NORTHWINDS INTEGRATED HEALTH NETWORK IPA INC: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- NORTHWINDS INTEGRATED HEALTH NETWORK IPA INC (EIN 83-4123043)
- Tax period
- 2020-01-01 to 2020-12-31
- Filed
- 2021-11-10
- IRS object ID
- 202123149349306927
- Schema version
- 2020v4.1
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2021-11-10T17:20:55-06:00 | ReturnTs |
| Tax Period End | 2020-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 161131146 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BONADIO & CO LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7936 SENECA TPKE | AddressLine1Txt |
| City | CLINTON | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 13323 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2020-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 834123043 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NORTHWINDS INTEGRATED HEALTH NETWORK IPA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | NORT | BusinessNameControlTxt |
| Phone | 5186232590 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 22 US OVAL SUITE 218 | AddressLine1Txt |
| City | PLATTSBURGH | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 12903 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MARK LUKENS | PersonNm |
| Person Title | PRESIDENT | PersonTitleTxt |
| Phone | 5186232590 | PhoneNum |
| Signature | 2021-11-10 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | MARK | PersonFirstNm |
| Person Last | LUKENS | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | RICHARD ZWEIFEL | PreparerPersonNm |
| PTIN | P00085938 | PTIN |
| Phone | 3157977781 | PhoneNum |
| Preparation | 2021-11-10 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2020 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | MARK LUKENS | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 22 US OVAL SUITE 218 | AddressLine1Txt |
| City | PLATTSBURGH | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 12903 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $769,333 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | N/A | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2019 | FormationYr |
| Legal Domicile State | NY | LegalDomicileStateCd |
| Activity Or Mission | IT IS THE MISSION OF NORTHWINDS INTEGRATED HEALTH NETWORK IPA TO LEVERAGE OUR EXTENSIVE NETWORK OF COMMUNITY-BASED PROVIDERS TO CONNECT PEOPLE TO ESSENTIALS FOR LIVING AND HIGH QUALITY CARE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 6 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 6 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 14 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $1,434,494 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $769,333 | CYProgramServiceRevenueAmt |
| PY Investment Income | $0 | PYInvestmentIncomeAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $1,434,494 | PYTotalRevenueAmt |
| CY Total Revenue | $769,333 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $0 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $0 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $505,522 | PYOtherExpensesAmt |
| CY Other Expenses | $326,339 | CYOtherExpensesAmt |
| PY Total Expenses | $505,522 | PYTotalExpensesAmt |
| CY Total Expenses | $326,339 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $928,972 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $442,994 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $1,067,108 | TotalAssetsBOYAmt |
| Total Assets EOY | $1,441,475 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $138,136 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $69,509 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $928,972 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $1,371,966 | NetAssetsOrFundBalancesEOYAmt |
| Mission | IT IS THE MISSION OF NORTHWINDS INTEGRATED HEALTH NETWORK IPA TO LEVERAGE OUR EXTENSIVE NETWORK OF COMMUNITY-BASED PROVIDERS TO CONNECT PEOPLE TO ESSENTIALS FOR LIVING AND HIGH QUALITY CARE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $290,284 | ExpenseAmt |
| Revenue | $769,333 | RevenueAmt |
| Desc | ACCOMPLISHMENTS FOR 2020 INCLUDE THE ENGAGEMENT IN A LEVEL TWO RISK BASED CONTRACT THAT WILL SUPPORT THE ADVANCEMENT OF INTEGRATION OF PHYSICAL AND BEHAVIORAL HEALTH ACROSS THE REGION. THIS CONTRACT SUPPORTS THE SUCCESSFUL COMPLETION OF OUR WORKPLAN REQUIREMENTS WITH THE NYS OFFICE OF MENTAL HEALTH. ADDITIONALLY, NORTHWINDS CONTINUED ITS DATA AGGREGATION AND ANALYSIS BY UTILIZING MEDICAID CLAIMS DATA (PSYCKES), ALLOWING THE IPA TO EVALUATE INDIVIDUAL PROVIDER AND NETWORK PERFORMANCE ON KEY MEASURES. NORTHWINDS COLLABORATED EXTENSIVELY TO SUPPORT RURAL POPULATION HEALTH AND REGIONAL ALL-PAYER MODELS THAT ADVANCE QUALITY OF CARE FOR PATIENTS, COST SAVINGS AND IMPROVE PROVIDER SATISFACTION. | Desc |
