BETA

BE THE CHANGE IN MENTAL HEALTH: Form 990EZ, tax year 2021

View the entire original 990 at ProPublica ↗

Organization
BE THE CHANGE IN MENTAL HEALTH (EIN 85-1043181)
Tax period
2021-01-01 to 2021-12-31
Filed
2022-11-14
IRS object ID
202213189349209071
Schema version
2021v4.2
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2022-11-14T18:51:06-06:00ReturnTs
Tax Period End2021-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN814234542PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1BPM LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line14200 BOHANNON DRIVE SUITE 250AddressLine1Txt
CityMENLO PARKCityNm
State AbbreviationCAStateAbbreviationCd
ZIP940251021ZIPCd
FieldValueIRS element (for citing)
Return Type990EZReturnTypeCd
Tax Period Begin2021-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN851043181EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1BE THE CHANGE IN MENTAL HEALTHBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlBETHBusinessNameControlTxt
Phone5306802810PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line12800 CLEVELAND AVENUE SUITE CAddressLine1Txt
CitySANTA ROSACityNm
State AbbreviationCAStateAbbreviationCd
ZIP95403ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonMARISHA CHILCOTT MDPersonNm
Person TitleCEO/CMOPersonTitleTxt
Phone5306802810PhoneNum
Signature2022-11-14SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstMARISHAPersonFirstNm
Person LastCHILCOTT MDPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonTAMARA L MCINERNEYPreparerPersonNm
PTINP00011797PTIN
Phone6508556800PhoneNum
Preparation2022-11-14PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer3TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2021TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990-EZ IRS990EZ

FieldValueIRS element (for citing)
Method Of Accounting CashYes (X)MethodOfAccountingCashInd
Website AddressWWW.BTCMENTALHEALTH.ORGWebsiteAddressTxt
Organization501c3Yes (X)Organization501c3Ind
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Gross Receipts$121,999GrossReceiptsAmt
Info In Schedule O Part IYes (X)InfoInScheduleOPartIInd
Contributions Gifts Grants Etc$121,998ContributionsGiftsGrantsEtcAmt
Program Service Revenue$1ProgramServiceRevenueAmt
Total Revenue$121,999TotalRevenueAmt
Salaries Other Comp Empl Bnft$15,298SalariesOtherCompEmplBnftAmt
Fees And Other Pymt To Ind Cntrct$3,808FeesAndOtherPymtToIndCntrctAmt
Occupancy Rent Utlts And Maint$15,155OccupancyRentUtltsAndMaintAmt
Printing Publications Postage$272PrintingPublicationsPostageAmt
Other Expenses Total$31,356OtherExpensesTotalAmt
Total Expenses$65,889TotalExpensesAmt
Excess Or Deficit For Year$56,110ExcessOrDeficitForYearAmt
Net Assets Or Fund Balances BOY$16,925NetAssetsOrFundBalancesBOYAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Net Assets Or Fund Balances EOY$73,035NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIYes (X)InfoInScheduleOPartIIInd

Cash Savings And Investments CashSavingsAndInvestmentsGrp

FieldValueIRS element (for citing)
BOY$6,078BOYAmt
EOY$0EOYAmt

Other Assets Total Detail OtherAssetsTotalDetail

FieldValueIRS element (for citing)
BOY$11,082BOYAmt
EOY$73,462EOYAmt

Form990 Total Assets Form990TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$17,160BOYAmt
EOY$73,462EOYAmt

Sum Of Total Liabilities SumOfTotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$235BOYAmt
EOY$427EOYAmt

Net Assets Or Fund Balances NetAssetsOrFundBalancesGrp

FieldValueIRS element (for citing)
BOY$16,925BOYAmt
EOY$73,035EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
Primary Exempt PurposeTO BRING PSYCHEDELIC-ASSISTED PSYCHOTHERAPY TO THE PUBLIC IN A SAFE, MEDICALLY SUPERVISED AND MANAGED, LEGAL MANNER. TO CREATE THE SCALABLE MODEL BY WHICH THIS LIFE-SAVING THERAPY CAN BE DELIVERED TO MILLIONS OF HUMANS ACROSS THE SOCIOECONOMIC SPECTRUM. TO SERVE ALL PEOPLE WITH A NEED THAT CAN BE MET AND A SELF-MOTIVATED DESIRE TO BE WELL, REGARDLESS OF ABILITY TO PAY, COLOR OF SKIN, RELIGIOUS OR POLITICAL AFFILIATION, GENDER OR SEXUAL ORIENTATION. TO REDEFINE/RE-ORGANIZE/RESTRUCTURE THE SERVICE OF MENTAL HEALTH TREATMENT FROM THAT OF ON-GOING PHARMACOLOGIC DRUG USE AND RECURRENT THERAPY SESSIONS TO THAT OF RESULTS/OUTCOME-DRIVEN PACKAGES THAT ARE INCENTIVIZED BY RESOLUTION OF THE ISSUE AND STAIR-STEP PROGRESS TOWARD CURE OF ILLNESS.PrimaryExemptPurposeTxt

Program Srvc Accomplishment ProgramSrvcAccomplishmentGrp

FieldValueIRS element (for citing)
Description Program Srvc AccomIN 2021, BE THE CHANGE IN MENTAL HEALTH WAS BUILDING THE CLINIC AND TEAM.DescriptionProgramSrvcAccomTxt
Grants And Allocations$0GrantsAndAllocationsAmt
Program Service Expenses$3,858ProgramServiceExpensesAmt
FieldValueIRS element (for citing)
Total Program Service Expenses$3,858TotalProgramServiceExpensesAmt

Officer Director Trustee Empl OfficerDirectorTrusteeEmplGrp (9 entries)

