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
2011
Open to Public Inspection
Name of the organization
HENRY M JACKSON FOUNDATION FOR THE ADVANCEMENT OF MILITARY MEDICINE
Employer identification number
52-1317896
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 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 support?
Yes
No
Yes
No
Yes
No
Total
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2011
Schedule A (Form 990 or 990-EZ) 2011
Page 2
Part II
Support Schedule for Organizations Described in IRC 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) 2007
(b) 2008
(c) 2009
(d) 2010
(e) 2011
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
261,929,336
339,545,646
394,448,302
428,206,625
412,994,676
1,837,124,585
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..
261,929,336
339,545,646
394,448,302
428,206,625
412,994,676
1,837,124,585
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.
1,837,124,585
Section B. Total Support
Calendar year(or fiscal year beginning in)
(a) 2007
(b) 2008
(c) 2009
(d) 2010
(e) 2011
(f) Total
7
Amounts from line 4..
261,929,336
339,545,646
394,448,302
428,206,625
412,994,676
1,837,124,585
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
-9,240,402
728,806
2,781,828
1,197,763
1,161,136
-3,370,869
9
Net income from unrelated business activities, whether or not the business is regularly carried on..
10
Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..
7,533,527
7,196,050
6,384,545
4,389,366
8,826,429
34,329,917
11
Total support (Add lines 7 through 10).
1,868,083,633
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 2010 (line 6 column (f) divided by line 11 column (f))
.........
14
98.343 %
15
Public Support Percentage for 2009 Schedule A, Part II, line 14
...............
15
98.200 %
16a
33 1/3% support test—2011.
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—2010.
If the organization did not check the 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—2011.
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—2010.
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) 2011
Schedule A (Form 990 or 990-EZ) 2011
Page 3
Part III
Support Schedule for Organizations Described in IRC 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) 2007
(b) 2008
(c) 2009
(d) 2010
(e) 2011
(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) 2007
(b) 2008
(c) 2009
(d) 2010
(e) 2011
(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 2011 (line 8 column (f) divided by line 13 column (f))
.........
15
16
Public support percentage from 2010 Schedule A, Part III, line 15
...............
16
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2011 (line 10c column (f) divided by line 13 column (f))
......
17
18
Investment income percentage from 2010 Schedule A, Part III, line 17
.............
18
19a
33 1/3% support tests—2011.
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—2010.
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) 2011
Schedule A (Form 990 or 990-EZ) 2011
Page 4
Part IV
Supplemental Information.
Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or 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) 2011
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
2011
Open to Public Inspection
Name of the organization
HENRY M JACKSON FOUNDATION FOR THE ADVANCEMENT OF MILITARY MEDICINE
Employer identification number
52-1317896
Identifier
Return Reference
Explanation
Form 990, Header, Line B
The Henry M. Jackson Foundation was required to complete a re-audit for FY2011. The Foundation's consolidated financial statements as of September 30, 2011 contained the following errors: (1) understatement of grants and contracts revenue of approximately $4 million, and (2) overstatement of general and administrative expenses of $3.9 million and understatement of research grants and contracts expenses of $2.2 million resulting in an overall overstatement of approximately $1.7 million. Total impact resulted in an increase to net assets of approximately $5.7 million. Based on the result of the re-audit, HJF made the following adjustments in FY 2011 that impacted FY 2012: The orgainization increased Grants and Contracts Receivable by $993,250, decreased Accounts Payable and Accrued Expenses by $1,623,756, decreased Deferred Revenue by $3,208,261, and increased other Payables by $52,334, all the above in the balance sheet. In FY 2012 Federal Grant Revenue increased by 314,515. Program Service Revenue decreased by $1,600. Total Expenses decreased by $119,217. Net Assets increased by $432,132. Additional changes have also been made to the presentation of the Form 990. Form 990, Part III, Question 1 The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc. is a private, not-for-profit organization authorized by Congress to support medical research at the Uniformed Services University of the Health Sciences and throughout the armed forces. The Foundation provides scientific and research project management support to the military medical community around the world. Grants, contracts and cooperative agreements from government and nongovernment sponsors, as well as gifts from corporate and individual contributions, fund the research projects and educational programs. Form 990, Part IV, Question 12b As the organization and its subsidiary meet the GAAP requirements for consolidation, the organization received consolidated audited financial statements for the year in which it is completing the return. An independent auditing firm conducted the audit of the financial statements. The audited financial statements were prepared in accordance with GAAP. Form 990, Part VI, Question 7a Pursuant to the organization's governing documents, the Council of Directors shall include the Chairmen and ranking minority members of the Committees on Armed Services and of the Senate and the House of Representatives or their designees from the membership of such committee and the Dean (President) of the Uniformed Services University of the Health Sciences. These directors elect the remaining directors.
Form 990, Part VI, Section B, Line 11b
The HJF Accounting department completed the form 990, and it was reviewed by the Director of Accounting and Director of IC and Reporting. HJF then provided the form 990 to the Council of Directors at least one week prior to filing it with the IRS. The accounting department will respond and make changes if necessary to any of the director's comments.
Form 990, Part VI, Section B, Line 12c
Employees must disclose all actual and any apparent conflicts of interest. To comply with this requirement, all new employees execute a conflict of interest disclosure form as part of initial in-process. They also recertify their conflict of interest status at the conclusion of the online ethics training, which is completed by all new employees. Additionally, all employees update their conflict of interest status annually. Directors have been made aware of their obligation to report any actual or perceived conflicts. The conflict of interest updates are reviewed by the Ethics Department. When appropriate, the Ethics Department works with the employee to create a mitigation plan that addresses the perceived or actual conflict. Any needed restrictions are tailored to fit the situation and can include, for example, modification of work schedules and restricting decision making capacity. Mitigation plans are reviewed by the Ethics Officer and are signed by the employee and employee's supervisor.
Form 990, Part VI, Section B, Line 15
A consulting company utilizing multiple survey sources was hired to establish the market rates for the Chief Executive Officer and Chief Financial Officer positions every year taking into account not-for-profit organizations similar in size to HJF. All other positions are priced at the time of creation, hire or promotion. The HR VP was market priced in FY 2011. General Counsel was priced in 2008. Vice President for Sponsored Programs was 2006. The VP of Operations in 2000 and VP of Public Private Partnerships in 2010. The compensation system is a market based system where by positions are market priced initially and then monitored annually based on overall market factors and surveys from industry experts such as KPMG, Lockton, Mercer, and Culpepper.
Form 990, Part VI, Section C, Line 19
The conflict of interest policy is available on HJF's website. HJF's governing documents, annual financial statements and A-133 report are available upon request.
Form 990, Part XI, Line 5
Unrealized gains on investments carried at market value.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.