| Total Program Service Expenses | $290,284 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | 0 | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | 0 | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 6 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 6 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | NY | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | REBECCA EVANSKY | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5186232590 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 22 US OVAL SUITE 218 | AddressLine1Txt |
| City | PLATTSBURGH | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 12903 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (15 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|
| MARK LUKENS | ||||||
| PRESIDENT | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| VALERIE AINSWORTH | ||||||
| TREASURER | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| CONNIE WILLIE | ||||||
| SECRETARY | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| RICHELLE GREGORY | ||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| TERRI MORSE | ||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| ANDREA DEEPE | ||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| JOANNE CASWELL | ||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| JAY ULRICH | ||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| MIKE KETTLE | ||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| JULIA BEEBE | ||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| BOB ROSS | ||||||
| VICE PRESIDENT | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| DAVID NELSON | ||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| JENNIFER BARRON | ||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| JAMES BUTTON | ||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| REBECCA EVANSKY | ||||||
| DIRECTOR OF OPERATIONS | 40.00 | Yes (X) | $49,993 | $0 | $7,977 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $49,993 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $7,977 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | 0 | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| COORDINATION OF INTERG | 624100 | $687,500 | $687,500 |
| MEMBERSHIP DUES | 624100 | $81,833 | $81,833 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $769,333 | TotalProgramServiceRevenueAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $769,333 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $769,333 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $154,577 | TotalAmt |
| Program Services | $131,390 | ProgramServicesAmt |
| Management And General | $23,187 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,539 | TotalAmt |
| Program Services | $19,158 | ProgramServicesAmt |
| Management And General | $3,381 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $29,691 | TotalAmt |
| Program Services | $25,237 | ProgramServicesAmt |
| Management And General | $4,454 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $46,910 | TotalAmt |
| Program Services | $46,910 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,925 | TotalAmt |
| Program Services | $5,657 | ProgramServicesAmt |
| Management And General | $4,268 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $952 | TotalAmt |
| Program Services | $809 | ProgramServicesAmt |
| Management And General | $143 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,145 | TotalAmt |
| Program Services | $3,523 | ProgramServicesAmt |
| Management And General | $622 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (2 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| DATA MANAGEMENT | $50,100 | $50,100 | $0 |
| BAD DEBT EXPENSE | $7,500 | $7,500 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $326,339 | TotalAmt |
| Program Services | $290,284 | ProgramServicesAmt |
| Management And General | $36,055 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,067,108 | BOYAmt |
| EOY | $1,431,475 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $10,000 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,067,108 | BOYAmt |
| EOY | $1,441,475 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $138,136 | BOYAmt |
| EOY | $64,509 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $5,000 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $138,136 | BOYAmt |
| EOY | $69,509 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $928,972 | BOYAmt |
| EOY | $1,371,966 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $928,972 | BOYAmt |
| EOY | $1,371,966 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,067,108 | BOYAmt |
| EOY | $1,441,475 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $442,994 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | Yes (1) | AccountantCompileOrReviewInd |
Acct Compile Or Review Basis AcctCompileOrReviewBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FS Audited | 0 | FSAuditedInd |
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | Yes (X) | SupportingOrganization509a3Ind |
