2022-05-12T19:26:27-05:00 2021-06-30 351178661 BLUE & CO LLC 500 N MERIDIAN ST SUITE 200 INDIANAPOLIS IN 46204 990 2020-07-01 351534713 ADULT & CHILD MENTAL HEALTH CENTER INC ADUL 3178825122 222 E OHIO ST INDIANAPOLIS IN 46204 YADIRA HOWE CFO 3178825122 2022-05-12 1 YADIRA HOWE 999009999 NATHAN A RODGERS CPA P01568275 3176334705 2022-05-12 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z ADULT & CHILD HEALTH ALLEN BROWN 222 E OHIO STREET INDIANAPOLIS IN 46204 45433179 0 X WWW.ADULTANDCHILD.ORG X 1982 IN WITH HOPE, COMPASSION, AND CREATIVITY WE DELIVER LIFE-ENHANCING PHYSICAL, SOCIAL, AND BEHAVIORAL HEALTHCARE SERVICES. 12 12 785 12 99241 91253 8849466 10997578 36675313 32892118 662661 20199 491972 893495 46679412 44803390 0 0 0 0 34627771 34174831 0 0 0 10714669 10244320 45342440 44419151 1336972 384239 27963136 28911092 10882764 11342862 17080372 17568230 X OUR MISSION: WITH HOPE, COMPASSION, AND CREATIVITY WE DELIVER LIFE-ENHANCING PHYSICAL, SOCIAL, AND BEHAVIORAL HEALTHCARE SERVICES. [ORGANIZATION'S MISSION CONTINUED ON SCHEDULE O] 0 0 34384228 29274086 1. THE ORGANIZATION IS A LICENSED COMMUNITY HEALTH CENTER, CERTIFIED FEDERALLY QUALIFIED HEALTH CENTER LOOK ALIKE AND A LICENSED CHILD PLACEMENT AGENCY WITH THE PURPOSE OF HEALTH AND WELLNESS BY ESTABLISHING, MAINTAINING AND PROMOTING A COMMUNITY ORGANIZATION THAT PROVIDES HIGH QUALITY HEALTH CARE AND SOCIAL SERVICES TO AN UNDERSERVED POPULATION. THE SERVICES PROVIDED BY THE ORGANIZATION INCLUDE PRIMARY CARE, PSYCHIATRIC CARE, THERAPEUTIC CARE, SCHOOL-BASED SERVICES, SUPPORTIVE HOUSING, SUPPORTIVE EMPLOYMENT, THERAPEUTIC FOSTER CARE, AND ADDICTIVE DISEASE SERVICES. THE ORGANIZATION ACCEPTS PATIENTS REGARDLESS OF THEIR INDIVIDUAL ABILITY TO PAY, THEIR RACE, AGE, SEX, CREED, SEXUAL ORIENTATION OR NATIONAL ORIGIN. 1513663 3618032 THERAPEUTIC FOSTER CARE 35897891 1 0 0 0 0 0 0 0 1 0 1 1 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 35 0 1 785 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 12 12 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 IN X YADIRA HOWE CFO 3178825122 222 E OHIO STREET INDIANAPOLIS IN 46204 TOM GAUNT CHAIR 1.00 X X 0 0 0 JOE VILLANUEVA VICE CHAIR 1.00 X X 0 0 0 SUE COLLINS RN SECRETARY 1.00 X X 0 0 0 JOEL GITHIRI TREASURER 1.00 X X 0 0 0 AMBER CLARKE MEMBER 1.00 X 0 0 0 COLLEEN GORE MEMBER 1.00 X 0 0 0 ROBERT HURLEY MEMBER 1.00 X 0 0 0 DENNIS DJ MAHLER MEMBER 1.00 X 0 0 0 CAROLE MCKINNEY MEMBER 1.00 X 0 0 0 LESLIE KELLY MEMBER 1.00 X 0 0 0 DAWN SHIMP MEMBER 1.00 X 0 0 0 BARBARA THURMAN MEMBER 1.00 X 0 0 0 ALLEN BROWN CHIEF EXECUTIVE OFFICER 40.00 X 270640 0 32686 YADIRA HOWE CHIEF FINANCIAL OFFICER 40.00 X 139308 0 24732 DAN ARENS COO 40.00 X 152614 0 31826 CHARLES COATS MD ASSOCIATE MEDICAL OFFICER 20.00 X 228829 0 38625 CHRISTINE NEGENDANK MD CHIEF MEDICAL OFFICER 40.00 X 264831 0 19101 