Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for instructions and 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)
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(a) 2018 | (b) 2019 | (c) 2020 | (d) 2021 | (e) 2022 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | ||||||
| 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 | ||||||
| 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. | ||||||
Calendar year
(or fiscal year beginning in)
![]() |
(a) 2018 | (b) 2019 | (c) 2020 | (d) 2021 | (e) 2022 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | ||||||
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | ||||||
| 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 | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2018 | (b) 2019 | (c) 2020 | (d) 2021 | (e) 2022 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | 34,572 | 1,094,503 | 2,689,612 | 3,257,571 | 2,317,293 | 9,393,551 |
| 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 | 4,824,528 | 4,286,802 | 3,630,629 | 3,022,033 | 2,644,467 | 18,408,459 |
| 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 | 4,859,100 | 5,381,305 | 6,320,241 | 6,279,604 | 4,961,760 | 27,802,010 |
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons | 0 | |||||
| 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. | 0 | |||||
| c | Add lines 7a and 7b.. | 0 | |||||
| 8 | Public support. (Subtract line 7c from line 6.) | 27,802,010 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2018 | (b) 2019 | (c) 2020 | (d) 2021 | (e) 2022 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 4,859,100 | 5,381,305 | 6,320,241 | 6,279,604 | 4,961,760 | 27,802,010 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 499 | 649 | 497 | 69 | 511 | 2,225 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | 499 | 649 | 497 | 69 | 511 | 2,225 |
| 11 | Net income from unrelated business activities not included on 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.) .. | 3,490 | 2,039 | 24,089 | 1,572 | 1,520 | 32,710 |
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 4,863,089 | 5,383,993 | 6,344,827 | 6,281,245 | 4,963,791 | 27,836,945 |
| 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 0.015 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 0.035 | 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 | 1 | |
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
2 | |
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | 3 | |
| 4 Amounts paid to acquire exempt-use assets | 4 | |
| 5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI) | 5 | |
| 6 Other distributions (describe in Part VI). See instructions | 6 | |
| 7Total annual distributions. Add lines 1 through 6. | 7 | |
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
8 | |
| 9 Distributable amount for 2022 from Section C, line 6 | 9 | |
| 10 Line 8 amount divided by Line 9 amount | 10 | |
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2022 |
(iii) Distributable Amount for 2022 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2022 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2022 (reasonable cause required-- explain in Part VI).
See instructions. |
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| 3 Excess distributions carryover, if any, to 2022: | ||||
| a From 2017....... | ||||
| b From 2018....... | ||||
| c From 2019....... | ||||
| d From 2020....... | ||||
