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)
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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.") .. | 4,305 | 176,221 | 3,717,620 | 6,175,868 | 3,421,207 | 13,495,221 |
| 2 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.... | 0 | |||||
| 3 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | 0 | |||||
| 4 | Total. Add lines 1 through 3 | 4,305 | 176,221 | 3,717,620 | 6,175,868 | 3,421,207 | 13,495,221 |
| 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) .. | 124,762 | |||||
| 6 | Public support. Subtract line 5 from line 4. | 13,370,459 | |||||
Calendar year
(or fiscal year beginning in)
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(a) 2018 | (b) 2019 | (c) 2020 | (d) 2021 | (e) 2022 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 4,305 | 176,221 | 3,717,620 | 6,175,868 | 3,421,207 | 13,495,221 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | 5,433 | 9,940 | 16,488 | 31,657 | 20,044 | 83,562 |
| 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.).. | 330,992 | 53,467 | 166,552 | 143,505 | 694,516 | |
| 11 | Total support. Add lines 7 through 10 | 14,273,299 | |||||
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.") . | ||||||
| 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) 2018 | (b) 2019 | (c) 2020 | (d) 2021 | (e) 2022 | (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 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 |
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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, PART I, LINE 1 | (CONT) EARLY DETECTION AND TREATMENT OF MENTAL ILLNESS AND SUBSTANCE ABUSE BY PROVIDING A COMPREHENSIVE RANGE OF HIGH QUALITY SERVICES AND EDUCATION IN THE MOST EFFICIENT AND EFFECTIVE MANNER FOR THE RESIDENTS AND THE COMMUNITIES OF BACA, BENT, CROWLEY, KIOWA, OTERO AND PROWERS COUNTIES. |
| FORM 990, PART III, LINE 1 | (CONT) HIGH QUALITY SERVICES AND EDUCATION IN THE MOST EFFICIENT AND EFFECTIVE MANNER FOR THE RESIDENTS AND THE COMMUNITIES OF BACA, BENT, CROWLEY, KIOWA, OTERO AND PROWERS COUNTIES. |
| FORM 990 PART V, LINE 2 A & B | FORM 990, PART VII, SECTION A, COLUMN D FOR A PARTIAL PERIOD OF THE FISCAL YEAR (JULY 2022 TO MARCH 6, 2023) THE ORGANIZATION WAS IN A COMMON PAYMASTER RELATIONSHIP WITH ITS RELATED ENTITY SOUTHEAST BEHAVIORAL HEALTH GROUP. sOUTHEAST BEHAVIORAL HEALTH GROUP WAS THE EMPLOYER OF RECORD, FILING ALL PERTINENT TAX DOCUMENTS ON A QUARTERLY AND ANNUAL BASIS AS NEEDED, INCLUDING MAKING REQUIRED TAX DEPOSITS. HOWEVER, AS THese INDIVIDUALS have MET THE DEFINITION OF COMMON LAW EMPLOYEES, THEIR SALARIES/WAGES ARE REFLECTED ON FORM 990, PART VII, SECTION A, COLUMN D, LINES 1 THROUGH 16 AND PART IX, LINES 5 THROUGH 10 AS INSTRUCTED PER IRS GUIDELINES. AS OF MARCH 6,2023 THE FILING ORGANIZATION ENTERED INTO A MERGER AGREEMENT WITH VALLEY-WIDE HEALTH SYSTEMS, INC AND ALL EMPLOYEES WERE TRANSFERRED TO VALLEY-WIDE HEALTH SYSTEM. FOR THE SHORT PERIOD MARCH 2023 THROUGH JUNE 30, 2023, THE FILING ORGANIZATION HAD A CONTRACT SERVICE AGREEMENT WITH VALLEY-WIDE HEALTH SYSTEM FOR STAFF SERVICES. |
| FORM 990, PART VI, SECTION A, LINE 3 | AS OF MARCH 5, 2023, southeast mental health services CONTRACTED WITH THE RELATED ORGANIZATION, VALLEY-WIDE HEALTH SYSTEM, INC. FOR MANAGEMENT SERVICES, ADMINISTRATIVE SERVICES, AND PROGRAMMATIC, MEDICAL STAFF SERVICES. since VALLEY-WIDE HEALTH SYSTEM, INC. AND southeast mental health services ARE BOTH RELATED ORGANIZATIONS, ALL THE COMPENSATION PAID DURING THE 2022 CALENDAR YEAR TO THE OFFICERS AND HIGHLY COMPENSATED EMPLOYEES HAS BEEN DETAILED OUT ON THE FORM 990, PART 7, SECTION A. THE FOLLOWING INDIVIDUALS SERVED southeast mental health services DURING THE 2022 CALENDAR YEAR AS OFFICERS, AND STARTING MARCH 6, 2023, SERVED PARTNERSHIP FOR PROGRESS WITHIN A CONTRACTED SERVICE ARRANGEMENT THROUGH VALLEY-WIDE HEALTH SYSTEMS, INC: JOSEPH CARRICA, III, DIVENA MORTIMEYER, LAURA DIPRINCE. THE FOLLOWING OFFICERS OF VALLEY-WIDE HEALTH SYSTEMS INC. STARTED SERVING SOUTHEAST MENTAL HEALTH SERVICES WITHIN A CONTRACTED SERVICE ARRANGMENT, AS OF MARCH 6, 2023: JANIA ARNOLDI, CEO, AND JAVIER MARTINEZ, CFO. |
