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
2012
Open to Public Inspection
Name of the organization
FAMILY LIFELINE
Employer identification number
54-0737133
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) 2012
Schedule A (Form 990 or 990-EZ) 2012
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) 2008
(b) 2009
(c) 2010
(d) 2011
(e) 2012
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
1,678,954
1,489,743
2,293,782
2,643,894
2,558,692
10,665,065
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
1,678,954
1,489,743
2,293,782
2,643,894
2,558,692
10,665,065
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)..
134,553
6
Public support. Subtract line 5 from line 4.
10,530,512
Section B. Total Support
Calendar year
(or fiscal year beginning in)
(a) 2008
(b) 2009
(c) 2010
(d) 2011
(e) 2012
(f) Total
7
Amounts from line 4..
1,678,954
1,489,743
2,293,782
2,643,894
2,558,692
10,665,065
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
1,936
16,538
23,850
5,022
11,448
58,794
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.)..
11
Total support (Add lines 7 through 10).
10,723,859
12
Gross receipts from related activities, etc. (see instructions)
..................
12
615,612
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 2012 (line 6, column (f) divided by line 11, column (f))
.........
14
98.200 %
15
Public support percentage for 2011 Schedule A, Part II, line 14
...............
15
98.320 %
16a
33 1/3% support test—2012.
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—2011.
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—2012.
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—2011.
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) 2012
Schedule A (Form 990 or 990-EZ) 2012
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) 2008
(b) 2009
(c) 2010
(d) 2011
(e) 2012
(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) 2008
(b) 2009
(c) 2010
(d) 2011
(e) 2012
(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 2012 (line 8, column (f) divided by line 13, column (f))
.........
15
16
Public support percentage from 2011 Schedule A, Part III, line 15
...............
16
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2012 (line 10c, column (f) divided by line 13, column (f))
......
17
18
Investment income percentage from 2011 Schedule A, Part III, line 17
.............
18
19a
33 1/3% support tests—2012.
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—2011.
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) 2012
Schedule A (Form 990 or 990-EZ) 2012
Page 4
Part IV
Supplemental Information.
Complete this part to 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) 2012
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
2012
Open to Public Inspection
Name of the organization
FAMILY LIFELINE
Employer identification number
54-0737133
Identifier
Return Reference
Explanation
ORGANIZATION'S MISSION
FORM 990 - ORGANIZATION'S MISSION
FAMILY LIFELINE BRINGS HEALTH AND HOPE INTO THE HOME THROUGH A VARIETY OF HOME VISITING PROGRAMS. WHETHER THE FAMILY IS JUST STARTING OUT WITH YOUNG CHILDREN OR CARING FOR AN ELDERLY PARENT, WE ARE THERE AS A LIFELINE TO PROVIDE INTENSIVE PERSONALIZED SERVICE IN THE HOMES OF THOSE WE SERVE. OUR FIVE PROGRAMS - CHIP (CHILDREN'S HEALTH INVOLVING PARENTS) OF GREATER RICHMOND AND PETERSBURG, PARENTS AS TEACHERS, HEALTHY FAMILIES, ELDERFRIENDS AND HOME CARE - PROVIDE TOOLS AND RESOURCES TO HELP FAMILIES ACHIEVE SAFETY, STABILITY AND SUCCESS. OUR PROGRAMS TARGET FAMILIES WITH A VARIETY OF RISK FACTORS - MANY ROOTED IN POVERTY.
FIRST ACCOMPLISHMENT DESCRIPTION
FORM 990, PAGE 2, PART III, LINE 4A
WELL-BEING; (2)PROMOTING OPTIMAL CHILD DEVELOPMENT AND SCHOOL READINESS; (3) STRENGTHENING POSITIVE PARENTING KNOWLEDGE AND BEHAVIORS; AND (4) REDUCING THE PERSONAL AND SITUATIONAL STRESSES ASSOCIATED WITH CHILD MALTREATMENT. PAT PROGRAM OBJECTIVES INCLUDE (1) INCREASING PARENT KNOWLEDGE OF CHILDHOOD DEVELOPMENT AND EARLY LEARNING ACTIVITIES; (2) IMPROVING POSITIVE PARENTING BEHAVIORS THAT SUPPORT A CHILD'S SOCIAL AND EMOTIONAL COMPETENCE; AND (3) PROVIDING EARLY DETECTION OF DEVELOPMENTAL DELAYS. IN FISCAL YEAR 2012-2013, OUR HF PROGRAM EXPERIENCED GREAT SUCCESS. -SERVED TO 269 FAMILIES, WHICH INCLUDED 510 PARENTS AND CHILDREN -99% OF FAMILIES REMAINED FREE OF CHILD ABUSE AND NEGLECT -96% OF PARENTS PROVIDED LEARNING-RICH HOMES OPTIMAL FOR SUPPORTING HEALTHY BRAIN DEVELOPMENT AND SCHOOL READINESS -96% OF PARENTS GAINED POSITIVE PARENTING KNOWLEDGE PROVEN EFFECTIVE IN FOSTERING HEALTHY CHILD DEVELOPMENT IN FISCAL YEAR 2012-2013, OUR PAT PROGRAM EXPERIENCED GREAT SUCCESS. -SERVED 107 FAMILIES, WHICH INCLUDED 229 PARENTS AND CHILDREN -98% OF CHILDREN WERE ROUTINELY SCREENED FOR POSSIBLE HEALTH/DEVELOPMENTAL DELAYS -11 CHILDREN HAD SUSPECED DELAYS IDENTIFIED AND WERE REFERRED FOR FURTHER ASSESSMENT; 8 HAD A CONFIRMED DELAY -100% OF CHILDREN WITH A CONFIRMED DELAY WERE CONNECTED TO APPROPRIATE THERAPEUTIC SERVICES (E.G. EARLY INTERVENTION) -IMPORTANT NOTE: RESEARCH HAS SHOWN THAT WHEN DETECTED AND TREATED EARLY, MORE THAN HALF OF CHILDREN WITH DEVELOPMENTAL DELAYS OVERCOME THE DELAY BY AGE 3.
