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
2011
Open to Public Inspection
Name of the organization
TEENWISE MINNESOTA
Employer identification number
41-1722338
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) 2011
Schedule A (Form 990 or 990-EZ) 2011
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) 2007
(b) 2008
(c) 2009
(d) 2010
(e) 2011
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
561,358
782,971
714,218
520,158
387,021
2,965,726
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..
561,358
782,971
714,218
520,158
387,021
2,965,726
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)..
205,622
6
Public Support. Subtract line 5 from line 4.
2,760,104
Section B. Total Support
Calendar year(or fiscal year beginning in)
(a) 2007
(b) 2008
(c) 2009
(d) 2010
(e) 2011
(f) Total
7
Amounts from line 4..
561,358
782,971
714,218
520,158
387,021
2,965,726
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
8,846
3,385
1,630
1,830
401
16,092
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..
11
Total support (Add lines 7 through 10).
2,981,818
12
Gross receipts from related activities, etc. (See instructions.)
..................
12
74,873
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
92.560 %
15
Public Support Percentage for 2009 Schedule A, Part II, line 14
...............
15
90.230 %
16a
33 1/3% support test—2011.
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—2010.
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—2011.
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—2010.
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) 2011
Schedule A (Form 990 or 990-EZ) 2011
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) 2007
(b) 2008
(c) 2009
(d) 2010
(e) 2011
(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) 2007
(b) 2008
(c) 2009
(d) 2010
(e) 2011
(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 2011 (line 8 column (f) divided by line 13 column (f))
.........
15
16
Public support percentage from 2010 Schedule A, Part III, line 15
...............
16
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2011 (line 10c column (f) divided by line 13 column (f))
......
17
18
Investment income percentage from 2010 Schedule A, Part III, line 17
.............
18
19a
33 1/3% support tests—2011.
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—2010.
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) 2011
Schedule A (Form 990 or 990-EZ) 2011
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) 2011
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
2011
Open to Public Inspection
Name of the organization
TEENWISE MINNESOTA
Employer identification number
41-1722338
Identifier
Return Reference
Explanation
ORGANIZATION'S MISSION
FORM 990 - ORGANIZATION'S MISSION
TEENWISE MINNESOTA IS THE STATEWIDE LEADER IN PROMOTING ADOLESCENT SEXUAL HEALTH, PREVENTING ADOLESCENT PREGNANCY AND GAINING SUPPORT FOR ADOLESCENT PARENTS. WE ACHIEVE THIS BY DEVELOPING, STRENGTHENING AND ADVANCING SCIENCE-BASED POLICIES AND PROGRAMS.
FIRST ACCOMPLISHMENT DESCRIPTION
FORM 990, PAGE 2, PART III, LINE 4A
RANGE OF ORGANIZATIONS INCLUDING, COMMUNITY BASED AGENCIES (22%), PUBLIC HEALTH ORGANIZATIONS (19%), GOVERNMENT AGENCIES (16%), SCHOOLS (15%), HEALTH CARE PROVIDERS (11%), AND ORGANIZATIONS INVOLVED IN ADVOCACY (2%). PLANNED AND DELIVERED 10 PROFESSIONAL TRAINING PROGRAMS ON IMPLEMENTING EVIDENCE-BASED SEXUALITY EDUCATION. PROVIDED TECHNICAL ASSISTANCE TO COMMUNITY-BASED ORGANIZATIONS IN SUPPORT OF THEIR EFFORTS TO SELECT, IMPLEMENT AND EVALUATE SCIENCE-BASED APPROACHES TO TEEN PREGNANCY, HIV AND STI PREVENTION. PROVIDED ONE NATIONAL TRAINING (IN BALTIMORE) FOR THE OFFICE OF ADOLESCENT HEALTH REGARDING ADAPTATION OF EVIDENCE-BASED PROGRAMS. PARTICIPATING WITH THE CHILD SAFETY AND PERMANENCY DIVISION OF DHS, THE MINNESOTA INDIAN WOMEN'S RESOURCE CENTER AND THE MINNESOTA DEPARTMENT OF HEALTH, IN A NATIONAL PROJECT TO IMPLEMENT A PREGNANCY AND SEXUALLY TRANSMITTED INFECTION PREVENTION CURRICULUM, MAKING PROUD CHOICES (MPC), FOR YOUTH IN FOSTER CARE IN MINNESOTA. THIS WORK IS SUPPORTED BY THE ANNIE E. CASEY FOUNDATION, THE AMERICAN PUBLIC HUMAN SERVICES ASSOCIATION, THE NATIONAL CAMPAIGN TO PREVENT TEEN AND UNPLANNED PREGNANCY AND THE NATIONAL ASSOCIATION OF PUBLIC CHILD WELFARE ADMINISTRATORS. WORKED WITH THE MINNEAPOLIS PUBLIC SCHOOLS TO IMPLEMENT AND MONITOR AN EVIDENCE-BASED SEXUALITY EDUCATION HEALTH CURRICULUM IN ALL MINNEAPOLIS PUBLIC SCHOOLS MIDDLE SCHOOLS. COORDINATED THE MINNESOTA SEXUALITY RESOURCE REVIEW PANEL (MSERRP), A GROUP OF PROFESSIONALS WITH EXPERTISE IN SEXUALITY EDUCATION AND HIV PREVENTION THAT REVIEWS AND RECOMMENDS SEXUALITY EDUCATION AND HIV PREVENTION CURRICULA AND RESOURCES FOR USE IN SCHOOLS AND COMMUNITIES. AT THE BEGINNING OF OUR FISCAL YEAR, THERE WERE 25 MEMBERS; THE MEMBERSHIP WAS REDUCED TO SIX BY THE MINNESOTA DEPARTMENT OF EDUCATION IN MARCH OF 2012 DUE TO BUDGET CUTS. WORKED IN COLLABORATION WITH 25 PUBLIC AGENCIES, COMMUNITY-BASED ORGANIZATIONS AND COALITIONS TO PROMOTE IMPLEMENTATION OF EVIDENCE-BASED APPROACHES. SERVED AS MINNESOTA'S CERTIFIED REPLICATION PARTNER FOR THE TEEN OUTREACH PROGRAM, AN EVIDENCED BASED YOUTH DEVELOPMENT AND PREGNANCY PREVENTION PROGRAM. HELD OUR FIRST WEBINAR FOCUSED ON NEW SEXUALITY EDUCATION STANDARDS. FORTY-FIVE PEOPLE REGISTERED.
