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
DONOR ALLIANCE INC
Employer identification number
84-1003771
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
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
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)..
6
Public support. Subtract line 5 from line 4.
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..
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
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).
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 2013 (line 6, column (f) divided by line 11, column (f))
.........
14
15
Public support percentage for 2012 Schedule A, Part II, line 14
...............
15
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.") .
36,860
511,431
1,799,705
1,824,324
1,892,684
6,065,004
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......
27,801,031
30,627,040
31,926,162
28,943,789
31,073,751
150,371,773
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.
27,837,891
31,138,471
33,725,867
30,768,113
32,966,435
156,436,777
7a
Amounts included on lines 1, 2, and 3 received from disqualified persons...
0
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.
11,012,224
11,006,288
9,383,528
9,191,051
9,170,424
49,763,515
c
Add lines 7a and 7b..
11,012,224
11,006,288
9,383,528
9,191,051
9,170,424
49,763,515
8
Public support (Subtract line 7c from line 6.)
106,673,262
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...
27,837,891
31,138,471
33,725,867
30,768,113
32,966,435
156,436,777
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
338,875
233,725
298,888
497,746
580,548
1,949,782
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c
Add lines 10a and 10b.
338,875
233,725
298,888
497,746
580,548
1,949,782
11
Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
13,669
5,398
19,067
12
Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)
..
2,261
-3,174
3,040
32,549
18,246
52,922
13
Total support. (Add lines 9, 10c, 11, and 12.)..
28,192,696
31,369,022
34,033,193
31,298,408
33,565,229
158,458,548
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
67.320 %
16
Public support percentage from 2012 Schedule A, Part III, line 15
...............
16
64.570 %
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2013 (line 10c, column (f) divided by line 13, column (f))
......
17
1.230 %
18
Investment income percentage from 2012 Schedule A, Part III, line 17
.............
18
1.150 %
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
DONOR ALLIANCE INC
Employer identification number
84-1003771
Return Reference
Explanation
FORM 990, PART III, LINE 1
DONOR ALLIANCE SAVES LIVES THROUGH ORGAN AND TISSUE DONATION AND TRANSPLANTATION. AS A CENTER OF EXCELLENCE, DONOR ALLIANCE SERVES ALL WHO NEED TRANSPLANTATION BY OPTIMIZING AVAILABLE ORGANS AND TISSUES WITH A COMMITMENT TO EDUCATION, COLLABORATION, INNOVATION, AND INFLUENCING POLICY. DONOR ALLIANCE IS ONE OF 58 FEDERALLY DESIGNATED, NON-PROFIT ORGAN PROCUREMENT ORGANIZATIONS SERVING COLORADO AND MOST OF WYOMING. ADDITIONALLY, IT IS A MEMBER OF AND ACCREDITED BY BOTH THE ASSOCIATION OF ORGAN PROCUREMENT ORGANIZATIONS (AOPO) AND AMERICAN ASSOCIATION OF TISSUE BANKS (AATB).
