2019-05-13T08:16:07-05:00 2018-06-30 061009205 BLUM SHAPIRO & COMPANY PC CPA'S 29 S MAIN STREET PO BOX 272000 WEST HARTFORD CT 061272000 990 2017-07-01 060646757 CLIFFORD W BEERS GUIDANCE CLINIC INC CLIF 2037721270 93 EDWARDS STREET NEW HAVEN CT 06511 DR ALICE FORRESTER CHIEF EXECUTIVE OFFICER 2037721270 2019-05-10 1 LORI BUDNICK P00046310 8605614000 2019-05-10 64.251.63.131 2019-05-10 08:38:44 ED P AE4F84C66CF7EFD26554BEC15325CB8203138E58 B49528270D5C596423F272EFB472E66EFBF6AFC8 2017 2019-02-21 02:37:17Z DR ALICE FORRESTER 93 EDWARDS STREET NEW HAVEN CT 06511 14044324 0 X WWW.CLIFFORDBEERS.ORG X 1913 CT OUTPATIENT CLINIC PROVIDING COMMUNITY BASED MENTAL HEALTH SERVICES FOR CHILDREN AND THEIR FAMILIES. 17 17 235 40 0 16910 12229515 10632203 2210259 2746155 60617 62515 18658 22990 14519049 13463863 0 0 0 0 12348825 11709893 0 0 609364 3266277 3192721 15615102 14902614 -1096053 -1438751 5573812 4958107 1461234 2177134 4112578 2780973 X TO PROVIDE INTEGRATED SERVICES ADDRESSING MENTAL, PHYSICAL, AND SOCIAL DETERMINANTS IN ORDER TO IMPROVE THE HEALTH, RESILIENCY, AND QUALITY OF LIFE OF CHILDREN, FAMILIES, AND COMMUNITIES. 0 0 11322390 2746155 CLIFFORD BEERS PROVIDES A BROAD RANGE OF OUTPATIENT PROGRAMS AND SERVICES INCLUDING TRADITIONAL OUTPATIENT THERAPY, SPECIALIZED SERVICES TO TARGET PROBLEM SEXUAL BEHAVIOR, SCHOOL-BASED HEALTH CLINICS TO MORE EASILY REACH CHILDREN, AND COMMUNITY DRIVEN CRISIS WORK. THE CLINIC IS PRESENTLY SERVING THE NEWTOWN, CT COMMUNITY AFTER THE TRAGEDY OF 12/14/12. ALL CLINIC PROGRAMS AND SERVICES ARE DESIGNED TO RESPOND TO THE NEEDS OF THE COMMUNITY AND, THEREFORE, MORPH AS NEEDED. THE CLINIC USES A TRAUMA-INFORMED APPROACH TO CARE, SERVING 18+ TOWNS/CITIES IN THE GREATER NEW HAVEN AREA.CONTINUED ON SCHEDULE OEMPS CRISIS SERVICES IS A 24/7 HOTLINE (2-1-1) FOR FAMILIES FACING A CRISIS BUT NOT LIFE-THREATENING SITUATION (E.G., SIGNIFICANT SAFETY ISSUE, THREATS OF SUICIDE, DESTRUCTION TO PROPERTY). CARE COORDINATION IS FOR FAMILIES AT RISK OF HAVING CHILDREN PLACED IN RESIDENTIAL CARE AND AIMS TO COLLABORATE WITH FAMILIES, COMMUNITY SUPPORTS, AND OTHER PROVIDERS TO COORDINATE THE FAMILY'S CARE AND EMPOWER THE FAMILY TO ADVOCATE FOR THEMSELVES.CHILD FIRST IS AN EVIDENCE-BASED IN-HOME PROGRAM FOR CHILDREN 0-5 WHO ARE AT HIGH RISK FOR ABUSE OR NEGLECT. THE CLINIC GUIDES/SUPPORTS NEW PARENTS TO FOSTER BOTH THE PARENT-CHILD CONNECTION AND THE CHILD'S DEVELOPMENT. CHILD FIRST ALSO CONSULTS WITH PRESCHOOLS AND DAY CARE CENTERS ON ISSUES REGARDING THE BEHAVIORAL HEALTH NEEDS OF YOUNG