| e From 2021....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2022 distributable amount | ||||
|
i
Carryover from 2017 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from line 3f. | ||||
| 4Distributions for 2022 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2022 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from line 4. | ||||
|
5
Remaining underdistributions for years prior to 2022, 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 2022. 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 2023. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2018..... | ||||
| b Excess from 2019..... | ||||
| c Excess from 2020..... | ||||
| d Excess from 2021..... | ||||
| e Excess from 2022..... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|---|
| SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: | MICELLANEOUS - 2018 AMOUNT: $ 3,490. 2019 AMOUNT: $ 2,039. 2020 AMOUNT: $ 24,089. 2021 AMOUNT: $ 1,572. 2022 AMOUNT: $ 1,520. |
| 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, PART III, LINE 1 | TO ASSIST AND SUPPORT FAMILIES/CAREGIVERS OF CHILDREN/YOUTH WITH EMOTIONAL, BEHAVIORAL AND MENTAL HEALTH NEEDS, AS WELL AS ASSIST POLICY MAKERS, AGENCIES AND PROVIDERS TRANSFORM SYSTEMS TO ENSURE CHILDREN/YOUTH SUCCEED IN SCHOOL, LIVE WITH FAMILIES IN THE COMMUNITY, AVOID DELINQUENCY, AND BECOME PRODUCTIVE ADULTS. |
| FORM 990, PART III, LINE 4A | PARENT-TO-PARENT SERVICES FOR ARIZONA NETWORK ORGANIZATIONS: PARENT-TO-PARENT SERVICES FOR MEMBERS OF ARIZONA NETWORK ORGANIZATIONS (ARIZONA COMPLETE CARE MEDICAID) PROVIDE INDIVIDUALIZED SUPPORT AND FAMILY EDUCATION. THESE SERVICES ARE DELIVERED BY TRAINED PARENT PARTNERS WHO HAVE 1ST HAND EXPERIENCE IN RAISING A CHILD WITH BEHAVIORAL HEALTH AND/OR SUBSTANCE ABUSE CHALLENGES. BUILD CAREGIVER SYSTEM NAVIGATION SKILLS TO PARTICIPATE IN THEIR CHILD(S) SUPPORT PLANS THAT BUILD ON THE STRENGTH OF CAREGIVER AND CHILD. SUPPORT AND SERVICES ARE PRIMARILY PROVIDED IN THE HOME, COMMUNITY, AND SCHOOLS (HCBS), WITH ONE-ON-ONE SESSIONS AND GROUP SKILL TRAINING SESSIONS AND HOME CARE FAMILY TRAINING. 1,100 UNDUPLICATED MEMBERS SERVED. |
| FORM 990, PART III, LINE 4B | PARENTS FOR PARENTS - MERCY CARE: PARENTS FOR PARENTS (P4P) -118, PIPER-23, FATHERHOOD ENGAGEMENT PROGRAM -180 AND NURTURING PARENT PROGRAM -75 INCLUDE COLLABORATIVE PROJECTS WITH DCS, MERCY CARE AND THE GOVERNOR'S OFFICE FOR YOUTH FAITH & FAMILIES WITHIN THE TRAUMA-INFORMED SUBSTANCE ABUSE PREVENTION PROGRAMS (TISAPP) -53, FEDERALLY FUNDED BY US HHS SUBSTANCE ABUSE BLOCK GRANT (SABG). WORKING WITH MARICOPA, PIMA AND YAVAPAI COUNTY JUVENILE JUSTICE COURT AND OTHER CHILD WELFARE STAKEHOLDERS INVOLVED IN DEPENDENCY CASES, PARENT ALLIES WHO ACHIEVED PERMANENCY FOR THEIR OWN CHILDREN ARE TRAINED TO PROVIDE SUPPORT TO OTHER PARENTS NEW TO THE JUDICIAL SYSTEM PROVIDING HOPE, ENCOURAGEMENT, AND RESOLUTION SKILLS FOR SUCCESSFUL OUTCOMES OF REUNIFICATION WITH THEIR CHILDREN. 449 PARENTS PARTICIPATING IN ACTIVE DCS DEPENDENCY CASES WERE SUPPORTED. |
