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. Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
Colorado Health Institute
Employer identification number
74-3082235
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 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 monetary support
Yes
No
Yes
No
Yes
No
Total
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 2
Part II
Support Schedule for Organizations Described in Sections 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) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
2,859,608
919,591
2,149,472
2,950,979
2,509,042
11,388,692
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
2,859,608
919,591
2,149,472
2,950,979
2,509,042
11,388,692
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)..
9,603,739
6
Public support. Subtract line 5 from line 4.
1,784,953
Section B. Total Support
Calendar year
(or fiscal year beginning in)
(a) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(f) Total
7
Amounts from line 4..
2,859,608
919,591
2,149,472
2,950,979
2,509,042
11,388,692
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
5,616
2,957
965
706
10,498
20,742
9
Net income from unrelated business activities, whether or not the business is regularly carried on..
10
Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)..
147,294
147,294
11
Total support (Add lines 7 through 10).
11,556,728
12
Gross receipts from related activities, etc. (see instructions)
..................
12
2,420,717
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 2013 (line 6, column (f) divided by line 11, column (f))
.........
14
15.450 %
15
Public support percentage for 2012 Schedule A, Part II, line 14
...............
15
21.820 %
16a
33 1/3% support test—2013.
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—2012.
If the organization did not check a 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—2013.
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—2012.
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) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 3
Part III
Support Schedule for Organizations Described in Section 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) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(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) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(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 2013 (line 8, column (f) divided by line 13, column (f))
.........
15
16
Public support percentage from 2012 Schedule A, Part III, line 15
...............
16
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2013 (line 10c, column (f) divided by line 13, column (f))
......
17
18
Investment income percentage from 2012 Schedule A, Part III, line 17
.............
18
19a
33 1/3% support tests—2013.
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—2012.
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) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 4
Part IV
Supplemental Information.
Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; and Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
Colorado Health Institute (the Institute) is a not-for-profit corporation established on November 12, 2002 to advance the overall health of the people of Colorado by serving as an independent and impartial source of reliable and relevant health related information to policy makers, funding organizations, health planners, the business and nonprofit communities, consumer groups, health care providers, and the media. The Institute was established through three equal grants totaling $5,700,000 from Caring for Colorado Foundation, The Colorado Trust, and Rose Community Foundation. These foundations and The Colorado Health Foundation (collectively, the Four Foundations) continue to provide funding for future operations. The Institute is publicly supported under the following facts and circumstances: 1) Public Support is well in excess of 10 percent? The Institute has had more than 33 1/3% public support since inception until 2011 when the public support percentage was 27.17%, 2012 the percentage was 21.82%, and 2013 the percentage was 15.57%.2) Support is received from a representative number of persons rather than from members of a single family? The Institute receives a majority of its grant support primarily from four foundations (the "four foundations") in Denver, though these foundations support organizations throughout Colorado. One of these foundations is a public foundation, and the other three are private foundations. The Institute also received two grants in 2013, one from a university and one from the State of Colorado Department of Health Care Policy and Financing. Other funding is received from contracts. Some of these contracts are from the "four foundations". However, in 2013, the Institute had contract work with fifteen other entities, three of those being with the State of Colorado, and twelve contracts with other not-for-profit organizations.3)Is the governing body representative of the broad interests of the public? In 2013, the Institute's board of trustees was made up of nine trustees that represent experts in the field of health as well as community leaders. Seven of the nine trustees have no affiliation to the private foundations that provide the Institute support. 4)The facilities of the organization are available to the public on a continuing basis? The Institute provides continuous health data and research at no charge to the public through its website, and also through many projects in collaboration with the State of Colorado and other stakeholders in the public health arena. Additionally, CHI allows other health organizations meeting space at no charge and often host covenings with many public stakeholders.5)Is the organization an educational one or a research institution that regularly publishes scholarly journals? The Institute's purpose is to provide health education and research, much of which is disseminated through their own website. In 2013, CHI responded to 391 information requests from the public and gave 97 public presentations. 6) Do members of the public with special knowledge or expertise, public officials or civic or community leaders, participate in, or sponsor, programs of the organization? The Institute's programs provide evidence-based analysis and expertise on health care policy to legislators and policymakers, leading health organizations as well as health foundations in the State of Colorado. These stakeholders provide their support to the Institute through grants, contracts, and representation on the board of directors.7) Does the organization maintain a definitive program to accomplish its charitable work in the community? The Institute's programs support its vision of improving the health of all Coloradans by supporting health policy discussions with evidence-based analysis and expertise.8) Does the organization receive a significant part of its funds from a public charity or a governmental agency to which it is in some way accountable? As noted above, the Institute received support in the form of a grant from one public foundation and contracts from the State of Colorado and other not-for-profit organizations.9)The Institute is not a membership organization.
Explanation
Schedule A (Form 990 or 990-EZ) 2013
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.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
Colorado Health Institute
Employer identification number
74-3082235
Return Reference
Explanation
Form 990, Part VI, Section B, line 11
Colorado Health Institute's board of trustees review the Form 990 during a board meeting prior to being submitted to the IRS.
Form 990, Part VI, Section B, line 12c
The Colorado Health Institute's (CHI) conflict of interest policy requires full disclosure of potential conflicts of interest and, if a conflict exists, abstention from any action by or on behalf of CHI. Failure to comply with this policy could result in removal from their position. The board begins each meeting with a conflict of interest disclosure. A detailed written description of each conflict of interest and the procedures followed to clear the conflict is provided semi-annually to the Audit Committee for their review. The board of trustees did not vote or take any action on transactions considered conflicts of interest in 2013.
Form 990, Part VI, Section B, line 15
In 2012, CHI contracted with Mountain States Employer's Council to perform a comprehensive review of CHI's compensation. An executive compensation committee was convened to evaluate the salary of the President & CEO. CHI received updated information from Mountain States for 2013 compensation.
Form 990, Part VI, Section C, line 19
Colorado Health Institute makes its governing documents, conflict of interest policy and financial statements available to the public upon request. Additionally, its articles of incorporation are available to the public on the Colorado Secretary of State's website.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.