2020-07-09T18:35:11-05:00 2019-06-30 221478099 COHNREZNICK LLP 1301 AVENUE OF THE AMERICAS NEW YORK NY 10019 990 2018-07-01 112140888 QUEENS VILLAGE COMMITTEE FOR MENTAL HEALTH FOR J-CAP INC QUEE 7187121100 116-30 SUTPHIN BLVD JAMAICA NY 11434 RAUL RUSSI CEO 7187121100 2020-07-09 1 LORI ROTHE YOKOBOSKY CPA P01273422 2122970400 2020-07-09 209.59.242.37 2020-07-09 14:25:11 ED P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 0FC5460241256066D74A2C5C66FD8B85E1F8608D 2018 2020-09-23 17:36:50Z RAUL RUSSI 300 EAST 175TH STREET BRONX NY 10457 7008676 0 X WWW.JCAPPROGRAMS.COM X 1972 NY PROVIDE SERVICES, IN A RESIDENTIAL ENVIRONMENT, TO INDIVIDUALS WITH SUBSTANCE ABUSE AND ALCOHOL ABUSE DISORDER. OASAS LICENSED 24/7 CHEMICAL DEPENDENCE SERVICES INCL. COUNSELING, VOC/ED SUPPORT, FAMILY SUPPORT, ETC. ART. 28 D&TC; OP HIV/AIDS COUNSELING; SUPPORTIVE HOUSING, ENHANCED SERVICES FOR VETERANS. 10 10 110 0 0 0 5083793 4151356 2904903 2620947 351 187 2145 236186 7991192 7008676 0 0 0 0 5117032 5180029 0 0 0 3088474 2824941 8205506 8004970 -214314 -996294 9476326 8339237 5849286 5708491 3627040 2630746 OASAS LICENSED 24/7 CHEMICAL DEPENDENCE SERVICES INCL. COUNSELING, VOC/ED SUPPORT, FAMILY SUPPORT, ETC. ART. 28 D&TC; OP HIV/AIDS COUNSELING; SUPPORTIVE HOUSING, ENHANCED SERVICES FOR VETERANS. 0 0 5571640 2639584 RESIDENTIAL TREATMENT PROGRAM PROVIDES A THERAPEUTIC LIVING ENVIRONMENT THAT CONSIST OF 3 PHASES IN ORDER TO HELP INDIVIDUALS GAIN THEIR LIVES BACK FROM DRUG AND ALCOHOL ADDICTION. THEY ALSO PROVIDE MEDICAL SERVICES TO CLIENTS IN RESIDENTIALOUR RESIDENTIAL TREATMENT PROGRAM. 810850 OUTPATIENT SERVICES PROGRAM IS DESIGNED FOR INDIVIDUALS WHO HAVE A CURRENT OR RECENT HISTORY WITH SUBSTANCE ABUSE, BUT DO NOT REQUIRE AN INTENSIVE LEVEL OF TREATMENT IN A RESIDENTIAL TREATMENT ENVIRONMENT. THOSE ELIGIBLE LIVE IN A STABLE, SUPPORTIVE ENVIRONMENT AND ARE ENROLLED ON SCHOOL, A TRAINING PROGRAM OR ARE GAINFULLY EMPLOYED. OUR ARTICLE 28 D&TC FACILITY PROVIDES SERVICES TO THOSE WHO OFTEN ARE AFFECTED BY MULTIPLE MEDICAL AND PSYCHIATRIC CONDITIONS. 6382490 1 1 0 0 0 0 0 0 1 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 21 0 1 110 1 0 0 0 0 0 0 0 0 0 0 0 0 X 10 10 0 0 1 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 NY X VICKY GATELL SENIOR VP OF FINANCE 3479783642 1064 FRANKLIN AVENUE BRONX NY 10456 CELESTE LUCAS-POWERS TRUSTEE 2.00 X 0 0 0 DR HUGH NELSON TRUSTEE 2.00 X 0 0 0 GREG MAZZEO TRUSTEE 2.00 X 0 0 0 JAMES CORRELL SR TRUSTEE 2.00 X 0 0 0 JOE IABONI SECRETARY 2.00 X X 0 0 0 JOHN BUTLER TRUSTEE 2.00 X 0 0 0 MARIE WHITE TRUSTEE 2.00 X 0 0 0 RUTH DEUTSCH PRESIDENT 2.00 X X 0 0 0 STEPHEN CARBONE TREASURER 2.00 X X 0 0 0 STEVE JANJIC MD TRUSTEE 2.00 X 0 0 0 DIANE GONZALEZ CHIEF EXECUTIVE OFFICER 45.00 X 216234 0 15800 NANCY BRINN CHIEF OPERATING OFFICER 45.00 X 135497 0 15029 NILDA RUIZ CHIEF FINANCIAL OFFICER 45.00 X 129817 0 10160 481548 0 40989 3 0 