Attach to Form 990 or Form 990-EZ.
Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
| (i)Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 9 above (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
| Total | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any unusual grants.) .... | 2,209,021 | 2,851,651 | 3,662,028 | 2,516,860 | 3,284,613 | 14,524,173 |
| 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 | 2,209,021 | 2,851,651 | 3,662,028 | 2,516,860 | 3,284,613 | 14,524,173 |
| 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).. | 3,112,512 | |||||
| 6 | Public support. Subtract line 5 from line 4. | 11,411,661 | |||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 2,209,021 | 2,851,651 | 3,662,028 | 2,516,860 | 3,284,613 | 14,524,173 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | 379,556 | 304,776 | 259,670 | 364,498 | 262,567 | 1,571,067 |
| 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 VI.).. | ||||||
| 11 | Total support. Add lines 7 through 10. | 16,095,240 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (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.) | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (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 VI.) .. | ||||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | ||||||
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e |
Discount claimed for blockage or other factors (explain in detail in Part VI): |
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| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). | 4 | ||||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | ||||
| 6 | Multiply line 5 by .035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | ||
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
||
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | ||
| 4 Amounts paid to acquire exempt-use assets | ||
| 5 Qualified set-aside amounts (prior IRS approval required) | ||
| 6 Other distributions (describe in Part VI). See instructions | ||
| 7Total annual distributions. Add lines 1 through 6. | ||
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
||
| 9 Distributable amount for 2015 from Section C, line 6 | ||
| 10 Line 8 amount divided by Line 9 amount | ||
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2015 |
(iii) Distributable Amount for 2015 |
|
|---|---|---|---|---|
|
1
Distributable amount for 2015 from Section C, line 6 |
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|
2
Underdistributions, if any, for years prior to 2015 (reasonable cause required--see instructions) |
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| 3 Excess distributions carryover, if any, to 2015: | ||||
| a | ||||
| b | ||||
| c | ||||
| d From 2013....... | ||||
| e From 2014....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2015 distributable amount | ||||
|
i
Carryover from 2010 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | ||||
| 4Distributions for 2015 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2015 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from 4. | ||||
|
5
Remaining underdistributions for years prior to 2015, if any. Subtract lines 3g and 4a from line 2 (if amount greater than zero, see instructions) |
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|
6
Remaining underdistributions for 2015. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions) |
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|
7 Excess distributions carryover to 2016. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a | ||||
| b | ||||
| c Excess from 2013....... | ||||
| d From 2014....... | ||||
| e From 2015....... | ||||
| Facts And Circumstances Test |
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| Return Reference | Explanation |
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| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at| Return Reference | Explanation |
|---|---|
| Form 990, Part III, Line 4a, Program Services (continued): | Poison prevention education is provided through: 1) distribution of stickers, magnets, brochures, tip cards, and preschool DVD programs; 2) presentations at health fairs; 3) media features; 4) an electronic newsletter; and 5) two websites (www.poison.org, www.webPOISONCONTROL.org). An extensive toxicosurveillance program facilitates the prompt detection of hazardous products; once identified, the Center urges reformulation, repackaging, re-labeling, product redesign, or banning. Continuous real-time toxicosurveillance also focuses on detection of chemical or biological terrorism and emerging public health incidents. Clinical toxicology training is provided for health professional students, residents and fellows, practicing health professionals, first responders and public health personnel. The safe management of 65% of poison center callers at home cuts health care costs by avoiding unnecessary emergency department visits, unnecessary ambulance transports, and excessively long hospital stays. |
