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
JEWISH COMMUNITY SERVICES INC
Employer identification number
52-0607909
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.") ....
11,272,726
11,114,844
11,127,398
11,346,702
12,112,933
56,974,603
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
11,272,726
11,114,844
11,127,398
11,346,702
12,112,933
56,974,603
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.
56,974,603
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..
11,272,726
11,114,844
11,127,398
11,346,702
12,112,933
56,974,603
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
27,213
20,606
20,770
9,879
25,640
104,108
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.)..
128,665
168,619
222,431
369,245
321,412
1,210,372
11
Total support (Add lines 7 through 10).
58,289,083
12
Gross receipts from related activities, etc. (see instructions)
..................
12
8,262,433
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
97.740 %
15
Public support percentage for 2012 Schedule A, Part II, line 14
...............
15
98.140 %
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
JEWISH COMMUNITY SERVICES INC
Employer identification number
52-0607909
Return Reference
Explanation
FORM 990, PART III. LINE 1
THROUGH THE PROGRAMS AND SERVICES OF JEWISH COMMUNITY SERVICES, FAMILIES AND INDIVIDUALS WILL BE SUPPORTED IN MEETING BASIC NEEDS FOR ECONOMIC SUFFICIENCY; IN LIVING INDEPENDENTLY, IN ACHIEVING MENTAL HEALTH AND COMPETENCE; AND IN FEELING SUPPORTED BY AND CONNECTED TO THE JEWISH COMMUNITY IN WAYS THAT ARE MEANINGFUL TO THEM.
FORM 990, PART III, LINE 4A
THE SPECIAL NEEDS SERVICE CONSISTS OF THREE PROGRAMS: THE ALTERNATIVE LIVING UNITS (ALU), WHICH PROVIDE 24-HOUR RESIDENTIAL SERVICES FOR 27 INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES; SUPPORTED LIVING PROGRAM, WHICH OFFERS SUPPORTIVE SERVICES (BUDGETING, SOCIALIZATION, ETC) TO INDIVIDUALS WITH ABOUT 55 INDIVIDUALS WITH BOTH COGNITIVE AND PHYSICAL DISABILITIES IN THEIR HOMES; AND THE SPECIAL NEEDS CASE MANAGEMENT/ THERAPY PROGRAM, WHICH OFFERS COUNSELING AND CASE MANAGEMENT SERVICES TO ABOUT 40 INDIVIDUALS AND FAMILIES OF INDIVIDUALS WITH BOTH DEVELOPMENTAL AND PHYSICAL DISABILITIES. DEPENDING UPON THE NATURE AND SEVERITY OF THE DISABILITY, THESE SERVICES ARE PROVIDED IN CLIENTS' HOMES AND IN THE COMMUNITY. THE PROGRAM'S OBJECTIVE IS TO ENABLE CLIENTS TO IMPROVE AND MAINTAIN SELF-SUFFICIENCY AND QUALITY OF LIFE.
FORM 990, PART III, LINE 4B
JCS PROVIDES FINANCIAL ASSISTANCE TO INDIVIDUALS AND FAMILIES TO ENABLE THEM TO ARRIVE AT GOALS THAT HELP THEM MOVE TOWARDS FINANCIAL SELF-SUFFICIENCY. THESE GOALS ARE DEVELOPED BY AND AGREED UPON BY THE INDIVIDUAL/FAMILY AND THE JCS STAFF. JCS PROVIDES FINANCIAL ASSISTANCE IN A SENSITIVE MANNER THAT PRESERVES THE DIGNITY OF APPLICANTS WHILE PROVIDING ACCOUNTABILITY FOR THE DISBURSEMENT OF THESE COMMUNITY FUNDS. FINANCIAL ASSISTANCE IS FREQUENTLY PROVIDED ON AN EMERGENCY BASIS YET OCCASIONALLY, ON-GOING FINANCIAL AID IS NECESSARY. FINANCIAL ASSISTANCE IS ONLY PROVIDED AS PART OF A COMPREHENSIVE PLAN DRAWN UP TOGETHER BY THE SOCIAL WORKER/CASE MANAGER AND THE CLIENT THAT INCLUDES BOTH SHORT-TERM AND LONG-TERM GOALS. IN TOTAL, ASSISTANCE WAS PROVIDED TO ABOUT 600 HOUSEHOLDS DURING FY 2014. IN ADDITION, WITHIN ITS FINANCIAL ASSISTANCE PROGRAM, JCS SUBSIDIZES PERSONAL CARE SERVICES WHICH HELP ELDERLY, FRAIL INDIVIDUALS REMAIN IN THEIR HOMES. DURING FY 2014, 146 INDIVIDUALS RECEIVED THIS ASSISTANCE.
