2020-08-14T10:41:01-05:00 2019-09-30 341884125 CBIZ MHM LLC 4722 N 24TH ST STE 300 PHOENIX AZ 85016 990 2018-10-01 860290033 SOUTHWEST BEHAVIORAL HEALTH SERVICES INC SOUT 6022854279 3450 N 3RD STREET PHOENIX AZ 85012 MICHAEL FETT CFO 6022854279 2020-08-13 1 AMY A O'LOUGHLIN P00869687 6022646835 2020-08-13 12.221.96.220 2020-08-13 17:53:49 MS P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 1212D86953DF9911D4E957E54162B84DD93DFAA7 2018 2020-09-23 17:36:50Z STEVEN SHEETS 3450 N 3RD STREET PHOENIX AZ 85012 80865335 0 X WWW.SBHSERVICES.ORG X 1970 AZ WE INSPIRE PEOPLE TO FEEL BETTER AND REACH THEIR POTENTIAL, THROUGH HELPING PEOPLE DISCOVER THEIR STRENGTHS, WE IMPROVE OUR COMMUNITIES. 9 9 1329 17 0 0 78560709 78538674 3288793 2186256 509561 74091 249388 66314 82608451 80865335 62981 137061 0 0 55449868 51734167 0 0 0 26877656 27253623 82390505 79124851 217946 1740484 35359917 36272893 14309791 13482283 21050126 22790610 WE INSPIRE PEOPLE TO FEEL BETTER AND REACH THEIR POTENTIAL, THROUGH HELPING PEOPLE DISCOVER THEIR STRENGTHS, WE IMPROVE OUR COMMUNITIES. 0 0 68467688 137061 2186256 SBH PROVIDES SERVICES IN PREVENTION, OUTREACH SERVICES, COMMUNITY INTEGRATION, HOME-BASED COUNSELING, CASE MANAGEMENT, METHADONE MAINTENANCE, CRISIS RECOVERY, COMMUNITY HOUSING, RESIDENTIAL SERVICES AND OUTPATIENT COUNSELING FOR CHILDREN AND ADULTS SUFFERING FROM VARIOUS BEHAVIORAL AND SUBSTANCE ABUSE PROBLEMS. 68467688 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 1 218 0 1 1329 1 0 0 0 0 0 0 0 0 0 0 0 0 X 9 9 0 0 1 0 0 0 0 1 1 0 1 1 0 1 1 1 1 1 1 0 0 X MICHAEL FETT 6022854279 3450 N 3RD STREET PHOENIX AZ 85012 MATT HATFIELD CHAIR 0.30 X X 0 0 0 KURT BRAATZ DIRECTOR 0.30 X 0 0 0 KEVIN LAWSON DIRECTOR 0.30 X 0 0 0 RICHARD HEROLD DIRECTOR 0.30 X 0 0 0 ADRIENNE SCHECK PHD IMMEDIATE PAST CHAIR 0.30 X 0 0 0 LUCY TREIMAN PHD DIRECTOR 0.30 X 0 0 0 PATRICIA VALADEZ DIRECTOR 0.30 X 0 0 0 MICHELLE QUINTANILLA DIRECTOR 0.30 X 0 0 0 STEVE THOMPSON DIRECTOR 0.30 X 0 0 0 DONALD LOGUE LEFT 319 DIRECTOR 0.30 X 0 0 0 MICHAEL CYLKOWSKI LEFT 919 DIRECTOR 0.30 X 0 0 0 MICHAEL HARRIS LEFT 419 DIRECTOR 0.30 X 0 0 0 MICHAEL FETT VP FINANCE 40.00 X 168596 0 32105 DEBORAH WOODARD VP COMM/SECRETARY 40.00 X 117399 0 13628 JEFFREY JORDE FORMER PRESIDENT/CEO (THRU 5/18) 40.00 X 288673 0 12781 STEVEN SHEETS INTERIM PRESIDENT/CEO 40.00 X 189152 0 15157 JOSHUA BURGETT PSYCH NURSE PRACTITIONER 40.00 X 344808 0 18925 SCOTT MCCALL PSYCHIATRIST 40.00 X 343596 0 0 AARON GOLDMAN REGIONAL MEDICAL DIRECTOR 36.00 X 305249 0 27027 RAMIRO GUILLEN CHIEF MEDICAL OFFICER 40.00 X 294284 0 17307 ANDREA PUPILLO PSYCH NURSE PRACTITIONER 40.00 X 270398 0 4828 2322155 0 141758 50 0 1 0 WEST IP COMMUNICATIONS P O BOX 74007080 CHICAGO IL 60674 NETWORK SERVICES 546869 SOUTHWEST HUMAN DEVELOPMENT 