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
LAKE COUNTY CRISIS CENTER - A SAFE PLACE
Employer identification number
36-3032700
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.") ....
1,762,289
2,163,749
1,987,085
1,857,168
2,223,235
9,993,526
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
1,762,289
2,163,749
1,987,085
1,857,168
2,223,235
9,993,526
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)..
5,996
6
Public support. Subtract line 5 from line 4.
9,987,530
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..
1,762,289
2,163,749
1,987,085
1,857,168
2,223,235
9,993,526
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
223
6,375
369
6,846
8,178
21,991
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.)..
134,694
418,608
196,039
192,988
292,367
1,234,696
11
Total support (Add lines 7 through 10).
11,250,213
12
Gross receipts from related activities, etc. (see instructions)
..................
12
131,709
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
88.780 %
15
Public support percentage for 2012 Schedule A, Part II, line 14
...............
15
89.870 %
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
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
LAKE COUNTY CRISIS CENTER - A SAFE PLACE
Employer identification number
36-3032700
Return Reference
Explanation
FORM 990, PAGE 2, PART III, LINE 4A
VIOLENCE AND OUR SERVICES. DURING THE YEAR, WE RECEIVED 2,570 CRISIS CALLS.
FORM 990, PAGE 2, PART III, LINE 4D
FAMILY VISITATION CENTER - A SAFE PLACE'S FAMILY VISITATION CENTER SUPERVISED AND FACILITATED 1,484 CUSTODY EXCHANGES AND 1,185 VISITATIONS, WITH SAFETY OF CHILDREN AND VICTIMS AS THE PRIMARY CONCERN. DURING THE FIRST 6 MONTHS OF THE YEAR, 96 FAMILIES (100 CUSTODIAL PARENTS, 96 NON- CUSTODIAL PARENTS, AND 183 CHILDREN) WERE SERVED AND DURING THE SECOND SIX MONTHS, 87 FAMILIES WERE SERVED (91 CUSTODIAL PARENTS, 87 NON-CUSTODIAL PARENTS, AND 153 CHILDREN). 72% OF CASES INVOLVE FAMILIES IMPACTED BY DOMESTIC VIOLENCE, WITH THE MAJORITY OF THE REMAINING FAMILIES IMPACTED BY CHILD ABUSE. (OTHER CASES INVOLVE SEXUAL ASSAULT AND STALKING). IN ADDITION, THE CENTER PROVIDED 6 TRAINING EVENTS TO 63 PERSONS INVOLVED IN VISITATION AND CUSTODY EXCHANGE CASES. LEGAL ADVOCACY - OUR LEGAL ADVOCACY PROGRAM, LOCATED IN THE LAKE COUNTY COURTHOUSE PROVIDED ASSISTANCE TO 1,391 VICTIMS SEEKING ORDERS OF PROTECTION FOR DOMESTIC VIOLENCE. OUR LEGAL ADVOCACY TEAM ASSISTED VICTIMS IN OBTAINING 1,394 EMERGENCY, 9 INTERIM AND 458 PLENARY DOMESTIC VIOLENCE ORDERS OF PROTECTION. ONLY 1.5% OF VICTIMS FILING WERE DENIED ORDERS. IN ADDITION, WE ASSISTED 643 VICTIMS TO OBTAIN ORDER OF PROTECTION RELATED TO SEXUAL ASSAULT, AND STALKING/NO-CONTACT. THROUGH THE STAFF, INCLUDING SEVERAL VOLUNTEERS, OVER 4,000 HOURS OF ADVOCACY WAS PROVIDED TO VICTIMS. OUTREACH & EDUCATION - WE WORK TO EDUCATE THE COMMUNITY ABOUT THE DYNAMICS AND EFFECTS OF DOMESTIC VIOLENCE, AND ADVOCATE FOR VICTIMS, WHILE RAISING AWARENESS OF THE SERVICES THAT ARE AVAILABLE THROUGH MULTIPLE OUTREACH EFFORTS BY STAFF MEMBERS DEDICATED TO OUR EDUCATION PROGRAMS AS WELL AS THROUGH STAFF MEMBERS FROM EVERY AREA OF OUR AGENCY. EDUCATION AND OUTREACH ARE PROVIDED AT BUSINESSES, RELIGIOUS INSTITUTIONS AND OTHER COMMUNITY GATHERINGS. WE ALSO EDUCATE PROFESSIONALS SUCH AS SOCIAL WORKERS OR LAW ENFORCEMENT OFFICIALS WHO MAY COME IN CONTACT WITH DOMESTIC VIOLENCE VICTIMS. WE PROVIDED OVER 770 HOURS OF EDUCATION THROUGH 448 PRESENTATIONS TO 6,990 PEOPLE. TO ADDRESS THE ISSUES OF TEEN DATING VIOLENCE, A SAFE PLACE ALSO FACILITATES HEALTHY DATING PRESENTATIONS AT LOCAL SCHOOLS AND AGENCIES TO EDUCATE YOUTH AND TEENS. 