SECOND ACCOMPLISHMENT DESCRIPTION
FORM 990, PAGE 2, PART III, LINE 4B
CAREGIVERS. WE OFFER CUSTOMIZED COMPANION CARE, PERSONAL ASSISTANCE, HOMEMAKER SERVICES, AS WELL AS CAREGIVER RESPITE. ALL OLDER ADULTS AND INDIVIDUALS WITH DISABILITIES, LIVING IN THE METRO RICHMOND AREA, WHO REQUIRE ASSISTANCE WITH CARRYING OUT ACTIVITIES OF DAILY LIVING ARE ELIGIBLE FOR SERVICES. SERVICES ARE AVAILABLE FOR A FEW HOURS A WEEK OR 24 HOURS A DAY, INCLUDING WEEKENDS, DEPENDING ON NEED. SUBSIDIZED SERVICES ARE AVAILABLE. FAMILY LIFELINE'S ELDERFRIENDS IS A VOLUNTEER-BASED FRIENDLY VISITATION PROGRAM THAT PROVIDES COMPANIONSHIP, OUTREACH, AND ADVOCACY TO ISOLATED OLDER ADULTS LIVING IN THE METRO RICHMOND AREA. PROGRAM OBJECTIVES INCLUDE: (1) RELIEVING LONELINESS AND IMPROVING ELDERS' OVERALL QUALITY OF LIFE; (2) BUILDING SUSTAINABLE, MUTUALLY REWARDING INTERGENERATIONAL RELATIONSHIPS BETWEEN ELDERS AND VOLUNTEERS; AND (3) INVESTING IN HUMAN CAPITAL SOLUTIONS TO HELP ADVANCE OUR MISSION. WE PAIR VOLUNTEERS WITH SOCIALLY ISOLATED SENIORS. VOLUNTEERS MAKE A YEAR-LONG COMMITMENT TO VISIT THEIR ELDERS ON A WEEKLY BASIS, STRENGTHEN THE SOCIAL NETWORKS OF OLDER ADULTS WHO WISH TO REMAIN INDEPENDENT AND AGE-IN-PLACE FOR AS LONG AS POSSIBLE. SERVICES ARE FREE AND AVAILABLE TO OLDER ADULTS, AGE 60 AND OVER, WHO REPORT FEELING LONELY. IN FISCAL YEAR 2012-2013, OUR SENIOR CARE SERVICES EXPERIENCED GREAT SUCCESS. -HOME CARE PROVIDED 40,050 HOURS OF SERVICES TO 41 INDIVIDUALS LIVING WITH CHRONIC CONDITIONS THAT LIMIT THEIR DAILY ACTIVITIES -CLIENTS, WHO WOULD OTHERWISE NEED INSTITUTIONAL-BASE CARE, SPENT 7,958 ADDITIONAL DAYS IN THE COMFORT AND SAFETY OF THEIR HOMES -BY DELAYING PLACEMENT IN A NURSING HOME, THE NET SAVINGS TO THE VIRGINIA MEDICAID PROGRAM TOTALED NEARLY 936,000 -ELDERFRIENDS SUPPORTED 114 VOLUNTEER-ELDER MATCHES -VOLUNTEERS PROVIDED MORE THAN 4,685 HOURS OF SUPPORT, CONTRIBUTING NEARLY 133,000 IN SERVICES AND IN-KIND DONATIONS -100% OF VOLUNTEERS SAID PARTICIPATING IN THE PROGRAM WAS A PERSONALLY REWARDING EXPERIENCE -96% OF ELDERS SAID THEIR VOLUNTEER OFFERED THEM MUCH NEEDED EMOTIONAL SUPPORT
THIRD ACCOMPLISHMENT DESCRIPTION
FORM 990, PAGE 2, PART III, LINE 4C
AND A STABLE HOME ARE THE CORNERSTONES OF EVERY YOUNG CHILD'S PHYSICAL AND EMOTIONAL DEVELOPMENT AND THE FOUNDATIONS OF SCHOOL READINESS, EFFECTIVE LEARNING, AND FUTURE ACADEMIC ACHIEVEMENT. TEAMS COMPRISED OF PARENT, EDUCATOR, NURSE, AND SOCIAL WORKER FOCUS ON FAMILY WELLNESS AND THE EARLY IDENTIFICATION OF COMPLEX SOCIAL, ENVIRONMENTAL, AND BIOLOGICAL FACTORS THAT MAY NEGATIVELY AFFECT