2017-07-26T13:54:12-05:00 2016-12-31 450250958 Eide Bailly LLP 800 Nicollet Mall Suite 1300 Minneapolis MN 554027033 990 2016-01-01 410682405 Hazelden Betty Ford Foundation HAZE 6512134006 PO Box 11 Center City MN 55012 James Blaha VP CFO & CAO 6512134006 2017-07-25 1 Kim Hunwardsen CPA P00484560 6122536500 198.135.125.110 2017-07-25 14:04:14 CD P C7C8DB9543014370B6E09D707AD0C123D6D8C430 C2F93E997884607275CF0BC09EAA2E8662D9DCFA 2016 2021-01-29 14:40:06Z Mark Mishek PO Box 11 Center City MN 55012 218070013 0 X www.hazeldenbettyford.org X 1949 MN Hazelden Betty Ford Foundation is a force of healing and hope for individuals, families and communities affected by addiction to alcohol and other drugs. 23 23 1907 595 -192177 -194616 49029171 11517573 169226125 162523390 3312282 5609358 1984105 2514322 223551683 182164643 738411 1119791 0 0 104284365 109046151 0 0 3976297 77267808 79788372 182290584 189954314 41261099 -7789671 459943821 475419595 133821046 151836161 326122775 323583434 X Hazelden Betty Ford Foundation is a force of healing and hope for individuals, families and communities affected by addiction to alcohol and other drugs. This is accomplished through a commitment to treatment, publishing, higher education, research, public education and advocacy, and shared learning with other organizations. 0 0 124864839 139548467 Addiction Treatment for Adults, Youth and Families The goal of addiction treatment at Hazelden Betty Ford Foundation is lifelong recovery for each patient. The Foundation approaches treatment for addiction and co-occurring mental health disorders in a holistic way. Its treatment incorporates integrated clinical disciplines with individualized planning and care. Interdisciplinary care teams consist of addiction counselors, psychologists and psychiatrists, physicians and nurses, family specialists, spiritual care professionals, nutritionists and wellness specialists. In addition to addiction treatment, Hazelden Betty Ford Foundation provides assessment and evaluation services, intervention services, structured sober living, continuing care services and mental health services. Hazelden Betty Ford Foundation also understands that recovery from addiction involves rebuilding relationships with family members and friends. Through its family, parent, sibling and children's programs, loved ones receive education, guidance and support to achieve a healthier way of life. Its sites are located in Center City, Chaska, Maple Grove, Plymouth and St. Paul, Minnesota; Chicago, Illinois; Naples, Florida; New York, New York (in the Tribeca and Chelsea neighborhoods); Newton, Massachusetts; Beaverton and Springbrook, Oregon; and the Betty Ford Center in Rancho Mirage, West Los Angeles and San Diego, California; Irving, Texas; and Aurora, Colorado. In 2016, the following number of people directly benefited from Hazelden Betty Ford addiction treatment and recovery programs: Primary Treatment Adult 4,209 Family Program Adult 2,185 Day Treatment Adult 2,077 Mental Health Adult 2,040Outpatient Treatment Adult 1,409 Intensive Outpatient Adult 1,329 Renewal Center and Lodge 1,075 Children's Program 851Primary Treatment Youth 748 Mental Health Youth 535Family Program Youth 493 Day Treatment Youth 286Intensive Outpatient Youth 105 Outpatient Treatment Youth 89 Intermediate Care Services 87 DUII Diversion Program Oregon 36 Recovery Housing 3 TOTAL PATIENTS SERVED 17,557 Additionally, financial assistance is available as measured as gross charges foregone, and in 2016, nearly $7,800,000 was provided to 4,211 qualifying patients and family members. 16567506 20336414 Publication of Educational Materials Hazelden Publishing develops and distributes resources to help people recognize, understand and overcome addiction and co-occurring mental health disorders and other closely related problems. As the leading publisher of evidence-based curricula and other materials for professionals who work to prevent and treat addiction, the proven-effective resources of Hazelden Betty Ford are implemented in a variety of settings, including schools, other addiction treatment programs, correctional programs, government and military agencies, and mental health and counseling agencies. The publications, particularly its signature daily meditation books, are known the world over for helping people learn to apply recovery principles and practices to daily life. Daily meditation books and other Hazelden Publishing materials provide much-needed inspiration, encouragement, guidance and support for lifelong recovery from the disease of addiction. In 2016, through its BookAid program, the Hazelden Publishing sent 2,250 packages of 10,660 products that reached the lives of more than 200,000 people through 76 libraries serving programs and institutions in need. BookAid resources were sent to individuals and organizations in the United States and as far away as Tanzania and Ireland. The value of these products is in excess of $202,000. 