2019-08-02T05:21:42-05:00 2018-12-31 010723685 DERMODY BURKE & BROWN CPAS LLC 443 N FRANKLIN ST STE 100 SYRACUSE NY 132041441 990 2018-01-01 161363413 ONONDAGA CASE MANAGEMENT SERVICES INC ONON 3154727363 620 ERIE BOULEVARD W SUITE 302 SYRACUSE NY 13204 NANCY LEVETT PRESIDENT 3154727363 2019-07-22 1 CAROLYN S STURICK P01278448 3154719171 208.125.54.67 2019-07-22 13:10:56 ED P C3EC875729DC6C1F7103B5E1CCD2FF5B2FE2C350 03211B992F1F2C4B85B60DDA37D69CC2D5F58DB5 2018 2019-02-21 02:37:17Z CIRCARE NANCY LEVETT 620 ERIE BOULEVARD W SUITE 302 SYRACUSE NY 13204 10448332 0 X WWW.CIR.CARE X 1990 NY ONONDAGA CASE MANAGEMENT, INC. DBA CIRCARE (HEREINAFTER REFERRED TO AS "CIRCARE") SUPPORTS INDIVIDUALS AND THEIR FAMILIES IN MANAGING THEIR HEALTH AND CONNECTING TO RESOURCES IN ORDER TO ATTAIN AND LIVE A SATISFYING LIFE IN THEIR COMMUNITY. CIRCARE'S TEAM OF CARE MANAGERS, CLINICIANS, VOCATIONAL SPECIALISTS, PEER MENTORS, AND MEDICAL PROFESSIONALS ARE TRAINED IN A MULTITUDE OF EVIDENCE BASED PRACTICES PROVEN TO HELP PEOPLE ATTAIN THEIR DESIRED GOALS AND TO SUSTAIN RECOVERY AND BUILD RESILIENCE. 6 6 183 0 0 5480 2191008 2008201 7841858 8282342 58902 61200 38940 96461 10130708 10448204 0 0 0 0 7271156 7601572 0 0 0 2438034 2402097 9709190 10003669 421518 444535 10454228 10260255 6029189 5505941 4425039 4754314 X ONONDAGA CASE MANAGEMENT SERVICES, INC. ASSISTS PEOPLE WITH DIFFICULT LIFE CHALLENGES TO DEVELOP PERSONALLY MEANINGFUL LIVES. 0 0 6440774 6040414 CARE MANAGEMENT SERVICES SEE SCHEDULE O FOR FUTHER DETAILS. CIRCARE IS A NEW YORK STATE DESIGNATED LEAD HEALTH HOME COVERING EIGHT COUNTIES IN CENTRAL NEW YORK. HEALTH HOME IS THE NEW YORK STATE DEPARTMENT OF HEALTH'S PREFERRED CARE COORDINATION MODEL, IT IS NOT A PLACE BUT A NETWORK OF PROVIDERS WORKING TOGETHER TO ENHANCE AN INDIVIDUAL'S HEALTH AND OVERALL QUALITY OF LIFE. HEALTH HOME CARE MANAGEMENT IS A SERVICE MODEL DESIGNED FOR MEDICAID BENEFICIARIES TO ENSURE EFFECTIVE COORDINATION AND MANAGEMENT OF CARE, LEADING TO POSITIVE HEALTH OUTCOMES FOR INDIVIDUALS. AT THE END OF 2018, CIRCARE WAS CONTRACTED WITH SEVENTEEN DIFFERENT CARE MANAGEMENT AGENCIES ACROSS THE EIGHT COUNTIES TOUCHING THE LIVES OF 5,103 UNIQUE MEDICAID BENEFICIARIES. CIRCARE'S HEALTH HOME FUTURE INCLUDES ADDING ADDITIONAL HEALTH HOME CARE MANAGEMENT AGENCIES AND EXPANDING THE CURRENT CIRCARE HEALTH HOME COVERAGE AREA INTO ADDITIONAL COUNTIES.AS WELL AS BEING A HEALTH HOME, CIRCARE IS A HEALTH HOME CARE MANAGEMENT AGENCY WITHIN THE CIRCARE HEALTH HOME NETWORK. THROUGH HEALTH HOME CARE MANAGEMENT, CIRCARE CARE MANAGERS PROVIDE CARE COORDINATION TO MEDICAID BENEFICIARIES WHO HAVE A SERIOUS MENTAL ILLNESS, WHO ARE LIVING WITH HIV/AIDS, OR WHO HAVE TWO OR MORE CHRONIC HEALTH CONDITIONS. CIRCARE CARE MANAGERS WORK WITH INDIVIDUALS TO DEVELOP AND MAINTAIN A COMPREHENSIVE PLAN FOR ACCESSING AND USING SERVICES AND SUPPORTS NECESSARY FOR THE PERSON'S HEALTH. AS A HEALTH HOME CARE MANAGEMENT AGENCY, CIRCARE PROVIDED CARE MANAGEMENT SERVICES TO 1,822 ADULT MEDICAID BENEFICIARIES IN 2018.IN 2018 CIRCARE WAS IDENTIFIED AS A STATE DESIGNATED ENTITY. STATE DESIGNATED ENTITIES WAS A NEW CONCEPT DEVELOPED AND IMPLEMENTED BY NEW YORK STATE TO HELP CONNECT INDIVIDUALS TO CRITICAL HOME AND COMMUNITY BASED SERVICES. AT THE END OF 2018 CIRCARE WAS WELL UNDERWAY IN PROVIDING THESE SERVICES TO HARP MEMBERS AND CONTRACTED AS A PARTICIPATING PROVIDER WITH THREE MANAGED CARE ORGANIZATIONS IN CENTRAL NEW YORK INCLUDING FIDELIS, UNITED HEALTHCARE, AND MOLINA. 