2850 N 24TH ST PHOENIX AZ 85008 SACE OUTPATIENT SERVICE 454409 STEVENS LEINWEBER CONSTRUCTION INC 9590 E IRONWOOD SQ DR 101 SCOTTSDALE AZ 85258 REPAIRS 436743 AZHEM LLC P O BOX 1030 VAIL AZ 85641 COMPUTER MAINTENANCE 410426 NEW HORIZONS DISABILITY EMPOWERMENT 9400 E VALLEY RD PRESCOTT VALLEY AZ 86314 TRANSPORTION SERVICES 278103 30 78415078 123596 123596 78538674 CLIENT FEES 624100 1616994 1616994 RENTAL INCOME 531120 459018 459018 CONSULTING 624100 52851 52851 MEDICAL RECORDS 624100 33843 33843 TRAINING 624100 10754 10754 12796 12796 2186256 71091 71091 3000 0 3000 3000 3000 SNACK BAR/VENDING 900099 33307 33307 MISCELLANEOUS 900099 33007 33007 66314 80865335 2186256 0 140405 137061 137061 646733 646733 42944170 36920618 6023552 187162 177691 9471 4887304 4265165 622139 3068798 2621577 447221 190147 10371 179776 78050 78050 75246 48656 26590 65470 1205 64265 414064 169140 244924 259883 172576 87307 4245795 3756547 489248 1615371 1402510 212861 36913 34101 2812 2115922 1940779 175143 277994 186278 91716 SUPPLIES 10942693 10869484 73209 NURSING & PHYSICIAN SVS 2765855 2314042 451813 EQUIPMENT RENTAL/MAINT. 1654584 1103922 550662 BAD DEBT 1469962 1469962 1045674 866003 179671 79124851 68467688 10657163 0 994614 6841412 7578455 2751185 4345792 6411862 12782 16992 176428 47903 42663442 22613542 22108207 20049900 143639 153639 35359917 36272893 7706217 7458333 567182 421100 5018304 4679265 1018088 923585 14309791 13482283 X 17794763 19535247 3255363 3255363 21050126 22790610 35359917 36272893 1740484 0 X 0 1 X 1 1 1 X 60121436 65573053 72075982 78560709 78538674 354869854 60121436 65573053 72075982 78560709 78538674 354869854 354869854 39265 72600 75047 33441 71091 291444 123144 118531 141686 249388 66314 699063 355860361 11783653 0.99720 0.99700 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: MISCELLANEOUS INCOME - 2014 AMOUNT: $ 511. 2015 AMOUNT: $ 37,065. 2016 AMOUNT: $ 27,091. 2017 AMOUNT: $ 92,936. 2018 AMOUNT: $ 9,476. INSURANCE REFUND - 2014 AMOUNT: $ 89,926. 2015 AMOUNT: $ 55,074. 2016 AMOUNT: $ 61,714. SNACK BAR/VENDING - 2014 AMOUNT: $ 32,707. 2015 AMOUNT: $ 26,392. 2016 AMOUNT: $ 28,939. 2017 AMOUNT: $ 30,290. 2018 AMOUNT: $ 33,307. AMEX REWARDS - 2016 AMOUNT: $ 23,942. 2017 AMOUNT: $ 19,912. 2018 AMOUNT: $ 11,902. EHR INCETIVES - 2017 AMOUNT: $ 106,250. CONSTRUCTION REVENUE - 2018 AMOUNT: $ 11,629. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 4369392 4369392 20639878 8291615 12348263 10136477 7451054 2685423 6453447 5918145 535302 1064248 952728 111520 20049900 X 82089269 20666 1339793 1360459 80728810 136525 136525 80865335 80420826 20666 1411834 1432500 78988326 136525 136525 79124851 PART X, LINE 2: SBH HAS RECEIVED A DETERMINATION LETTER FROM THE INTERNAL REVENUE SERVICE AND ARIZONA DEPARTMENT OF