Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for the latest information.
| (i) Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 10 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 |
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Calendar year (or fiscal year beginning in) ![]() |
(a) 2014 | (b) 2015 | (c) 2016 | (d) 2017 | (e) 2018 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | 24,319 | 62,478 | 70,586 | 83,078 | 73,318 | 313,779 |
| 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 | 24,319 | 62,478 | 70,586 | 83,078 | 73,318 | 313,779 |
| 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. | 313,779 | |||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2014 | (b) 2015 | (c) 2016 | (d) 2017 | (e) 2018 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 24,319 | 62,478 | 70,586 | 83,078 | 73,318 | 313,779 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | 82 | 121 | 660 | 900 | 544 | 2,307 |
| 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 | 375,198 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2014 | (b) 2015 | (c) 2016 | (d) 2017 | (e) 2018 | (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) 2014 | (b) 2015 | (c) 2016 | (d) 2017 | (e) 2018 | (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): |
|||||
| 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 2018 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-2018 |
(iii) Distributable Amount for 2018 |
|
|---|---|---|---|---|
|
1
Distributable amount for 2018 from Section C, line 6 |
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|
2
Underdistributions, if any, for years prior to 2018 (reasonable cause required-- explain in Part VI). See instructions. |
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| 3 Excess distributions carryover, if any, to 2018: | ||||
| a From 2013....... | ||||
| b From 2014....... | ||||
| c From 2015....... | ||||
| d From 2016....... | ||||
| e From 2017....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2018 distributable amount | ||||
|
i
Carryover from 2013 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | ||||
| 4Distributions for 2018 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2018 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from 4. | ||||
|
5
Remaining underdistributions for years prior to 2018, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
6
Remaining underdistributions for 2018. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
7 Excess distributions carryover to 2019. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2014...... | ||||
| b Excess from 2015..... | ||||
| c Excess from 2016..... | ||||
| d Excess from 2017..... | ||||
| e Excess from 2018..... | ||||
