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
Lifeline Connections
Employer identification number
91-0787084
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.") ....
5,902,280
7,929,314
8,783,108
8,691,015
9,835,008
41,140,725
2
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
0
3
The value of services or facilities furnished by a governmental unit to the organization without charge..
0
4
Total. Add lines 1 through 3..
5,902,280
7,929,314
8,783,108
8,691,015
9,835,008
41,140,725
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)..
0
6
Public Support. Subtract line 5 from line 4.
41,140,725
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..
5,902,280
7,929,314
8,783,108
8,691,015
9,835,008
41,140,725
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
7,661
7,944
2,855
15,053
20
33,533
9
Net income from unrelated business activities, whether or not the business is regularly carried on..
0
10
Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..
0
11
Total support (Add lines 7 through 10).
41,174,258
12
Gross receipts from related activities, etc. (See instructions.)
..................
12
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
99.920 %
15
Public Support Percentage for 2009 Schedule A, Part II, line 14
...............
15
99.820 %
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:
10000105
Software Version:
2010v3.2
-
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
Lifeline Connections
Employer identification number
91-0787084
Identifier
Return Reference
Explanation
Form 990, Part VI, Line 19
Form 990, Part VI, Line 19: Other Organization Documents Publicly Available
REASONBLE REQUESTS FOR FINANCIAL STATEMENTS AND GOVERNING DOCUMENTS ARE FURNISHED UPON REQUEST AT THE MAIN OFFICE.
Form 990, Part VI, Line 15b
Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees
REVIEWED AND APPROVED BY BOARD.
Form 990, Part VI, Line 11
Form 990, Part VI, Line 11: Form 990 Review Process
A DRAFT 990 IS PRESENTED TO BOARD FOR FINAL APPROVAL PRIOR TO FILING.
Form 990, Part III, Line 4d
Form 990, Part III, Line 4d : Other Program Services Description
OTHER PROGRAM SERVICES 4: COMET IS AN OUTPATIENT PROGRAM FOR ADULTS WITH A CO-OCCURRING MENTAL ILLNESS AND METHAMPHETAMINE MISUSE, PROVIDING GROUP AND INDIVIDUAL THERAPY, EDUCATION, CASE MANAGEMENT, AND PEER SUPPORT. OTHER PROGRAM SERVICES 5: URINALYSIS SCREENING IS DRUG AND ALCOHOL TESTING PROVIDED TO INDIVIDUALS REFERRED BY THE SUPERIOR COURT SUPERVISED RELEASED PROGRAM, AND TO OTHERS ON A ONE-TIME OR ONGOING RANDOM BASIS. OTHER PROGRAM SERVICES 6: THE STATE CERTIFIED ASSESSMENT CENTER PROVIDES DIAGNOSTIC EVALUATION FOR DUI, DEFERRED PROSECUTION, AND EMPLOYER SELF REFERRALS. THE ASSESSMENT CENTER IS THE COMMUNITY GATEWAY FOR PUBLICLY-FUNDED TREATMENT PROGRAMS THROUGHOUT THE AREA. OTHER PROGRAM SERVICES 7: THE MENTAL HEALTH PROGRAM PROVIDES GROUP AND INDIVIDUAL THERAPY, MEDICATION MANAGEMENT, EDUCATION, PEER SUPPORT, AND CASE MANAGEMENT TO ADULTS WITH CO-OCCURING MENTAL ILLNESS AND SUBSTANCE USE DISORDER. OTHER PROGRAM SERVICES 8: THE JAIL PROGRAM PROVIDES MENTALLY ILL OFFENDERS WHO ARE TRANSITIONING FROM JAIL TO THE COMMUNITY WITH MENTAL HEALTH, CASE MANAGEMENT, AND PEER SUPPORT SERVICES. OTHER PROGRAM SERVICES 9: ADOLESCENT AND ADULT SUBSTANCE USE DISORDER ASSESSMENTS ARE PROVIDED. OTHER PROGRAM SERVICES 10: YOUTH AND FAMILY SERVICES IS AN ADOLESCENT PROGRAM THAT PROVIDES EDUCATION, ASSESSMENT, OUTPATIENT TREATMENT, AND REFERRAL FOR TREATMENT TO CLARK COUNTY YOUTH AND THEIR FAMILIES. WEEKLY SUPPORT GROUPS AND MONTHLY EDUCATIONAL EXPERIENCES ARE AVAILABLE TO THOSE WITH ALCOHOL AND/OR DRUG RELATED PROBLEMS. OTHER PROGRAM SERVICES 11: DRUG COURT CASE MANAGEMENT SERVICES ARE PROVIDED TO PARTICIPANTS IN THE SUPERIOR COURT DRUG COURT AS WELL AS THE DISTRICT COURT SUBSTANCE ABUSE COURT. OTHER PROGRAM SERVICES 12: THE DCFS OUTSTATION COUNSELOR IS AVAILABLE AT THE DIVISION OF CHILDREN AND FAMILY SERVICES ON A HALF-TIME BASIS TO PROVIDE CHEMICAL DEPENDENCY ASSESSMENTS AND TREATMENT REFERRALS. OTHER PROGRAM SERVICES 13: FLEX FUNDS PROVIDE DIRECT CLIENT ASSISTANCE SUCH AS RENTAL ASSISTANCE OR BUS PASSES TO THOSE IN NEED. OTHER PROGRAM SERVICES 14: FOOD SERVICES ARE PROVIDED TO SPECIFIC LIFELINE PROGRAMS, INCLUDING INPATIENT, ALCOHOL DETOXIFICATION, AND NW DEAF ADDICTION. THESE COSTS ARE SUBSTANTIALLY ALLOCATED TO PROGRAMS AND THE REMAINING BALANCE REPORTED AS A GENERAL PROGRAM COST OF THE ORGANIZATION. OTHER PROGRAM SERVICES 15: INTERIM SERVICES INCLUDE GROUP AND INDIVIDUAL SERVICES THAT MOTIVATE AND ENGAGE ADULTS WHO ARE PENDING ADMISSION TO INPATIENT TREATMENT. OTHER PROGRAM SERVICES 16: THE INVOLUNTARY TREATMENT ACT CHEMICAL DEPENDENCY COUNSELOR MANAGES THE PROCESS OF INVOLUNTARY COMMITMENTS FOR ADULTS WITH SUBSTANCE USE DISORDERS THAT GRAVELY DISABLE THEM. THIS INCLUDES ASSESSMENTS, CASE MANAGEMENT AND COURT SERVICES. OTHER PROGRAM SERVICES 17: NW DEAF ADDICTION IS A SPECIALIZED TREATMENT PROGRAM FOR CHEMICALLY DEPENDENT ADULTS WHO ARE DEAF OR HARD OF HEARING THAT PROVIDES OUTPATIENT, DAY TREATMENT, AND GROUP LIVING IN A CULTURALLY SPECIFIC ENVIRONMENT THAT USES AMERICAN SIGN LANGUAGE AS THE PRIMARY FORM OF COMMUNICATION.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.