1582113 1447486 CIRCARE'S OUTPATIENT BEHAVIORAL HEALTH CLINICSEE SCHEDULE O FOR FURTHER DETAILS. CIRCARE'S OUTPATIENT BEHAVIORAL HEALTH CLINIC IS LICENSED THROUGH THE NEW YORK STATE OFFICE OF MENTAL HEALTH AND SERVES INDIVIDUALS 17 YEARS AND OLDER. THE CLINIC SPECIALIZES IN PROVIDING HIGH QUALITY CLINICAL SERVICES TO INDIVIDUALS SEEKING BEHAVIORAL HEALTH INTERVENTIONS. CIRCARE'S TEAM OF LICENSED CLINICIANS ENGAGE INDIVIDUALS IN A MEANINGFUL AND HOPEFUL CHANGE PROCESS THAT SUPPORTS RECOVERY AND WELL?BEING AND, THE TEAM CONTINUOUSLY WORKS TO BUILD KNOWLEDGE AND SKILL SETS IN VARIOUS MODALITIES IN ORDER TO PROVIDE THE BEST TREATMENT POSSIBLE.IN 2018, CIRCARE'S OUTPATIENT BEHAVIORAL HEALTH CLINIC SERVED 712 INDIVIDUAL CLIENTS AND PROVIDED 12,479 VISITS, WHICH AVERAGES APPROXIMATELY 18 VISITS PER CLIENT. 872771 890903 ASSERTIVE COMMUNITY TREATMENT TEAM (ACT)SEE SCHEDULE O FOR FURTHER DETAILS. THE ASSERTIVE COMMUNITY TREATMENT TEAM (ACT) IS A MULTI-DISCIPLINARY TEAM THAT INCLUDES PSYCHIATRY, NURSING, SOCIAL WORK, VOCATIONAL, SUBSTANCE USE REHABILITATION AND A PEER SPECIALIST. THE TEAM SERVES INDIVIDUALS IN THE COMMUNITY WHO ARE DIAGNOSED WITH AND IMPAIRED BY A MENTAL HEALTH CONDITION. THE ACT SERVICE MODEL IS AN EVIDENCED BASED PRACTICE DESIGNED SPECIFICALLY TO ASSIST INDIVIDUALS WHO ARE NOT WELL ENGAGED BY TRADITIONAL SERVICES. NINETY PERCENT OF ACT SERVICES ARE PROVIDED IN THE COMMUNITY, AT A PERSON'S HOME, A SHELTER, THE HOME OF FAMILY AND FRIENDS AND AT MEDICAL AND OTHER APPOINTMENTS. IN 2018, THE ACT TEAM SERVED AN AVERAGE OF 49 INDIVIDUAL CLIENTS WITH A TOTAL OF 569 SERVICE UNITS PROVIDED BY THE PROGRAM. 8895658 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 35 0 1 183 1 0 0 0 0 0 0 0 0 0 0 0 0 X 6 6 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 NY X RUTH WELLS CHIEF FISCAL OFFICER 3154727363 620 ERIE BOULEVARD W SUITE 302 SYRACUSE NY 13204 NANCY LEVETT PRESIDENT 1.00 X X 0 0 0 CYNTHIA BARNABY BOARD MEMBER 1.00 X 0 0 0 RICHARD KILBURG TREASURER 1.00 X X 0 0 0 STACEY KEEFE SECRETARY 1.00 X X 0 0 0 ERIC CHASE BOARD MEMBER 1.00 X 0 0 0 LARI JIMERSON BOARD MEMBER 1.00 X 0 0 0 SCOTT EBNER EXECUTIVE DIRECTOR 40.00 X 92333 0 8026 RUTH WELLS CHIEF FISCAL OFFICER 40.00 X 73380 0 7486 165713 0 15512 0 0 0 0 600 ERIE PLACE LLC 620 ERIE BOULEVARD WEST SUITE 111 SYRACUSE NY 13204 RENT 424962 1 2008201 2008201 MEDICAID CASE MANAGEMENT 624100 5837175 5837175 CLINIC FEES 624100 1447486 1447486 PROGRAM SERVICE FEES 624100 997681 997681 8282342 61328 61328 128 -128 -128 -128 MISC. INCOME 900099 96461 96461 96461 10448204 8378803 0 61200 181225 181225 5794714 5347447 447267 110592 96365 14227 949652 837231 112421 565389 524995 40394 2708 