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 | |||||
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Total |
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Calendar year
(or fiscal year beginning in)
![]() |
(a) 2019 | (b) 2020 | (c) 2021 | (d) 2022 | (e) 2023 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | 2,886,255 | 2,852,272 | 60,000 | 132,254 | 252,982 | 6,183,763 |
| 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 | 2,886,255 | 2,852,272 | 60,000 | 132,254 | 252,982 | 6,183,763 |
| 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) .. | 2,187,068 | |||||
| 6 | Public support. Subtract line 5 from line 4. | 3,996,695 | |||||
Calendar year
(or fiscal year beginning in)
![]() |
(a) 2019 | (b) 2020 | (c) 2021 | (d) 2022 | (e) 2023 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 2,886,255 | 2,852,272 | 60,000 | 132,254 | 252,982 | 6,183,763 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | 10,318 | 20,165 | 510 | 2,825 | 10,090 | 43,908 |
| 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 | 6,227,671 | |||||
Calendar year (or fiscal
year beginning in) ![]() |
(a) 2019 | (b) 2020 | (c) 2021 | (d) 2022 | (e) 2023 | (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) 2019 | (b) 2020 | (c) 2021 | (d) 2022 | (e) 2023 | (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 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.) .. | ||||||
| 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 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 2023 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-2023 |
(iii) Distributable Amount for 2023 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2023 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2023 (reasonable cause required-- explain in Part VI).
See instructions. |
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| 3 Excess distributions carryover, if any, to 2023: | ||||
| a From 2018....... | ||||
| b From 2019....... | ||||
| c From 2020....... | ||||
| d From 2021....... | ||||
| e From 2022....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2023 distributable amount | ||||
|
i
Carryover from 2018 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from line 3f. | ||||
| 4Distributions for 2023 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2023 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from line 4. | ||||
|
5
Remaining underdistributions for years prior to 2023, 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 2023. 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 2024. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2019..... | ||||
| b Excess from 2020..... | ||||
| c Excess from 2021..... | ||||
| d Excess from 2022..... | ||||
| e Excess from 2023..... | ||||
| Facts And Circumstances Test |
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| Return Reference | Explanation |
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| Software ID: | |
| Software Version: |
| Return Reference | Explanation |
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| FORM 990 - ORGANIZATION'S MISSION | THE MISSION OF CBHS IS TO SUPPORT ITS MEMBERS' EFFORTS TO PROVIDE EFFECTIVE BEHAVIORAL HEALTH SERVICES TO THE MEDICAID, MEDICARE, AND UNINSURED POPULATION. CBHS DEVELOPS THE RESOURCES NECESSARY TO ESTABLISH LEADING EDGE RESPONSES TO THE EVOLVING HEALTH CARE SYSTEM IN NEW YORK STATE. CBHS PROMOTES RECOVERY ORIENTED AND OUTCOME-BASED SERVICES DESIGNED TO ENSURE HIGH QUALITY AND AFFORDABLE COSTS. |