| Supporting Org Type1 | Yes (X) | SupportingOrgType1Ind |
| Supported Organizations | 14 | SupportedOrganizationsCnt |
Supported Org Information SupportedOrgInformationGrp (14 entries)
| EINEIN | Organization TypeOrganizationTypeCd | Governing Document ListedGoverningDocumentListedInd | SupportSupportAmt | Other SupportOtherSupportAmt |
|---|---|---|---|---|
| CITIZEN ADVOCATES INC | ||||
| 141577715 | 10 | 0 | $0 | $0 |
| CHAMPLAIN VALLEY FAMILY CENTER | ||||
| 141638308 | 10 | 0 | $0 | $0 |
| MHA IN ESSEX | ||||
| 141579531 | 10 | 0 | $0 | $0 |
| FAMILIES FIRST IN ESSEX COUNTY | ||||
| 141763863 | 10 | 0 | $0 | $0 |
| BEHAVIORAL HEALTH SERVICES NORTH INC | ||||
| 141338346 | 10 | 0 | $0 | $0 |
| WARREN WASHINGTON ASSOCIATES FOR MENTAL HEALTH INC | ||||
| 141495169 | 10 | 0 | $0 | $0 |
| UNITED HELPERS CARE INC | ||||
| 222412205 | 10 | 0 | $0 | $0 |
| ST JOSEPH'S ADDICTION TREATMENT & RECOVERY | ||||
| 141536222 | 10 | 0 | $0 | $0 |
| CONIFER PARK INC | ||||
| 042806417 | 10 | 0 | $0 | $0 |
| NORTH COUNTRY FREEDOM HOMES | ||||
| 161180179 | 10 | 0 | $0 | $0 |
| ESSEX COUNTY MENTAL HEALTH | ||||
| 146002889 | 10 | 0 | $0 | $0 |
| ST LAWRENCE COUNTY COMMUNITY SERVICES | ||||
| 156000465 | 10 | 0 | $0 | $0 |
| LIBERTY HOUSE FOUNDATION | ||||
| 141568361 | 10 | 0 | $0 | $0 |
| CLINTON COUNTY COMMUNITY SERVICES | ||||
| 146002565 | 10 | 0 | $0 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supported Organizations Total | 14 | SupportedOrganizationsTotalCnt |
| Support Sum | $0 | SupportSumAmt |
| Other Support Sum | $0 | OtherSupportSumAmt |
Form990 Sch A Supporting Org Form990SchASupportingOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Listed By Name Governing Doc | Yes (1) | ListedByNameGoverningDocInd |
| Suprt Org No IRS Determination | Yes (1) | SuprtOrgNoIRSDeterminationInd |
| Supported Org Section C456 | 0 | SupportedOrgSectionC456Ind |
| Supported Org Not Organized US | 0 | SupportedOrgNotOrganizedUSInd |
| Organization Change Suprt Org | 0 | OrganizationChangeSuprtOrgInd |
| Support Non Supported Org | 0 | SupportNonSupportedOrgInd |
| Payment Substantial Contribtr | 0 | PaymentSubstantialContribtrInd |
| Loan Disqualified Person | 0 | LoanDisqualifiedPersonInd |
| Controlled Disqualified Prsn | 0 | ControlledDisqualifiedPrsnInd |
| Disqualified Prsn Controll Int | 0 | DisqualifiedPrsnControllIntInd |
| Disqualified Prsn Ownr Int | 0 | DisqualifiedPrsnOwnrIntInd |
| Excess Business Holdings Rules | 0 | ExcessBusinessHoldingsRulesInd |
| Contribution Controller | 0 | ContributionControllerInd |
| Contribution Family | 0 | ContributionFamilyInd |
| Contribution35 Controlled | 0 | Contribution35ControlledInd |
Form990 Sch A Type1 Suprt Org Form990SchAType1SuprtOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Power Appoint Majority Dir Trst | Yes (1) | PowerAppointMajorityDirTrstInd |
| Operate Benefit Non Suprt Org | 0 | OperateBenefitNonSuprtOrgInd |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART IV, SECTION A, LINE 2 | FormAndLineReferenceDesc |
| Explanation | IN ACCORDANCE WITH THE BYLAWS, CERTIAN SUPPORTED ORGANIZATIONS WHO ARE NOT REQUIRED TO BE RECOGNIZED AS EXEMPT FROM TAXATION UNDER 501(C)(3) OF THE INTERNAL REVENUE CODE, MAY BE A MEMBER IF THE ORGANIZATION IS A GOVERNMENT-RELATED ENTITY OR A TIER 3 MEMBER AND THEY MEET OTHER CRITIERA FOR PARTICIPATION. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | ORGANIZATION MEMBERS CONSIST OF TIER 1, TIER 2 AND TIER 3 CLASSES. TIER 1 MEMBERS EACH HAVE ONE VOTE AND TIER 2 MEMBERS COLLECTIVELY HAVE 1 VOTE. TIER 3 MEMBERS HAVE NO VOTING RIGHTS. |
| FORM 990, PART VI, SECTION A, LINE 7A | EACH TIER 1 MEMBER APPOINTS A REPRESENTATIVE TO THE BOARD TO VOTE ON MATTERS IN ACCORDANCE WITH THE INSTRUCTIONS OF THE MEMBER. TIER 2 MEMBERS SHALL DETERMINE HOW TO CAST THEIR ONE COLLECTIVE VOTE BY A TWO-THIRDS MAJORITY VOTE AMONG ALL TIER 2 MEMBERS. EACH TIER 2 MEMBER SHALL HAVE ONE VOTE FOR SUCH MATTERS. |
| FORM 990, PART VI, SECTION B, LINE 11B | BOARD MEMBERS ARE PROVIDED A COPY OF THE 990 TO REVIEW PRIOR TO FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | ANNUALLY, ALL STAFF AND BOARD MEMBERS ARE REQUIRED TO DISCLOSE ANY CONFLICT OF INTEREST BY SIGNING "CODE OF ETHICS" QUESTIONNAIRES. |
| FORM 990, PART VI, SECTION B, LINE 15A | THE BOARD OF DIRECTORS COMPARES POSITIONS TO SIMILAR ROLES IN MEMBER ORGANIZATIONS, MARKET DATA, AND REGIONAL PUBLIC SALARY DATA WHEN DETERMINING COMPENSATION FOR SENIOR LEADERSHIP. |
| FORM 990, PART VI, SECTION C, LINE 19 | GOVERNING DOCUMENTS ARE AVAILABLE UPON REQUEST FROM THE ORGANIZATION. |
| FORM 990, PART IX, LINE 11G | CLINICAL CONTRACTUAL: PROGRAM SERVICE EXPENSES 40,993. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 40,993. CONSULTING: PROGRAM SERVICE EXPENSES 5,917. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,917. |
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