5007375 1119791 5637069 Higher Education and Medical & Professional TrainingHazelden Betty Ford Graduate School of Addiction Studies The Hazelden Betty Ford Graduate School of Addiction Studies, accredited by the Higher Learning Commission, educates future leaders in addiction counseling to provide evidence-based integrated care for substance use and co-occurring disorders. The graduate school's innovative and comprehensive programs integrate direct clinical practice with academic training to build professional competency in the field of addiction counseling. In 2016, the school awarded 20 Master of Arts degrees in Addiction Counseling, 24 Master of Arts degrees in Addiction Counseling: Advanced Practice and 4 Master of Arts degrees in Addiction Studies: Integrated Recovery for Co-Occurring Disorders.Scholarship grants are provided to qualified participants of both the Graduate School (166 scholarships given) and medical and professional education programs (229 scholarships given). Medical & Professional EducationThe Professionals in Residence (PIR) program and the Summer Institute for Medical Students (SIMS) give medical students, residents and health care and legal professionals an in-depth experience with the dynamics of the disease of addiction. Intensive one-week programs blend classes presented by Hazelden Betty Ford Foundation physicians and expert clinicians with time spent interacting with patients or family members and staff on treatment units or family programs. Participants learn about the latest research and evidence-based methods from our multidisciplinary faculty.A two-week rotation on addiction for family medicine residents is available in Minnesota and California. A one-year accredited Addiction Medicine Fellowship is available at the Betty Ford Center in California. A Course on Addiction and Recovery Education (CARE) is available worldwide. The Minnesota and California sites also offer customized programming for larger groups. In 2016, the Minnesota and California programs welcomed a total of 1,350 participants. Community Care and Community Benefit: In meeting Hazelden Betty Ford's commitment to our mission and the underlying charitable purpose of our organization, we invest our time, financial resources and energy helping people and communities understand and address addiction as a treatable chronic disease, and spread the word that recovery is possible. "Be of service" is an integral core value that we demonstrate in a variety of ways. Hazelden Betty Ford provides treatment services to individuals and families who seek and qualify for care but are unable to pay the full cost. Our patient aid policy provides that Hazelden Betty Ford will annually establish a target amount of financial assistance. In addition, the Foundation provides a variety of other benefits for the public good including:Hazelden Betty Ford Graduate School of Addiction Studies: -The Hazelden Betty Ford Graduate School of Addiction Studies prepares future leaders in addiction counseling through the Master of Arts in Addiction Counseling and Master of Arts in Addiction Studies degrees. The school emphasizes public engagement as a means of serving constituent communities. In 2016, students provided 17,898 hours of clinical services at agencies reaching underserved and economically disadvantaged populations. The school offers a full scholarship each year to students who work at Chisago County Health and Human Services and provides continuing education to these Chisago County professionals at no cost. Forty-eight students graduated with master's degrees from the school in 2016. Overall, more than 92 percent of graduates who seek careers in the addiction treatment field find employment in their home communities or at regional or national treatment agencies. Faculty and graduate school leaders participate in public service events throughout the United States and make research, educational, and scholarly contributions to the field of addiction treatment.Butler Center for Research: -The Butler Center for Research (BCR) is dedicated to improving recovery from addiction by conducting clinical and institutional research, collaborating with other research centers, and communicating scientific findings. It is the Center's vision that sustained recovery for all who seek help will be achieved through advancements in knowledge and integration of research into practice. -In 2016, the BCR participated in the following activities: -As part of Hazelden Betty Ford's commitment to evidence-based practice, over 50 data analysis projects were conducted to inform clinical care and academic programming, identify treatment needs, drive data-based decision-making, guide strategic planning and contribute to the field's knowledge of addiction treatment. Several of these projects were utilized with insurance payers to demonstrate Hazelden Betty Ford's value proposition.-In 2016, the BCR launched a new research study collaboration with the National Association of Addiction Treatment Providers (NAATP) and 9 other addiction treatment provider organizations. This study will provide the first opportunity for participating providers to benchmark with each other on the same outcomes metrics and help drive the addiction field toward standardized outcomes measurement and reporting. BCR staff completed recruitment and baseline data collection for Hazelden Betty Ford's study in late 2016. Follow up data collection (through 12 months post-treatment) is underway and will continue through the end of 2017.-The BCR also published two manuscripts in 2016. The first outlined the "pay-for-performance" initiative in place between Hazelden Betty Ford and Health Partners and reported initial results of the program. The second outlined findings from a spirituality and recovery study.