| FORM 990, PART III, LINE 4C | PARENT ASSISTANCE CENTER: STATEWIDE PARENT HELPLINE CONNECTING PARENT/CAREGIVERS TO SUPPORT AND RESOURCES. OUR ACCESS AND CREDIBILITY WITH LOW-INCOME FAMILIES ALLOW US TO TARGET HARD-TO-REACH CHILDREN WHO ARE UNINSURED. ASSIST FAMILIES IN THE APPLICATION AND RENEWAL PROCESS, USING MOBILE ENROLLMENT, ONE-ON-ONE ASSISTANCE AND CONNECTIONS TO OTHER COMMUNITY RELATIONSHIPS FOR SERVICES AND REFERRALS. ALSO INCLUDES OTHER NAVIGATION SERVICES IN COLLABORATION WITH CITY OF PHOENIX MERCY CARE ARPA AND SUBSTANCE ABUSE BLOCK GRANT CORONA VIRUS RESPONSE AND RELIEF SUPPLEMENTAL APPROPRIATIONS ACT (CRRSAA) FUNDING WITH A RANGE OF COMMUNITY-BASED PROVIDERS TO DELIVER COMPREHENSIVE, CULTURALLY COMPETENT SERVICES FOR UNINSURED OR UNDERINSURED NON-TITLE XIX/XXI ELIGIBLE POPULATIONS. THROUGH AHCCCS ENROLLMENTS, PARENT ASSISTANCE CENTER CALLS/EMAIL RESPONSES, AND NAVIGATION OUTREACH, WE REACHED MORE THAN 18,824 PERSONS IN NEED. |
| FORM 990, PART VI, SECTION A, LINE 1A | PURSUANT TO ARTICLE 8 - COMMITTEES, THE BOARD SHALL ELECT AN EXECUTIVE COMMITTEE COMPOSED OF A MINIMUM OF ALL OFFICERS OF THE CORPORATION, AND ALL OTHER COMMITTEE CHAIRS AS DEEMED ADVISABLE, 10 TO SERVE ON THE EXECUTIVE COMMITTEE OF THE BOARD. THE EXECUTIVE COMMITTEE, UNLESS LIMITED IN A RESOLUTION OF THE BOARD, SHALL HAVE, AND MAY EXERCISE ALL THE AUTHORITY OF THE BOARD IN THE MANAGEMENT OF THE BUSINESS AND AFFAIRS OF THE CORPORATION BETWEEN MEETINGS OF THE BOARD, PROVIDED, HOWEVER, THAT THE EXECUTIVE COMMITTEE SHALL NOT HAVE THE AUTHORITY OF THE BOARD AS ENUMERATED IN ARTICLE 8 - COMMITTEE OF DIRECTORS. THE COMMITTEE CHAIR SHALL SUBMIT A SUMMARY REPORT OF THE BUSINESS CONDUCTED IN ANY MEETING OF THE EXECUTIVE COMMITTEE FOR DISSEMINATION TO THE BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 IS PREPARED BY THE ORGANIZATION'S PUBLIC ACCOUNTING FIRM BASED ON INFORMATION PROVIDED BY MANAGEMENT. ONCE THE DRAFT IS AVAILABLE, IT IS REVIEWED BY MANAGEMENT AND ANY CHANGES INCORPORATED INTO THE FILING. THE FORM 990 IS PRESENTED TO THE DESIGNATED COMMITTEE OF THE BOARD OF DIRECTORS PRIOR TO FILING WITH THE IRS. COPIES OF THE COMPLETED AND FILED FORM 990 ARE MADE AVAILABLE TO ALL BOARD MEMBERS. |
| FORM 990, PART VI, SECTION B, LINE 12C | EVERY BOARD MEMBER SIGNS A CONFLICT OF INTEREST DOCUMENT EACH YEAR WHICH IS KEPT ON FILE ELECTRONICALLY. AT THE BEGINNING OF EACH FISCAL YEAR, EACH BOARD MEMBER READS AND SIGNS THE CONFLICT OF INTEREST STATEMENT AND IT IS FILED IN THE BOARD FILES FOR REFERENCE. IF A BOARD MEMBER RECOGNIZES HE/SHE HAS A CONFLICT OF INTEREST, THEY REPORT THIS TO THE BOARD PRESIDENT AND EXECUTIVE DIRECTOR. IF AN EMPLOYEE RECOGNIZES HE/SHE HAS A CONFLICT OF INTEREST, THEY REPORT TO THE EXECUTIVE DIRECTOR. |
| FORM 990, PART VI, SECTION B, LINE 15A | THE EXECUTIVE'S DIRECTOR'S SALARY IS DETERMINED BY A REVIEW OF SALARY SURVEYS, MOSTLY NON PROFITS OF SIMILAR SIZE. A PERFORMANCE EVALUATION IS CONDUCTED BY THE BOARD OF DIRECTORS. THE RESULTING DOCUMENTATION IS DELIVERED BY THE PRESIDENT OF THE BOARD TO THE SECRETARY FOR FILING AND PROCESSING FOR THE PAYROLL DEPARTMENT IF ANY CHANGES WERE MADE AT THAT TIME. FOR ALL OTHER EMPLOYEES OF THE ORGANIZATION, COMPENSATION IS REVIEWED BY THE EXECUTIVE DIRECTOR. BASED ON THE REVIEW, COMPENSATION IS DETERMINED AND CHANGES MADE ARE GIVEN TO THE FINANCIAL SERVICES MANAGER FOR SYSTEM CHANGES. THIS PROCESS LAST TOOK PLACE IN 2020. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | CONSULTING: PROGRAM SERVICE EXPENSES 521,482. MANAGEMENT AND GENERAL EXPENSES 27,358. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 548,840. TEMPORARY STAFF: PROGRAM SERVICE EXPENSES 13,144. MANAGEMENT AND GENERAL EXPENSES 15,677. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 28,821. |
| FORM 990, PART XII, LINE 2C: | THE OVERSIGHT PROCESS OR SELECTION PROCESS HAS NOT CHANGED DURING THE TAX YEAR. |
| Software ID: | |
| Software Version: |