62 OF THESE PRESENTATION, WHICH WORK TO PREVENT DOMESTIC VIOLENCE THROUGH EDUCATION ON RED FLAGS, ABUSIVE DYNAMICS AND THE OPTIONS AVAILABLE FOR TEENS, WERE PROVIDED TO 1,683 YOUTHS DURING THE YEAR. ABUSER SERVICES - IPDAV - INTERVENTION PROGRAM FOR DOMESTICE ABUSE & VIOLENCE - WE ALSO WORK TO ELIMINATE DOMESTIC VIOLENCE AND INCREASE THE SAFETY OF VICTIMS BY WORKING DIRECTLY WITH ABUSERS. OUR ABUSER INTERVENTION PROGRAM PROVIDED OVER 3,000 HOURS OF COUNSELING THROUGH A SIX MONTH PROGRAM TO 293 PERPETRATORS OF ABUSE, TEACHING THEM ACCOUNTABILITY AND HELPING THEM TO EXAMINE AND CHANGE THEIR ABUSIVE BEHAVIORS. EACH PARTICIPANT IS INDIVIDUALLY ASSESSED BEFORE BEING PLACED IN A WEEKLY GROUP. 131 CLIENTS RECEIVED ASSESSMENTS DURING THE YEAR. HUMAN SERVICES COLLABORATION - DURING THE YEAR, A SAFE PLACE BECAME THE FISCAL AGENT FOR THE ALLIANCE FOR HUMAN SERVICES, AN ORGANIZATION DEDICATED TO CONTINUOUSLY IMPROVING THE DELIVERY OF HUMAN SERVICES IN LAKE COUNTY. TO ENSURE THE QUALITY OF LIFE FOR PEOPLE IN OUR COMMUNITIES. THE ALLIANCE TAKES A LEADERSHIP ROLE TO PROMOTE COLLABORATION, TO ENABLE THE DELIVERY OF INNOVATIVE, SUSTAINABLE PROGRAMS AND ACCESSIBLE SERVICES, AND TO ADVOCATE FOR THE HUMAN SERVICE SECTOR. THE ORGANIZATION IS WORKING TO OBTAIN ITS OWN 501(C)(3) STATUS. SIGNIFICANT ACCOMPLISHMENTS THUS FAR INCLUDE CHOOSING AND BEGINNING THE IMPLEMENTATION OF A SHARED DATA BASE HAS BEEN CHOSEN, SERVING AS THE NEW "HOME" FOR THE RESPOND COALITION, CREATING A FORMAL LINK WITH ILLINOIS PARTNERS FOR HUMAN SERVICES, AND GAINING ACCESS TO ENSURE THE HEALTH AND HUMAN SERVICES SECTOR "HAS A SEAT AT THE TABLE" IN CRITICAL MEETING THROUGHOUT LAKE COUNTY AND BEYOND. THE ALLIANCE HAS ALSO BEEN A CO-COORDINATOR OF THE EDUCATION AND ASSISTANCE EFFORTS FOR LAKE COUNTY REGARDING THE AFFORDABLE CARE ACT. HEALTH INSURANCE NAVIGATION - DURING THE YEAR, WE PARTICIPATED AS HEALTH INSURANCE "NAVIGATORS" IN THE COUNTY-WIDE EFFORT TO ENROLL THE UNINSURED UNDER THE PROVISIONS OF THE AFFORDABLE CARE ACT, HELPING MANY OF OUR CLIENTS AND OTHER NEEDING AFFORDABLE HEALTH INSURANCE. WE PROVIDED EDUCATION ON THE ACT TO 1,899 PERSONS AND DIRECTLY ASSISTED 307 PERSONS WITH THE ONLINE HEALTH INSURANCE APPLICATION PROCESS, ALSO PROVIDING POST- ENROLLMENT ASSISTANCE TO 579 PERSONS. WE ALSO PROVIDED 54 OUTREACH PRESENTATIONS TO OVER 1,000 PARTICIPANTS AND VARIOUS COMMUNITY AND CORPORATE/BUSINESS EVENTS. PERMANENT SUPPORTIVE HOUSING - AFFORDABLE, SAFE HOUSING (REPORTED UNDER A SAFE PLACE II LP) - IN THIS COMPANION TO OUR TRANSITIONAL LIVING PROGRAM, WE PROVIDED 14,306 NIGHTS OF SAFE HOUSING IN PERMANENT SUPPORTIVE HOUSING APARTMENTS TO 47 WOMEN AND 31 CHILDREN. THIS PROGRAM'S INCOME AND EXPENSES ARE REPORTED UNDER A SEPARATE TAXABLE ENTITY'S TAX RETURN (A SAFE PLACE II LP - SEE SCHEDULE R IN THIS FORM 990) FOR WHICH WE ARE THE GENERAL PARTNER. ALONG WITH AFFORDABLE HOUSING, THE TENANTS RECEIVE ON-SITE SUPPORTIVE SERVICES, INCLUDING DOMESTIC VIOLENCE SUPPORT GROUPS, LIFE SKILLS TRAINING, AD COUNSELING SERVICES FOR ADULTS AND CHILDREN, PROVIDED THROUGH AND REPORTED UNDER OUR COUNSELING AND LIFE SKILLS PROGRAM.
