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
Boys Town California Inc
Employer identification number
76-0720675
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.") ....
3,881,414
880,731
1,985,836
2,390,811
3,792,349
12,931,141
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
3,881,414
880,731
1,985,836
2,390,811
3,792,349
12,931,141
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)..
539,752
6
Public support. Subtract line 5 from line 4.
12,391,389
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..
3,881,414
880,731
1,985,836
2,390,811
3,792,349
12,931,141
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
12,000
12,000
13,000
12,000
62,000
111,000
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.)..
4,374
18,689
3,503
26,566
11
Total support (Add lines 7 through 10).
13,068,707
12
Gross receipts from related activities, etc. (see instructions)
..................
12
13,567,378
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
94.820 %
15
Public support percentage for 2012 Schedule A, Part II, line 14
...............
15
98.400 %
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
0 %
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
0 %
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:
13000230
Software Version:
13.6.0.0
-
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.
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
Boys Town California Inc
Employer identification number
76-0720675
Return Reference
Explanation
Form 990, Part III, Line 4d
Program Service Expenses 96,301, Grants and allocations 0, Revenue 9,001 The Behavioral Health Clinic provides outpatient psychotherapy to children, adults, and families. Its primary focus is behavioral-pediatric primary care mental health, which is a model of care that emphasizes close collaboration with primary care physicians, schools, and agencies to develop individually tailored treatment plans in a short-term, problem-solving, and prevention/early intervention mode. Therapy typically involves the whole family and is usually primarily behavior-oriented, though cognitive, mindfulness-based, family systems and humanistic/existential interventions may be employed, as appropriate. The typical episode of care lasts 5-7 hour long sessions. Families typically return for new episodes of care a few times over the lifespan as new problems arise. Service intensity is typically one session per week or one session per two weeks, tapering off as the episode of care ends. Individuals and families with more severe or chronic problems will have episodes of care lasting perhaps 10-20 sessions.
Form 990, Part III, Line 2
Refer to Part III Line 4d for explaination of program services that are new in 2013.
Form 990, Part III, Line 4a
for whom foster family placements are currently unavailable. A trained married couple and child care specialists provide a safe, family style environment where staff members conduct developmental and emotional assessments in order to create and implement age-appropriate development and educational plans. Due to the acute needs of this younger population, low child-to-adult ratios are an integral part of the program. Educational activities occur both in the home and in the community-based preschool settings. Staff members work closely with Social Services and other referral sources to establish permanency for these children.
Form 990, Part III, Line 4b
needed resources and social supports that are shown to sustain and/or improve families overall behavioral health.
Form 990, Part III, Line 4c
Aftercare interventions enable children from a variety of programs to find and maintain success at home, in school, and in their community. For older youth who are continuing their education or entering the work force, staff members provide ongoing support and reinforcement of social and independent-living skills that will help them achieve success.
Form 990, Part V, Line 2a
Father Flanagans Boys Home FFBH is the sole member of all subordinate/affiliate organizations. As part of the affiliate agreement with FFBH, all affiliates are to utilize FFBH employees to perform the mission of the organization. Costs incurred by FFBH for these employees are then passed on to the affiliate sites. Due to this arrangement, salaries are reported as a cost to the organization, but no W-2s are filed in the name of the affiliate organization.
Form 990, Part VI, Section A, Line 6
Father Flanagans Boys Home FFBH is the sole member of all subordinate organizations. Dissolution of any of the subordinate organizations shall occur only upon the approval of FFBH, in which event its net assets shall be distributed to FFBH.
Form 990, Part VI, Section A, Line 7a
Father Flanagans Boys Home, the sole member, hires/appoints the organizations executive director. According to the by-laws of the organization, the executive director is the president and a voting member of the board.
Form 990, Part VI, Section A, Line 7b
FFBH, the sole member, must approve the appointment or removal of subordinate organizations directors. All subordinate organizations operate under an affiliation agreement with FFBH that controls all of their activities. Dissolution of a subordinate organization shall only occur upon the approval of FFBH, in which event the net assets of the subordinate organization, shall be distributed to FFBH.
Form 990, Part VI, Section B, Line 11b
A review was initially performed by an external accounting firm. Then the organizations treasurer and president were provided a copy for review. After these reviews, an electronic copy of the final Form 990 was provided to all directors of the affiliate board before it was filed.
Form 990, Part VI, Section B, Line 12c
FFBH regularly and consistently monitors and enforces compliance with its conflict of interest policy mainly through official annual affirmations, self-reporting and observation. Directors are covered by a board of trustee policy, and a separate policy covers officers and employees. Directors must report any perceived or actual conflict of interest to the Chairman of the Boards Executive Committee. A director in question must cooperate in a review by the Executive Committee and has no vote in determining whether a conflict exists. A board member may be disqualified from participating in certain deliberations and votes during and after a review and may be required to resign if a conflict exists. Officers and higher level employees are required to and any other employee may at any time, report any situation involving a conflict of interest to their Associate Executive Director and or the Legal Department for review and determination as to how to proceed. Any perceived conflict of interest can also be reported for review through a confidential organizational ethics line at www.boystownethics.com.
Form 990, Part VI, Section C, Line 19
Governing documents, conflicts of interest policy and financial statements are available to the public upon request.
Form 990, Part VII, Section A, Line 1
Victor LaPuma provides services to Father Flanagans Boys Home and all affiliates, therefore the remaining 39 hours weekly is spent in that capacity. None of his salary is allocated to affiliates.
Form 990, Part XII, Line 3b
Boys Town California, Inc. is included in the A-133 audit that is completed on a consolidated basis for FFBH and its affiliates. There is not a separate A-133 audit for the monies awarded solely to Boys California, Inc.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.