YOLANDA BRAY APRN BEHAVIORAL HEALTH 40.00 X 123221 0 17911 ANNETTE KLEINHENZ APRN BEHAVIORAL HEALTH 40.00 X 121657 0 24400 JESSICA BISSEY CHIEF CLINICAL OFFICER 40.00 X 119687 0 13092 NICOLETTE BAER APRN BEHAVIORAL HEALTH 40.00 X 108906 0 33722 TINA BAXTER APRN BEHAVIORAL HEALTH 40.00 X 118481 0 25865 1648174 0 261960 17 0 1 0 STAR CARE LLC 11550 TOWNSEND COURT FISHERS IN 46037 CONTRACT PRESCRIBERS I.E. PSYCHIATRISTS 339550 LOCUMTENENSCOM PO BOX 405547 ATLANTA GA 30384 CONTRACT PRESCRIBERS I.E. PSYCHIATRISTS 162225 2 10753507 244071 10997578 NET PATIENT REVENUE 900099 27232092 27232092 MEDICARE/MEDICAID PMTS 900099 2987687 2987687 340B REVENUE 900099 2330124 2330124 BEHAVIORAL HEALTH, PRIMARY CARE, 900099 342215 342215 32892118 6477 6477 705865 581522 124343 124343 99241 25102 61989 48267 13722 13722 13722 769152 769152 769152 44803390 32892118 99241 814453 1056222 1056222 25447176 22123274 3323902 805597 656005 149592 4809532 3916447 893085 2056304 1674468 381836 18269 10290 7979 68935 38829 30106 2709384 1526123 1183261 29268 23079 6189 1040224 599841 440383 1806600 1331169 475431 123734 121564 2170 13840 10914 2926 106940 82685 24255 1108739 909817 198922 482683 396083 86600 RESIDENTIAL SERVICES 1513663 1513663 CLIENT EXPENSES 676018 533074 142944 STAFF RECRUITMENT AND D 261335 206076 55259 284688 224490 60198 44419151 35897891 8521260 0 525042 583686 3877929 4978257 1209692 965617 3476287 2891656 504973 409824 33381362 18239174 14352260 15142188 298504 368544 1787682 1768077 1930767 1803243 27963136 28911092 2965499 3813674 5553437 5211687 72068 73021 1313912 1164121 977848 1080359 10882764 11342862 X 17080372 17568230 17080372 17568230 27963136 28911092 X 384239 -34414 138033 X X 0 1 X 1 1 1 X SCHEDULE A, PART I, LINE 3: ADULT & CHILD MENTAL HEALTH CENTER, INC. HAS BEEN DETERMINED BY THE IRS TO BE A PUBLIC CHARITY UNDER IRS CODE SECTION 170(B)(1)(A)(III). THE ORGANIZATION PROVIDES A COMPREHENSIVE NETWORK OF PREVENTATIVE, DIAGNOSTIC, THERAPEUTIC AND REHABILITATIVE MEDICAL AND MENTAL HEALTH SERVICES, BUT DOES NOT MAINTAIN AN INPATIENT UNITY, AND IS NOT REQUIRED TO BE LICENSED AS A HOSPITAL FOR THE STATE OF INDIANA. SCHEDULE H IS NOT REQUIRED AS ONLY ORGANIZATIONS THAT OPERATE AT LEAST ONE FACILITY THAT IS, OR IS REQUIRED TO BE, LICENSED, REGISTERED, OR SIMILARLY RECOGNIZED BY THE STATE AS A HOSPITAL. 0 1 X 2895533 125959 3021492 13453042 5340672 10391624 8402090 372593 193114 411484 154223 1406502 7945504 7436066 1915940 1648443 1648443 15142188 PROMISSORY NOTE RED OAK INDUSTRIES 60000 C RED OAK INDUSTRIES INVESTMENT 60000 C A&C RESIDENTIAL PROPERTIES 1648077 C 1768077 457 PLAN ASSETS 106699 OTHER RECEIVABLES 150248 RENT RECEIVABLE 87268 RECEIVABLE - MENTAL HEALTH REVENUE 1459028 1803243 DEFERRED COMPENSATION 106699 ESTIMATED THIRD PARTY SETTLEMENTS 827229 DERIVATIVE LIABILITY 146431 