660 2048 96224 52959 43265 444562 391998 52564 73054 71075 1979 328025 291220 36805 239405 213539 25866 432321 385069 47252 127762 121398 6364 67710 34813 32897 174100 119679 54421 33838 24822 9016 PRACTICAL ASSISTANCE 381045 381045 BAD DEBT EXPENSE 1343 1343 10003669 8895658 1108011 0 1052431 998608 6101011 6107959 1067976 1125091 241682 233902 1287805 706241 716302 581564 1274826 1213131 10454228 10260255 393631 523236 5242578 4720898 392980 261807 6029189 5505941 X 4425039 4754314 4425039 4754314 10454228 10260255 444535 -115260 0 X 0 1 X 1 0 X 2333092 2203631 2120266 2191008 2008201 10856198 6554015 7406650 7825468 7841858 8282342 37910333 8887107 9610281 9945734 10032866 10290543 48766531 0 0 0 48766531 957 2654 6669 58902 61328 130510 957 2654 6669 58902 61328 130510 30966 29965 401 38940 96461 196733 8919030 9642900 9952804 10130708 10448332 49093774 0.99330 0.99460 0.00270 0.00150 X 299094 122611 176483 988711 583630 405081 581564 DUE TO FUNDING SOURCES 261807 261807 X 10332944 -115260 -115260 10448204 0 10448204 10003669 0 10003669 0 10003669 PART X, LINE 2: THE CORPORATION IS EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, AND UNDER SIMILAR REQUIREMENTS OF NEW YORK STATE LAW, NO PROVISION HAS BEEN MADE FOR FEDERAL OR STATE TAXES. ADMINISTRATIVE SERVICES OF UPSTATE NY, LLC WITH THE CONSENT OF ITS MEMBER, HAS ELECTED UNDER THE INTERNAL REVENUE CODE TO BE A LIMITED LIABILITY COMPANY. THE LLC MEMBER, ONONDAGA CASE MANAGEMENT SERVICES, INC. WILL REPORT THE INCOME FROM THE LLC ON ITS TAX RETURN. MANAGEMENT BELIEVES THAT SUBSTANTIALLY ALL OF THE CORPORATION'S INCOME DURING THE YEARS ENDED DECEMBER 31, 2018 AND 2017, WAS RELATED TO THE CORPORATION'S EXEMPT PURPOSE. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS REVIEWED BY THE BOARD IN DRAFT FORM DURING THE ANNUAL AUDIT REVIEW. THE SUPPLEMENTAL NARRATIVE IS FINALIZED AND PRESENTED TO THE BOARD FOR FINAL APPROVAL DURING A SUBSEQUENT BOARD MEETING. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS SIGN A CONFLICT OF INTEREST ACKNOWLEDGEMENT AND ANSWER A QUESTIONNAIRE TO DETERMINE IF ANY CONFLICTS EXIST. THE BOARD CHAIR WILL REVIEW THIS DOCUMENTATION AND DETERMINE IF ANY CONFLICT EXISTS. IN THE EVENT THAT A CONFLICT DOES EXIST, THE BOARD CHAIR WOULD THEN POINT THIS OUT AND / OR THE INDIVIDUAL WOULD NOT PARTICIPATE IN THE VOTING. FORM 990, PART VI, SECTION B, LINE 15A THE BOARD REVIEWS SIMILIAR NOT FOR PROFIT ORGANIZATION USING GUIDESTAR.ORG WHEN DETERMINING APPROPRIATE COMPENSATION FOR THE EXECUTIVE DIRECTOR. THE DELIBERATIONS ARE CONTEMPORANEOUSLY DOCUMENTED IN THE BOARD MINUTES. FORM 990, PART VI, SECTION C, LINE 19 THE 990 AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC ON GUIDESTAR.ORG OR UPON REQUEST IN THE ACCOUNTING DEPARTMENT. CURRENTLY, THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS OR CONFLICT OF INTEREST POLICY AVAILABLE. ADMINISTRATIVE SERVICES OF UPSTATE NY LLC 620 ERIE BOULEVARD W SUITE 302 SYRACUSE NY 13204 473985952 CONSOLIDATE ADMIN FUNCTIONS AND OTHER SERVICES WITH OTHER NOT-FOR-PROFITS NY 25000 ONONDAGA CASE MANAGEMENT SERVICES INC