FORM 990, PART III, LINE 4A
LINE 4A CLINICAL ACTIVITIES FOR ORGAN AND TISSUE DONATION DONOR ALLIANCE IS A LEADER IN FACILITATING THE DONATION AND RECOVERY OF TRANSPLANTABLE ORGANS AND TISSUES. WITH MORE THAN 120,000 PEOPLE AWAITING TRANSPLANTATION THROUGHOUT THE COUNTRY AND OVER 2,400 IN THE STATES OF COLORADO AND WYOMING, DONOR ALLIANCE IS DEDICATED AND FOCUSED ON RECOVERING LIFESAVING ORGANS FOR THOSE AWAITING TRANSPLANTATION. IN ORDER TO FULFILL ITS MISSION OF SAVING LIVES THROUGH ORGAN DONATION AND TRANSPLANTATION, DONOR ALLIANCE ESTABLISHES AND MAINTAINS STRONG RELATIONSHIPS WITH DONOR HOSPITALS HELPING THE HOSPITAL MAXIMIZE THEIR DONATION OPPORTUNITIES. DONOR ALLIANCE DEPLOYS AN EFFECTIVE FAMILY APPROACH AND RECOVERY PROGRAMS IN MORE THAN 100 HOSPITALS IN THE TWO STATE SERVICE AREA. ADDITIONALLY, DONOR ALLIANCE SAVES AND HEALS LIVES BY FACILITATING THE RECOVERY OF TISSUE FOR THOSE NEEDING HUMAN TISSUE ALLOGRAFTS. DONOR ALLIANCE RECORDED A RECORD YEAR IN TERMS OF OPERATIONAL RESULTS IN 2013, FACILITATING THE DONATION AND RECOVERY OF 463 ORGAN TRANSPLANTS FROM 148 LOCAL DONORS. ORGANS TRANSPLANTED INCREASED 4% FROM THE NEXT HIGHEST MARK OF 446 SET IN 2011. IMPROVEMENTS IN INNOVATION AND STEWARDSHIP HELPED LEAD TO 16% INCREASE OVER THE PREVIOUS HIGH MARK IN TISSUE DONORS; AS 1,177 LOCAL TISSUE DONORS ENABLED COUNTLESS LIVES TO BE SAVED AND HEALED. THE ORGANIZATION REPORTED A 92% AUTHORIZATION RATE, THE RATE AT WHICH DONOR FAMILIES SAY YES TO DONATION WHEN APPROACHED. ANOTHER KEY METRIC IN ENSURING THE GIFT OF LIFE IS MAXIMIZED; DONOR ALLIANCE POSTED THE FIFTH BEST CONVERSION RATE IN THE NATION WITH 88% OF ELIGIBLE DONORS BECOMING ACTUAL DONORS. NEARLY 60% OF THE 148 ORGAN DONORS AND 65% OF THE 1,177 TISSUE DONORS IN 2013 WERE LISTED ON EITHER THE COLORADO OR WYOMING STATE DONOR REGISTRIES RESPECTIVELY. BELOW IS A LIST OF OTHER SIGNIFICANT ACCOMPLISHMENTS AND PROGRAMS FOR 2013: DONOR ALLIANCE MAINTAINED IN-HOUSE HOSPITAL COORDINATOR POSITIONS AT KEY HOSPITALS TO IMPROVE CUSTOMER SERVICE, DONATION OUTCOMES AND INTERACTIONS WITH DONOR HOSPITAL STAFF. WORKING TO EXTEND THOSE EFFORTS THROUGH A CONSOLIDATED EDUCATIONAL PLATFORM, DONOR ALLIANCE HOSTED A DONATION SUMMIT FOR ITS WESTERN COLORADO AREA HOSPITALS. DONOR ALLIANCE RECOGNIZED FIVE COLORADO HOSPITALS AT THE COLORADO HOSPITAL ASSOCIATION'S ANNUAL MEETING WITH ENDING THE WAIT AWARDS IN APPRECIATION OF THEIR EXTRAORDINARY EFFORTS IN ORGAN AND TISSUE DONATION. REPRESENTATIVE OF THE ORGANIZATION'S COMMITMENT TO INNOVATION AND PROCESS IMPROVEMENT, DONOR ALLIANCE CONTINUED ITS PERFORMANCE EXCELLENCE JOURNEY IN 2013 FOCUSING ON STREAMLINING ITS STRATEGIC PLANNING PROCESS. THE ORGANIZATION WON THE COLORADO HEALTHCARE COMMUNICATORS MOST PRESTIGIOUS AWARD, THE GRAND GOLD LEAF, FOR ITS MULTI-PRONGED OBSERVANCE CAMPAIGN, ENTITLED DONOR ALLIANCE OBSERVES NATIONAL DONATE LIFE MONTH. BUILDING ON ITS 2011 ACHIEVEMENT OF OPENING THE DOORS TO A FREE-STANDING RECOVERY CENTER, 24% OF THE 148 ORGAN DONORS IN THE SERVICE AREA IN 2013 WERE RECOVERED AT THE SPECIALIZED, DENVER-AREA FACILITY ENSURING STREAMLINED PROCESSES. TISSUE UTILIZATION OF THE FACILITY WAS AT 91% WITH 1,076 TISSUE RECOVERIES TAKING PLACE AT THE RECOVERY CENTER.