-The Research Updates were disseminated to professionals, educators, researchers, students and other stakeholders. These two-page summaries of scientific findings from the field of addiction treatment research are provided at no cost as a community benefit to policymakers, treatment professionals and the public at large. Research Updates are also available on the BCR page at www.HazeldenBettyFord.org. Eight new Research Updates were created, including: Factors Impacting Early Alcohol and Drug Use Among Youths, Animal-Assisted Therapy for Substance Use Disorders, Prevalence of Adolescent Substance Misuse, Problem Drinking Behaviors Among College Students, The Importance of Recovery Management, The Brain Disease Model of Addiction, Substance Abuse Factors Among LGBTQ Individuals, Prescription Opioids and Dependence.Community Education and Relations: -We "livestream" the talks presented by speakers at the Hazelden Betty Ford's "Awareness Hour," an informative series of free public lectures that have been held since 1976 on select Saturdays throughout the year. Livestreaming effectively turns these local events into national public education opportunities, boosting the potential audience far beyond the live venue capacity of 500.-The Hazelden Betty Ford's Speakers Bureau helped place the organization's wide array of spokespeople at many related events throughout the country. Hazelden Betty Ford's employees delivered 261 presentations in 29 states.-Through its community relations services, the Visitors Program in Center City, Minnesota, scheduled and conducted 32 tours for 280 individuals. At Hazelden Betty Ford's location in Rancho Mirage, California, more than 140 tours were scheduled and conducted.-Volunteers at facilities in California, Illinois, Florida, Minnesota, New York, and Orgeon donated 16,614 hours, valued at more than $413,000.-Educational scholarships from Hazelden Betty Ford totaling $5,200 were awarded to students at six high schools in the Twin Cities and the surrounding Center City area.-Hazelden Betty Ford continues its involvement with Partners for a Drug Fee Chisago County, providing expertise, hosting meetings and allowing staff to serve on the organization's board. And we also co-sponsored and hosted an annual Women's Health Conference, a free community event that brings together medical providers and public health departments. Publishing: -Hazelden Publishing is the leading publisher of state-of-the-art resources for preventing, treating, and managing addiction and closely related issues. Translating research into practice, Hazelden Publishing helps organizations treat the whole client by offering information, guidance, tools, and support to meet their unique needs. With 182 new offerings in 2016, our publications continue to provide inspiration, guidance and encouragement to millions around the world every day. In 2016, Hazelden Publishing generated 41 new products, 9 new distributed products, 25 new services and trainings, 12 new e-books, 18 translation rights, 66 specialty products, and 11 new subscriptions. If not for our mission and commitment, much of this material would not be published and available to consumers because of its limited appeal to mainstream publishers. Hazelden Publishing's materials also reach underserved populations, including many customers in the community treatment, faith-based and corrections markets.Children's Programs:-The Children's Program provides prevention and education services to children and families with addiction. Programs are located in California, Texas and Colorado. No child has ever been turned away because of lack of financial ability to pay, and over 90% attend on scholarships.-In 2016, 1,588 children and family members participated in the program.-Staff of the Children's Program also participated in the Red Ribbon Campaign at numerous schools in the California, Texas and Colorado areas. Early prevention education and recovery awareness events were held in communities and schools, along with training sessions for school administrators, principals, counselors and teachers to provide information, resources and tools regarding the family disease of addiction. The training session, called Tools for the Journey, is also open to therapists, counselors, non-profits and other organizations that work with children.Web and Social Networks:-The corporate website, www.HazeldenBettyFord.org, continued to grow in 2016. "Thought for the Day" remained the most popular feature on the website, with over 6,000 visitors each day. "Thought for the Day" provides daily inspirational readings from one of six Hazelden Publishing meditation books. The website hosted over 6 million sessions for people seeking information on a variety of addiction-related topics, including treatment, recovery, education, public advocacy and products in our online bookstore. Nearly 1 million people read blog and newsletter articles. In 2016, website visitors more often used mobile devices than desktop computers to visit our website, with 62.78% using a small screen mobile device vs. 37.22% using a tablet or desktop computer.