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
FAMILIES USA FOUNDATION INC
Employer identification number
04-2730934
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.") ....
7,226,304
2,074,002
6,557,920
3,713,529
2,402,351
21,974,106
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
7,226,304
2,074,002
6,557,920
3,713,529
2,402,351
21,974,106
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)..
14,957,278
6
Public support. Subtract line 5 from line 4.
7,016,828
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..
7,226,304
2,074,002
6,557,920
3,713,529
2,402,351
21,974,106
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
1,005,375
1,079,244
1,342,570
1,537,541
1,178,443
6,143,173
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.)..
10,568
1,435
15,482
6,935
5,913
40,333
11
Total support (Add lines 7 through 10).
28,157,612
12
Gross receipts from related activities, etc. (see instructions)
..................
12
2,987,233
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
24.920 %
15
Public support percentage for 2012 Schedule A, Part II, line 14
...............
15
25.460 %
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
FAMILIES USA FOUNDATION MEETS THE FACTS AND CIRCUMSTANCES TEST OF REGULATION SECTION 1.170A-9(E)(3) BECAUSE IT RECEIVES A SIGNIFICANT AMOUNT OF ITS CONTRIBUTIONS FROM THE GENERAL PUBLIC, ALMOST TWO AND ONE-HALF TIMES MORE THAN THE 10% REQUIRED FOR THE FACTS AND CIRCUMSTANCES TEST. IT MAINTAINS AN ACTIVE PROGRAM OF SOLICITING FUNDS FROM THE PUBLIC, INDIVIDUALS, PUBLIC CHARITIES, AND A LARGE NUMBER OF PRIVATE FOUNDATIONS. THE GOVERNING BOARD OF FAMILIES USA FOUNDATION CONSISTS PRIMARILY OF MEMBERS OF THE PUBLIC WHO ARE NOT DISQUALIFIED PERSONS. FAMILIES USA FOUNDATION'S PROGRAMS BENEFIT THE PUBLIC AT LARGE.
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
FAMILIES USA FOUNDATION INC
Employer identification number
04-2730934
Return Reference
Explanation
FORM 990, PART III, LINE 2
HEALTH SYSTEM TRANSFORMATION - THE FOUNDATION ISSUED A SERIES OF REPORTS, BLOGS, INFOGRAPHICS AND OTHER RESOURCES TO INFORM ORGANIZATIONS FROM ACROSS THE COUNTRY WORKING TO IMPROVE HEALTH CARE QUALITY WHILE REDUCING HEALTH CARE COSTS. THE FOUNDATION ALSO PROVIDED TECHNICAL ASSISTANCE IN-PERSON, INCLUDING AT OUR ANNUAL CONFERENCE, AND OVER THE PHONE ABOUT THESE ISSUES.
FORM 990, PART VI, SECTION A, LINE 6
UNDER THE ORGANIZATION'S BYLAWS, THERE ARE THREE MEMBERS OF THE CORPORATION. SOME OF THE MEMBERS ARE ALSO DIRECTORS WITH THE RIGHT TO PARTICIPATE IN THE ORGANIZATION'S GOVERNANCE.
FORM 990, PART VI, SECTION A, LINE 7A
UNDER THE ORGANIZATION'S BYLAWS, MEMBERS OF THE CORPORATION ELECT THE MEMBERS OF THE BOARD OF DIRECTORS UNTIL SUCH TIME AS THE TWO ORIGINAL MEMBERS OF THE CORPORATION HAVE DIED.
FORM 990, PART VI, SECTION B, LINE 11
THE BOARD OF DIRECTORS DELEGATED TO THE AUDIT AND FINANCE COMMITTEE THE AUTHORITY TO REVIEW THE DRAFT OF THE FORM 990 PRIOR TO ITS FILING. THE AUDIT AND FINANCE COMMITTEE RECEIVES BY EMAIL THE DRAFT FORM AND ARE ASKED TO RESPOND IN WRITING TO ADRESS ANY QUESTIONS OR CONCERNS. WHEN THE FORM 990 IS FILED, A COPY OF IT IS PROVIDED TO THE BOARD OF DIRECTORS ALONG WITH A COPY OF THE AUDITED FINANCIAL STATEMENTS.
FORM 990, PART VI, SECTION B, LINE 12C
CONFLICT OF INTEREST DISCLOSURE FORMS ARE FILED ANNUALLY WITH COUNSEL BY THE APPROPRIATE OFFICERS, DIRECTORS AND KEY EMPLOYEES. COUNSEL MONITORS AND ENFORCES COMPLIANCE CONSISTENT WITH THE APPROVED CONFLICT OF INTEREST POLICY.
FORM 990, PART VI, SECTION B, LINE 15A
THE COMPENSATION OF THE EXECUTIVE DIRECTOR IS DETERMINED BY THE PRESIDENT AND THE TWO CHAIRS OF THE PERSONNEL AND AUDIT AND FINANCE COMMITTEES (BOTH INDEPENDENT PERSONS). THE DECISION IS EXPLAINED IN A WRITTEN DOCUMENT SUBMITTED BY THE PRESIDENT. FOR OTHER EMPLOYEES, THE EXECUTIVE DIRECTOR DETERMINES THE COMPENSATION. A PERIODIC SALARY COMPARABILITY SURVEY IS CONDUCTED TO ASSIST WITH THE DETERMINATIONS. A COMPENSATION SURVEY WAS LAST CONDUCTED JANUARY 2013.
FORM 990, PART VI, SECTION C, LINE 19
UPON WRITTEN REQUEST, THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FORM 990 AVAILABLE TO THE PUBLIC. GENERALLY THE ORGANIZATION DOES NOT MAKE ITS FINANCIAL STATEMENTS AVAILABLE TO THE GENERAL PUBLIC.
FORM 990, PART IX, LINE 11G
SUB-CONTRACT: PROGRAM SERVICE EXPENSES 642,250. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 642,250. EVENT PLANNING: PROGRAM SERVICE EXPENSES 57,311. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 57,311. DATA ANALYSIS: PROGRAM SERVICE EXPENSES 85,110. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 85,110. MEDIA & COMMUNICATIONS: PROGRAM SERVICE EXPENSES 320,624. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 320,624. PAYROLL PREPARATION: PROGRAM SERVICE EXPENSES 12,362. MANAGEMENT AND GENERAL EXPENSES 12,359. FUNDRAISING EXPENSES 437. TOTAL EXPENSES 25,158. BENEFITS ADMINISTRATION/TPA SERVICE: PROGRAM SERVICE EXPENSES 5,391. MANAGEMENT AND GENERAL EXPENSES 4,097. FUNDRAISING EXPENSES 1,090. TOTAL EXPENSES 10,578.
FORM 990, PART XII, LINE 2C
THE BOARD OF DIRECTORS DELEGATED TO THE AUDIT AND FINANCE COMMITTEE THE AUTHORITY TO REVIEW THE AUDIT OF THE FINANCIAL STATEMENTS AND SELECT THE INDEPENDENT AUDITOR. THIS PROCEDURE IS THE SAME AS IN THE PRIOR YEAR.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.