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
RESPONSE HELP FOR SURVIVORS OF DOMESTIC VIOLENCE & SEXUAL ASSAULT
Employer identification number
74-2328814
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.") ....
266,152
305,729
286,667
196,450
239,011
1,294,009
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..
12,331
12,331
13,426
12,534
10,770
61,392
4
Total. Add lines 1 through 3
278,483
318,060
300,093
208,984
249,781
1,355,401
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)..
77,744
6
Public support. Subtract line 5 from line 4.
1,277,657
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..
278,483
318,060
300,093
208,984
249,781
1,355,401
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
3,168
4,253
3,870
3,546
3,237
18,074
9
Net income from unrelated business activities, whether or not the business is regularly carried on..
760
50,528
2,459
2,801
1,384
57,932
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).
1,431,407
12
Gross receipts from related activities, etc. (see instructions)
..................
12
2,429
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
89.260 %
15
Public support percentage for 2012 Schedule A, Part II, line 14
...............
15
84.120 %
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
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
RESPONSE HELP FOR SURVIVORS OF DOMESTIC VIOLENCE & SEXUAL ASSAULT
Employer identification number
74-2328814
Return Reference
Explanation
FORM 990, PAGE 1, PART I, LINE 6
OUR PROGRAM HAS BEEN SPECIFICALLY DESIGNED SO THAT MOST OF OUR DIRECT SERVICES ARE PROVIDED BY OUR VOLUNTEER ADVOCATES WHO TAKE TURNS BEING ON- CALL. ALL VOLUNTEER ADVOCATES COMPLETE A MANDATORY 30-HOUR TRAINING THAT IS HELD TWICE PER YEAR IN ORDER TO HELP PREPARE THEM BE ABLE TO ADDRESS MOST SITUATIONS THAT MAY ARISE WHILE ON-CALL. PRESENTATIONS GIVEN IN THIS TRAINING ARE ALSO TIME VOLUNTEERED BY PROFESSIONALS IN THE COMMUNITY SUCH AS LAW ENFORCEMENT, DISTRICT ATTORNEYS, MENTAL HEALTH PROVIDERS, CHILD PROTECTION AND SURVIVORS. OUR STAFF PROVIDES THE ADVOCATES WITH SUPERVISION AND SUPPORT AS NEEDED AS WELL AS DURING OUR BI-MONTHLY MEETINGS WHICH ARE HELD THROUGHOUT THE YEAR TO PROVIDE ADDITIONAL TRAINING AND SUPPORT. IN 2013, RESPONSE SERVED 209 NEW, UNDUPLICATED CLIENTS AND A TOTAL OF 561 INDIVIDUAL SURVIVORS OF WHICH 39 WERE NEW UNDUPLICATED HISPANIC CLIENTS FOR A TOTAL OF 876 AGENCY CONTACTS FOR THE 2013 YEAR. OUR VICTIM ADVOCATES PROVIDED OVER 10,933 VOLUNTEERS HOURS TO SUPPORT ALL 561 SURVIVORS OF DOMESTIC VIOLENCE AND SEXUAL ASSAULT CASES IN PITKIN AND WESTERN EAGLE COUNTIES. RESPONSE'S ROLE IS ADVOCACY, WHICH PROVIDES A NON- JUDGMENTAL AND CONFIDENTIAL SUPPORT SYSTEM. SURVIVORS ARE PROVIDED WITH COMPREHENSIVE INFORMATION TO HELP THEM MAKE THE BEST-INFORMED DECISIONS FOR THEMSELVES. TODAY, WE'VE GROWN TO INCLUDE PREVENTION PROGRAMS WITHIN THE SCHOOLS, SUCH AS TEEN DATING VIOLENCE, SEXUAL AND CYBER BULLYING, POST TRAUMATIC STRESS DISORDER THERAPY, ASSISTANCE WITH APPLICATIONS FOR VICTIM'S COMPENSATION, U-VISAS AND IMMIGRATION, AS WELL HUMAN TRAFFICKING SUPPORT SERVICES. THE COST-BENEFIT OF THESE SERVICES TO RESPONSE AND OUR FUNDERS IS ESTIMATED AT 225 PER CLIENT/PER RESPONSE STAFF MEMBER.
