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.) .... | 84,920 | 96,321 | 96,868 | 83,772 | 87,661 | 449,542 |
| 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 | 84,920 | 96,321 | 96,868 | 83,772 | 87,661 | 449,542 |
| 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. | 449,542 | |||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 84,920 | 96,321 | 96,868 | 83,772 | 87,661 | 449,542 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | 9,407 | 8,234 | 37,468 | 8,856 | 37,380 | 101,345 |
| 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. | 550,887 | |||||
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) |
||||
| 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, PAGE 2, PART III, LINE 4B | SESSIONS ARE COURT-ORDERED, THE EVALUATION RESULTS ARE 97.4% POSITIVE. |
| FORM 990, PAGE 2, PART III, LINE 4D | THE ORGANIZATION CARRIES ON MANY OTHER PROGRAMS. BRIEF DESCRIPTIONS OF THESE FOLLOW: KIDS ON THE BLOCK EDUCATION PROGRAM. THE PURPOSE OF THESE PRESENTATIONS IS TO EDUCATE CHILDREN FROM PRESCHOOL THROUGH HIGH SCHOOL ON TOPICS RELATED TO MENTAL HEALTH, EITHER SPECIFIC MENTAL HEALTH CONDITIONS LIKE DEPRESSION, AUTISM, OR SUBSTANCE ABUSE, OR GENERAL MENTAL WELL-BEING LIKE BULLYING, PRESCRIPTION DRUG MISUSE, ORGANIZATION, MOODS, AND TREATING OTHERS WITH RESPECT. TEACHERS/ADULT LEADERS ARE GIVEN AN EVALUATION TO COMPLETE THAT INCLUDES DEMOGRAPHICS. RESULTS INCLUDE NUMBER OF SESSIONS PRESENTED, ATTENDANCE, AND EVALUATION INFORMATION. OUR CHILD OUR DIVORCE PROGRAM. THIS IS A COURT MANDATED CLASS FOR PEOPLE GOING THROUGH A DIVORCE WHO HAVE CHILDREN UNDER THE AGE OF EIGHTEEN. ITS PURPOSE IS TO TEACH PARENTS HOW TO HELP THEIR CHILDREN, IN A DEVELOPMENTALLY APPROPRIATE WAY, AS THE FAMILY GOES THROUGH THE DIVORCE PROCESS. IT IS ALSO TO REMIND THEM OF APPROPRIATE AND INAPPROPRIATE WAYS TO ACT AND TO KEEP IN MIND WHAT IS BEST FOR THEIR CHILDREN. THE CLASSES ARE 3 HOUR ONE TIME SESSIONS. SPOUSES ARE NOT ALLOWED TO ATTEND THE SAME CLASS. ATTENDANCE/SIGN IN/DEMOGRAPHIC SHEETS ARE KEPT FOR EACH SESSION AND CERTIFICATES ARE GIVEN ON SUCCESSFUL COMPLETION OF THE CLASS. PARTICIPANTS ARE GIVEN AN EVALUATION AT THE END OF THE SESSION. EDUCATION PROGRAMS. EDUCATION PROGRAMS WERE PROVIDED FOR CHILDREN FROM PRE-SCHOOL THROUGH MIDDLE SCHOOL AGES. THE TEACHERS AND CHILDREN REALLY ENJOY THESE PROGRAMS. THEY TEACH ABOUT TOPICS SUCH AS MOODS, AUTISM, AND BULLYING. MENTAL HEALTH EDUCATION: SERVICES ARE PROVIDED TO EDUCATE MEMBERS OF THE COMMUNITY ON TOPICS THAT RELATE TO MENTAL HEALTH CONDITIONS AS WELL AS TOPICS THAT INCREASE OVERALL GOOD MENTAL HEALTH. THESE SERVICES ARE PROVIDED ON AN AGE-APPROPRIATE BASIS FOR PEOPLE FROM PRE-SCHOOL AGE THROUGH ADULTS. PEOPLE ARE LINKED WITH PROGRAMS AND SERVICES AS NEEDED. MENTAL HEALTH EDUCATION SERVICES ARE PROVIDED FREE OF