2024-12-05T11:45:47-06:00 2024-06-30 910189318 MOSS ADAMS LLP 805 SW BROADWAY 1400 PORTLAND OR 97205 990 2023-07-01 910869129 PENINSULA BEHAVIORAL HEALTH PENI 3604570431 118 EAST 8TH STREET PORT ANGELES WA 98362 WENDY SISK CHIEF EXECUTIVE OFFICER 3604570431 2024-12-03 1 0 WENDY CAMPOS P00448102 5032421447 2024-12-03 2023 2024-10-15 13:58:12Z WENDY SISK 118 EAST 8TH STREET PORT ANGELES WA 98362 17183331 0 X WWW.PENINSULABEHAVIORAL.ORG X 1971 WA PROVIDE QUALITY COMPREHENSIVE BEHAVIORAL HEALTH SERVICES TO RESIDENTS IN CLALLAM COUNTY. 7 7 176 10 0 0 311659 813138 15698095 15730886 281786 265817 -28288 -14249 16263252 16795592 192388 456960 0 0 12301400 12626089 0 0 88956 3248500 3210452 15742288 16293501 520964 502091 21409141 21913457 7588531 7590756 13820610 14322701 X PENINSULA BEHAVIORAL HEALTH IS CLALLAM COUNTY'S PRIMARY RESOURCE FOR BEHAVIORAL HEALTH AND CO-OCCURRING SUBSTANCE USE DISORDER COUNSELING. PBH BELIEVES THAT EVERYONE, DESERVES ACCESS TO QUALITY BEHAVIORAL HEALTHCARE. PBH IS PROUD TO MAKE BEHAVIORAL HEALTHCARE AND THERAPY AFFORDABLE AND ACCESSIBLE TO OUR COMMUNITY. IN 2020, PBH WAS AWARDED AN EXPANSION GRANT FROM SAMSHA, TRANSFORMING US INTO A CCBHC. 0 0 4355533 276967 5237297 CLINICAL OUTPATIENT SERVICES - A WIDE RANGE OF CARING SERVICES IS AVAILABLE TO MEET THE NEEDS OF PERSONS WITH SERIOUS MENTAL ILLNESS OR SUBSTANCE USE DISORDER. STAFF WITH A VARIETY OF SPECIALTIES OFFER EVALUATIONS, THERAPY AND PREVENTION STRATEGIES TO SUPPORT INDIVIDUALS IN THE COMMUNITY AT CRITICAL STAGES OF LIFE. KEY SERVICES INCLUDE ADULT OUTPATIENT THERAPY, COMMUNITY SUPPORT SERVICES, CARE NAVIGATION, YOUTH OUTPATIENT SERVICES, INCLUDING WISE SERVICES AND EVIDENCE BASED PRACTICES. 3063731 5916 4264866 MEDICAL SERVICES - PSYCHIATRIC EVALUATIONS, CONSULTATION WITH PRIMARY CARE PROVIDERS AND PSYCHIATRIC MEDICATION MONITORING. 3766585 174077 6040997 CLINICAL INTENSIVE SERVICES - CRISIS INTERVENTION SERVICES, INCLUDING CRISIS RESPITE CARE, COMMUNITY RESPONSE TO CRISIS CALLS. SERVICES INCLUDE COMMUNITY OUTREACH SERVICES TO THOSE UNHOUSED IN THE COMMUNITY. 450472 0 187726 RESIDENTIAL SERVICES - THE QUALITY OF LIFE FOR MENTALLY ILL CITIZENS AND CAREGIVERS IS ENHANCED THROUGH RESIDENTIAL OPTIONS THAT INTEGRATE RECOVERY WITH PRACTICAL INDEPENDENT LIVING SKILLS. ADULT TRANSITION HOMES AND APARTMENTS WITH SUPPORTED LIVING ARRANGEMENTS ARE OFFERED WHEN LESS THAN A SUPERVISED ENVIRONMENT ARE REQUIRED. 450472 0 187726 11636321 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 26 0 1 176 1 0 0 0 0 0 1 1 0 0 0 0 0 0 X 7 7 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 X DAWN BROWN 3604570431 118 EAST 8TH STREET PORT ANGELES WA 98362 WENDY SISK CHIEF EXECUTIVE OFFICER 40.00 X 223769 0 42434 JOSEPH REIS CHIEF MEDICAL OFFICER 40.00 X 217667 0 41317 MARGARET DEPEW PSYCHIATRIC ARNP 40.00 X 164003 0 33070 DANIELLE DEOLIVEIRA PSYCHIATRIC ARNP 36.00 X 155339 0 38018 LINDA BOARDMAN PSYCHIATRIC ARNP 40.00 X 163713 0 28458 DAWN BROWN CHEF FINANCIAL OFFICER 40.00 