CHILDREN.SCHOOL-BASED HEALTH CLINICS ARE IN FOUR SCHOOLS. ON-SITE LOCALES HELP OVERCOME FINANCIAL, CULTURAL, TRANSPORTATION AND STIGMA BARRIERS TO CARE.JOTLAB (JUVENILES OPTING FOR TREATMENT TO LEARN APPROPRIATE BEHAVIORS) OFFERS TREATMENT FOR CHILDREN AND ADOLESCENTS ENGAGING IN PROBLEM SEXUAL BEHAVIOR OR AT-RISK BEHAVIOR. TREATMENT CAN FOLLOW TRADITIONAL WEEKLY OUTPATIENT THERAPY OR CAN BE AS MUCH AS 15 HOURS/WEEK VIA THE INTENSIVE OUTPATIENT (IOP) PROGRAM.PROJECT CATCH (COLLABORATION ADVOCACY AND TREATMENT FOR CHILDREN) FOCUSES ON THE TRAUMA OF SEXUAL ABUSE AND DOMESTIC VIOLENCE. CATCH PROVIDES SUPPORT, CASE MANAGEMENT, AND ADVOCACY TO HELP CHILDREN AND THEIR FAMILIES RECOVER FROM THESE TRAUMAS. 11322390 1 1 0 0 0 0 0 0 0 1 1 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 102 0 1 235 1 1 1 0 0 0 0 0 0 0 0 0 X 17 17 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CT X MICHAEL RISO CFO 2037778648 5 SCIENCE PARK NEW HAVEN CT 06511 THOMAS SANSONE ESQ PRESIDENT 2.00 X X 0 0 0 ROCHELLE CUMMINGS VICE-PRESIDENT 2.00 X X 0 0 0 MAUREEN FRANK SECRETARY 2.00 X X 0 0 0 DOMINIC SCHIOPPO TREASURER 2.00 X X 0 0 0 WILLIAM S COLWELL ESQ BOARD MEMBER 1.00 X 0 0 0 KAREN DUBOIS-WALTON BOARD MEMBER 1.00 X 0 0 0 JACQUELINE EPRIGHT BOARD MEMBER 1.00 X 0 0 0 LYNN GABBARD BOARD MEMBER 1.00 X 0 0 0 RICHARD LEIBIGER BOARD MEMBER 1.00 X 0 0 0 WILLIAM T KOSTURKO BOARD MEMBER 1.00 X 0 0 0 STEPHEN H KOVEL BOARD MEMBER 1.00 X 0 0 0 CHRISTOPHER LEVESQUE BOARD MEMBER 1.00 X 0 0 0 TED NOVICKI BOARD MEMBER 1.00 X 0 0 0 YAN SEARCY BOARD MEMBER 1.00 X 0 0 0 FREDERICK J STREETS BOARD MEMBER 1.00 X 0 0 0 TINA C WEINER BOARD MEMBER 1.00 X 0 0 0 CHERYL WILLIAMS BOARD MEMBER 1.00 X 0 0 0 ALICE FORRESTER CHIEF EXECUTIVE OFFICER 35.00 X 167402 0 35621 MICHAEL RISO CHIEF FINANCIAL OFFICER 35.00 X 137905 0 6907 PIETER JOOST VAN WATTUM MD MEDICAL DIRECTOR 22.00 X 164098 0 3900 CHRISTINE MONTGOMERY VP CLINICIAL & COMMUNITY SERVICES 35.00 X 103454 0 22724 PAUL RAU CHILD PSYCHIATRIST 35.00 X 105106 0 0 TISA A ADKINSON DO ASSOCIATE MEDICAL DIRECTOR 35.00 X 183832 0 28357 RITA PARADIS VP OF BUSINESS DEVELOPMENT 35.00 X 100479 0 10198 962276 0 107707 7 0 1 0 HEALTH MANAGEMENT ASSOCIATES 120 NORTH WASHINGTON SQUARE STE 70 LANSING MI 48933 CONSULTING 121329 1 62041 8694276 1875886 10632203 CLIENT FEES 624100 2530262 2530262 FEE FOR SERVICE 900099 215893 215893 2746155 61148 61148 557916 556549 1367 1367 1367 9713 62041 23912 -14199 -14199 CONFERENCE AND OTHER 900099 37189 37189 37189 13463863 2746155 0 85505 942123 532655 409468 8734604 6950876 1456660 