| Form 990, Part V, Lines 2a b, Part VII & IX Compensation and benefits: | National Capital Poison Center (NCPC) does not have any employees. The George Washington University Medical Center (GWU) employs the staff of NCPC (except the Medical Director). NCPC reimburses GWU for all expenses paid on behalf of NCPC including, but not limited to, salaries and benefits for GWU staff assigned to the NCPC. Georgetown University (GU) employs the Medical Director and pays her salary and benefits. NCPC reimburses GU for these expenses. GWU and GU file all required federal employment returns. |
| Form 990, Part VI, Section A, line 4 | The Organization's bylaws were amended during the fiscal year to comply with the DC Not-for-Profit Corporation Act of 2012. |
| Form 990, Part VI, Section A, line 8b | No committees are authorized to act on behalf of the governing body. |
| Form 990, Part VI, Section B, line 11 | Form 990 was distributed to the entire Board for review and comment. The Finance Committee conducts a detailed review and approves the Form 990 for submission. |
| Form 990, Part VI, Section B, line 12c | A conflict of interest policy has been adopted by the Board of Directors and governs transactions that might benefit officers or directors. The policy supplements policies of the employing universities which also apply to the Center's staff. The policy defines financial interests as compensation arrangements, ownership, or investment interests in any entity negotiating with NCPC. The policy outlines specific exclusions, including charitable gifts from an individual and compensation from the Center, identifies procedures to avoid conflicts, and establishes a Conflicts Committee comprised of three independent Board members to review conflicts. The Conflicts Committee is empowered to determine whether financial interests are conflicts and to impose any appropriate restrictions or sanctions on persons with a conflict. |
| Form 990, Part VI, Section B, line 15 | Process for determining compensation: Executive Director: Salary and increases are determined by Georgetown University School of Medicine and approved by the Center's Board of Directors. Comparability data for professors or emergency medicine by geographic region were obtained from the Association of American Medical Colleges in 2007. Treasurer of Corporation/Development Director: Salary range determined by the George Washington University based on job classification questionnaire and position responsibilities outlined when position was created (2005). Executive Director recommended salary for Development Director based on applicant's qualifications. Prior to hire, the individual's salary was approved by 1) The Center's Board of Directors, 2) Chair of emergency medicine, the George Washington University (GWU), 3) GWU medical center budget office, and 4) GWU human resources office. Annual increases fall within ranges approved by these same entities. |
| Form 990, Part VI, Section C, line 19 | Copies of governing documents, conflicts of interest policy, and financial statements are made available to the public upon request. |
| Form 990, Part VII Compensation & Benefits Reporting: | NCPC has no direct employees, and issues no W-2's. All staff are assigned to NCPC by the universities that employ them. Since NCPC does not issue W-2's, the compensation and benefits amounts reported in Part VII are the wages and fringe benefits reimbursed to the university employer during the calendar year 2015 for each listed individual. The $100,000 threshold in Form 990, Part VII for highly compensated employees was considered to have been met if the total wages reimbursed to the university employer by NCPC for the individual's salary in calendar year 2015 exceeded $100,000. Nontaxable fringe benefits are allocated in Part VII, Column (F) based upon the fringe benefit rate charged by the universities times each employee's reported compensation, less the calculated employer portions of social security and medicare taxes. |
| Form 990, Part IX, line 11g | Toxicologist consultants and webPOISONCONTROL professional fees: Program service expenses 1,290,841. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,290,841. |
| Form 990, Part IX, Compensation and benefits reporting: | NCPC has no direct employees. All staff are assigned to NCPC by the universities that employ them. The compensation and benefits amounts reported in Part IX, Lines 5, 7 and 9 are the compensation and fringe benefits charged by the university employer to NCPC during the fiscal year. NCPC reimburses the universities for all expenses paid on behalf of NCPC including, but not limited to, salaries and benefits for staff assigned to the NCPC. Fringe benefits, including employer payroll taxes, are reimbursed to GWU and GU based upon a fringe benefit rate. Form 990, Part IX, Statement of Functional Expenses, reports the total fringe benefit amount for employees amount on Line 9, Other employee benefits. Fringe benefits for officers, less calculated employer social security and medicare taxes, are reported on Line 5, Compensation of current officers, directors, and key employees. |
| Form 990, Part XII, Line 2c: | The Organization's Finance Committee assumes responsibility for oversight of the audit of its financial statement and selection of an independent accountant. The oversight process has not changed from prior years. |
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