION HEALTH, WHO HAS SOLE AUTHORITY IN MAKING THE DECISIONS FOR ELECTING THE MEMBERS OF THE GOVERNING BODY.
DECISIONS OF THE GOVERNING BODY SUBJECT TO APPROVAL BY MEMBER
FORM 990, PART VI, QUESTION 7B
THE BYLAWS STATE THAT THE BOARD OF TRUSTEES OF THE CORPORATION SHALL NOT TAKE ACTION ON THE FOLLOWING LIST OF ITEMS WITHOUT THE APPROVAL OF THE MEMBER: 1. APPROVE THE MISSION AND VISION STATEMENTS FOR THE CORPORATION, 2. APPROVE THE FORMATION OR ACQUISITION OF NEW LEGAL ENTITIES FOR WHICH ASCENSION HEALTH WILL SERVE AS THE SOLE OR CONTROLLING ENTITY AND, SUBJECT TO CANONICAL REQUIREMENTS, APPROVE THE SALE, TRANSFER, OR SUBSTANTIAL CHANGE IN USE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION OR THE DIVESTITURE, DISSOLUTION, CLOSURE, MERGER, CONSOLIDATION, CHANGE IN CORPORATE MEMBERSHIP, OR CORPORATE REORGANIZATION OF THE CORPORATION, 3. APPROVE REQUIREMENTS, APPROVE CHANGES, AND ASSURE COMPLIANCE WITH REQUIREMENTS FOR GOVERNING DOCUMENTS OF THE CORPORATION AND ITS SUBSIDIARY ORGANIZATIONS, 4. APPOINT OR REMOVE, WITH OR WITHOUT CAUSE, THE CHAIR OF THE BOARD OF THE CORPORATION, 5. APPROVE THE TRANSFER OF ASSETS AND THE REALLOCATION OF DEBT AMONG THE CORPORATION AND OTHER REGIONAL/LOCAL HEALTH MINISTRY ORGANIZATIONS IN ACCORDANCE WITH THE NATIONAL SYSTEM AUTHORITY MATRIX, 6. APPROVE THE TRANSFER OR ENCUMBRANCE OF THE ASSETS OF THE CORPORATION AND ITS SUBSIDIARY HOSPITAL CORPORATIONS, IF ANY, IN ACCORDANCE WITH THE NATIONAL SYSTEM AUTHORITY MATRIX, 7. APPROVE THE STRATEGIC AND FINANCIAL PLANS AND CONSOLIDATED CAPITAL AND OPERATING BUDGETS FOR THE CORPORATION, OR 8. APPROVE THE INCURRENCE OF DEBT OF THE CORPORATION OR ITS SUBSIDIARY ORGANIZATIONS IN EXCESS OF LIMITS SET FORTH IN THE NATIONAL SYSTEM AUTHORITY MATRIX.
CONTINUATION OF EXEMPT SERVICE ACHIEVEMENTS
FORM 990, PART III, LINE 4A
THERE ARE APPROXIMATELY 11,000 CHILDREN AGE FIVE AND UNDER IN THE SCHOOL DISTRICTS IN THE DEPAUL CHILDREN'S CENTER AREA: SOUTH SAN ANTONIO ISD AND HARLANDALE ISD. THE MOST RECENT HEAD START COMMUNITY ASSESSMENT ESTIMATES THAT ABOUT 28% OF THEM ATTEND CHILDCARE. THE DEPAUL CHILDREN'S CENTER SERVES OVER 375 YOUNG CHILDREN ANNUALLY.
CONTINUATION OF EXEMPT PURPOSE ACHIEVEMENTS
FORM 990, PART III, LINE 4B
DCSSA'S SERVICES ARE PROVIDED ON A CO-PAY AND/OR SLIDING SCALE FEE, BASED ON A FAMILY'S INCOME AND HOUSEHOLD SIZE. HOWEVER, EMERGENCY SOCIAL SERVICES (FOOD PANTRY, FINANCIAL CRISIS, CLOTHING, UTILITY ASSISTANCE, ETC.) ARE PROVIDED AT NO COST. OUR PROGRAMS HAVE A STRONG HOLISTIC ORIENTATION, WITH PARTICIPATION AND EMPOWERMENT AS INTEGRAL DIMENSIONS OF WHAT WE DO. TARGET POPULATION -- OUR TARGET POPULATION IS TYPICALLY COMPRISED OF HISPANICS, SINGLE MOTHERS, THE ELDERLY, POOR AND WORKING POOR RESIDENTS OF SOUTH SAN ANTONIO. OF THOSE CLIENTS WHO SEEK OUR SOCIAL SERVICES, 73% ARE FEMALE, 27% ARE MALE. TWENTY PERCENT OF THOSE SERVED ARE BETWEEN ZERO AND 20 YEARS OLD, 63% ARE BETWEEN 21 AND 54 YEARS OLD, AND 17% ARE 55 OR OLDER. EIGHTY-FIVE PERCENT OF THE CLIENTS WE SERVE FALL AT OR BELOW 150% OF THE FEDERAL POVERTY LEVEL. TARGET GEOGRAPHIC AREA -- PRIMARY GEOGRAPHIC AREA (ZIP CODES) INCLUDE: 78211, 78224, 78221, 78214, 78242, 78221, 78214, AND 78264. IN ADDITION, CLIENTS REFERRED BY SCHOOL PERSONNEL AND/OR OTHER COLLABORATIVE PARTNERS IN THE COMMUNITY ARE ALSO SERVED.
OTHER CHANGES IN NET ASSETS OR FUND BALANCES
FORM 990, PART XI, LINE 5
OTHER CHANGES IN NET ASSETS OR FUND BALANCES CONSIST OF THE FOLLOWING: PENSION RELATED CHANGES OTHER THAN NET PERIODIC PENSION COSTS, INCLUDED AS OTHER CHANGE IN NET ASSETS FOR FINANCIAL STATEMENTS 188,672 UNREALIZED LOSS NOT INCLUDED IN REVENUE FOR FORM 990 (183) TOTAL TO FORM 990, PART XI, LINE 5 188,489
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.