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
HOPE STREET GROUP
Employer identification number
45-0497577
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.") ....
1,145,731
458,271
1,360,226
1,713,350
2,187,746
6,865,324
2
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
0
3
The value of services or facilities furnished by a governmental unit to the organization without charge..
0
4
Total. Add lines 1 through 3
1,145,731
458,271
1,360,226
1,713,350
2,187,746
6,865,324
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)..
4,395,126
6
Public support. Subtract line 5 from line 4.
2,470,198
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..
1,145,731
458,271
1,360,226
1,713,350
2,187,746
6,865,324
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
3,822
2,382
1,108
1,582
1,321
10,215
9
Net income from unrelated business activities, whether or not the business is regularly carried on..
0
10
Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)..
0
11
Total support (Add lines 7 through 10).
6,875,539
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 2012 (line 6, column (f) divided by line 11, column (f))
.........
14
35.930 %
15
Public support percentage for 2011 Schedule A, Part II, line 14
...............
15
30.030 %
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:
12000229
Software Version:
2012v2.0
-
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
HOPE STREET GROUP
Employer identification number
45-0497577
Identifier
Return Reference
Explanation
Form 990, Part XII, Line 2c
Form 990, Part XII, Line 2: Change of Oversight or Selection Process
AN AUDIT COMMITTEE WAS ESTABLISHED WHEN IT WAS NECESSARY TO HAVE AN AUDIT. THE MEMBERS ARE INDEPENDENT BOARD MEMBERS. THEY WILL COMMUNICATE WITH THE INDEPENDENT ACCOUNTANTS AND REVIEW ALL AUDIT REPORTS.
Form 990, Part VI, Line 19
Form 990, Part VI, Line 19: Other Organization Documents Publicly Available
MADE AVAILABLE UPON REQUEST
Form 990, Part VI, Line 15a
Form 990, Part VI, Line 15a: Compensation Review & Approval Process - CEO, Top Management
CONFIDENTIAL PEER AND EXECUTIVE EVALUATIONS ARE SUBMITTED TO EXECUTIVE REVIEW COMMITTEE; RECENT MARKET COMPENSATION SURVEY IS PROVIDED; EXECUTIVE REVIEW COMMITTEE EVALUATES DATA; EXECUTIVE COMMITTEE MAKES RECOMMENDATION AND PRESENTS TO BOARD FOR APPROVAL; DETERMINATIONS ARE APPROVED OR MODIFIED AS REQUIRED BY CONSENSUS.
Form 990, Part VI, Line 12c
Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts
PRESIDENT OBTAINS WRITTEN CONFLICT OF INTEREST STATEMENT AT BOARD MEETING OR BY MAIL OR EMAIL ANNUALLY.
Form 990, Part VI, Line 11b
Form 990, Part VI, Line 11b: Form 990 Review Process
Copy in PDF emailed to the Board Members
Form 990, Part III, Line 4d
Form 990, Part III, Line 4d: Other Program Services Description
OTHER PROGRAM SERVICES 4: Health care:Following the successful completion of the Using Open Innovation to Reinvent Primary Care project, we engaged in a three-month promotion of the recommendations. The promotional efforts included meetings with top policymakers such as Dr. Don Berwick and Senator Warner. In addition, the report was actively promoted via social media.As a result of the promotion process, we began to collect feedback from a variety of stakeholders in the health care policy landscape. We wanted to assess which recommendations in the report would be most aligned with our overall goal of promoting policies to drive down costs while improving outcomes. We spent the first quarter of 2012 convening a health policy council that would attend our Annual Colloquium to review this question. In addition, we engaged in a strategic planning process to assess where Hope Street Group should focus.Health Care Policy Council and the Annual ColloquiumThe Hope Street Group Health Care Policy council is led by Bob Kocher (Hope Street Group board member) and includes Colloquium facilitation support provided by Kavita Patel (Managing Director, Clinical Transformation and Delivery, Engelberg Center for Health Care Reform, Brookings Institute). Together, in collaboration with Monique Nadeau (Hope Street Group President/CEO), they have been recruiting supporters for our efforts and selecting participants for the Council who will attend the Colloquium.Hope Street Groups 2012 Annual Colloquium will highlight and explore solutions to the systemic obstacles to the American Dream. Nationwide, outdated systems are being realigned through what we at Hope Street Group call, policy transformations. These policy transformations are creating better incentives at the local and state level to improve education for our children, enhance the quality and efficiency of our healthcare, and create jobs. When approached holistically, these transformations offer the early sketches of a blueprint for how to pragmatically transform our nation.This year, the Colloquium will take place at the Kaiser Family Foundation on May 24, 2012 in Washington, DC. It will feature over 70 national, state and local leaders in politics, philanthropy, business and government, all trailblazers in issue areas that have a direct impact on the economic opportunities in America. This event will provide these leaders and practitioners the opportunity to come together to expand and/or develop solutions to some of the most complicated problems of our time.Strategic PlanningHope Street Group engaged in an organization-wide strategic planning process that included a complete review of our work, approach, and model. The goal of the organizational strategic planning has been to establish a platform for the larger mission of economic opportunity and to provide a framework for how the policies areas of education, health care, and job creation relate. .As part of the strategic planning process, we evaluated the structure and focus of the health care work. We hired a premier strategic planning firm, Wellspring, to develop a three year strategic plan. Wellspring has been helpful in coordinating our thoughts, conducting interviews, and documenting options. Similarly, Wellspring conducted 20+ interviews and conducted a landscape analysis. Their work was completed in January of the New Year, and we are incredibly encouraged by the direction Based on this work, in 2012 we expect to test the payment reform use case against donor receptivity and harmonics with our mission.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.