TitleTitleTxtAverage Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRtCompensationCompensationAmtEmployee Benefit ProgramEmployeeBenefitProgramAmtExpense Account Other AllwncExpenseAccountOtherAllwncAmt
TIMOTHY WEBB
BOARD MEMBER1.00$0$0$0
TRACY WEBB
BOARD MEMBER1.00$0$0$0
ETHAN SCHRAM
BOARD MEMBER1.00$0$0$0
KATHRYN LARSON
BOARD MEMBER1.00$0$0$0
LINDA MCMAHON
BOARD MEMBER1.00$0$0$0
MARISHA CHILCOTT MD
CEO/CMO20.00$0$0$0
SUSAN FETTE
CHAIRPERSON1.00$0$0$0
NANCY DILLON-SHORE
TREASURER1.00$0$0$0
MICHELLE CRIPPEN
SECRETARY, DIRECTOR OF OPERATIONS40.00$12,338$0$0
FieldValueIRS element (for citing)
Info In Schedule O Part VYes (X)InfoInScheduleOPartVInd
Activities Not Previously Rpt0ActivitiesNotPreviouslyRptInd
Chg Made To Orgnzng Doc Not Rpt0ChgMadeToOrgnzngDocNotRptInd
Organization Had UBI0OrganizationHadUBIInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Organization Dissolved Etc0OrganizationDissolvedEtcInd
Direct Indirect Pltcl Expend$0DirectIndirectPltclExpendAmt
Made Loans To From Officers0MadeLoansToFromOfficersInd
Tax Imposed Under IRC4911$0TaxImposedUnderIRC4911Amt
Tax Imposed Under IRC4912$0TaxImposedUnderIRC4912Amt
Tax Imposed Under IRC4955$0TaxImposedUnderIRC4955Amt
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
Tax Imposed On Organization Mgr$0TaxImposedOnOrganizationMgrAmt
Tax Reimbursed By Organization$0TaxReimbursedByOrganizationAmt
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
States Where Copy Of Return Is FldCAStatesWhereCopyOfReturnIsFldCd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1THE ORGANIZATIONBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line12800 CLEVELAND AVENUE SUITE CAddressLine1Txt
CitySANTA ROSACityNm
State AbbreviationCAStateAbbreviationCd
ZIP95403ZIPCd
FieldValueIRS element (for citing)
Phone5306802810PhoneNum
FieldValueIRS element (for citing)
Foreign Financial Account0ForeignFinancialAccountInd
Foreign Office0ForeignOfficeInd
Donor Advised Fnds0DonorAdvisedFndsInd
Operate Hospital0OperateHospitalInd
Tanning Services Provided0TanningServicesProvidedInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
School Operating0SchoolOperatingInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Part VI Of Comp Of Hghst Pd EmplNONEPartVIOfCompOfHghstPdEmplTxt
Part VI Hghst Pd Cntrct Prof SrvcNONEPartVIHghstPdCntrctProfSrvcTxt
Filed Schedule AYes (1)FiledScheduleAInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990-EZ, PART I, LINE 16 - OTHER EXPENSESDESCRIPTION: ADMINISTRATIVE EXPENSES. AMOUNT: 6,543. DESCRIPTION: MEALS. AMOUNT: 12. DESCRIPTION: MARKETING. AMOUNT: 5,550. DESCRIPTION: TRAVEL. AMOUNT: 870. DESCRIPTION: CONFERENCES, CONVENTIONS, MEETINGS. AMOUNT: 269. DESCRIPTION: BUSINESS EXPENSES. AMOUNT: 8,834. DESCRIPTION: PAYROLL TAXES. AMOUNT: 6,465. DESCRIPTION: PAYROLL FEES. AMOUNT: 408. DESCRIPTION: WORKERS COMPENSATION. AMOUNT: 349. DESCRIPTION: SUPPLIES. AMOUNT: 865. DESCRIPTION: MISC. EXPENSES. AMOUNT: 219. DESCRIPTION: BANKING. AMOUNT: 50. DESCRIPTION: STAFF DEVELOPMENT. AMOUNT: 922. TOTAL TO FORM 990-EZ, LINE 16: 31,356.
FORM 990-EZ, PART II, LINE 24 - OTHER ASSETSDESCRIPTION: LEASE DEPOSIT. BEG. OF YEAR AMOUNT: 4,416. END OF YEAR AMOUNT: 4,416. DESCRIPTION: PREPAID EXPENSES. BEG. OF YEAR AMOUNT: 6,666. END OF YEAR AMOUNT: 28,776. DESCRIPTION: CASH. BEG. OF YEAR AMOUNT: 0. END OF YEAR AMOUNT: -106. DESCRIPTION: OTHER DEPRECIABLE ASSETS. BEG. OF YEAR AMOUNT: 0. END OF YEAR AMOUNT: 40,376.
FORM 990-EZ, PART II, LINE 26 - OTHER LIABILITIESDESCRIPTION: CREDIT CARD PAYABLE. BEG. OF YEAR AMOUNT: 235. END OF YEAR AMOUNT: 427.

Transfer Prsnl Bnft Contracts Decl TransferPrsnlBnftContractsDecl

FieldValueIRS element (for citing)
DeclarationTHE ORGANIZATION DID NOT, DURING THE YEAR, RECEIVE ANY FUNDS, DIRECTLY,OR INDIRECTLY, TO PAY PREMIUMS ON A PERSONAL BENEFIT CONTRACT.THE ORGANIZATION, DID NOT, DURING THE YEAR, PAY ANY PREMIUMS, DIRECTLY,OR INDIRECTLY, ON A PERSONAL BENEFIT CONTRACT.DeclarationDesc

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