| 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.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| FORM 990, PAGE 2, PART III, LINE 2 | THE HOPE LIVES SURVIVORSHIP PROGRAM ENCOURAGES BREAST CANCER SURVIVORS AS THEY TRANSITION BACK TO A HEALTHY LIFE BY HELPING THEM LEARN TO MANAGE THEIR OVERALL HEALTH WITH INDEPENDENCE AND CONFIDENCE. WOMEN IN RURAL MOUNTAIN COMMUNITIES ARE SO WELL-SERVED BY THE KINDS OF SUPPORT WE PROVIDE BECAUSE TECHNOLOGY ENABLES THEM TO CONTACT HOPE LIVES SUPPORT PERSONS AT ANY TIME. SURVIVORSHIP PLANNING IS THE ROADMAP TO "A NEW NORMAL" OF MOVING FORWARD WITH LIVING FOR THE PATIENT AND THEIR FAMILY. AFTER A SUCCESSFUL PILOT IN 2018, WE ARE EAGER TO CONTINUE THIS EDUCATIONAL AND SUPPORTIVE PROGRAM AND ANTICIPATE SERVING 64 WOMEN IN 2019 WITH EXPANDED GEOGRAPHICAL REACH. AFTER PRIMARY TREATMENT, BREAST CANCER SURVIVORS MAY BE GIVEN A SURVIVORSHIP CARE PLAN FROM THEIR TREATMENT TEAM WHICH PROVIDES A BRIEF SUMMARY OF THE PATIENT'S TREATMENT, MEDICAL TEAM, RECOMMENDED PREVENTIVE AND FOLLOW-UP APPOINTMENT SCHEDULES, AND BEHAVIORAL RECOMMENDATIONS FOR PREVENTION, HEALTH MAINTENANCE AND REDUCING THE LIKELIHOOD OF RECURRENCE OF CANCER. THE HOPE LIVES SURVIVORSHIP PROGRAM IS DESIGNED BY ALENE NITZKY, DEVELOPER AND OWNER OF THE CANCER HARBORS PROGRAM, DEVELOPED AS A REMEDY TO THE LIMITED SUPPORT AVAILABLE FOR OPTIMIZING HEALTH AND RECOVERY AFTER PRIMARY CANCER TREATMENT. IT IS BASED ON SOCIAL AND COGNITIVE PSYCHOLOGICAL THEORIES OF LEARNING, MOTIVATION, HEALTH BEHAVIOR, AND BEHAVIOR CHANGE, WHICH PROPOSE THAT BUILDING SELF-EFFICACY AROUND LEARNING NEW HEALTH BEHAVIORS AND SKILLS THROUGH GUIDANCE, SOCIAL SUPPORT, AND COACHING, ARE LIKELY TO ENHANCE LEARNING AND SUCCESS. THE PROGRAM EMPHASIZES GUIDED LEARNING IN HEALTH LITERACY AND COMMON SURVIVOR NEEDS, GROUP SUPPORT, AND PROFESSIONAL FACILITATION TO IMPROVE WELL-BEING AND QUALITY OF LIFE FOR SURVIVORS WHO OFTEN STRUGGLE WITH RESTORING NORMAL FUNCTIONING AFTER CANCER TREATMENT. FATIGUE AND ANXIETY ARE AMONG THE MOST COMMON STRUGGLES FOR CANCER PATIENTS AFTER TREATMENT. THE RECOVERY NEEDS ADDRESSED BY THE PROGRAM INCLUDE SUPPORT, SKILL- BUILDING, AND EVIDENCE-BASED LEARNING MATERIALS IN THE FOLLOWING SIX AREAS: 1.POST-TREATMENT ADJUSTMENT AND COPING WITH FATIGUE (MOVING BEYOND THE PATIENT ROLE) 2.PHYSICAL ACTIVITY, NUTRITION AND WEIGHT CONTROL 3.SELF-CARE AND RESTORATION 4.MENTAL & EMOTIONAL HEALTH, RELATIONSHIPS & SUPPORT 5.SELF-ADVOCACY AND HEALTH LITERACY 6.GOAL-SETTING, COGNITIVE SUPPORT, MOVING FORWARD THROUGH GROUP PARTICIPATION, SHARING, DISCUSSION, READING, AND ENGAGING IN RECOMMENDED ACTIVITIES TO BUILD SKILLS AROUND SELF-CARE AFTER TREATMENT, IT WAS HYPOTHESIZED THAT PARTICIPANTS IN THE PROGRAM WOULD EXPERIENCE IMPROVEMENTS IN FATIGUE, WELL-BEING, AND QUALITY OF LIFE. THE LONG-TERM GOAL IS TO TRANSITION THE PILOT PROGRAM INTO A SECONDARY PROGRAM ONCE PATIENTS ARE BEYOND TREATMENT. |