1080359 X PART IV, LINE 2B: THE ORGANIZATION IS AN AGENT FOR SOCIAL SECURITY FUNDS HELD FOR PATIENTS - REPRESENTATIVE PAYEE ACCOUNTS. THERE IS A CORRESPONDING ASSET REPORTED IN FORM 990, PART X. PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE CORPORATION AND RECOGNIZE A TAX LIABILITY IF THE CORPORATION HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY VARIOUS FEDERAL AND STATE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE CORPORATION, AND HAS CONCLUDED THAT AS OF JUNE 30, 2021 AND 2020, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. THE CORPORATION IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. X X X 0 0 0 0 0 0 0 0 0 ALLEN BROWN CHIEF EXECUTIVE OFFICER 245640 0 25000 0 0 0 8870 0 23816 0 303326 0 0 0 CHRISTINE NEGENDANK MD CHIEF MEDICAL OFFICER 253121 0 11710 0 0 0 10659 0 8442 0 283932 0 0 0 CHARLES COATS MD ASSOCIATE MEDICAL OFFICER 228829 0 0 0 0 0 9648 0 28977 0 267454 0 0 0 DAN ARENS COO 145032 0 7582 0 0 0 2849 0 28977 0 184440 0 0 0 YADIRA HOWE CHIEF FINANCIAL OFFICER 131908 0 7400 0 0 0 5484 0 19248 0 164040 0 0 0 A INDIANA FINANCE AUTHORITY 351602316 2016-02-25 6835000 SEE PART VI 0 0 0 A 598063 6835000 90620 6744380 0 0 0 1 A 0 1 1 1 0 0.22150 0.12630 0.34780 0 0 0 A 0 1 0 0 1 1 PNC 10.000000000000 0 0 0 0 1 A 1 SCHEDULE K, PART I, LINE A, COULMN F: THE PROCEEDS OF THE PROJECT BONDS WILL BE LOANED TO THE BORROWER FOR THE PURPOSE OF FINANCING, REFINANCING OR REIMBURSING ALL OR A PORTION OF: (I) THE ACQUISITION, CONSTRUCTION, RENOVATION AND EQUIPPING OF APPROXIMATELY 77,145 SQUARE FOOT HEALTH CARE FACILITY LOCATED AT 603 E. WASHINGTON STREET, INDIANAPOLIS, IN 46204, TOGETHER WITH THE PURCHASE OF EQUIPMENT AND FURNISHINGS TO BE LOCATED HEREIN; (II) THE RENOVATION OF APPROXIMATELY 5,550 SQUARE FEET OF AN APPROXIMATELY 56,400 SQUARE FOOT HEALTH CARE FACILITY LOCATED AT 222 E. OHIO STREET, INDIANAPOLIS, IN 46204 TOGETHER WITH THE PURCHASE OF EQUIPMENT AND FURNISHINGS TO BE LOCATED HEREIN; (III) THE RENOVATION OF APPROXIMATELY 7,434 SQUARE FEET OF AN APPROXIMATELY 14,900 SQUARE FOOT HEALTH CARE FACILITY LOCATED AT 1860 AND 1866 NORTHWOOD PLAZA DRIVE, FRANKLIN, IN 46131 TOGETHER WITH THE PURCHASE OF EQUIPMENT AND FURNISHINGS TO BE LOCATED HEREIN. FORM 990, PART I, ITEM C DBA: ADULT AND CHILD CENTER FORM 990, PART III, LINE 1: [ORGANIZATION'S MISSION CONTINUED] OUR VISION: WE STRIVE FOR CARING COMMUNITIES, WHERE EVERY CHILD, ADULT, AND FAMILY HAVE OPPORTUNITIES TO LIVE HEALTHY, HAPPY LIVES. OUR VALUES: THE FOLLOWING VALUE AND BELIEF STATEMENTS ARE THE FOUNDATION OF THE SERVICES WE PROVIDE: -WE BELIEVE IN PEOPLE AND THE STRENGTH OF DIVERSITY. WE DEEPLY RESPECT THE IDEAS, BACKGROUNDS, AND LIVED EXPERIENCES OF THOSE WE SERVE TO CREATE SAFE, INCLUSIVE ENVIRONMENTS WHERE EVERYONE IS WELCOME. -WE BELIEVE IN MEETING PEOPLE WHERE THEY ARE. EVERYONE'S