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
NEW JERSEY PREVENTION NETWORK INC
Employer identification number
22-3427837
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.") ....
5,383,489
5,501,975
3,469,611
2,070,751
2,232,279
18,658,105
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
5,383,489
5,501,975
3,469,611
2,070,751
2,232,279
18,658,105
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.
18,658,105
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..
5,383,489
5,501,975
3,469,611
2,070,751
2,232,279
18,658,105
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
1,373
1,855
1,219
850
634
5,931
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.)..
5,471
2,179
4,217
16,685
26,275
54,827
11
Total support (Add lines 7 through 10).
18,718,863
12
Gross receipts from related activities, etc. (see instructions)
..................
12
659,134
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
99.680 %
15
Public support percentage for 2012 Schedule A, Part II, line 14
...............
15
99.810 %
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
NEW JERSEY PREVENTION NETWORK INC
Employer identification number
22-3427837
Return Reference
Explanation
Form 990, Part I, Line 1, Description of Organization Mission:
The New Jersey Prevention Network is a public health agency working to prevent substance abuse, addiction, and other chronic diseases by building capacity among professionals, fostering positive collaboration among providers, and strengthening the field of prevention through the use of evidence-based practices and strategies. NJPN demonstrates that Prevention Works!
Form 990, Part III, Line 1, Description of Organization Mission:
The New Jersey Prevention Network is a public health agency working to prevent substance abuse, addiction, and other chronic diseases by building capacity among professionals, fostering positive collaboration among providers, and strengthening the field of prevention through the use of evidence-based practices and strategies. NJPN demonstrates that Prevention Works!
Form 990, Part III, Line 4a, Program Service Accomplishments:
Annual Addiction Conference: The Annual Addiction Conference was the 14th annual conference that was coordinated by NJPN. NJPN successfully secured sponsorships and fees to offer this workforce development event. This year's conference brought over 945 addiction professionals and other community members to the Atlantic City Convention Center for keynotes, workshops, and exhibits that highlighted current trends and resources to strengthen the prevention, early intervention, treatment, and recovery support services in New Jersey. An active planning committee and conference partners participated in the planning and implementation of this successful event. NJ Highway Traffic Safety: A special track was created during NJPN's Annual Addiction Conference that was funded through the Highway Traffic Safety Department grant. This track targeted preventionists that would reach youth and provide teen driving safety programs. A power session and two workshops were offered that made the connection between drug and alcohol use by youth and the high risk of drinking and drugged driving. Addictions Training and Workforce Development (ATWD) Project: This workforce development project provides a full series of training workshops for individuals who are interested in becoming certified alcohol and drug counselors. The full curriculum of courses is provided at 10 sites throughout the state, free of charge to participants. Advanced training is provided for CADC and LCADC professionals. CPS scholarships are offered through established classes at various locations throughout the state. Community Transformation Grant (CTG): NJPN is the lead agency for the CTG grant through funding from the Center for Disease Control and Prevention (CDC). The CTG has created the Coalition for a Healthy NJ that will focus on chronic disease prevention within New Jersey's 13 small counties (under 500,000 in population) and address five strategic directions identified by CDC. These five strategic directions include tobacco-free living, active living and healthy eating, high quality clinical preventive services, social and emotional wellness, and healthy and safe physical environment. NJPN is leading a comprehensive needs assessment to determine the chronic disease health burden within the targeted counties and will prioritize these needs. The current grant is a capacity level project with the opportunity to apply for additional funding to implement interventions to address the identified priorities. The Coalition for a Healthy NJ currently has over 125 members and five Strategic Advisory Groups (SAG) that are providing NJPN with guidance and recommendations in each focus area. This year NJPN selected a county partner covering each of the 13 counties. These county partners were selected through a competitive process and will be part of the implementation phase as needed. Training and Technical Assistance for the Regional Coalition Project: The NJDMHAS created a network of Regional Coalitions to address the state's substance abuse priorities. NJPN was selected to provide technical assistance and support to the 17 Regional Coalitions regarding implementing the Strategic Prevention Framework including needs assessment, capacity building, planning, and implementation. Through trainings, webinars, and one-on-one technical assistance, NJPN is supporting the effective implementation of environmental strategies that will make population level change within New Jersey. Evaluation Support for the Regional Coalitions (Rutgers' Contract): NJPN has been contracted by Rutgers to assist them in providing evaluation support to the 17 Regional Coalitions. The Evaluation Team has created consistent data collection tools that the Regional Coalitions have utilized during their needs assessment process to capture statewide information on the substance abuse trends, policy scan details, and prevention resources. As this project moves forward, a comprehensive evaluation plan will be developed and implemented to measure the successes of the Regional Coalition Project. Military Personnel and their Families: NJPN coordinates this statewide project through a network of local prevention partners that provide prevention programs to military personnel and their families. NJPN provides training and technical assistance and our local partners provide the direct services. Two evidence-based programs are provided in 11 counties throughout the state, including Military Family Night which uses the Strengthening Families curriculum, and Achieving Personal Balance which uses the Coping with Work and Family Stress curriculum.
Form 990, Part VI, Section B, line 11
The board reviews and approves the form 990 each year.
Form 990, Part VI, Section B, line 12c
The organization requires each board member to sign a "Conflict of Interest Assurance Statement" on an annual basis. In addition, new board members are required to sign this statement immediately.
Form 990, Part VI, Section B, line 15a
A regular review of the executive director's performance is completed and approved by the Board of Directors. When budget permits, current salary, field scan of executive salaries, budget management, performance and accomplishments were considered in determining compensation. There are no other compensated officers or key employees of the organization.
Form 990, Part VI, Section C, line 19
The organization's governing documents, conflict of interest policy, and financial statements are available upon request. Interested parties can submit a written request along with a self-addressed stamped envelope to the Executive Director of NJPN and a copy will be mailed to them within 1 week of receipt of the request.
Form 990, Part IX, line 11g
PROGRAM DEVELOPMENT: Program service expenses 637,364. Management and general expenses 400. Fundraising expenses 0. Total expenses 637,764. TRAINERS: Program service expenses 79,339. Management and general expenses 0. Fundraising expenses 0. Total expenses 79,339. INTERPRETERS: Program service expenses 900. Management and general expenses 0. Fundraising expenses 0. Total expenses 900. GUEST SPEAKERS: Program service expenses 9,800. Management and general expenses 0. Fundraising expenses 0. Total expenses 9,800. OTHER: Program service expenses 55,787. Management and general expenses -9,228. Fundraising expenses 0. Total expenses 46,559.
Form 990, Part XI,Line 2C
The process of overseeing the audit has not changed.
Form 990, Part VI, Section B, Line 15b
The organization has no other officers or key employees therefore there was no review/approval of their compensation.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.