X 169685 0 20550 KATHY STEVENS CHIEF OPERATIONS OFFICER 40.00 X 157496 0 23832 TIMI IDDINGS PSYCHIATRICT ARNP 36.00 X 138962 0 28545 CHRISTINE BURNELL PRIMARY CARE ARNP 40.00 X 139242 0 18174 DAVID ARAND PRESIDENT 2.00 X X 0 0 0 RUSS BRITTON PRESIDENT (THRU 4/26) 2.00 X X 0 0 0 TOM O'DONNELL VICE PRESIDENT 2.00 X X 0 0 0 MIKE HILL TREASURER 2.00 X X 0 0 0 JODY COPELAND TREASURER (THRU 5/16) 2.00 X X 0 0 0 DESI LARSON SECRETARY 2.00 X X 0 0 0 MARCH PICKER BOARD MEMBER 2.00 X 0 0 0 ELIZABETH CHRISTIAN BOARD MEMBER 2.00 X 0 0 0 VICKI LOWE BOARD MEMBER 2.00 X 0 0 0 1529876 0 274398 17 0 1 0 ALL IN ONE SERVICES LLC 9321 OLD OLYMPIC HIGHWAY SEQUIM WA 98382 CONSTRUCTION 962037 GENOA HEALTHCARE COMPANY PO BOX 856494 MINNEAPOLIS MN 55485 MEDICATION FOR MEDICAL SERVICES 222235 QUALIFACTS SYSTEMS INC PO BOX 4577 CAROL STREAM IL 60197 ELECTRONIC HEALTH RECORD SOFTWARE 173737 MOSS ADAMS LLP 999 3RD AVENUE STE 2800 SEATTLE WA 98104 ACCOUNTING SERVICES 119123 4 43988 111000 658150 813138 FIMC CONTRACT 624100 12610430 12610430 LOCAL GOVERNMENT CONTRACTS 624100 2008618 2008618 PRIMARY CARE MEDICAL SERVICES 621110 877158 877158 RESIDENTIAL SUPPORTED LIVING CARE 623990 231345 231345 OTHER PATIENT REVENUE 621110 3335 3335 15730886 141270 141270 12287 0 12287 12287 12287 465000 340453 124547 124547 124547 20750 111000 47286 -26536 -26536 16795592 15730886 0 251568 456960 456960 924254 434269 401029 88956 8658165 6871138 1787027 444828 320572 124256 1807381 1365027 442354 791461 621965 169496 11126 4178 6948 128947 3907 125040 131027 89086 41941 27944 356 27588 356605 196236 160369 468493 221205 247288 481409 176673 304736 89379 45524 43855 8274 8274 141856 71179 70677 677805 425611 252194 288867 288867 PROGRAM OPERATIONS 237857 237641 216 DUES, FEES, LICENSES 72725 34080 38645 TRAINING 66338 60714 5624 WA STATE B&O TAXES 21800 0 21800 16293501 11636321 4568224 88956 3451000 3562122 2727253 3702007 1672280 931075 124172 36442 215790 192493 17052685 4146369 12533348 12906316 515331 536797 169967 46205 21409141 21913457 990834 1333331 772490 714867 1297169 942587 4528038 4599971 7588531 7590756 X 13820610 14322701 13820610 14322701 21409141 21913457 502091 0 X 0 1 X 1 0 X 654517 2868958 3466800 311659 813138 8115072 10684716 11707233 15761691 15698095 15730886 69582621 11339233 14576191 19228491 16009754 16544024 77697693 16307 9210 10369 6227 12697 54810 0 16307 9210 10369 6227 12697 54810 77642883 43399 31524 16754 293674 153557 538908 43399 31524 16754 293674 153557 538908 11382632 14607715 19245245 16303428 16697581 78236601 0.99240 0.99320 0.00690 0.00580 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 26343 731 27074 24201 2142 26343 28540 -4339 24201 23444 5138 42 28540 22563 881 23444 1.00000 0.00000 0.00000 1 0 1988554 1988554 4966659 1060012 3906647 7837920 1950390 5887530 1965706 1135967 829739 293846 293846 12906316 REFUNDABLE ADVANCE 4580840 LEASE LIABILITY 19131 4599971 X 16842878 0 16842878 -47286 -47286 16795592 16340787 47286 47286 