| FORM 990, PART VI, SECTION A, LINE 6 & 7 A | VALLEY-WIDE HEALTH SYSTEM IS THE SOLE MEMBER OF THE FILING ORGANIZATION AND VALLEY-WIDE HEALTH SYSTEM APPOINTS THE BOARD MEMBERS TO SERVE ON THE FILING ORGANIZATION'S BOARD. |
| FORM 990, PART VI, SECTION B, LINE 11 B | THE 990 IS REVIEWED AT THE MONTHLY BOARD OF DIRECTORS MEETING PRIOR TO THE SUBMISSION OF THE 990 TO THE INTERNAL REVENUE SERVICE. |
| FORM 990, PART VI, SECTION B, LINE 12 C | ANNUALLY, THE ORGANIZATION REVIEWS AND DISCUSSES THE CONFLICT OF INTEREST POLICY AND REQUESTS THAT EACH BOARD MEMBER LIST AND ACKNOWLEDGE ANY KNOWN CONFLICTS. ALL MEMBERS OF THE BOARD OF DIRECTORS AND STAFF ARE COVERED UNDER THE CONFLICT-OF-INTEREST POLICY. AT EACH BOARD AND COMMITTEE MEETING, IF THERE IS A DISCUSSION OF SELECTING OR ENGAGING A VENDOR OR SERVICE PROVIDER, ALL IN ATTENDANCE ARE ASKED TO RECUSE THEMSELVES FROM THIS DISCUSSION IF THERE COULD BE A PERCEIVED CONFLICT. |
| FORM 990, PART VI, SECTION B, LINE 15 A & B | THE BOARD OF DIRECTORS REVIEWS THE COMPENSATION FOR THE CHIEF EXECUTIVE OFFICER BY COMPARING THEIR COMPENSATION TO THE COMPENSATION OF INDIVIDUALS IN LIKE POSITIONS, IN COMPARABLE ORGANIZATIONS USING FORMS 990, COMPENSATION STUDIES, AND OTHER AVAILABLE DATA INCLUDING, BUT LIMITED TO: CCHN, BOFL AND MOUNTAIN STATE EMPLOYEE COMPENSATION SURVEYS. THE BOARD THEN APPROVES ANY CHANGES IN COMPENSATION BASED ON THIS INFORMATION. THE CHIEF EXECUTIVE OFFICER IS RESPONSIBLE FOR EVALUATING PAY RATES OF OTHER KEY EMPLOYEES USING THE SAME COMPENSATION STUDIES AND DATA. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION WILL PROVIDE IN A TIMELY MANNER, COPIES OF ALL GOVERNING DOCUMENTS INCLUDING ITS CONFLICT-OF-INTEREST POLICIES AND FINANCIAL STATEMENTS WHEN REQUESTED IN WRITING OR IN PERSON. |
| FORM 990, PART VII, SECTION A | DURING THE FISCAL YEAR ENDING 6-30-2023, SOUTHEAST BEHAVIORAL HEALTH GROUP 'S BOARD OF DIRECTORS AND OFFICERS EXPANDED TO INCLUDE THE OFFICERS AND BOARD OF DIRECTORS OF VALLEY-WIDE HEALTH SYSTEM. THE EXPANSION CAME FROM ENACTMENT OF A MEMORANDUM OF UNDERSTANDING (MOU) BETWEEN VALLEY-WIDE HEALTH SYSTEM AND SOUTHEAST MENTAL HEALTH SERVICES (SOUTHEAST). SOUTHEAST OPERATED AS A COMMUNITY MENTAL HEALTH CENTER AND IS AFFILIATED WITH SOUTHEAST BEHAVIORAL HEALTH GROUP, PARTNERSHIP FOR PROGRESS, FAMILY GUIDANCE INSTITUTE, AND SOUTHEAST WELLNESS WORKS, LLC (COLLECTIVELY, THE HEALTH GROUP). TO BETTER SERVE ITS COMMUNITIES AND TO CAPITALIZE ON AVAILABLE SYNERGIES THE BOARDS OF DIRECTORS OF VALLEY-WIDE HEALTH SYSTEM AND THE HEALTH GROUP DEEMED IT TO BE IN THE BEST INTEREST OF ALL PARTIES FOR VALLEY-WIDE HEALTH SYSTEM TO ENTER INTO A TRANSACTION WITH SOUTHEAST AND ITS RESPECTIVE AFFILIATES. AS A RESULT OF THE AGREEMENT, VALLEY-WIDE HEALTH SYSTEM BECAME A RELATED ENTITY OF THE SOUTHEAST BEHAVIORAL HEALTH GROUP. |
| FORM 990, PART XII, LINE 2 C | AS OF MARCH 2023, THE ORGANIZATION CAME UNDER THE CONTROL OF VALLEY-WIDE HEALTH SYSTEMS, INC. VALLEY-WIDE HEALTH SYSTEMS HAS AN AUDIT COMMITTEE THAT IS TASKED TO OVERSEE THE CONSOLIDATED FINANCIAL STATEMENT AUDIT AND SELECT THE INDEPENDENT AUDITOR. |
| FORM 990 PART IX LINE 11G | DESCRIPTION:CONTRACTED SERVICES - VWHS TOTAL FEES:2396388 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:CONSULTANTS TOTAL FEES:48833 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:TELEHEALTH TOTAL FEES:45763 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:CONTRACT WORK TOTAL FEES:98174 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:EHR SERVICE TOTAL FEES:258759 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:PURCHASED SERVICES TOTAL FEES:311413 |
| Software ID: | |
| Software Version: |