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.") .. | 283,082 | 551,740 | 1,019,398 | 571,988 | 355,821 | 2,782,029 |
| 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 | 283,082 | 551,740 | 1,019,398 | 571,988 | 355,821 | 2,782,029 |
| 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. | 2,782,029 | |||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2014 | (b) 2015 | (c) 2016 | (d) 2017 | (e) 2018 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 283,082 | 551,740 | 1,019,398 | 571,988 | 355,821 | 2,782,029 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | 14,367 | 15,733 | 136,824 | 130,258 | 260,391 | 557,573 |
| 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 | 3,339,602 | |||||
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 |
|---|
| Return Reference | Explanation |
|---|
| Software ID: | 18007340 |
| Software Version: | 19.1.1.0 |
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| Form 990, Part III, Line 4d | Program Service Expenses 1,056,101, Grants and allocations 0, Revenue 1,625,139 The Substance Use Disorders Treatment program represents the cost of providing services for the treatment of substance use/abuse/dependence conditions including day treatment and outpatient treatment to individuals eighteen years or older in St. Joseph, Cameron, and Maryville Missouri. Compulsive gambling services are also available to those age eighteen years and older. Substance Abuse Traffic Offender Program services are also available for traffic related offenses. |
| Form 990, Part III, Line 4d | Program Service Expenses 882,179, Grants and allocations 0, Revenue 971,463 The Intake/Therapy/Crisis program provides assessments to mental health consumers, on a walk-in basis. This assessment determines eligibility for services. Therapy provides outpatient counseling to adult, children, and families. |
| Form 990, Part III, Line 4d | Program Service Expenses 1,471,065, Grants and allocations 0, Revenue 2,564,553 The Specialized Services program includes Assertive Community Treatment ACT, Psychosocial Rehabilitation Services/Illness Management and Recovery PSR/IMR, and Intensive Treatment of Co-occurring Disorders ITCD. ACT and ITCD expand the treatment team approach to include ancillary professionals such as substance abuse counselors, vocational specialists, and registered nurses. Community based services are provided via a shared caseload approach to individuals with the most significant impairment due to serious and persistent mental illness. PSR/IMR provides services, mostly in a group environment, focusing on skill building to promote recovery from illness. |
| Form 990, Part III, Line 4d | Program Service Expenses 438,602, Grants and allocations 0, Revenue 5,508 Healthcare Home program is a team approach consisting of a RN director, LPNs, and a primary care consultant who work with consumers who have both a severe mental illness and a chronic health condition by ensuring the consumers are receiving appropriate medical care. |
| Form 990, Part III, Line 4d | Program Service Expenses 898,925, Grants and allocations 0, Revenue 1,354 Crisis Services provide emergency services and evaluations to individuals in the community. This also includes the Emergency Room Enhancement program. This program works closely with the local emergency room to coordinate care for individuals who present to the ER by linking them with appropriate services. |
| Form 990, Part III, Line 4d | Program Service Expenses 695,270, Grants and allocations 0, Revenue 882,374 The Justice Reinvestment Initiative JRI is a pilot program designed to provide comprehensive community-based services for individuals under the supervision of the Department of Corrections who have substance use disorders and/or co-occurring substance use disorders and mild to moderate mental illness. The JRI pilot is in Buchanan County only, and the team consists of substance use counselors, community support specialists, housing, employment, and peer specialists. |
| Form 990, Part VI, Section B, Line 11b | This tax return is prepared by the independent accounting firm that performed the financial audit of the Organizations financial statements. The tax return is reviewed by the Finance Committee of the Board of Directors and the CO-CEO former VP of Finance. Any questions or concerns they have are discussed with the Preparer. Once all issues are resolved, the tax return is provided to the Board of Directors for their review prior to filing with the Internal Revenue Service. |
| Form 990, Part VI, Section B, Line 12c | The Organization conducts periodic review to monitor proposed and ongoing transactions for potential conflicts of interest. The Organization requires each member of the Board of Directors and officers to sign an annual statement which affirms that they understand the Organizations conflict of interest policy and will disclose any potential conflicts as soon as they become aware. |
| Form 990, Part VI, Section B, Line 15a | The Executive Committee reviews salary/benefit information obtained from publicly available sources regarding compensation arrangements for the top executive officer at comparative community mental health service organizations. The results are doucmented contemporaneously and are used in setting the President/CEOs or CO-CEO compensation. The President/CEO nor the CO-CEOs participate in the discussions regarding their compensation |
| Form 990, Part VI, Section B, Line 15b | The President/CEO reviews salary/benefit information obtained from publicly available sources regarding compensation arrangements for top financial officers at comparative community mental health service organizations. The results are documented contemporaneously and are used in setting the top financial officers compensation. |
| Form 990, Part VI, Section C, Line 19 | These documents are maintained at the Organizations corporate office see mailing address and made available to requesting parties at no charge. |
| Form 990, Part IX, Line 11g | Contracts for repairs and maintenance services. |
| Form 990, Part V, Line 1c | This question is not applicable however, the question must be answered to electronically file. Accordingly, we checked no as we have not received correspondence from the IRS requiring back-up withholding. |
| Form 990, Part XII, Line 3a | This question is not applicable however, the question must be answered to electronically file. Accordingly, we checked no to signify that the question is not applicable. |
| Software ID: | 18007340 |
| Software Version: | 19.1.1.0 |