16293501 0 16293501 PART V, LINE 4: FUNDS ARE HELD BY CLALLAM COMMUNITY FOUNDATION, CANNOT BE SPENT WITHOUT PENINSULA BEHAVIORAL HEALTH APPROVAL AND CURRENTLY ARE NOT BEING DRAWN FROM. THE INTENDED USE OF THE FUNDS IS TO HELP SUPPORT PROGRAM OPERATIONS. PART X, LINE 2: THE ORGANIZATION IS NOT SUBJECT TO INCOME TAX, BECAUSE IT IS A TAX-EXEMPT ORGANIZATION UNDER INTERNAL REVENUE CODE SECTION 501(C)(3). ACCORDINGLY, NO PROVISION FOR INCOME TAX IS INCLUDED IN THESE FINANCIAL STATEMENTS. FOR THE 2024 AND 2023 FINANCIAL STATEMENTS, THE ORGANIZATION HAS ACCOUNTED FOR UNCERTAIN TAX POSITIONS WHEREBY THE EFFECT OF THE UNCERTAINTY WOULD BE RECORDED IF THE OUTCOME WAS CONSIDERED PROBABLE AND WAS REASONABLY ESTIMABLE. AS OF JUNE 30, 2024 AND 2023, THE ORGANIZATION HAD NOT IDENTIFIED ANY UNCERTAIN TAX POSITIONS REQUIRING ACCRUAL OR DISCLOSURE. PART XI, LINE 4B - OTHER ADJUSTMENTS: FUNDRAISING EVENT EXPENSES -47,286. PART XII, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EVENT EXPENSES 47,286. GALA 131750 111000 20750 1570 16192 28644 880 131750 111000 20750 1570 16192 28644 880 47286 -26536 1 PATIENT MEDICATION, TRANSPORTATION AND LIVING ASSISTANCE 56 281095 PATH HOUSING ASSISTANCE 121 174077 PBH COMMUNITY FUND PHARMACY ASSISTANCE 14 1788 PART I, LINE 2: FUNDS ARE PROVIDED TO INDIGENT PATIENTS WHO ARE IN NEED OF ASSISTANCE WITH PAYING FOR PRESCRIBED MEDICATIONS, TRANSPORTATION AND OTHER LIVING NECESSITIES. SUBSTANTIATION IS REQUIRED TO BE PROVIDED BEFORE FUNDS ARE GIVEN. X X 0 0 0 0 0 0 0 0 0 WENDY SISK CHIEF EXECUTIVE OFFICER 190269 0 33500 0 0 0 13924 0 28510 0 266203 0 0 0 JOSEPH REIS CHIEF MEDICAL OFFICER 214167 0 3500 0 0 0 11177 0 30140 0 258984 0 0 0 MARGARET DEPEW PSYCHIATRIC ARNP 159915 0 4088 0 0 0 11486 0 21584 0 197073 0 0 0 DANIELLE DEOLIVEIRA PSYCHIATRIC ARNP 151839 0 3500 0 0 0 7878 0 30140 0 193357 0 0 0 LINDA BOARDMAN PSYCHIATRIC ARNP 160213 0 3500 0 0 0 8093 0 20365 0 192171 0 0 0 DAWN BROWN CHEF FINANCIAL OFFICER 166185 0 3500 0 0 0 9362 0 11188 0 190235 0 0 0 KATHY STEVENS CHIEF OPERATIONS OFFICER 153448 0 4048 0 0 0 10977 0 12855 0 181328 0 0 0 TIMI IDDINGS PSYCHIATRICT ARNP 135462 0 3500 0 0 0 6962 0 21583 0 167507 0 0 0 CHRISTINE BURNELL PRIMARY CARE ARNP 135742 0 3500 0 0 0 6986 0 11188 0 157416 0 0 0 A WASHINGTON HEALTHCARE FACILITIES AUTHORITY 911108929 2014-08-22 1292000 8TH STREET PROPERTY 0 0 0 A 533194 1292000 1292000 2004 1 0 1 1 A 0 1 0 0 0.01000 0.00000 0.01000 0 0 1 A 0 0 1 0 1 0 0 0 1 A 1 FORM 990, PART VI, SECTION B, LINE 11B THE PREPARED FORM 990 IS REVIEWED FIRST BY THE CHIEF FINANCIAL OFFICER, THEN THE CHIEF EXECUTIVE OFFICER FOR RECOMMENDATION TO THE BOARD FOR FORMAL APPROVAL BEFORE FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C ALL BOARD MEMBERS SHALL SUBMIT, UPON ASSUMING THEIR POSITIONS AND THEREAFTER, ANNUAL IN WRITING TO THE PRESIDENT OF THE PENINSULA BEHAVIORAL HEALTH BOARD, A LIST OF ALL BUSINESSES OR OTHER ORGANIZATIONS OF WHICH HE OR SHE IS AN OFFICER, MEMBER, OWNER OR EMPLOYEE, OR FOR