327068 87879 66040 18969 2870 1197162 899064 259587 38511 748125 570205 153362 24558 28434 1500 26934 46328 46328 980017 742859 111978 125180 21856 3820 13941 4095 560938 352425 172615 35898 349154 293210 48703 7241 442671 315671 105650 21350 77970 73052 4253 665 49171 32244 16143 784 31867 31867 148484 120828 23404 4252 82704 68134 12325 2245 REPAIRS AND MAINTENANCE 288182 239779 44969 3434 EMERGENCY ASSISTANCE 47432 47432 37513 12596 13704 11213 14902614 11322390 2970860 609364 771139 25114 666717 41590 270440 296766 82736 107964 3020683 1776257 1203988 1244426 2516484 3166244 62308 76003 5573812 4958107 750093 650971 171141 62187 540000 1463976 1461234 2177134 X 2400784 1196669 423501 296011 1288293 1288293 4112578 2780973 5573812 4958107 -1438751 107146 0 X 0 1 X 1 1 1 X 6771252 11609743 11801731 12229515 10632203 53044444 6771252 11609743 11801731 12229515 10632203 53044444 53044444 33662 21145 39083 58944 62515 215349 60036 35586 4006 3233 37189 140050 53399843 0.99330 0.99210 X 2429533 1000000 150498 451526 3128505 1963323 1001000 238664 773454 2429533 2313499 749 -2855 348070 1963323 1578956 903936 53607 223000 2313499 1408889 274067 104000 1578956 0.52680 0.06180 0.41140 0 0 2192957 1360725 832232 300084 73383 226701 527642 342149 185493 1244426 13740875 107146 145043 24823 277012 13463863 0 13463863 15072480 145043 24823 169866 14902614 0 14902614 PART V, LINE 4: THE CLINIC'S BOARD OF DIRECTORS HAS APPROVED A SPENDING POLICY THAT EVALUATES AN ANNUAL SPENDING TARGET OF 4.25% OF THE AVERAGE QUARTERLY ENDING MARKET VALUE OVER THE PRECEDING TWENTY QUARTERS. THIS IS CONSISTENT WITH THE CLINIC'S OBJECTIVE TO MAINTAIN THE PURCHASING POWER OF THE ENDOWMENT ASSETS HELD IN PERPETUITY, AS WELL AS TO PROVIDE REAL GROWTH THROUGH NEW GIFTS AND INVESTMENT RETURN. PART XI, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EXPENSES NETTED WITH REVENUE ON FORM 990 24,823. PART XII, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EXPENSES NETTED WITH REVENUE ON FORM 990 24,823. BOH BREAKFAST 71754 62041 9713 4840 16525 2547 FRIENDS OF JIMMY MILLER 71754 62041 9713 4840 16525 2547 23912 -14199 X X X 0 0 0 0 0 0 0 0 0 ALICE FORRESTER CHIEF EXECUTIVE OFFICER 167402 0 0 0 0 0 15925 0 19696 0 203023 0 0 0 PIETER JOOST VAN WATTUM MD MEDICAL DIRECTOR 164098 0 0 0 0 0 0 0 3900 0 167998 0 0 0 TISA A ADKINSON DO ASSOCIATE MEDICAL DIRECTOR 183832 0 0 0 0 0 0 0 28357 0 212189 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B THE REVIEW PROCESS OF THE FORM 990 IS DONE BY THE FINANCE COMMITTEE OF THE BOARD. AFTER THE