-Hazelden Betty Ford's Social Community - an online network for people interested in recovery - featured discussion boards, chatrooms, blogs, a book club and online meetings accessible to anyone from anywhere in the world. Hazelden Betty Ford launched a new version of the online recovery community in 2016, called the www.TheDailyPledge.org, and went from no members in February to finishing the year with 3,725 members, more than 25,000 visitors and over 250,000 page views.-Hazelden Betty Ford's Facebook, Twitter, YouTube, LinkedIn and other social media accounts, which have over 53,000 followers, along with our online Alumni Network and award-winning mobile apps, offered additional access to recovery resources, providing daily inspiration, information and fellowship.Resource Center:-In 2016, Hazelden Betty Ford's Resource Center received a total of 114,457 calls and 2,251 online inquiries from people seeking information, assistance, and products related to addiction issues. -Part of the Resource Center's work is connecting people with the help they need, in the form of products, services, and free information. For those in need of resources beyond what Hazelden Betty Ford provides, the Resource Center searches its database of more than 30,000 agencies to locate other possible assistance. 146439720 1 1 0 1 0 0 0 1 0 1 1 1 0 1 1 1 0 1 0 0 1 0 1 0 1 0 1 1 0 1 1 1 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 1 1 1 0 0 1 1021 0 1 1907 1 1 1 1 CJ 0 0 0 1 1 0 0 0 0 X 23 23 1 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 1 0 AL AK AZ AR CT FL IL KS KY LA MD MA MI MS MN NH NJ NM NY NC ND OH OK OR PA RI SC TN UT VA WA WV WI X James Blaha VP Chief Financial & Administrative Officer 6512134006 15251 Pleasant Valley Road Center City MN 55012 William Cirone Chair 5.00 0.00 X X 0 0 0 Susan Engeleiter Vice Chair 2.00 0.00 X X 0 0 0 Mary Turner Pattiz Vice Chair 2.00 0.00 X X 0 0 0 Catherine Lane Weyerhaeuser Secretary 2.00 0.00 X X 0 0 0 Susan Ford Bales Member 1.00 0.00 X 0 0 0 Vaden F Bales Member - served part year 1.00 0.00 X 0 0 0 John K Butler Member 1.00 0.00 X 0 0 0 Harve Ferrill Member 1.00 1.00 X 0 0 0 The Hon Susan Fox Gillis Member 1.00 1.00 X 0 0 0 James R Greenbaum Member 1.00 0.00 X 0 0 0 A John Huss Jr Member 1.00 0.00 X 0 0 0 Andrew Jeon MD Member 1.00 0.00 X 0 0 0 William J Lammers Member 1.00 0.00 X 0 0 0 Eric Lund Member 1.00 0.00 X 0 0 0 Lester Munson Member 1.00 1.00 X 0 0 0 Austin P Olney Member 1.00 0.00 X 0 0 0 Gloria Perez Member 1.00 0.00 X 0 0 0 Madeline Redstone Member 1.00 1.00 X 0 0 0 Cini Gannon Robb Member 1.00 0.00 X 0 0 0 G Aubrey Serfling Member 1.00 0.00 X 0 0 0 Michael Sime Member 1.00 0.00 X 0 0 0 Mary Farnham Whitney Member 1.00 0.00 X 0 0 0 Frank B Wilderson Jr PHD Member 1.00 0.00 X 0 0 0 MaryPat Woodard Member 1.00 0.00 X 0 0 0 James Blaha Treasurer, VP CFO and CAO 50.00 10.00 X 331247 0 48712 Mark Mishek President and CEO 50.00 10.00 X 596474 0 80424 Nicholas Motu VP Mktg, Comm. Bus Dev, IRA 50.00 0.00 X 283137 0 48359 Dr Marvin Seppala Chief Medical Officer 50.00 0.00 X 472654 0 57815 Valerie Slaymaker VP Edu, Quality & Research 50.00 0.00 X 222580 0 32484 Jennifer Lohse VP General Counsel 50.00 10.00 X 196668 0 43708 James Steinhagen VP SW Region/Admin BFC 50.00 0.00 X 322616 0 50519 John Driscoll SR VP Recovery Services 50.00 0.00 X 282641 0 54773 William Moyers VP Public Affairs & Comm Rel 50.00 0.00 X 215556 0 45534 Elizabeth Farver-Smith VP Philanthropy & Alumni Relations 50.00 0.00 X 222767 0 23735 Joseph Jaksha VP Publisher 50.00 0.00 X 239180 0 42859 Dr Joseph Lee Youth Continuum Medical Dir 50.00 0.00 X 316747 0 65063 Pamela Shultz Staff Physician 50.00 0.00 X 292252 0 37941 Robert Poznanovich Exec Dir Bus Development 50.00 0.00 X 274316 0 26308 Dr Jeffery Young Medical Director 50.00 0.00 X 277747 0 39203 Dr Katarzyna Litak Psychiatrist 50.00 0.00 X 261978 0 37434 Mark Sheets Exec. Dir. Youth Continuum, Former key employee 50.00 0.00 X 233993 0 45472 Janice Vondrachek Executive Director Oregon, Former key employee 50.00 0.00 X 228517 0 25536 5271070 0 805879 119 1 1 0 Sodexho Inc & Affiliates 4800 Paysphere Circle Chicago IL 60674 Food Service 2406594 Innovo Advisors LLC 18242 Dove Court Eden Prairie MN 55347 Technology Consultants 1154479 Xerox Corporation 45 Glover Avenue Norwalk CT 06856 Duplication Services 743778 RR Donnelley 111 South Wacker Drive Chicago IL 60606 Warehouse Management 561128 Cerner Corporation 2800 Rockcreek Parkway Kansas City MO 64117 Technology Consultants 507861 29 720969 10796604 179937 11517573 Addiction Treatment 623990 137020437 137020437 Publishing 511130 19968004 19968004 Higher Education 611600 5534949 5534949 162523390 1118092 1118092 39995000 35461566 42168 4533434 -42168 4491266 4491266 109575 720969 401636 -292061 -292061 Corporate Support Fee 561000 2998560 2998560 Personal Property Rent 900002 23115 23115 Income from Partnership 900003 -215292 -215292 2806383 182164643 165521950 -192177 5317297 1113659 1113659 6132 6132 4152862 1511404 2431931 209527 81068563 64649703 14305905 2112955 3805417 3043246 688034 74137 14002658 11033348 2528145 441165 6016651 4650871 1239430 126350 854209 11258 842951 116574 116574 62090 62090 118381 118381 14534740 10828031 3570489 136220 3926844 3229863 390103 306878 5755037 3459789 2194456 100792 3734636 127707 3602084 4845 2131491 2131491 4646965 3575830 949556 121579 2856114 1944147 705899 206068 668726 531601 128876 8249 1888231 1394237 486999 6995 18318575 14013968 4212947 91660 Provision for Bad Debt 6625656 6625656 Cost of Materials Sold 3196421 3192137 4284 