WHICH HE OR SHE ACTS AS AN AGENCY WITH WHICH PENINSULA BEHAVIORAL HEALTH HAS ENTERED, OR MIGHT REASONABLY IN THE FUTURE ENTER INTO A RELATIONSHIP OR A TRANSACTION WHERE PENINSULA BEHAVIORAL HEALTH MIGHT COMPETE AGAINST SUCH ORGANIZATION AND IN WHICH THE BOARD MEMBER OR EXECUTIVE WOULD HAVE CONFLICTING INTERESTS. THE PRESIDENT OF THE BOARD SHALL BECOME FAMILIAR WITH THE STATEMENTS OF ALL BOARD MEMBERS IN ORDER TO GUIDE HIS OR HER CONDUCT IN CHAIRING MEETINGS SHOULD A CONFLICT ARISE. WHEN ANY MATTERS COMES BEFORE THE BOARD AND RAISES THE ISSUE OF A CONFLICT FOR BOARD MEMBERS, THE AFFECTED BOARD MEMBER SHALL MAKE KNOWN THE POTENTIAL CONFLICT, WHETHER DISCLOSED BY WRITTEN STATEMENT OR NOT. DISCLOSURE SHOULD BE MADE AS SOON AS POSSIBLE AS PRACTICABLE AS TO AVOID ANY ADVERTENT HARM TO PENINSULA BEHAVIORAL HEALTH. THE MEMBER SHALL ANSWER ANY QUESTIONS THAT MIGHT BE ASKED BY OTHER BOARD MEMBERS OR LEGAL COUNSEL. THE PRESIDENT, WITH THE ASSISTANCE OF LEGAL COUNSEL, MAY REQUEST THE BOARD MEMBER TO: 1. REFRAIN FROM PARTICIPATING IN THE DISCUSSION INVOLVING THE CONFLICT. 2. LEAVE THE ROOM WHILE THE MATTER IS BEING DISCUSSED. 3. REFRAIN FROM VOTING ON ANY MATTER RELATED TO THE ISSUE. FORM 990, PART VI, SECTION B, LINE 15A CEO COMPENSATION IS REVIEWED ANNUALLY UTILIZING SALARY SURVEY DATA SPECIFIC TO OUR INDUSTRY. THE HR DIRECTOR REVIEWS AND MAKES RECOMMENDATIONS FOR ANY CHANGES. THE BOARD PROVIDES A PERFORMANCE EVALUATION FOR THE CEO ALONG WITH APPROVING COMPENSATION INCREASES AND BONUSES. OTHER OFFICER AND KEY EMPLOYEE COMPENSATION INCREASES ARE DETERMINED ANNUALLY DURING THE BUDGETING PROCESS, ALONG WITH OTHER STAFF COMPENSATION INCREASES, AND APPROVED BY THE BOARD VIA THE BUDGET APPROVAL PROCESS. PERFORMANCE EVALUATIONS ARE COMPLETED AND THEN RAISE PERCENTAGES DETERMINED BY EXECUTIVE MANAGEMENT, STAYING WITHIN BUDGETED GUIDELINES APPROVED DURING THE BUDGET CYCLE. FORM 990, PART VI, SECTION C, LINE 18 COPIES OF THE ORGANIZATION'S FORM 990 AND FORM 1023 APPLICATION ARE MAINTAINED IN THE OFFICE OF THE CFO. THE DOCUMENTS ARE AVAILABLE FOR PUBLIC INSPECTION DURING REGULAR BUSINESS HOURS BY REQUESTING THE RECEPTIONIST TO CALL EXTENSION 199, OR BY MAIL DIRECTED TO THE CFO, 118 E. 8TH ST., PORT ANGELES, WA 98362 OR BY FAXING A REQUEST TO THE CFO AT FAX NUMBER (360) 457-0493. FORM 990, PART VI, SECTION C, LINE 19 COPIES OF THE AUDITED FINANCIAL STATEMENTS ARE MAINTAINED IN THE OFFICE OF THE CFO. THE INFORMATION IS AVAILABLE FOR PUBLIC INSPECTION DURING BUSINESS HOURS OF 9:00 A.M. TO 4:00 P.M. BY REQUESTING THE RECEPTIONIST TO CALL EXTENSION 199, OR BY MAIL DIRECTED TO THE CFO, 118 E. 8TH ST., PORT ANGELES, WA 98362 OR BY FAXING A REQUEST TO THE CFO AT FAX NUMBER (360) 457-0493. THE ORGANIZATION'S GOVERNING DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC BY CONTACTING THE CEO'S OFFICE AT (360) 457-0431, EXT. 154. THE ORGANIZATION'S CONFLICT OF INTEREST POLICY IS MADE AVAILABLE FOR PUBLIC VIEWING AND IS POSTED ON THE RECEPTION AREA BULLETIN BOARD.