FINANCE COMMITTEE REVIEWS AND APPROVES THE FORM 990, THE FINANCE COMMITTEE'S APPROVAL PROCESS IS COMMUNICATED TO THE BOARD, AND A COPY IS PROVIDED TO EACH BOARD MEMBER. EACH BOARD MEMEBER HAS AN OPPORTUNITY TO REVIEW THE FORM 990 BEFORE THE FINAL REPORT IS FILED. FORM 990, PART VI, SECTION B, LINE 12C THE CLINIC HAS A FORMAL CONFLICT OF INTEREST POLICY THAT DESCRIBES SPECIFIC CONFLICTS THAT WOULD NEED TO BE DISCLOSED IF THEY WERE APPLICABLE. ALL DIRECTORS AND OFFICERS ARE REQUIRED TO COMPLETE AND SIGN A CONFLICT OF INTEREST STATEMENT IN THE FORM THAT HAS BEEN APPROVED BY THE BOARD, PRIOR TO TAKING OFFICE OR ACCEPTING NOMINATION AS A DIRECTOR OR OFFICER AND ANNUALLY THEREAFTER; AND SHALL HAVE A CONTINUING RESPONSIBILITY TO DISCLOSE TO THE CORPORATION AS SOON AS ANY POTENTIAL CONFLICT IS KNOWN, SUCH POTENTIAL CONFLICT OF INTEREST ARISING DURING THEIR TENURE AS AN OFFICER OR DIRECTOR. THE SECRETARY OF THE CORPORATION KEEPS ALL CONFLICT OF INTEREST STATEMENTS ON FILE IN THE CORPORATE RECORDS. THE SECRETARY OF THE CORPORATION REVIEWS EACH NEW, ANNUAL OR AMENDED STATEMENT, AND WHEN REQUESTED TO DO SO SHALL CAUSE ANY SUBSTANTIAL FINANCIAL OR OWNERSHIP INTEREST IN ANY OTHER ENTITY WITH THIS CORPORATION CONTRACTS TO BE DISCLOSED TO ALL STATE AND FEDERAL AGENCIES, INLUDING MEDICAID AUTHORITIES, WHICH ARE ENTITLED TO REQUEST AND RECEIVE THIS INFORMATION. FORM 990, PART VI, SECTION B, LINE 15 YES, THE CLINIC UTILIZED A SEARCH FIRM THAT CONDUCTED A NATIONAL SEARCH TO FILL THE EXECUTIVE DIRECTOR POSITION IN 2007. AS PART OF THAT PROCESS, THE SEARCH FIRM ASSISTED WITH ESTABLISHING THE COMPENSATION RANGE, EVALUATING THE CANDIDATES, AND PREPARED SUMMARY DOCUMENTATION FOR THE FINAL CANDIDATES, AND PREPARED SUMMARY DOCUMENTATION FOR THE FINAL CANDIDATES. THE EXECUTIVE COMMITTEE OF THE BOARD WORKED CLOSELY WITH THE SEARCH FIRM TO REACH THE FINAL DECISION AND STRUCTURE THE FINAL EMPLOYMENT OFFER. THE EXECUTIVE DIRECTOR'S COMPENSATION IS BASED ON HER CONTRACT. ADDITIONALLY, THE CLINIC UTILIZES INDUSTRY DATA PREPARED BY THE CONNECTICUT COMMUNITY PROVIDERS ASSOCIATION TO EVALUATE AND BENCHMARK MARKET COMPENSATION FOR THE OTHER KEY EMPLOYEES IN THE ORGANIZATION. FORM 990, PART VI, SECTION C, LINE 19 OTHER THAN THE INFORMATION DISCLOSED IN THE ANNUAL FORM 990 REPORT, THE CLINIC DOES NOT MAKE ITS GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC. THE CLINIC MAKES ITS AUDITED FINANCIAL STATEMENTS AVAILABLE TO FUNDERS AS PART OF GRANT FUNDING OR BANK LOAN REQUESTS THAT ARE EVALUATED AND DETERMINED TO BE APPROPRIATE AND NECESSARY.