Patient Food 2849160 2542340 306820 MNCare Tax 1506586 1506586 5997936 5316716 652343 28877 189954314 146439720 39538297 3976297 2304126 2016494 7484318 6938818 19616243 25433775 2755770 2227578 820817 774537 338783752 140169818 202910177 198613934 68780193 72232727 68106333 66296946 12146856 12107012 75018988 88777774 459943821 475419595 30915125 29531544 1340615 1087923 59996371 58881060 3226024 2970000 13877500 35372911 48458134 133821046 151836161 X 283423023 280350027 11133692 11612213 31566060 31621194 326122775 323583434 459943821 475419595 X -7789671 5256218 -5888 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 0 0 0 1 49460 1 151611 0 201071 0 Part II-B, Line 1: The ongoing effort to confront the growing prescription pain pill and heroin epidemic was the main focus of the Hazelden Betty Ford Institute for Recovery Advocacy in 2016. By informing audiences and key stakeholders about important issues, the Institute's goal is to improve the formulation of policy at its earliest stage. The Institute also supports each Hazelden Betty Ford Foundation facility, its employees and other interested stakeholders by responding to requests and providing them with information on relevant federal, state and local legislation. The Institute was involved in several public forums on the dangers of prescription painkiller misuse. It hosted some of these events and collaborated on others, providing speakers and information as part of its focus on influencing public perception and awareness through education about addiction, treatment and recovery. The Institute played a key role in organizing a symposium to advance addiction medicine called Medicine Responds to Addiction, on Oct. 25. It also hosted several events surrounding the Big Texas Rally for Recovery Oct. 1-2 in Dallas, Texas, including a workshop. Another marquee event took place in September, in Minneapolis, Minnesota. The Institute co-hosted a national symposium, called Saving Lives: Innovative Solutions to the Opioid Crisis, with the U.S. Department of Justice. The event, which focused on partnerships between law enforcement and public health, was held at the Minneapolis Convention Center on Sept. 7-8 and drew more than 600 people from around the country. In addition, the Institute hosted, sponsored or provided speakers for 45 other events focused on opioids, other policy areas and/or stigma, including school and community forums as well as national and state conventions. The Institute also produced blogs and audio-video content, provided or secured interviews to support its advocacy agenda and generated social media impressions & unique website users. In other policy activity, the Institute continued to play a leading role in the Parity Implementation Coalition (PIC), which advocates for robust implementation of the federal "parity" law that expands access to addiction treatment through private health care insurance. The Hazelden Betty Ford Institute for Recovery Advocacy regularly receives requests for information on addiction, treatment and recovery issues from federal, state and local legislatures and governments. Membership in associations related to the addiction field and the preservation of the services the organization provides allows it to join forces with others sharing similar concerns and interests. The Institute tapped its resources to influence policy and public attitudes by engaging the news media and collaborating with grassroots community-based organizations across the country on local, state and federal policy issues. The Hazelden Betty Ford Institute for Recovery Advocacy advances these Guiding Principles: Addiction to alcohol and other drugs is a chronic illness and a public health problem affecting all Americans; addiction is a treatable illness with measurable outcomes of success, and the Hazelden Betty Ford Foundation's treatment modality offers people the best opportunity to find lifelong recovery; standardized treatment outcomes are integral to ensuring that people receive proper care. These outcome standards must also help to define the treatment field's role in the continuum of health care services at the state and federal level; all people with addiction disease deserve to find recovery through a level of treatment and related services that is appropriate to meet their individual needs; the stigma of addiction is a major barrier to recovery; access to care will improve by ending discrimination against people with this illness. 793414 X X 0 32305773 55134 2203419 4128266 30436060 23924016 10859094 -1049450 1427887 32305773 23609984 433839 789217 909024 23924016 22276984 -895535 3113248 884713 23609984 20241452 385331 2484179 833978 22276984 0.00000 1.00000 0 0 11074395 11074395 215719077 81548467 134170610 2279262 707787 1571475 95783688 50917829 44865859 13927330 6995735 6931595 198613934 2467464 F PIMCO Stockplus Limited Partner 11811663 F AT MLP Fund, LLC 8535573 F Rimrock High Income Plus Fund LTD 6552687 F Commingled International Investors 14015781 F Fir Tree International Value Fund 5927569 F Lighthouse Global 7192920 F Discovery Global Marco LTD Series 1 6288091 F Pine River Fund Initial Series 1 3258198 F Energy Capital 247000 F 66296946 Intercompany Receivables 83874810 Film and Video Costs, net 238535 CSV Life Insurance 225804 Curriculum Costs, net 17415 Collections 793414 Goodwill 2187766 Split