FORM 990, PAGE 2, PART III, LINE 4A
WERE FROM GARFIELD COUNTY, AND 11% WERE FROM OTHER LOCATIONS IN AND OUT OF STATE. CONTINUED ON SCHEDULE O-- ADVOCACY SERVICES INCLUDED 24-HOUR HELP LINE AND CRISIS INTERVENTION; EMERGENCY SHORT-TERM/TEMPORARY SHELTER; SAFETY PLANNING; MEDICAL ADVOCACY (ACCOMPANIMENT TO THE DOCTOR, HOSPITAL, OR SEXUAL ASSAULT NURSE EXAMINER EXAM); CULTURALLY INCLUSIVE AND COMPETENT ONE-ON-ONE COUNSELING AND ADVOCACY; INFORMATION AND REFERRAL; INFORMATION ABOUT AND ASSISTANCE WITH APPLICATIONS FOR VICTIM'S COMPENSATION; IMMIGRATION AND HUMAN TRAFFICKING SUPPORT SERVICES; GARDEN OF HOPE SANCTUARY FOR SURVIVORS AND OTHER VISITORS; RESOURCE LIBRARY; AND A VICTIM-WITNESS TASK FORCE THAT ENSURED A COLLABORATIVE, VICTIM-CENTER APPROACH TO SERVING VICTIMS OF CRIME. OUR PROGRAM HAS BEEN SPECIFICALLY DESIGNED SO THAT MOST OF OUR DIRECT SERVICES ARE PROVIDED BY TRAINED VOLUNTEER ADVOCATES. IN FISCAL YEAR 2012, VOLUNTEER ADVOCATES (15 NEW IN FISCAL YEAR 2012 AND 57 TOTAL) PROVIDED 10,367 VOLUNTEER HOURS TO SUPPORT 649 SURVIVORS OF DOMESTIC VIOLENCE AND SEXUAL ASSAULT, HALF OF WHOM WERE LATINO. THE COST-BENEFIT OF THESE VOLUNTEER SERVICES TO RESPONSE AND OUR FUNDERS WAS ESTIMATED AT 250,000. OUR CRISIS LINE RECEIVED 187 CALLS, OUR AGENCY SERVED 808 CONTACTS, AND WE PROVIDED 22 NIGHTS OF EMERGENCY HOUSING. IN-KIND DONATIONS FOR THE YEAR ENDED DECEMBER 31, 2013 INCLUDED OFFICE SPACE FROM PITKIN COUNTY VALUED AT 10,770 AND EMERGENCY SHELTER FROM LOCAL HOTELS VALUED AT 1,500.
FORM 990, PAGE 2, PART III, LINE 4D
EDUCATION AND PREVENTION: DEVELOPED AND PRESENTED PREVENTION PROGRAMS TO LOCAL SCHOOLS AND THE COMMUNITY IN BOTH ENGLISH AND SPANISH. YOUTH-TARGETED EDUCATION AND PREVENTION PROGRAMS WERE EXPANDED. WE CONDUCTED 50 PRESENTATIONS AT ASPEN HIGH SCHOOL, ASPEN MIDDLE SCHOOL, AND BASALT HIGH SCHOOL TO REACH 890 STUDENTS WITH MESSAGES ABOUT CYBER-BULLYING, SEXUAL BULLYING, TEEN DATING VIOLENCE AWARENESS, AND HEALTHY RELATIONSHIPS. THESE PRESENTATIONS WERE GIVEN IN COLLABORATION WITH THE ASPEN COUNSELING CENTER AND THE ASPEN POLICE DEPARTMENT. COMMUNITY EDUCATION AND AWARENESS INCLUDED A FOUR-COUNTY INFORMATION CAMPAIGN ENTITLED "AFTER THE HURT HOPE;" "FRIENDS AND FAMILY" PRESENTATIONS; "MAKE IT YOUR BUSINESS," AN EDUCATION PROGRAM FOR EMPLOYERS AND EMPLOYEES (PRESENTED IN COLLABORATION WITH THE COLORADO BAR ASSOCIATION); WEEKLY NEWSPAPER ADS; BUS POSTERS/ADS (IN ENGLISH AND SPANISH); TV AND RADIO ADS AND INTERVIEWS; GUEST EDITORIALS AND LETTERS TO THE EDITOR; COUNTER CARDS IN DRESSING ROOMS, RESTROOMS, SCHOOLS, DOCTORS' AND THERAPISTS' OFFICES, AND BUSINESSES (IN BOTH ENGLISH AND SPANISH). TOTAL PROGRAM EXPENSES FOR THE 9-MONTH PERIOD ENDED DECEMBER 31, 2012 WERE 30,560.