FORM 990, PART III, LINE 4C
THE THERAPY PROGRAM PROVIDES MENTAL HEALTH AND THERAPEUTIC SERVICES TO AGENCY CLIENTS. IN ADDITION TO OFFICE-BASED SERVICES, SERVICES MAY BE PROVIDED IN CLIENTS' HOMES AND IN THE COMMUNITY. THE PROGRAM'S OBJECTIVE IS TO ENABLE CLIENTS TO IMPROVE AND MAINTAIN SELF-SUFFICIENCY AND QUALITY OF LIFE. PSYCHIATRY SERVICES AND HOME BASED PSYCHIATRIC REHABILITATION SERVICES ARE ALSO PROVIDED. DURING FY 2014, THERAPY STAFF SAW APPROXIMATELY 1,500 CLIENTS. ABOUT 680 INDIVIDUALS WERE SEEN BY PSYCHIATRY STAFF AND 30 RECEIVED PSYCHIATRIC REHABILITATION SERVICES.
FORM 990, PART VI, SECTION B, LINE 11
THE EXECUTIVE DIRECTOR AND CHIEF ADMINISTRATIVE OFFICER WILL SIGN THE AGENCY'S TAX RETURNS PRIOR TO FILING WITH THE IRS. THE AUDIT SUB-COMMITTEE OF THE BUDGET AND ADMINISTRATION COMMITTEE, WILL REVIEW THE FORM 990 BEFORE IT IS SENT TO THE BOARD OF DIRECTORS AND TO THE IRS.
FORM 990, PART VI, SECTION B, LINE 12C
EACH TRUSTEE, OFFICER, COMMITTEE MEMBER AND EMPLOYEE IN A POSITION TO INFLUENCE OR VOTE ON JEWISH COMMUNITY SERVICES ("JCS") POLICY OR EXPENDITURES (A "KEY INDIVIDUAL") SHALL COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE TO FULLY AND COMPLETELY DISCLOSE THE MATERIAL FACTS ABOUT ANY ACTUAL OR POTENTIAL CONFLICTS OF INTEREST. THE DISCLOSURE STATEMENT SHALL BE COMPLETED UPON HIS/HER ASSOCIATION WITH THE AGENCY, AND SHALL BE UPDATED ANNUALLY THEREAFTER. THE CONFLICT OF INTEREST STATEMENTS SHALL BE FILED WITH THE OFFICIAL CORPORATE RECORDS OF THE AGENCY. WITH RESPECT TO ANY PROPOSED CONTRACT OR OTHER TRANSACTION BETWEEN JCS AND ONE OR MORE KEY INDIVIDUALS, FAMILY MEMBERS, OR RELATED ENTITIES, WHICH IS CONSIDERED BY THE BOARD OF DIRECTORS, THE OFFICERS, OR ANY COMMITTEE OF JCS FOR AUTHORIZATION, APPROVAL OR RATIFICATION, THE FOLLOWING RULES SHALL APPLY: 1. FULL DISCLOSURE, IN WRITING, OF THE RELATIONSHIP OR INTEREST SHALL BE MADE BY THE KEY INDIVIDUAL TO THE PRESIDENT OF THE BOARD AND TO THE CHAIRMAN OF ANY COMMITTEE ACTING ON THE CONTRACT OR TRANSACTION. 