Interest Agreements 1440030 88777774 Asset Retirement Obligation 312656 Intercompany Payables 48644938 Sodexho Contract Obligation 240000 Capitalized Finance Costs -739460 48458134 X Part III, Line 4: Hazelden Betty Ford maintains a collection of historically significant books and archives on recovery and addiction which can be used for research as well as being on public display. Part V, Line 4: Earnings from the endowment funds are used for the purposes as specified by donor restrictions, including patient aid, operations, research, student aid, prevention programs and special projects. Part X, Line 2: In accordance with the accounting standard on Accounting for Uncertainty in Income Taxes, the Foundation addresses the determination of whether tax benefits claimed on a tax return should be recorded in the financial statements. Under this guidance, the Foundation may recognize the tax benefit from an uncertain tax position only if it is more likely than not that the tax position will be sustained on examination by taxing authorities, based on the technical merit of the position. Examples of tax positions include the tax-exempt status of the Foundation and various tax positions related to the potential sources of unrelated business taxable income. There were no unrecognized tax benefits identified or recorded as liabilities, as of December 31, 2016 and 2015. 0 Central America and Caribbean 0 1 Program Services Hazelden Publishing sells and distributes books and related items. Education and preventive instruction is provided to high school students, parents and educators. 9975 East Asia and Pacific 0 0 Program Services Hazelden Publishing sells and distributes books and related items. Education and preventive instruction is provided to high school students, parents and educators. 27660 Europe 0 0 Program Services Hazelden Publishing sells and distributes books and related items. Education and preventive instruction is provided to high school students, parents and educators. 29577 Middle East and North Africa 0 0 Program Services Education and preventive instruction is provided to high school students, parents and educators. 25803 North America 0 1 Program Services Hazelden Publishing sells and distributes books and related items. Education and preventive instruction is provided to high school students, parents and educators. 2848 South America 0 0 Program Services Hazelden Publishing sells and distributes books and related items. Education and preventive instruction is provided to high school students, parents and educators. 16931 South Asia 0 0 Program Services Hazelden Publishing sells and distributes books and related items. Education and preventive instruction is provided to high school students, parents and educators. 4473 Sub-Saharan Africa 0 0 Program Services Hazelden Publishing sells and distributes books and related items. Education and preventive instruction is provided to high school students, parents and educators. 6404 0 2 0 0 0 2 123671 0 123671 Scholarship for Graduate School of Addiction Studies The Netherlands 1 6132 Book 0 0 0 0 0 0 Beamer Awards Dinner 660137 626837 33300 32356 44000 93878 108380 Recovery Cup - Golf & Tennis Event 123157 93457 29700 14515 15941 0 6871 1 47250 675 46575 24275 40229 14931 6260 830544 720969 109575 71146 100170 108809 121511 401636 -292061 1 1 X 0 1 X 0 1 0 1 1 5739574 5739574 0.03020 5739574 5739574 0.03020 4931897 1586160 3345737 0.01760 1108459 1108459 0.00580 1102205 199271 902934 0.00480 7142561 1785431 5357130 0.02820 12882135 1785431 11096704 0.05840 1 6814867 1 1 1 1 Betty Ford Center 39000 Bob Hope Drive Rancho Mirage CA 92270 www.hazeldenbettyford.org/locations/ 106330120 X Betty Ford Center 1 0 0 1 X X X X X X X X 15 1 0 0 1 X See Part V - Section B, Line 7d X X 1 15 1 See Part V - Section B, Line 10a 0 1 X 400.000000000000 X X 1 1 X X X 1 X See Part V, Section C X See Part V, Section C X See Part V, Section C X X X X X X 1 X 0 X X X X 1 X 0 0 Betty Ford Center Part V, Section B, Line 5: In November of 2015 the organization consulted with over a dozen stakeholders, staff, physicians and other members of management. Betty Ford Center Part V, Section B, Line 7d: www.hazeldenbettyford.org/locations/betty-ford-center-rancho-mirage Betty Ford Center Part V, Section B, Line 11: The CHNA identified gaps in services that Betty Ford Center is able to provide. The strategies for addressing these gaps are detailed within the implementation plan. The gaps to be addressed include the following:-Expanding services to treat addiction in individuals aged 55 and older;-Establishing additional outpatient treatment facilities within the service area-Offering children's services to the community-Presenting education on addiction, treatment, and recovery-Providing training on marijuana and options for prevention, intervention, and treatment; and-Addressing the opioid epidemic in the State of California through advocacy, prevention, education, and treatmentThe strategy to expand services to those age 55 and older calls for the development and implementation of a business plan to expand services for older adults through the "Recovery@60Plus Program." The second strategy being considered is the collaboration with senior housing communities and/or agencies in and around Betty Ford Center to enchance awareness of the signs and symptoms of prescription