A CHILD'S ABILITY TO LEARN. THE PROGRAM IS AVAILABLE TO LOW-INCOME PREGNANT WOMEN AND FAMILIES WITH YOUNG CHILDREN UNDER THE AGE OF 6,RESIDING WITHIN THE GREATER RICHMOND AND PETERSBURG AREA. SERVICES ARE FREE, VOLUNTARY, AND OFFERED UNTIL PARTICIPATING CHILDREN REACH SCHOOL AGE. IN FISCAL YEAR 2012-2013, OUR CHIP PROGRAMS EXPERIENCED GREAT SUCCESS. -SERVED 427 FAMILIES, WHICH INCLUDED 955 PARENTS AND CHILDREN -97% OF CHILDREN HAD HEALTH INSURANCE COVERAGE -98% OF CHILDREN HAD A PRIMARY MEDICAL CARE PROVIDER FOR SICK AND WELL CARE -94% OF CHILDREN WERE UP TO DATE WITH ALL AGE-APPROPRIATE IMMUNIZATIONS -93% OF CHILDREN WERE CONNECTED TO A PRIMARY DENTAL CARE PROVIDER FOR REGULAR CHECK-UPS AND CLEANINGS
ALL OTHER ACCOMPLISHMENT DESCRIPTION
FORM 990, PAGE 2, PART III, LINE 4D
COMMUNITY SERVICES - THE PROGRAM PROVIDES EMERGENCY FOOD FOR FAMILIES IN CRISIS.
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990
FORM 990, PAGE 6, PART VI, LINE 11B
ELECTRONIC COPY OF RETURN IS FORWARDED TO ALL BOARD MEMBERS PRIOR TO FILING. MEMBERS ARE ASKED TO REVIEW THE FORM AND SEND ANY QUESTIONS TO AGENCY MANAGEMENT. ANY QUESTIONS SUBMITTED ARE PRESENTED BY THE FINANCIAL DIRECTOR AND PRESIDENT AT THE NEXT BOARD MEETING. ALL RESULTS OF THE REVIEW ARE RECORDED IN THE MINUTES OF THE MEETING. ANY UNRESOLVED ISSUES ARE SUBMITTED TO THE PROFESSIONAL TAX RETURN PREPARERS FOR RESOLUTION. ONCE THIS IS COMPLETED THE FORM 990 IS FILED WITH THE IRS.
ENFORCEMENT OF CONFLICTS POLICY
FORM 990, PAGE 6, PART VI, LINE 12C
ANNUALLY EACH DIRECTOR, PRINCIPAL OFFICER, MEMBER OF A COMMITTEE SHALL SIGN A STATEMENT THAT AFFIRMS THAT SUCH PERSON HAS RECEIVED, UNDERSTANDS AND AGREES TO COMPLY WITH THE POLICY.
COMPENSATION PROCESS FOR TOP OFFICIAL
FORM 990, PAGE 6, PART VI, LINE 15A
THE BOARD OF DIRECTORS AUTHORIZES THE EXECUTIVE COMMITTEE TO REVIEW AND RECOMMEND COMPENSATION DECISIONS FOR THE PRESIDENT/CEO. SUCH DECISIONS ARE REPORTED TO AND SUBJECT TO APPROVAL BY THE FULL BOARD OF DIRECTORS.
GOVERNING DOCUMENTS DISCLOSURE EXPLANATION
FORM 990, PAGE 6, PART VI, LINE 19
THE AGENCY WEBSITE HAS A SUMMARY OF AUDITED FINANCIAL RESULTS AND AGENCY CONTACT INFORMATION TO REQUEST COPIES OF THE AGENCY'S AUDITED FINANCIALS AND FORM 990. ADDITIONALLY, THE WEBSITE HAS A LINK TO GUIDESTAR WHICH MAINTAINS AN ONLINE COPY OF THE AGENCY'S FORM 990. AUDITED FINANCIAL STATEMENTS AND FORM 990 ARE PROVIDED TO ALL FUNDING ENTITIES UPON REQUEST. GOVERNING DOCUMENTS ARE NOT SPECIFICALLY OFFERED TO THE PUBLIC BUT WOULD BE PROVIDED IF REQUESTED.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.