| FORM 990, PAGE 2, PART III, LINE 4A | INTEGRATIVE SUPPORTIVE CARE FOR PATIENTS IN TREATMENT FOR BREAST CANCER INTEGRATIVE MEDICINE IS A TOTAL APPROACH TO MEDICAL CARE THAT COMBINES STANDARD MEDICINE WITH COMPLEMENTARY, ALTERNATIVE MEDICINE PRACTICES THAT HAVE BEEN SHOWN TO BE SAFE AND EFFECTIVE. THEY TREAT THE PATIENT'S MIND, BODY, AND SPIRIT. COMPLEMENTARY MEDICINE IS TREATMENTS THAT ARE USED ALONG WITH STANDARD MEDICAL TREATMENTS BUT ARE NOT CONSIDERED TO BE STANDARDS TREATMENTS. EXAMPLE: ACUPUNCTURE HELPS LESSEN SOME SIDE EFFECTS OF CANCER TREATMENT. OUR PROGRAM COVERS BOTH AREAS AND OFFERS SUPPORTIVE CARE SERVICES AND PRODUCTS DESIGNED TO HELP MANAGE THE EMOTIONAL, PHYSICAL, SOCIAL AND FINANCIAL SIDE EFFECTS OF BREAST CANCER TREATMENT. ANYONE RESIDING IN LARIMER OR WELD COUNTIES, OR A NON-RESIDENT RECEIVING TREATMENT IN ONE OF THE TWO COUNTIES, 18-YEARS OF AGE, AND CURRENTLY IN TREATMENT FOR BREAST CANCER IS ELIGIBLE TO APPLY. THROUGHOUT OUR 19-YEAR HISTORY, HOPE LIVES HAS EFFECTIVELY PROVIDED SERVICES AND PRODUCTS THAT MAY PROVIDE QUALITY OF LIFE DURING CANCER TREATMENT. IN 2018, THE NUMBER OF PATIENTS ENROLLED IN OUR PROGRAM TRIPLED FROM PRIOR YEARS WITH TOTAL PARTICIPATION AS 115 (WOMEN AND MEN) EQUALING OVER 90,000 OF SERVICES AND PRODUCTS. EACH PROGRAM PARTICIPANT RECEIVES A SET FINANCIAL ALLOWANCE WHICH THEY ARE ABLE TO DRAW-DOWN VIA SERVICES RECEIVED. THIS ALLOWANCE IS MANAGED BY OUR CARE NAVIGATOR AND OFFICE ADMINISTRATOR. MANY PARTICIPANTS APPRECIATE ACUPUNCTURE SERVICE WHICH REDUCES OR ELIMINATES NAUSEA FROM CHEMOTHERAPY. OTHERS SEEK TO USE THEIR ALLOWANCE ON MASTECTOMY PRODUCTS, WIGS, AND HOUSEKEEPING SERVICES. A MONTHLY SUPPORT GROUP IS AVAILABLE TO ATTEND AND FACILITATED BY A LICENSED PSYCHOTHERAPIST. A NEW CHALLENGE FOR OUR ORGANIZATION IS KEEPING UP WITH THE GROWTH OF PROGRAM PARTICIPATION AND THE ABILITY TO MEET THE FUNDING NECESSARY DUE TO OUR GEOGRAPHIC POPULATION EXPANSION AND THE RATE OF DIAGNOSED CASES. HOPE LIVES PRIDES ITSELF FOR BEING GOOD STEWARDS OF THE FINANCIAL CONTRIBUTIONS RECEIVED FROM PRIVATE AND CORPORATE GIFTS AND GRANT AWARDS. WE CONTINUE TO ANALYZE OUR FISCAL RESPONSIBILITIES AND MAINTAIN TRUST STANDARDS AS SET BY THE BETTER BUSINESS BUREAU. |
| FORM 990, PAGE 6, PART VI, LINE 11B | THE 990 WILL BE PROVIDED TO THE BOARD MEMBERS WHOM WILL APPROVE FOR FILING. |
| FORM 990, PAGE 6, PART VI, LINE 12C | CONFLICTS OF INTEREST ARE DISCUSSED ON A REGULAR BASIS. |
| FORM 990, PAGE 6, PART VI, LINE 15A | A REVIEW IS MADE FOR SIMILIAR POSITIONS FOR COMPENSATION AND APPROVAL BY THE BOARD. |
| FORM 990, PAGE 6, PART VI, LINE 18 | THE 990 IS POSTED ON THE COLORADO GIVES DAY WEBSITE THROUGH COMMUNITY FIRST FOUNDATION. 990 IS ALSO POSTED ON THE COLORADO SECRETARY OF STATE WEBSITE. |
| FORM 990, PAGE 6, PART VI, LINE 19 | FORM 990 WILL BE PROVIDED UPON REQUEST. |
| FORM 990, PART XI, LINE 9 | RECONCILED NET ASSETS -50 |
| Software ID: | |
| Software Version: |