SECOND ACCOMPLISHMENT DESCRIPTION
FORM 990, PAGE 2, PART III, LINE 4B
PROVIDED TWO PROFESSIONAL TRAINING WORKSHOPS FOR PROVIDERS OF ADOLESCENT PARENT SERVICES ON A VARIETY OF TOPICS INCLUDING MENTAL HEALTH OF TEEN PARENTS, CO-PARENTING, EDUCATION NEEDS OF YOUNG PARENTS AND BREASTFEEDING. PROVIDED THE LATEST RESEARCH, RESOURCES, PROGRAM UPDATES, FUNDING OPPORTUNITIES AND LEGISLATIVE ISSUES RELATED TO ADOLESCENT PARENTS, THROUGH A MONTHLY ELECTRONIC NEWSLETTER. CONVENED HENNEPIN COUNTY TEEN PARENT CONNECTIONS - A DIVERSE GROUP OF SERVICE PROVIDERS OF ADOLESCENT PARENT SERVICES.
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990
FORM 990, PAGE 6, PART VI, LINE 11B
1.FORM 990 IS MADE AVAILABLE FOR REVIEW BY ALL BOARD MEMBERS DURING A REGULARLY SCHEDULED BOARD MEETING. 2.A SIGN-UP SHEET IS PROVIDED FOR THOSE BOARD MEMBERS WHO WISH TO RECEIVE A HARD COPY. 3.HARD COPIES ARE MAILED TO THOSE WHO WISH TO RECEIVE ONE. 4.BOARD MEMBERS NOT IN ATTENDANCE AT SAID BOARD MEETING ARE MADE AWARE BY EMAIL OF THE AVAILABILITY OF THE FORM 990. 5.HARD COPIES ARE MAILED TO THOSE WHO WISH TO RECEIVE ONE.
ENFORCEMENT OF CONFLICTS POLICY
FORM 990, PAGE 6, PART VI, LINE 12C
1.ALL FINANCIAL CONTRACTS WITH EXTERNAL ENTITIES ARE REVIEWED FOR POTENTIAL CONFLICT. 2.POLICY IS DISCUSSED ANNUALLY AT STAFF MEETING. STAFF IS REQUIRED TO RE-SIGN DOCUMENT AFTER REVIEW. 3.POLICY IS DISCUSSED ANNUALLY AT BOARD MEETING. BOARD MEMBERS ARE REQUIRED TO RE-SIGN DOCUMENT AFTER REVIEW.
COMPENSATION PROCESS FOR TOP OFFICIAL
FORM 990, PAGE 6, PART VI, LINE 15A
1.BOARD EXECUTIVE COMMITTEE REVIEWS COMPARABILITY SALARY DATA FOR ALL STAFF USING THE MINNESOTA COUNCIL OF NONPROFITS' REPORT, "MINNESOTA NONPROFIT SALARY AND BENEFITS SURVEY" (UPDATED EVERY TWO YEARS). 2.BOARD PRESIDENT SURVEYS BOARD MEMBERS AND STAFF MEMBERS REGARDING EXECUTIVE DIRECTOR'S PERFORMANCE. BOARD PRESIDENT AND VICE PRESIDENT REVIEW RESULTS WITH EXECUTIVE DIRECTOR AND RECOMMEND ANY PAY RAISE IN WRITING TO EXECUTIVE DIRECTOR
GOVERNING DOCUMENTS DISCLOSURE EXPLANATION
FORM 990, PAGE 6, PART VI, LINE 19
1.TEENWISE MINNESOTA MAKES THE FOLLOWING GOVERNING DOCUMENTS AVAILABLE ON ITS WEBSITE, GUIDESTAR AND CHARITIES REVIEW COUNCIL: INTERNAL REVENUE SERVICES 501C3 DETERMINATION LETTER STATE OF MINNESOTA ATTORNEY GENERAL REGISTRATION LETTER STRATEGIC PLAN 2.TEENWISE MINNESOTA PROVIDES A SUMMARY OF ITS FINANCIAL STATEMENTS IN ITS ANNUAL REPORT, WHICH IS MAILED TO FUNDERS, DONORS AND MEMBERS AND AVAILABLE ONLINE.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.