drug addiction and alcoholism.In addressing the needs of additional outpatient service facilities within the service area, Betty Ford Center has created a business plan to expand services in the San Diego area and will continue to assess the need for outpatient services in the area.The next area of significant need is the offering of children's services to the community. The strategy is to collaborate with schools and school districts in the service area to reach more students. The other tactic is to expand opportunities for impacted children to attend Children's Progams through scholarship programs. The Children's Program is funded entirely through donor support.The fourth priority is to educate the community on addiction, treatment, and recovery which as a three pronged plan:-Expand the community service programming for both the surrounding outreach and online communities by sponsoring 6-8 Awareness Hour programs per year on various topics as they relate to addiction.-Feature internal and external experts in their field as speakers; and-Provide educational materials and online resources for all individuals.The next priority is to provide training and education on marijuana and options for prevention, intervention and treatment which will be accomplished by serving as a resource and promoting materials being developed by the wider Hazelden Betty Ford Foundation for different audiences to better understand and address the use and legalization of marijuana. The organization will also facilitate "thought leaders" to provide education on marijuana, its medical uses, and options for prevention, intervention, and treatment.The final priority is to address the opioid epidemic in State of California. This will be accomplished by providing broad-based advocacy efforts and community education to address the opioid crisis. The organization will mobilize the local communities on prevention, intervention, and referral to treatment strategies to impact the opioid epidemic. Education will also be provided on both the community and professional level about the proven track record of the evidence-based Comprehensive Opioid Response with Twelve Steps treament protocol along with training for other treatment providers. Betty Ford Center Part V, Section B, Line 13h: Factors other than the Federal Poverty Guidelines that are used by Hazelden Betty Ford for determining eligibilty for financial assistance include proof of household income, evaluation of assets, number of dependents living in the household, debt associated with major assets to determine net worth, major monthly debt payments to calculate debt to income ratio, and trust documents, if any. Betty Ford Center Part V, Section B, Line 16j: www.hazeldenbettyford.org/locations/betty-ford-center-rancho-mirage Part V, Section B, Line 22b The maximum amount that can be charged for FAP-eligible individuals for medically necessary care was calculated using the lookback method with private health insurers only as Hazelden Betty Ford Foundation does not receive Medicare or Medicaid funding. 13 1 - Hazelden in Center City 15251 Pleasant Valley Road Center City MN 55012 Inpatient addiction treatment center for adults 2 - Hazelden in Plymouth 11505 36th Avenue North Plymouth MN 55441 Inpatient/outpatient addiction treatment center for adolescents/young adults 3 - Hazelden in Springbrook 1901 Esther Street Newberg OR 97132 Inpatient addiction treatment center for adults 4 - Hazelden in St Paul 680 Stewart Avenue St Paul MN 55102 Outpatient addiction treatment center for adults & recovery housing 5 - Hazelden in Florida 950 6th Ave N Suite 101 Naples FL 34102 In/outpatient addiction treatment center for adults & recovery housing 6 - Hazelden Chicago 867 North Dearborn Street Chicago IL 60610 Outpatient addiction treatment center for adults, adolescents & young adults 7 - Hazelden New York at Tribeca Twelve 283 West Broadway New York NY 10013 Outpatient addiction treatment center for young adults & recovery housing 8 - Hazelden in Maple Grove 7001 E Fish Lake Road Suite 120 Maple Grove MN 55311 Outpatient addiction treatment center for adults 9 - Hazelden New York in Chelsea 322 8th Ave Fl 1200 New York NY 10001 Outpatient addiction treatment center for adults 10 - Hazelden in Chaska 1107 Hazeltine Blvd Ste 300 Chaska MN 55318 Outpatient addiction treatment center for adults, adolescents & young adults 11 - Hazelden in Beaverton 6600 SW 105th Ave Suite 120 Beaverton OR 97008 Outpatient addiction treatment center for adults 12 - Betty Ford Center in Los Angeles 10700 Santa Monica Blvd Suite 310 Los Angeles LA 90025 Outpatient addiction treatment center for adults 13 - Betty Ford Center in San Diego 11720 El Camino Real Suite 200 San Diego CA 92130 Outpatient addiction treatment center for adults Part I, Line 3c: Factors other than the Federal Poverty Guidelines that are used by Hazelden Betty Ford for determining eligibilty for financial assistance include proof of household income, evaluation of assets, number of dependents living in the household, debt associated with major assets to determine net worth, major monthly debt payments to calculate debt to income ratio, and trust documents, if any. Part V, Section B, Line 10a www.hazeldenbettyford.org/locations/betty-ford-center-rancho-mirage Part III, Line 2: The bad debt expense is calculated as 75% of the accounts