1 0 COMMUNITY WELLNESS CENTER OF AMERICA 169-25 137TH AVE JAMAICA NY 11434 MEDICAL PROVIDER SERVICES 374825 H2M ARCHITECTS & ENGINEERS 538 BROADHOLLOW RD MELVILLE NY 11747 ARCHITECT SERVICES 311207 JEAN-PIERRE MD 1061 FORDHAM LANE WOODMERE NY 11598 MEDICAL PROVIDER SERVICES 134700 3 4126659 24697 4151356 HUMAN RESOURCES ADMNISTRATION 623990 1482265 1482265 OTHER SHELTER SERVICES 623990 605144 605144 MEDICAID - ARTICLE 28 623990 359461 359461 SUPPLEMENTAL SECURITY INCOME 623990 99000 99000 OTHER CLIENT SERVICES 623990 71405 71405 3672 3672 2620947 187 187 INSURANCE RECOVERIES 900099 217549 217549 MISCELLANEOUS 900099 18637 18637 236186 7008676 2639584 0 217736 515140 431342 83798 3839000 3206160 632840 60959 52825 8134 335327 290578 44749 429603 372275 57328 515168 62368 452800 70419 70419 326892 286936 39956 299 299 96556 89446 7110 91012 85203 5809 338125 332206 5919 39081 37329 1752 22434 20320 2114 370896 370896 110190 96175 14015 FOOD 409249 408928 321 REPAIRS & MAINTENANCE 240198 67152 173046 CONSUMBALE SUPPLIES 82452 82045 407 EQUIPMENT RENTAL & MAIN 68280 61868 6412 43690 28139 15551 8004970 6382490 1622480 0 42128 177036 1429543 296520 181166 76236 200409 339358 73240 20327 13330532 5923350 7527262 7407182 22578 22578 9476326 8339237 1789655 2028300 52996 58305 210000 4006635 3411886 5849286 5708491 X 3627040 2630746 3627040 2630746 9476326 8339237 -996294 0 X X 0 1 X 1 0 X 5406019 4777927 4894713 5083793 4151356 24313808 5406019 4777927 4894713 5083793 4151356 24313808 24313808 56252 45428 477970 351 187 580188 1550 15638 44255 236186 297629 25191625 13963198 0.96520 0.97490 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: OTHER REVENUE - 2015 AMOUNT: $ 1,550. 2016 AMOUNT: $ 15,638. 2017 AMOUNT: $ 1,505. 2018 AMOUNT: $ 18,637. FUNDRAISING - 2017 AMOUNT: $ 42,750. INSURANCE RECOVERIES - 2018 AMOUNT: $ 217,549. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 2645000 2645000 8738974 5121557 3617417 1080260 71481 1008779 748776 617371 131405 117522 112941 4581 7407182 DUE TO GOVERNMENT AGENCIES 2716875 DUE TO OASAS 695011 3411886 X 7008676 0 7008676 0 7008676 8004970 0 8004970 0 8004970 PART IV, LINE 2B: THE HUMAN RESOURCE AGENCY (HRA) PROVIDES A SET AMOUNT OF PERSONAL NEED DOLLARS (PNA) FOR CERTAIN CLIENTS. THESE AMOUNTS ARE DISTRIBUTED TO CLIENTS UPON REQUEST AND ARE DEDUCTED FROM THE INDIVIDUALS PNA ACCOUNT. IN ADDITION, ANY FEES THAT THE ORGANIZATION INCURS IN SUPPLYING THESE CLIENTS WITH PERSONAL NEED OBJECTS, SUCH AS TOILETRIES OR METRO CARDS, ARE ALSO DEDUCTED FROM THE ACCOUNT. WHEN THE CLIENT COMPLETES THE PROGRAM, ANY MONEYS REMAINING ARE DISTRIBUTED TO THEIR INDIVIDUAL ACCOUNTS. IF A CLIENT DOES NOT COMPLETE THE PROGRAM, ANY REMAINING FUNDS MAY NEED TO BE RETURNED TOO HRA. PART X, LINE 2: THE ORGANIZATION HAS NO UNRECOGNIZED TAX BENEFITS AT JUNE 30, 2019. THE ORGANIZATION'S FEDERALAND STATE INCOME TAX RETURNS PRIOR TO FISCAL