2. THE CONTRACT OR TRANSACTION SHALL BE CONSIDERED PROPERLY AUTHORIZED, APPROVED OR RATIFIED ONLY IF THERE IS A FAVORABLE VOTE OF A MAJORITY OF JCS TRUSTEES, OFFICERS OR COMMITTEE MEMBERS (WHICHEVER GROUP IS ACTING ON THE CONTRACT OR TRANSACTION) PRESENT AND VOTING AT SUCH MEETING. THE PERSON HAVING A CONFLICT SHALL VACATE THE ROOM IN WHICH THE MATTER IS BEING VOTED UPON AND SHALL NOT PARTICIPATE IN THE FINAL DELIBERATION OR DECISION REGARDING THE MATTER, OTHER THAN TO BE AVAILABLE TO PRESENT FACTUAL INFORMATION OR RESPOND TO QUESTIONS. 3. THE KEY INDIVIDUAL WHO HAS SUCH A RELATIONSHIP OR INTEREST SHALL NOT BE COUNTED IN DETERMINING THE EXISTENCE OF A QUORUM FOR THE PURPOSE OF VOTING UPON THE CONTRACT OR TRANSACTION AT ANY MEETING. 4. THE MINUTES OF THE MEETING SHALL REFLECT THAT THE CONFLICT DISCLOSURE WAS MADE, THE VOTE TAKEN, AND WHERE APPLICABLE, THE ABSTENTION FROM VOTING AND PARTICIPATION OF THE KEY INDIVIDUAL. IF THE BOARD OF DIRECTORS HAS REASON TO BELIEVE THAT AN INTERESTED PARTY HAS FAILED TO DISCLOSE AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST, IT SHALL INFORM THE PERSON OF THE BASIS FOR SUCH BELIEF AND TAKE THE APPROPRIATE ACTION. THE CHIEF ADMINISTRATIVE OFFICER AND CHAIR OF THE BOARD BUDGET AND ADMINISTRATION COMMITTEE ARE RESPONSIBLE FOR MAKING SURE THAT THIS POLICY IS COMPLIED WITH IF A CONFLICT ARISES WITH AN INTERESTED PARTY.
FORM 990, PART VI, SECTION B, LINE 15
THE COMPENSATION OF THE EXECUTIVE DIRECTOR IS DETERMINED AND DOCUMENTED BY THE JCS BOARD PRESIDENT, GENERALLY IN CONSULTATION WITH THE FIRST VICE-PRESIDENT, AND REVIEWED BY THE ASSOCIATED'S INDEPENDENT COMPENSATION COMMITTEE. IN ORDER TO ASSURE THAT THE COMPENSATION IS APPROPRIATE TO THE POSITION, INDEPENDENT COMPARABLE COMPENSATION DATA IS REFERENCED. WITHIN GENERAL GUIDELINES SET BY JCS' BOARD OF DIRECTORS, THE EXECUTIVE DIRECTOR DETERMINES AND DOCUMENTS THE COMPENSATION OF OTHER EXECUTIVE STAFF (THE CAO AND THE OUTCOME AREA DIRECTORS). EXECUTIVE STAFF COMPENSATION IS REVIEWED BY THE JCS BOARD PRESIDENT. IN ORDER TO ASSURE THAT THE COMPENSATION IS APPROPRIATE TO THE POSITION, INDEPENDENT COMPARABLE COMPENSATION DATA IS REFERENCED.
FORM 990, PART VI, SECTION C, LINE 19
THE FOLLOWING DOCUMENTS ARE PROVIDED TO THE PUBLIC UPON REQUEST FOR THE SAME PERIOD OF DISCLOSURE AS SET FORTH IN SECTION 6104(D): - GOVERNING DOCUMENTS - CONFLICT OF INTEREST POLICY - AUDITED FINANCIAL STATEMENTS. UNAUDITED ESTIMATED STATEMENTS MAY BE PROVIDED TO SELECT FUNDERS.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.