| FORM 990, PAGE 2, PART III, LINE 4A | CBHS REALIZES THE NEED FOR NIMBLE, RESPONSIVE, COST EFFECTIVE WAYS TO SERVE PEOPLE WITH BEHAVIORAL HEALTH CHALLENGES, AND OTHER POPULATIONS. IN ORDER TO ACCELERATE OUR KNOWLEDGE AND PREPARATION FOR VALUE-BASED CONTRACTING, WE ARE PARTNERING WITH HEALTHCARE PROVIDERS, HEALTH HOMES, AND MANAGED CARE COMPANIES TO CREATE THE OUTCOMES NEEDED FOR THE FUTURE. CBHS IS CREATING A DEEP MENU OF INNOVATIVE SERVICES THAT ARE FINANCIALLY VIABLE AND RESPONSIVE TO PEOPLE'S NEEDS. WE HAVE BEEN LEADERS IN NEW YORK STATE'S TRANSFORMATION TO A PERSON-CENTERED MODEL OF CARE AND ARE RECOGNIZED FOR OUR RECOVERY SERVICES THAT ARE OUTCOME-DRIVEN AND THAT INCORPORATE PEER AND NATURAL SUPPORTS. WE UTILIZE STRENGTH-BASED PLANNING IN OUR BEHAVIORAL HEALTH AND CHILD WELFARE SERVICES THAT DRAWS HEAVILY UPON NATURAL SUPPORTS TO PROMOTE POSITIVE OUTCOMES. DURING 2018, CBHS WAS AWARDED AN EXPANDED CONTRACT THROUGH WESTCHESTER MEDICAL CENTER PSS TO CONTINUE IMPROVEMENTS IN POPULATION HEALTH FROM PEOPLE WITH COMPLEX NEEDS INCLUDING TRANSITIONING TO COMMUNITY OUTPATIENT CARE FOLLOWING PSYCHIATRIC HOSPITALIZATION. ALSO IN 2018, CBHS RECEIVED AN AWARD OF A BEHAVIORAL HEALTH CARE COLLABORATION GRANT THROUGH THE NEW YORK STATE OFFICE OF MENTAL HEALTH. IN ADDITION, CBHS INC. PROVIDED LEADERSHIP THROUGH THE HUDSON VALLEY IN PROVIDING CARE MANAGEMENT FOR PEOPLE WITH COMPLEX NEEDS AND INTEGRATING PRIMARY AND BEHAVIORAL HEALTH CARE. |
| FORM 990, PAGE 6, PART VI, LINE 6 | EACH CLASS A MEMBER SHALL APPOINT AN INDIVIDUAL TO SERVE AS A DIRECTOR (EACH, A "CLASS A DIRECTOR"), WHICH INDIVIDUAL SHALL BE RELATED TO THE CLASS A MEMBER BY EMPLOYMENT OR SERVICE ON THE BOARD OF DIRECTORS OF THAT CLASS A MEMBER. IN ADDITION TO THE CLASS A DIRECTOR, EACH CLASS A MEMBER SHALL APPOINT AN ALTERNATE DIRECTOR TO VOTE IN THE ABSENCE OF THE CLASS A DIRECTOR APPOINTED BY THAT CLASS A MEMBER (AN "ALTERNATE CLASS A DIRECTOR"). THE RIGHTS, IF ANY, OF CLASS B MEMBERS TO HAVE REPRESENTATION ON THE BOARD SHALL BE DETERMINED BY THE BOARD AT SUCH TIME AS THE BOARD MAKES THE DETERMINATION TO ADMIT CLASS B MEMBERS. THE CLASS C MEMBER SHALL APPOINT FOUR (4) INDIVIDUALS TO SERVE AS DIRECTORS (EACH, A "CLASS C DIRECTOR"), WHICH INDIVIDUALS SHALL BE RELATED TO THE CLASS C MEMBER BY EMPLOYMENT OR SERVICE ON THE BOARD OF DIRECTORS OF THE CLASS C MEMBER. IN ADDITION TO THE CLASS C DIRECTORS, THE CLASS C MEMBER SHALL APPOINT FOUR (4)ALTERNATE DIRECTORS TO VOTE IN THE ABSENCE OF THE CLASS C DIRECTORS APPOINTED BY THE CLASS C MEMBER (EACH A "ALTERNATE CLASS C DIRECTOR"). |
| FORM 990, PAGE 6, PART VI, LINE 7A | EACH CLASS A MEMBER SHALL APPOINT AN INDIVIDUAL TO SERVE AS A DIRECTOR (EACH, A "CLASS A DIRECTOR"), WHICH INDIVIDUAL SHALL BE RELATED TO THE CLASS A MEMBER BY EMPLOYMENT OR SERVICE ON THE BOARD OF DIRECTORS OF THAT CLASS A MEMBER. IN ADDITION TO THE CLASS A DIRECTOR, EACH CLASS A MEMBER SHALL APPOINT AN ALTERNATE DIRECTOR TO VOTE IN THE ABSENCE OF THE CLASS A DIRECTOR APPOINTED BY THAT CLASS A MEMBER (AN "ALTERNATE CLASS A DIRECTOR"). THE RIGHTS, IF ANY, OF CLASS B MEMBERS TO HAVE REPRESENTATION ON THE BOARD SHALL BE DETERMINED BY THE BOARD AT SUCH TIME AS THE BOARD MAKES THE DETERMINATION TO ADMIT CLASS B MEMBERS. THE CLASS C MEMBER SHALL APPOINT FOUR (4) INDIVIDUALS TO SERVE AS DIRECTORS (EACH, A "CLASS C DIRECTOR"), WHICH INDIVIDUALS SHALL BE RELATED TO THE CLASS C MEMBER BY EMPLOYMENT OR SERVICE ON THE BOARD OF DIRECTORS OF THE CLASS C MEMBER. IN ADDITION TO THE CLASS C DIRECTORS, THE CLASS C MEMBER SHALL APPOINT FOUR (4)ALTERNATE DIRECTORS TO VOTE IN THE ABSENCE OF THE CLASS C DIRECTORS APPOINTED BY THE CLASS C MEMBER (EACH A "ALTERNATE CLASS C DIRECTOR"). |