YEAR 2016 ARE CLOSED AND MANAGEMENT CONTINUALLY EVALUATES EXPIRING STATUTES OF LIMITATIONS, AUDITS, PROPOSED SETTLEMENTS, CHANGES IN TAX LAW AND NEW AUTHORITATIVE RULINGS. THE ORGANIZATION RECOGNIZES INTEREST AND PENALTIES ASSOCIATED WITH TAX MATTERS AS OPERATING EXPENSES AND INCLUDES ACCRUED INTEREST AND PENALTIES WITH ACCRUED EXPENSES IN THE STATEMENTS OF FINANCIAL POSITION. PART XI, LINE 4B - OTHER ADJUSTMENTS: FUNDRAISING EXPENSES PART XII, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EXPENSES X X 0 0 0 0 0 0 0 0 0 DIANE GONZALEZ CHIEF EXECUTIVE OFFICER 216234 0 0 0 0 0 2162 0 13638 0 232034 0 0 0 NANCY BRINN CHIEF OPERATING OFFICER 135497 0 0 0 0 0 1354 0 13675 0 150526 0 0 0 FORM 990, PART IV, LINE 20A: THE ORGANIZATION IS LICENSED UNDER ARTICLE 28 OF NEW YORK STATE PUBLIC HEALTH LAW. HOWEVER, SUBSECTION 10 OF ARTICLE 28 EXCLUDES CERTAIN HEALTHCARE FACILITIES FROM THE DEFINITION OF GENERAL HOSPITAL. THEREFORE THE ORGANIZATION IS NOT INCLUDING SCHEDULE H IN THE CURRENT YEAR FORM 990, AS THEY DO NOT MEET THE DEFINITION. FORM 990, PART VI, SECTION A, LINE 4 THE ORGANIZATION AMENDED ITS BYLAWS. EFFECTIVE JUNE 27, 2019, THROUGH A REORGANIZATION AGREEMENT, ACACIA NETWORK, INC. BECAME THE SOLE MEMBER OF THE ORGANIZATION AND IS THEREFORE CONSIDERED THE PARENT COMPANY. FORM 990, PART VI, SECTION A, LINE 6 ACACIA NETWORK, INC. IS SOLE MEMBER OF THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A ACACIA NETWORK, INC. AS THE SOLE MEMBER OF THE ORGANIZATION HAS THE POWER TO APPOINT THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 IS PREPARED BY A CPA FIRM FROM AUDITED FINANCIAL STATEMENTS, AS WELL AS, FROM INFORMATION FORM THE ORGANIZATION. THE CPA FIRM FURNISHES A DRAFT FORM 990 WHICH IS REVIEWED BY MANAGEMENT. AFTER APPROVAL, THE FULL BOARD HAS AN OPPORTUNITY TO REVIEW AND COORDINATE ANY APPROPRIATE CHANGES TO FORM 990 BEFORE IT IS FINALIZED AND FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION CONSISTENTLY ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY BY MONITORING EVERY TRANSACTION INVOLVING A MEMBER OF THE BOARD. IN ADDITION, TO BOARD MEMBERS, OFFICERS AND ALL OTHER EMPLOYEES ARE REQUIRED TO COMPLETE THE DISCLOSURE ANNUALLY. THE BOARD REGULARLY REVIEWS THE CONFLICT OF INTEREST POLICY AND IF THERE IS A CONFLICT, THE BOARD MEMBER HAS TO RESIGN. FORM 990, PART VI, SECTION B, LINE 15 THE PROCESS FOR DETERMINING COMPENSATION INCLUDES THE HUMAN RESOURCES DEPARTMENT REVIEWING THE COMPENSATION OF THE CEO AND OTHER OFFICERS BY COMPARING THEM TO SALARIES BEING OFFERED WITHIN THE SAME INDUSTRY AT COMPARABLE POSITIONS. THE BOARD OF DIRECTORS MAKES THE FINAL DECISION ON THE AMOUNT OF COMPENSATION TO BE PAID. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. ACACIA NETWORK INC 300 EAST 175TH STREET BRONX NY 10459 134014082 MANAGEMENT ACTIVITIES NY 501(C)(3) LINE 12A, I N/A 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0