CHARGE. THESE SERVICES ARE PROVIDED THROUGH SPEAKING PRESENTATIONS, HAND-OUTS, AND PARTICIPATION IN HEALTH AND WELLNESS FAIRS. PARENT EDUCATION: SERVICES ARE PROVIDED TO ASSIST PARENTS, GRANDPARENTS AND STEP-PARENTS TO DEVELOP EFFECTIVE PARENTING SKILLS. MENTAL HEALTH SUPPORT GROUP: THIS IS A PEER SUPPORT GROUP THAT MEETS WEEKLY TO ENABLE PEOPLE WITH MENTAL ILLNESS AND THEIR FAMILIES AND FRIENDS TO DISCUSS ISSUES AND OFFER MUTUAL SUPPORT. IT IS OPEN TO ALL AND THERE IS NO FEE TO ATTEND. IT IS HELD AT A LOCAL CHURCH THAT IS HANDICAPPED ACCESSIBLE. GIFT LIFT: SERVICES PROVIDE HOLIDAY GIFTS TO RESIDENTS OF HENDRICKS COUNTY WHO RESIDE IN STATE PSYCHIATRIC HOSPITALS, COUNTY NURSING HOMES, AND THE COUNTY HOME. SOME OF THE WISH LISTS INCLUDE ITEMS THAT ARE VERY BASIC NEEDS FOR THE RECIPIENTS. INDIVIDUAL ADVOCACY: SERVICES INCLUDE ASSISTING PEOPLE WITH MENTAL ILLNESS IN DEALING WITH OTHER AGENCIES TO ACCESS APPROPRIATE SERVICES. INFORMATION AND REFERRAL: SERVICES INCLUDE UTILIZING COMMUNITY CONTACTS THAT CAN BE REFERRED TO AS INDIVIDUALS REQUEST ASSISTANCE. WESTSIDE WIDOWED SUPPORT GROUP: THIS GROUP MEETS REGULARLY TO PROVIDE SOCIAL ACTIVITIES AND PEER-TO-PEER MUTUAL SUPPORT. QPR (QUESTION, PERSUADE, REFER): THIS IS A SUICIDE PREVENTION PROGRAM THAT FOCUSES ON EDUCATING PEOPLE TO RECOGNIZE THE SIGNS THAT SOMEONE MIGHT BE SUICIDAL, RESPOND APPROPRIATELY AND GET HELP FOR THE INDIVIDUAL. INDY READS THIS COLLABORATION STARTED IN SEPTEMBER OF 2014. INDY READS HOLDS AN ADULT LITERACY LAB AT OUR FACILITY ONCE PER WEEK. SO FAR, ALL OF THE STUDENT PARTICIPANTS HAVE BEEN FROM CUMMINS BEHAVIORAL HEALTH SYSTEMS. THERE IS NO COST TO US FOR THIS PROGRAM. TANGRAM WE HAVE AN MOU WITH THIS AGENCY TO PROVIDE THE USE OF THEIR JOB SEARCH SOFTWARE, WORKFORCE ACCELERATOR. IT HELPS TO MATCH PEOPLE WITH DISABILITIES AND VETERANS TO COMPANIES THAT NEED AND WANT TO HIRE THEM. WORKONE WE ARE WORKING WITH THIS AGENCY TO PLACE APPROPRIATE INTERNS WITH OUR AGENCY. THEIR POSITIONS WOULD BE PAID BY WORKONE. THEY WOULD LEARN JOB SKILLS AND LIFE SKILLS THAT WOULD HELP THEM BE SUCCESSFUL IN FUTURE EMPLOYMENT. |
| FORM 990, PAGE 6, PART VI, LINE 11B | THE BOARD REVIEWS THE FORM 990 ANNUALLY AND DIRECTS QUESTIONS TO THE CPA PREPARING THE FORM. AFTER CHANGES ARE APPROVED, THE RETURN IS FILED. |
| FORM 990, PAGE 6, PART VI, LINE 12C | THE ORGANIZATION REQUIRES STAFF AND MEMBERS OF THE BOARD TO SIGN A WRITTEN CONFLICT OF INTEREST POLICY STATEMENT ANNUALLY. THESE ARE THEN REVIEWED BY THE BOARD. |
| FORM 990, PAGE 6, PART VI, LINE 19 | ALL REQUIRED INFORMATION IS MADE AVAILABLE THE TO THE PUBLIC UPON REQUEST AND BUDGET INFORMATION IS INCLUDED IN THE ORGANIZATION'S ANNUAL REPORT. |
| FORM 990, PART XI, LINE 9 | FUNDRAISING EXPENSES 12,197 FUNDRAISING EXPENSES -12,197 |
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