FORM 990, PAGE 6, PART VI, LINE 11B
APPROXIMATELY A WEEK PRIOR TO FILING THE FORM 990, A DRAFT IN PDF FORMAT IS SENT TO ALL BOARD MEMBERS ALONG WITH AN EMAIL CALLING THEIR ATTENTION TO VARIOUS PORTIONS OF THE FORMS. COMMENTS AND CORRECTIONS ARE STRONGLY ENCOURAGED.
FORM 990, PAGE 6, PART VI, LINE 12C
THE CONFLICT OF INTEREST POLICY REQUIRES OFFICERS, DIRECTORS, AND KEY EMPLOYEES TO ANNUALLY DISCLOSE INTERESTS THAT COULD GIVE RISE TO CONFLICTS. THE POLICY IS REVIEWED ANNUALLY, AND INDIVIDUALS ARE REQUIRED TO ADVISE BOARD MEMBERS THROUGHOUT THE YEAR IN THE EVENT THAT POTENTIAL CONFLICTS ARISE. POTENTIAL CONFLICTS OF INTEREST ARE THEN REVIEWED BY THE BOARD OF DIRECTORS.
FORM 990, PAGE 6, PART VI, LINE 15A
THE BOARD OF DIRECTORS REVIEWS AND APPROVES THE EXECUTIVE DIRECTOR'S ANNUAL SALARY, WITH NO PARTICIPATION BY THE EXECUTIVE DIRECTOR OR OTHER INTERESTED PERSONS. THE EXECUTIVE DIRECTOR'S SALARY IS ESTABLISHED USING COMPARABLE DATA FOR SIMILARLY QUALIFIED PERSONS IN FUNCTIONALLY COMPARABLE POSITIONS AT SIMILAR NONPROFITS; CONSIDERATION OF ROLES AND RESPONSIBILITIES OF THE EXECUTIVE DIRECTOR; AND COST OF LIVING DATA. COMPARABLE MARKET DATA IS OBTAINED FROM SALARY SURVEYS AND FORM 990S FILED BY COMPARABLE NOT-FOR-PROFIT ORGANIZATIONS. DISCUSSIONS AND DECISIONS REGARDING THE COMPENSATION ARE DOCUMENTED IN FINANCE COMMITTEE MEETING MINUTES. THE EXECUTIVE DIRECTOR ALSO RECEIVES REIMBURSEMENTS FOR ROUTINE, REASONABLE, AND DOCUMENTED EXPENSES INCURRED DURING THE YEAR UNDER AN ACCOUNTABLE PLAN.
FORM 990, PAGE 6, PART VI, LINE 15B
A LINE ITEM BUDGET IS APPROVED BY THE BOARD OF DIRECTORS ANNUALLY. THE BOARD APPROVES THE OVERALL SALARIES AND BENEFITS EXPENSES. DISCUSSIONS AND DECISIONS REGARDING THE BUDGET ARE DOCUMENTED IN BOARD MEETING MINUTES. THE EXECUTIVE DIRECTOR REVIEWS AND APPROVES THE SALARIES OF OTHER OFFICERS OR KEY EMPLOYEES, WITH NO PARTICIPATION BY THE INTERESTED PERSONS, IN ACCORDANCE WITH THE ANNUAL BUDGET. THE EXECUTIVE DIRECTOR ESTABLISHES SALARIES USING COMPARABLE DATA FOR SIMILARLY QUALIFIED PERSONS IN FUNCTIONALLY COMPARABLE POSITIONS AT SIMILAR NONPROFITS; CONSIDERATION OF ROLES AND RESPONSIBILITIES OF THE OFFICER OR KEY EMPLOYEE; AND COST OF LIVING DATA. COMPARABLE MARKET DATA IS OBTAINED FROM SALARY SURVEYS AND FORM 990S FILED BY COMPARABLE NOT-FOR- PROFIT ORGANIZATIONS.
FORM 990, PAGE 6, PART VI, LINE 19
WE CONSIDER REQUESTS ON A CASE-BY-CASE BASIS.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.