FORM 990, PAGE 6, PART VI, LINE 6
PER BY-LAWS - THE GENERAL MEMBERSHIP SHALL CONSIST OF INDIVIDUALS AND COMMUNITY GROUPS INTERESTED IN AND WHO CONTRIBUTE FINANCIALLY, OR IN-KIND, TO THE ANNUAL OPERATION OF THE ORGANIZATION.
FORM 990, PAGE 6, PART VI, LINE 7A
FROM BY-LAWS - DIRECTORS SHALL BE ELECTED BY THE GENERAL MEMBERSHIP AT THE ANNUAL MEETING OF THE MEMBERS. THE ANNUAL MEETING OF THE MEMBERS SHALL BE HELD WITHIN 120 DAYS OF THE CLOSE OF THE FISCAL YEAR. EACH MEMBER PRESENT AT A MEETING, EITHER IN PERSON OR BY PROXY, SHALL BE ENTITLED TO ONE VOTE ON EACH MATTER SUBMITTED TO A VOTE OF THE MEMBERS.
FORM 990, PAGE 6, PART VI, LINE 11B
THE FINANCE COMMITTEE (COMPRISED OF BOARD MEMBERS) REVIEWS THE COMPLETED FORM 990 AND APPROVES FORWARDING TO THE EXECUTIVE COMMITTEE OF THE BOARD, A COMMITTEE DESIGNATED BY THE BOARD AS HAVING FINAL AUTHORIZATION FOR APPROVAL OF THE FORM 990. THE EXECUTIVE COMMITTEE IS PROVIDED WITH THE COMPLETED FORM 990, MAKES CHANGES AS NECESSARY, AND GIVES FINAL APPROVAL FOR SUBMISSION. THE EXECUTIVE COMMITTEE, AS AUTHORIZED IN THE ORGANIZATION'S BY-LAWS, HAS THE POWER TO ACT FOR THE BOARD WHEN THE BOARD IS UNAVAILABLE OR WHEN DESIGNATED TO DO SO BY THE BOARD. AFTER APPROVAL, THE EXECUTIVE COMMITTEE PROVIDES AN OVERVIEW OF THE FORM 990 CONTENTS AT A REGULARLY SCHEDULED BOARD MEETING.
FORM 990, PAGE 6, PART VI, LINE 12C
IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICT OF INTEREST, AN INTERESTED PERSON MUST DISCLOSE THE EXISTENCE OF THE FINANCIAL INTEREST AND BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE DIRECTORS AND MEMBERS OF COMMITTEES WITH GOVERNING BOARD DELEGATED POWERS CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. THE REMAINING BOARD OR COMMITTEE MEMBERS SHALL DECIDE IF A CONFLICT OF INTEREST EXISTS. AFTER DISCLOSURE OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE INTERESTED PERSON, HE/SHE SHALL LEAVE THE GOVERNING BOARD OR COMMITTEE MEETING WHILE THE DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON. AN INTERESTED PERSON MAY MAKE A PRESENTATION AT THE GOVERNING BOARD OR COMMITTEE MEETING, BUT AFTER THE PRESENTATION, HE/SHE SHALL LEAVE THE MEETING DURING THE DISCUSSION OF, AND THE VOTE ON, THE TRANSACTION OR ARRANGEMENT INVOLVING THE POSSIBLE CONFLICT OF INTEREST. IN ADDITION, ALL INTERESTED PERSONS MUST COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE (PRIOR TO) UPON BECOMING AN OFFICER OR UPON JOINING THE BOARD OF DIRECTORS OR ANY COMMITTEE AND AT LEAST ANNUALLY THEREAFTER. THE EXECUTIVE DIRECTOR WILL ENSURE THAT THIS TAKES PLACE AND BRING ANY POTENTIAL CONFLICTS TO THE EXECUTIVE COMMITTEE'S ATTENTION.
FORM 990, PAGE 6, PART VI, LINE 19
GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICIES AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST BY WRITTEN REQUEST AND/OR REVIEW ON THE ORGANIZATION'S PREMISES.
FORM 990, PAGE 12, PART XII, LINE 2C
THERE WERE NO CHANGES IN THE REVIEW PROCESS IN FY2014
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.