NORTHWINDS INTEGRATED HEALTH NETWORK IPA INC: Form 990, tax year 2019
View the entire original 990 at ProPublica ↗
- Organization
- NORTHWINDS INTEGRATED HEALTH NETWORK IPA INC (EIN 83-4123043)
- Tax period
- 2019-04-01 to 2019-12-31
- Filed
- 2020-11-16
- IRS object ID
- 202023219349316097
- Schema version
- 2019v5.1
- Note
- A later return for the same period supersedes this one.
- 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 | 2020-11-16T15:12:49-06:00 | ReturnTs |
| Tax Period End | 2019-12-31 | 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 | 6 WEMBLEY CT | AddressLine1Txt |
| City | ALBANY | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 12205 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2019-04-01 | 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 | 5184831251 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 125 FINNEY BOULEVARD | AddressLine1Txt |
| City | MALONE | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 12953 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | REBECCA EVANSKY | PersonNm |
| Person Title | DIRECTOR OF OPERATIONS | PersonTitleTxt |
| Phone | 5184831251 | PhoneNum |
| Signature | 2020-11-16 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | RICHARD ZWEIFEL | PreparerPersonNm |
| PTIN | P00085938 | PTIN |
| Phone | 5184644080 | PhoneNum |
| Preparation | 2020-11-16 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 4.28.134.154 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2020-11-16 | IPDt |
| IP Tm | 13:42:41 | IPTm |
| IP Timezone | ES | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 943164EDC27B847738794D359BF890359084E7A9 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 7B1DF318C80CA19F99E4756696E09B37872C374C | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2019 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Initial Return | Yes (X) | InitialReturnInd |
| Principal Officer | REBECCA EVANSKY | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 125 FINNEY BOULEVARD | AddressLine1Txt |
| City | MALONE | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 12953 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $1,434,494 | 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 | 7 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 7 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 15 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| CY Contributions Grants | $1,434,494 | CYContributionsGrantsAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| CY Total Revenue | $1,434,494 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| CY Salaries Comp Emp Bnft Paid | $151,489 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| CY Other Expenses | $354,033 | CYOtherExpensesAmt |
| CY Total Expenses | $505,522 | CYTotalExpensesAmt |
| CY Revenues Less Expenses | $928,972 | CYRevenuesLessExpensesAmt |
| Total Assets EOY | $1,067,108 | TotalAssetsEOYAmt |
| Total Liabilities EOY | $138,136 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances EOY | $928,972 | 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 | $479,692 | ExpenseAmt |
| Revenue | $1,434,494 | RevenueAmt |
| Desc | ACCOMPLISHMENTS FOR 2019 INCLUDE THE ADVANCEMENT OF THE BEHAVIORAL HEALTH CARE COLLABORATIVE (BHCC) TO THE FORMATION OF AN INDEPENDENT PRACTICE ASSOCIATION (IPA). THIS AFFILIATION ALLOWED FOR THE FACILITATION OF CONTRACTING WITH MANAGED CARE ORGANIZATION AND RESULTED IN THE NEGOTIATIONS OF A LEVEL TWO VALUE BASED CONTRACT WITH THE ADIRONDACKS ACO AND FIDELIS. ADDITIONALLY, NORTHWINDS PUBLISHED AN UP-BLINDED DATA DASHBOARD 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 | $479,692 | 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 |
| 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 | 7 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 7 | 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 | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | 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 | 0 | WhistleblowerPolicyInd |
| Document Retention Policy | 0 | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | 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 | MARK LUKENS | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5184831251 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 125 FINNEY BOULEVARD | AddressLine1Txt |
| City | MALONE | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 12953 | 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 |
| REID ANTHONY | ||||||
| TREASURER | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| ROBERT ROSS | ||||||
| VICE PRESIDENT | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| ANGELA DOE | ||||||