ROAD TO RECOVERY AND WELLNESS HAS A DIFFERENT ROUTE, DESTINATION, AND ETA. AS PARTNERS IN HEALTH, WE ARE FLEXIBLE WHEN ADDRESSING EACH PERSON'S NEEDS. -WE LOVE WHAT WE DO AND A GENUINE DESIRE TO IMPROVE LIVES DRIVES US FORWARD. WORKING HARD AND PLAYING HARD BUILDS THE STRONG TEAMS NEEDED FOR OUR MISSION-DRIVEN CULTURE. -WHATEVER WE DO, WE DO WELL. WE ARE DEDICATED TO THE BEST QUALITY OF CARE AND QUALITY OF LIFE FOR THE PERSONS WE SERVE. WE USE DATA TO SET PERFORMANCE GOALS, MEASURE PROGRESS TOWARD THOSE GOALS, AND EMBRACE THE LEARNING OPPORTUNITIES THAT INFORM OUR WORK. -WE ARE CHAMPIONS FOR HEALTH EQUITY AND THE PROMISE OF HEALTHY COMMUNITIES. WE BELIEVE IN HIGH QUALITY, AFFORDABLE HEALTHCARE AND SOCIAL SERVICES FOR ALL. FORM 990, PART VI, SECTION B, LINE 11B THE PROCESS OF REVIEWING THE FORM 990 INCLUDES A DETAILED REVIEW OF THE FORMS AND REQUESTED SCHEDULES BY THE CHIEF FINANCIAL OFFICER. ADDITIONALLY, EACH VOTING MEMBER OF THE ORGANIZATION'S GOVERNING BODY IS PROVIDED WITH A COPY OF THE FORM 990 INCLUDING REQUESTED SCHEDULES, AS ULTIMATELY FILED WITH THE IRS, FOR REVIEW AND APPROVAL PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C EACH BOARD MEMBER AND OFFICER ARE REQUIRED TO SUBMIT ANNUALLY INFORMATION REGARDING CONFLICTS OF INTEREST AND POSSIBLE CONFLICTS OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION PACKAGE FOR THE CEO IS SET BY THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS AND APPROVED BY THE ENTIRE BOARD. THE EXECUTIVE COMMITTEE USES THE ANNUAL SALARY SURVEY CONDUCTED BY THE INDIANA COUNCIL OF COMMUNITY MENTAL HEALTH CENTERS AND OTHER APPLICABLE SALARY SURVEYS. SALARIES OF OTHER OFFICERS AND KEY EMPLOYEES ARE SET IN A SIMILAR FASHION BY THE CEO. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE BY REQUEST. THE ORGANIZATION'S ANNUAL REPORT IS AVAILABLE ON ITS WEB PAGE AT WWW.ADULTANDCHILD.ORG IN "ANNUAL REPORTS" SECTION UNDER THE "ABOUT US DROP DOWN MENU. THE ARTICLES OF INCORPORATION CAN BE VIEWED ON THE INDIANA SECRETARY OF STATE WEBPAGE. FORM 990, PART XI, LINE 9: UNREALIZED LOSS ON DERIVATIVE 138,033. FORM 990, PART XII, LINE 2C, OVERSIGHT OF AUDIT: THE BUDGET AND FINANCE COMMITTEE ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE FINANCIAL STATEMENTS AUDIT AND PROVIDES RECOMMENDATIONS TO THE BOARD OF DIRECTORS FOR APPROVAL. LIKEWISE, THE COMMITTEE ASSUMES RESPONSIBILITY FOR THE SELECTION OF THE INDEPENDENT AUDITORS BY REVIEWING POSSIBLE PROPOSALS AND MAKING RECOMMENDATIONS FOR APPROVAL TO THE BOARD OF DIRECTORS. NO PROCESSES HAVE CHANGED FROM PRIOR YEAR. ADULT & CHILD RESIDENTIAL PROPERTIES LLC 222 E OHIO STREET STE 400 INDIANAPOLIS IN 46204 475591352 RESIDENTIAL RENTAL PROPERTY IN ADULT & CHILD MENTAL HEALTH CENTER C -19605 2097147 1.00000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 ADULT & CHILD RESIDENTIAL PROPERTIES LLC P