2018-07-30T15:29:21-05:00 2017-12-31 010723685 DERMODY BURKE & BROWN CPAS LLC 443 N FRANKLIN ST STE 100 SYRACUSE NY 132041441 990 2017-01-01 161363413 ONONDAGA CASE MANAGEMENT SERVICES INC ONON 3154727363 620 ERIE BOULEVARD W SUITE 302 SYRACUSE NY 13204 NANCY LEVETT PRESIDENT 3154727363 2018-07-09 1 CAROLYN S STURICK P01278448 3154719171 2017 2022-09-23 18:48:47Z CIRCARE NANCY LEVETT 620 ERIE BOULEVARD W SUITE 302 SYRACUSE NY 13204 10130708 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 6 176 0 0 0 2120266 2191008 7825468 7841858 6669 58902 401 38940 9952804 10130708 0 0 0 0 6765164 7271156 0 0 0 2331126 2438034 9096290 9709190 856514 421518 10400632 10454228 6428491 6029189 3972141 4425039 X ONONDAGA CASE MANAGEMENT SERVICES, INC. ASSISTS PEOPLE WITH DIFFICULT LIFE CHALLENGES TO DEVELOP PERSONALLY MEANINGFUL LIVES. 0 0 6505106 5593987 HEALTH HOME CARE MANAGEMENTSEE SCHEDULE O FOR FUTHER DETAILS. CIRCARE'S LARGEST PROGRAM, HEALTH HOME CARE MANAGEMENT, PROVIDES 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. 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. 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.IN ADDITION TO PROVIDING THE SERVICE AT CIRCARE, THE ORGANIZATION IS DEEMED A REGIONAL LEAD HEALTH HOME BY NEW YORK STATE. AS A LEAD HEALTH HOME, CIRCARE IS RESPONSIBLE FOR MANAGING A NETWORK OF PROVIDERS ("DOWNSTREAM AGENCIES") AND THE PROVISION OF HEALTH HOME CARE MANAGEMENT SERVICES TO ELIGIBLE ENROLLEES IN EIGHT CENTRAL NEW YORK COUNTIES.AS A HEALTH HOME CARE MANAGEMENT AGENCY, CIRCARE PROVIDED CARE MANAGEMENT SERVICES TO 2,350 ADULT MEDICAID BENEFICIARIES IN 2017. 849223 909355 ASSERTIVE COMMUNITY TREATMENTSEE 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. ACT IS OFTEN REFERRED TO A "MENTAL HEALTH CLINIC ON WHEELS". PRIOR TO ACT SERVICES, INDIVIDUALS ARE OFTEN HOSPITALIZED FOR PSYCHIATRIC REASONS AND/OR FREQUENTLY PRESENT IN EMERGENCY DEPARTMENTS.IN 2017, THE ACT TEAM SERVED AN AVERAGE OF 57 UNIQUE INDIVIDUALS WITH A TOTAL OF 684 TOTAL NUMBER OF SERVICE UNITS PROVIDED. 1359810 1377456 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 2017, CIRCARE'S OUTPATIENT BEHAVIORAL HEALTH CLINIC SERVED 700 CLIENTS AND PROVIDED A TOTAL OF 12,400 INDIVIDUAL SESSIONS WHICH AVERAGES TO APPROXIMATELY 18 VISITS PER CLIENT. 8714139 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 74 0 1 176 1 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 CHRISTOPHER LEVATINO FORMER BOARD MEMBER 1.00 X 0 0 0 KERRY LANGAN FORMER BOARD MEMBER 1.00 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 90998 0 9731 RUTH WELLS CHIEF FISCAL OFFICER 40.00 X 73898 0 9225 164896 0 18956 0 0 0 0 600 ERIE PLACE LLC 620 ERIE BOULEVARD WEST SUITE 111 SYRACUSE NY 13204 RENT 466488 PAULA ZEBROWKSI 620 ERIE BOULEVARD WEST SUITE 302 SYRACUSE NY 13204 PSYCHIATRIC SERVICES 136494 2 2190913 95 2191008 MEDICAID CASE MANAGEMENT 624100 5721925 5721925 CLINIC FEES 624100 1377456 1377456 PROGRAM SERVICE FEES 624100 742168 742168 MEDICARE MEDICATION 624100 309 309 7841858 58902 58902 MISC. INCOME 900099 38940 38940 38940 10130708 7880798 0 58902 183851 183851 5499619 5148896 350723 107597 98092 9505 899538 802551 96987 580551 544190 36361 84132 50981 33151 500997 413220 87777 38782 35169 3613 223742 182727 41015 256968 232052 24916 445331 406061 39270 133494 126505 6989 95372 67580 27792 155618 111565 44053 41347 32299 9048 SPECIFIC ASSISTANCE TO 459479 459479 BAD DEBT EXPENSE 2772 2772 9709190 8714139 995051 0 1264815 1052431 7290920 6101011 912601 1067976 236978 241682 1249589 533287 695318 716302 1274826 10400632 10454228 660932 393631 5385579 5242578 381980 392980 6428491 6029189 X 3972141 4425039 3972141 4425039 10400632 10454228 421518 31380 0 X 0 1 X 1 0 X 2845267 2333092 2203631 2120266 2191008 11693264 5317311 6554015 7406650 7825468 7841858 34945302 8162578 8887107 9610281 9945734 10032866 46638566 0 0 0 46638566 396 957 2654 6669 58902 69578 396 957 2654 6669 58902 69578 84700 30966 29965 401 38940 184972 8247674 8919030 9642900 9952804 10130708 46893116 0.99460 0.98050 0.00150 0.00030 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 286955 82972 203983 962634 450315 512319 716302 DUE TO FUNDING SOURCES 392980 392980 X 10162088 31380 31380 10130708 0 10130708 9709190 0 9709190 0 9709190 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 IS UNAWARE OF ANY UNRELATED BUSINESS ACTIVITIES THAT MAY BE SUBJECT TO UNRELATED BUSINESS INCOME TAX OR ANY ACTIVITIES THAT WOULD JEOPARDIZE THE CORPORATION'S EXEMPT STATUS. 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