REVENUE STATING THAT IT IS EXEMPT FROM FEDERAL AND ARIZONA INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE BASED ON THE INFORMATION SUBMITTED. SBH WILL MAINTAIN THEIR EXEMPT STATUS AS LONG AS OPERATIONS CONTINUE TO COMPLY WITH THE INTERNAL REVENUE CODE AND ARIZONA REVISED STATUTES. INCOME DETERMINED TO BE UNRELATED BUSINESS INCOME ("UBI") WOULD BE TAXABLE. MANAGEMENT DOES NOT BELIEVE SBH HAS ANY UBI FOR THE YEAR ENDED SEPTEMBER 30, 2019. THE ORGANIZATION EVALUATES THEIR UNCERTAIN TAX POSITIONS, IF ANY, ON A CONTINUAL BASIS THROUGH REVIEW OF THEIR POLICIES AND PROCEDURES AND DISCUSSIONS WITH OUTSIDE EXPERTS. THE FEDERAL EXEMPT ORGANIZATION BUSINESS INCOME TAX RETURN (FORM 990) FOR 2016. 2017 AND 2018 OF SBH ARE SUBJECT TO EXAMINATION BY THE IRS, GENERALLY FOR THREE YEARS AFTER THEY WERE FILED. PART XI, LINE 2D - OTHER ADJUSTMENTS: REVENUE FROM RELATED ENTITIES 1,339,793. PART XI, LINE 4B - OTHER ADJUSTMENTS: ELIMINATING ENTRY 136,525. PART XII, LINE 2D - OTHER ADJUSTMENTS: EXPENSES FROM RELATED ENTITIES 1,411,834. PART XII, LINE 4B - OTHER ADJUSTMENTS: ELIMINATING ENTRY 136,525. 1 FLEX FUNDS & HOUSING OPPORTUNITIES FOR PERSONS WITH AIDS EMERGENCY ASSISTANCE 227 137061 PART I, LINE 2: THE ORGANIZATION CONFIRMS THAT RECIPIENTS ARE ELIGIBLE TO RECEIVE ASSISTANCE AND THAT THEY DO NOT EXCEED THE MAXIMUM BENEFITS ALLOWANCE. CHECKS ARE WRITTEN DIRECTLY TO SERVICE VENDORS TO PAY FOR RECIPIENTS' EXPENSES. 0 0 0 0 0 0 0 1 0 MICHAEL FETT VP FINANCE 149458 0 19000 0 138 0 3078 0 29027 0 200701 0 0 0 JEFFREY JORDE FORMER PRESIDENT/CEO (THRU 5/18) 211888 0 40000 0 36785 0 3700 0 9081 0 301454 0 0 0 STEVEN SHEETS INTERIM PRESIDENT/CEO 189098 0 0 0 54 0 2883 0 12274 0 204309 0 0 0 JOSHUA BURGETT PSYCH NURSE PRACTITIONER 338808 0 6000 0 0 0 100 0 18825 0 363733 0 0 0 SCOTT MCCALL PSYCHIATRIST 343596 0 0 0 0 0 0 0 0 0 343596 0 0 0 AARON GOLDMAN REGIONAL MEDICAL DIRECTOR 290249 0 15000 0 0 0 3417 0 23610 0 332276 0 0 0 RAMIRO GUILLEN CHIEF MEDICAL OFFICER 284284 0 10000 0 0 0 4385 0 12922 0 311591 0 0 0 ANDREA PUPILLO PSYCH NURSE PRACTITIONER 270398 0 0 0 0 0 0 0 4828 0 275226 0 0 0 PART I, LINE 7 ANNUALLY THE BOARD CREATES AN AD HOC COMMITTEE IN CHARGE OF REVIEWING THE CEO'S AND CFO'S PERFORMANCE AND MAKING A RECOMMENDATION TO THE FULL BOARD REGARDING BONUS AND PAY INCREASE. A THE ARIZONA HEALTH FACILITIES AUTHORITY (2015 A) 860453292 040507EM3 2015-03-10 4600000 FINANCING ADMIN/OUTPATIENT BUILDING 0 0 0 B THE ARIZONA HEALTH FACILITIES AUTHORITY (2015 B) 860453292 2015-12-01 1800000 OFFICE BUILDING 0 0 0 A 4600000 150609 4600000 2015 1 0 1 1 B 1800000 41012 1800000 2016 0 0 1 1 A 0 0 0 0 0 0 1 B 0 0 0 0 0 0 0 A 0 0 0 0 1 0 0 0 1 B 0 0 0 0 1 0 0 0 1 A 0 B 1 X 18609 THRIFT SHOP VALUE X SUPPLIES 1 104987 FAIR MARKET VALUE 0 0 0 FORM 990, PART VI, SECTION A, LINE 4 THE BYLAWS WERE AMENDED TO ALLOW FOR THE TERMS OF THE DIRECTORS TO BE STAGGERED SO THAT APPROXIMATELY ONE-THIRD OF THE TERMS EXPIRE EACH YEAR. TERM LIMIT RESTRICTIONS CAN BE WAIVED BY THE AFFIRMATIVE VOTE OF A MAJORITY OF THE INCUMBENT DIRECTORS THEN SERVING. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY AN OUTSIDE ACCOUNTING FIRM AND IS REVIEWED BY THE DIRECTOR OF FINANCE AND CFO BEFORE BEING SIGNED BY THE CEO. FORM 990, PART VI, SECTION B, LINE 12C THE MEMBERS OF THE SBH BOARD OF DIRECTORS AND SBH EXECUTIVE PERSONNEL ACKNOWLEDGE THE NEED FOR DISCLOSURE OF INTEREST(S). ANY SITUATION IN WHICH A POSSIBLE CONFLICT OF INTEREST MIGHT ARISE WILL BE REPORTED PROMPTLY IN WRITING TO THE CORPORATION. ALL PERSONNEL ARE REQUIRED TO REPORT A REAL OR POTENTIAL CONFLICT OF INTEREST TO THEIR IMMEDIATE SUPERVISOR PRIOR TO ENGAGING IN ANY TRANSACTION THAT MAY BE PERCEIVED AS A CONFLICT OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15A ANNUALLY THE BOARD CREATES AN AD HOC COMMITTEE IN CHARGE OF REVIEWING THE CEO'S PERFORMANCE AND MAKING A RECOMMENDATION TO THE FULL BOARD REGARDING BONUS AND ANY PAY INCREASE. THE CEO'S EVALUATION IS BASED ON 20 MEASURABLE OBJECTIVES THAT ARE WEIGHTED AND TALLIED FOR A TOTAL SCORE. THE CEO'S SALARY IS COMPARED WITH SALARIES OF NOT-FOR-PROFIT COMPANIES NATIONWIDE - MEMBERS OF THE MENTAL HEALTH CORPORATION OF AMERICA. THE RECOMMENDATIONS OF THE AD HOC COMMITTEE ARE FORWARDED TO ALL BOARD MEMBERS FOR DISCUSSION AND FINAL RECOMMENDATION. REVIEWS WERE LAST PERFORMED JANUARY 2019. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S ARTICLES OF INCORPORATION, BY-LAWS AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON WRITTEN REQUEST. VILLA AGAVE CORPORATION 7439 S 7TH ST PHOENIX AZ 85042 942902649 HOUSING AZ 501(C)(3) LINE 7 N/A 0 MIHALIC'S PROJECT 1408 E HIGHLAND AVE PHOENIX AZ 85014 860667653 HOUSING AZ 501(C)(3) LINE 11 N/A 0 VILLA DE CONFIANZA 2060 N 35TH AVE PHOENIX AZ 85009 742537585 HOUSING AZ 501(C)(3) LINE 11 N/A 0 TOBY HOUSE II 3450 NORTH THIRD STREET PHOENIX AZ 85012 742420528 HOUSING AZ 501(C)(3) LINE 11 N/A 0 TOBY HOUSE III 3450 NORTH THIRD STREET PHOENIX AZ 85012 860742062 HOUSING AZ 501(C)(3) LINE 11 N/A 0 TOBY HOUSE IV 3450 NORTH THIRD STREET PHOENIX AZ 85012 860897449 HOUSING AZ 501(C)(3) LINE 11 N/A 0 TOBY HOUSE V 3450 NORTH THIRD STREET PHOENIX AZ 85012 860950586 HOUSING AZ 501(C)(3) LINE 11 N/A 0 TOBY HOUSE VI 3450 NORTH THIRD STREET PHOENIX AZ 85012 860981650 HOUSING AZ 501(C)(3) LINE 7 N/A 0 TOBY HOUSE VII 3450 NORTH THIRD STREET PHOENIX AZ 85012 861025879 HOUSING AZ 501(C)(3) LINE 11 N/A 0 TOBY HOUSE VIII 3450 NORTH THIRD STREET PHOENIX AZ 85012 710931900 HOUSING AZ 501(C)(3) LINE 7 N/A 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 1 0 0