FORM 990, PART III, LINE 4B
LINE 4B COMMUNITY RELATIONS AND PUBLIC EDUCATION A LARGE BARRIER TO AUTHORIZATION FOR DONATION IS LACK OF KNOWING THE FACTS ABOUT DONATION. MANY MYTHS AND MISCONCEPTIONS ABOUT ORGAN AND TISSUE DONATION PERSIST, AND PREVENT PEOPLE FROM BECOMING DONORS. DONOR ALLIANCE WORKS DIRECTLY WITH COMMUNITY LEADERS AND GATEKEEPERS TO PROVIDE INFORMATION, ANSWER QUESTIONS, LISTEN TO CONCERNS AND ULTIMATELY FIND WAYS TO ENCOURAGE NEW DONORS TO SAY YES. DONOR ALLIANCE INSPIRES THE PUBLIC TO REGISTER AS ORGAN AND TISSUE DONORS THROUGH COMMUNITY PARTNERSHIPS, PUBLIC OUTREACH AND EDUCATION CAMPAIGNS THROUGHOUT ITS DONATION SERVICE AREA. COLORADO'S DONOR DESIGNATION RATE (THE RATE AT WHICH PEOPLE SAY YES WHEN OBTAINING OR RENEWING THEIR DRIVER'S LICENSE) WAS 67.3% PERCENT AT THE CLOSE OF 2013 MAKING IT ONE OF THE HIGHEST PERFORMING STATE DONOR REGISTRIES IN THE NATION. WYOMING, RANKED 10TH HIGHEST WITH A 59.3% PERCENT DONOR DESIGNATION RATE. DONOR ALLIANCE HOSTS AN ANNUAL EVENT HONORING DONORS AND RECOGNIZING FAMILIES FOR THEIR LOVED ONE'S GIFT. THE FAMILIES OF 85 ORGAN AND TISSUE DONORS ATTENDED THE DONOR FAMILY TRIBUTE IN 2013. DONOR ALLIANCE OVERSEES A PROGRAM WITH LOCAL BUSINESSES CALLED WORKPLACE PARTNERSHIP FOR LIFE. THIS PROGRAM ALLOWS COLORADO AND WYOMING BUSINESSES TO PARTNER WITH DONOR ALLIANCE TO INCREASE AWARENESS AND ENCOURAGE REGISTERING AS ORGAN, EYE, AND TISSUE DONORS. DONOR ALLIANCE ALSO MANAGES A SCHOOL-CURRICULUM PROGRAM THAT EDUCATES MIDDLE AND HIGH SCHOOL STUDENT ON THE SCIENCE BEHIND ORGAN AND TISSUE DONATION. THE PROGRAM, TITLED TRANSPLANTATION SCIENCE, REACHED MORE THAN 11,500 STUDENTS IN BOTH COLORADO AND WYOMING IN 2013. THE ORGANIZATION'S EXTENSIVE COLLABORATION WITH THE COLORADO DIVISION OF MOTOR VEHICLES CONTINUED THROUGHOUT 2013 WITH OUTREACH, EDUCATION AND COLLATERAL MATERIALS PROVIDED TO ALL 56 DRIVER'S LICENSE OFFICES IN COLORADO AS WELL AS 29 IN WYOMING.
FORM 990, PART VI, SECTION B, LINE 11
THE 990 IS REVIEWED FIRST INTERNALLY BY THE CFO AND CEO. IT IS THEN REVIEWED BY THE FINANCE/AUDIT COMMITTEE CHAIR AND PROVIDED TO THE BOARD OF DIRECTORS BEFORE IT IS FILED.