| SECRETARY | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| VALERIE AINSWORTH | ||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| CONNIE WILLIE | ||||||
| BOARD MEMBER | 1.00 | 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 | |
| GENA CHIASSON | ||||||
| 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 | |
| JAMES BUTTON | ||||||
| INTERIM EXECUTIVE DIRECTOR | 25.00 | Yes (X) | Yes (X) | $0 | $85,000 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $85,000 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $0 | 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 |
| Membership Dues | $122,667 | MembershipDuesAmt |
| Government Grants | $575,000 | GovernmentGrantsAmt |
| All Other Contributions | $736,827 | AllOtherContributionsAmt |
| Total Contributions | $1,434,494 | TotalContributionsAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,434,494 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $137,302 | TotalAmt |
| Program Services | $116,707 | ProgramServicesAmt |
| Management And General | $20,595 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,187 | TotalAmt |
| Program Services | $12,059 | ProgramServicesAmt |
| Management And General | $2,128 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $339,682 | TotalAmt |
| Program Services | $339,682 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,259 | TotalAmt |
| Program Services | $1,920 | ProgramServicesAmt |
| Management And General | $339 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,944 | TotalAmt |
| Program Services | $9,302 | ProgramServicesAmt |
| Management And General | $1,642 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Management And GeneralManagementAndGeneralAmt | Program ServicesProgramServicesAmt |
|---|---|---|---|
| BANK SERVICE CHARGES | $569 | $569 | |
| EXPENSED EQUIPMENT | $553 | $553 | |
| POSTAGE | $26 | $4 | $22 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $505,522 | TotalAmt |
| Program Services | $479,692 | ProgramServicesAmt |
| Management And General | $25,830 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $1,067,108 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $1,067,108 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $138,136 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $138,136 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Org Does Not Follow FASB117 | Yes (X) | OrgDoesNotFollowFASB117Ind |
Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Pd In Cap Srpls Land Bldg Eqp Fund PdInCapSrplsLandBldgEqpFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $928,972 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $928,972 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $1,067,108 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $928,972 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | 0 | FSAuditedInd |
| 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 | 0 | ListedByNameGoverningDocInd |
| Suprt Org No IRS Determination | 0 | SuprtOrgNoIRSDeterminationInd |
| Supported Org Section C456 | 0 | SupportedOrgSectionC456Ind |
| Supported Org Not Organized US | 0 | SupportedOrgNotOrganizedUSInd |
| Organization Change Suprt Org | Yes (1) | OrganizationChangeSuprtOrgInd |
| Supported Org Class Designated | 0 | SupportedOrgClassDesignatedInd |
| 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 (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART III LINE 1. | 2019 IS THE ORGANIZATION'S INITIAL FILING YEAR AND IS BEING FILED AS A SHORT YEAR. |
| PART IV, SECTION A, LINE 1: | ORGANIZATIONS APPLY FOR MEMBERSHIP AND ARE REQUIRED TO MEET VARIOUS LICENSING AND PARTICIPATION REQUIREMENTS. |
| PART IV, SECTION A, LINE 5A: | SINCE THIS IS THE ORGANIZATION'S FIRST YEAR, ALL ORGANIZATIONS LISTED ON SCHEDULE A WERE ADDED IN 2019. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | BOARD MEMBERS ARE GIVEN A COPY OF THE 990 TO REVIEW PRIOR TO FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | ANNUALLY, ALL STAFF, BOARD MEMBERS AND VOLUNTEERS ARE REQUIRED TO DISCLOSE ANY CONFLICT OF INTEREST BY SIGNING "CODE OF ETHICS" QUESTIONNAIRES. |
| FORM 990, PART VI, SECTION C, LINE 19 | GOVERNING DOCUMENTS ARE AVAILABLE UPON REQUEST FROM THE ORGANIZATION. |
| FORM 990, PART VI, SECTION B, LINE 13 & LINE 14 | DURING 2019 THE ORGANIZATION WAS DEVELOPING POLICIES AND PROCEDURES RELATED TO WHISTLEBOWERS AND DOCUMENT RETENTION. THESE POLICIES WERE IMPLEMENTED IN 2020. |
| FORM 990, PART IX, LINE 11G | CLINICAL CONTRACTUAL: PROGRAM SERVICE EXPENSES 140,962. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 140,962. CONSULTING: PROGRAM SERVICE EXPENSES 198,720. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 198,720. |
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