| FORM 990, PAGE 6, PART VI, LINE 11B | CBHS INC. HAS ITS FORM 990 PREPARED BY AN OUTSIDE ACCOUNTING FIRM AND HAS ESTABLISHED THE FOLLOWING REVIEW PROCESS TO ENSURE THAT THE INFORMATION REPORTED IS COMPLETE AND ACCURATE. AFTER THE FORM 990 HAS BEEN PREPARED, IT IS REVIEWED BY THE CO-CHAIRS AND TREASURER OF THE BOARD, MEMBERS OF THE FINANCE COMMITTEE, AND THE CEO. ONCE READY FOR FILING, THE FORM 990 IS ELECTRONICALLY SENT TO THE BOARD OF DIRECTORS FOR REVIEW AND COMMENTING. ALL QUESTIONS AND COMMENTS ARE ADDRESSED AND THE RETURN IS FINALIZED AND APPROVED FOR FILING. |
| FORM 990, PAGE 6, PART VI, LINE 12C | ANNUAL WRITTEN CONFLICT OF INTEREST DISCLOSURE STATEMENT: DIRECTORS, OFFICERS AND KEY EMPLOYEES. ALL DIRECTORS, OFFICERS AND KEY EMPLOYEES WILL, AT LEAST ANNUALLY, FILE A WRITTEN CONFLICT OF INTEREST DISCLOSURE STATEMENT WITH THE BOARD SECRETARY. THE BOARD SECRETARY WILL PROVIDE COPIES OF ALL COMPLETED STATEMENTS TO THE CHAIR OF THE FINANCE AND AUDIT COMMITTEE OR THE CHAIR OF THE BOARD. CONTINUING OBLIGATION TO UPDATE ANNUAL WRITTEN CONFLICT OF INTEREST DISCLOSURE STATEMENT: DIRECTORS, OFFICERS AND KEY EMPLOYEES. EVERY DIRECTOR, OFFICER AND KEY EMPLOYEE HAS AN AFFIRMATIVE OBLIGATION TO UPDATE HIS OR HER ANNUAL WRITTEN CONFLICT OF INTEREST DISCLOSURE STATEMENT WHENEVER THERE ARE NEW OR CHANGED FACTS OR CIRCUMSTANCES THAT CREATE A DISCLOSABLE CONFLICT OF INTEREST. ALL SUCH STATEMENTS ARE TO BE FILED WITH THE BOARD SECRETARY. THE BOARD SECRETARY WILL PROVIDE COPIES OF ALL COMPLETED STATEMENTS TO THE CHAIR OF THE FINANCE AND AUDIT COMMITTEE OR THE CHAIR OF THE BOARD. THE ADOPTION, IMPLEMENTATION OF AND COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY SHALL BE OVERSEEN BY THE BOARD OR THE DESIGNATED FINANCE AND AUDIT COMMITTEE OF THE BOARD AS DETERMINED BY THE BOARD ANNUALLY. RELATED PARTY TRANSACTIONS: A. CBHS MAY NOT ENTER INTO A RELATED PARTY TRANSACTION UNLESS THE TRANSACTION IS DETERMINED TO BE FAIR, REASONABLE AND IN CBHS'S BEST INTEREST AT THE TIME OF THE DETERMINATION; B. IN CONSIDERING THE RELATED PARTY TRANSACTION, THE FINANCE AND AUDIT COMMITTEE OR THE INDEPENDENT DIRECTORS ON THE BOARD SHALL ENSURE THAT ANY DIRECTOR, OFFICER, KEY EMPLOYEE AND EMPLOYEE WHO HAS AN INTEREST IN THE RELATED PARTY TRANSACTION HAS DISCLOSED IN GOOD FAITH ALL MATERIAL FACTS CONCERNING SUCH INTEREST; AND C. NO RELATED PARTY MAY PARTICIPATE IN THE DELIBERATIONS OR VOTING RELATING TO ANY RELATED PARTY TRANSACTION. HOWEVER, THE FINANCE AND AUDIT COMMITTEE OR THE INDEPENDENT DIRECTORS ON THE BOARD MAY REQUEST THAT A RELATED PARTY PRESENT INFORMATION CONCERNING A RELATED PARTY TRANSACTION AT A MEETING PRIOR TO THE COMMENCEMENT OF DELIBERATIONS OR VOTING RELATING THERETO. |
| FORM 990, PAGE 6, PART VI, LINE 19 | THE ORGANIZATION MAKES ITS FORM 990 AVAILABLE FOR PUBLIC INSPECTION AS REQUIRED UNDER SECTION 6104 OF THE INTERNAL REVENUE CODE. THE RETURN IS POSTED ON GUIDESTAR.ORG AND OTHER SIMILAR TYPES OF WEBSITES. IN ADDITION, THE FINANCIAL STATEMENTS, CONFLICT OF INTEREST POLICY, ARTICLES OF INCORPORATION AND BY-LAWS ARE ALSO AVAILABLE UPON WRITTEN REQUEST OR BY CALLING THE ORGANIZATION DIRECTLY. |
| FORM 990, PART IX, LINE 11G | SUBCONTRACT LABOR 75,532 0 0 |
| FORM 990, PART XI, LINE 9 | PRIOR PERIOD ADJUSTMENT -173,693 |
| Software ID: | |
| Software Version: |