FORM 990, PART VI, SECTION B, LINE 12C
THE CONFLICT OF INTEREST FORM IS FILLED OUT ANNUALLY BY ALL DIRECTORS AND EMPLOYEES AND REVIEWED BY THE BOARD CHAIR AND CEO. AS PART OF THE FORM, THEY ACKNOWLEDGE THAT THEY WILL DISCLOSE ANY CONFLICTS WHICH CURRENTLY EXIST, OR ANY THAT MAY ARISE DURING THE YEAR. THE POLICY ADDRESSES "MOONLIGHTLING" OR ANY ACTIVITY WHEN A DIRECTOR, EMPLOYEE OR THEIR FAMILY MEMBER IS INVOLVED THAT MAY RESULT IN PERSONAL GAIN. BOARD OF DIRECTOR'S DISCLOSED CONFLICTS WILL BE ADDRESSED BY THE BOARD AND THE CONFLICTED PARTY WILL ABSTAIN FROM VOTING ON ANY MATTERS THAT DIRECTLY IMPACT THEIR FINANCIAL SITUATION. EMPLOYEE DISCLOSED CONFLICTS WILL BE ADDRESSED BY THE SENIOR LEADERSHIP OF DONOR ALLIANCE. FAILURE TO DISCLOSE CONFLICTS COULD RESULT IN DISMISSAL OF A DIRECTOR OR TERMINATION OF AN EMPLOYEE.
FORM 990, PART VI, SECTION B, LINE 15
IN 2013, DONOR ALLIANCE EXECUTIVE COMPENSATION COMMITTEE UTILIZED A 2012, INDEPENDENT 3RD PARTY SURVEY COMPENSATION CONSULTANT REPORT AND AN ASSOCIATION OF ORGAN PROCUREMENT ORGANIZATIONS (AOPO) SURVEY TO EVALUATE AND DETERMINE SALARY ADJUSTMENTS FOR THE TOP EXECUTIVES (CEO, COO AND CFO). THE EXECUTIVE COMPENSATION COMMITTEE IS COMPRISED OF A SUBSET OF THE BOARD OF DIRECTORS AND NONE OF THE COMMITTEE MEMBERS HAVE A CONFLICT OF INTEREST WITH REGARD TO COMPENSATION. THE CEO, COO AND CFO ARE NOT PRESENT AT THE MEETING DURING DISCUSSION OF THEIR COMPENSATION. ALL DISCUSSIONS ARE DOCUMENTED IN THE EXECUTIVE COMPENSATION COMMITTEE MEETING MINUTES. THE CHAIRMAN OF THE BOARD IS RESPONSIBLE FOR COMPLETING AN ANNUAL PERFORMANCE APPRAISAL ON THE CEO BASED ON PRE-DETERMINED GOALS AND COMPETENCIES WITH INPUT FROM ALL BOARD MEMBERS. THE CEO IS RESPONSIBLE FOR COMPLETING AN ANNUAL PERFORMANCE APPRAISAL ON THE CFO AND COO BASED ON PRE-DETERMINED GOALS AND COMPETENCIES. AFTER ALL THE INFORMATION IS PRESENTED, THE EXECUTIVE COMPENSATION COMMITTEE APPROVES COMPENSATION LEVELS FOR THE NEXT YEAR BASED ON THE INDEPENDENT SALARY SURVEYS, PERFORMANCE EVALUATIONS, AND THE CEO'S RECOMMENDATION FOR THE COO AND CFO. KEY EMPLOYEES ARE EVALUATED ANNUALLY BY EXECUTIVE LEADERSHIP (CEO, CFO AND COO) AND SALARY INCREASES ARE BASED ON THEIR PERFORMANCE, WITHIN PRESCRIBED SALARY RANGES. THE HUMAN RESOURCES DIRECTOR REVIEWS INDEPENDENT 3RD PARTY SALARY SURVEYS TO EVALUATE THE SALARY RANGES, AND THEY HAVE BEEN DETERMINED TO BE REASONABLE COMPARED TO ORGANIZATIONS OF SIMILAR SIZE AND SCOPE OF RESPONSIBILITY. PERFORMANCE IS BASED ON PRE-DETERMINED GOALS AND COMPETENCIES.
FORM 990, PART VI, SECTION C, LINE 19
THE FINANCIAL STATEMENTS, CONFLICT OF INTEREST POLICY, AND ARTICLES OF INCORPORATION AND BY-LAWS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.