receivable over 90 days. Part III, Line 4: All patient service revenue is produced from private pay, commercial insurance, or managed care insurance contracts. The primary collection risks relates to private pay accounts, including private pay for which the primary insurance carrier has paid the amounts covered by the applicable agreement, but patient responsibility amounts (deductibles and copayments) remain outstanding. The allowance for doubtful accounts relates primarily to private pay accounts over 90 days old. The allowance is calculated based on balances over 90 days and on historical experience and management's evaluation of outstanding accounts receivable at the end of each year. Hazelden Betty Ford's collection policies include a review of all accounts against certain standard collection criteria and are written off when all reasonable internal collection efforts have been performed. Accounts with balances over 90 days old determined to possess positive collectability attributes are fowarded to an external collection agency. Write-offs are based upon specific identification and the write-off process requires an adjustment entry to the patient accounting system. Receivables are generally unsecured. The Betty Ford Center does not charge interest on accounts receivable balances that are past due. Part III, Line 9b: The Betty Ford Center will not engage in extraordinary collection actions before it makes a reasonable effort to determine whether a patient is eligible for financial assistance under the financial aid policy. Actions that may be taken against a patient for nonpayment include utilizing a collection agency for debts older than 120 days. If a collection agency identifies a patient as meeting the Betty Ford Center's financial assistance eligibility criteria, the patient's account may be considered for patient aid. Collection activity will be suspended on these accounts and the Betty Ford Center will review the financial assistance application. If the entire account is adjusted, the account will be returned to the Betty Ford Center. If a partial adjustment occurs, the patient fails to cooperate with the financial assistance process, or if the patient is not eligible for patient aid, collection activity will resume. Part VI, Line 2: A community health needs assessment was completed for Betty Ford Center in 2015 which allows the organization to understand the needs of the community. Part VI, Line 3: Hazelden Betty Ford will include notices regarding the availablity of patient aid on its website, and in marketing and program-related materials, and in locations where there is a high volume of admission and or registration related activity. Part VI, Line 4: The service area for Betty Ford Center, the only hospital in the Hazelden Betty Ford Foundation organization, has been defined to include Los Angeles County, Orange County, Riverside County, San Bernardino County, and San Diego County. The service area definition was determined by calculating the area where the majority of Betty Ford Center's inpatient population resides. The service areas have a total population of nearly 20.6 million and represents approximately 50% of the statewide population of nearly 40 million residents. The Hispanic, Latino, or Spanish service area population totals 9.2 million. This represents 44.3% of the total report area population. The service area household income is nearly 3% lower than California's average of $87,152, and nearly 15% higher than the national average of $74,699. The service area (83%) graduation rates fair slightly lower than statewide (83.8%) averages but fair slightly better than the United States (82.2%) graduation rates. Within the service area 16.4% or nearly 3.3 million individuals are living in households with income below the Federal Poverty Level. As of August 2015, total unemployment in the service area was 792,444 or 7.9% of the civilian non-institutionalized population age 16 and older (non-seasonally adjusted). 1 Scholarships for Graduate School of Addiction Studies 165 486609 Book Scholarships for Professionals in Residence Training (PIR) 124 306850 Book Scholarships for Summer Institute for Medical Students (SIMS) 105 315000 Book Educational assistance for local high school students 6 5200 Book Part I, Line 2: Hazelden Betty Ford provides the assistance as part of its program services activity. All scholarships are provided to individuals and monitored through the Graduate School of Addiction Studies, the Professionals in Residence and Medical Education training programs and the Community Relations department to ensure the monies are used for the purpose intended. The tuition paid for those programs and the funds given to assist with the tuition is tracked by each individual. X X X X X 0 1 0 0 0 0 0 0 0 James Blaha Treasurer, VP CFO and CAO 315424 0 12536 0 3287 0 28576 0 22279 0 382102 0 0 0 Mark Mishek President and CEO 552541 0 32465 0 11468 0 56809 0 26434 0 679717 0 0 0 Nicholas Motu VP Mktg, Comm. Bus Dev, IRA 268091 0 12215 0 2831 0 16529 0 33749 0 333415 0 0 0 Dr Marvin Seppala Chief Medical Officer 439412 0 19187 0 14055 0 33900 0 26412 0 532966 0 0 0 Valerie Slaymaker VP Edu, Quality & Research 212863 0 9236 0 481 0 16249 0 17728 0 256557 0 0 0 Jennifer Lohse VP General Counsel 191624 0 4768 0 276 0 12176 0 32968 0 241812 0 0 0 James Steinhagen VP SW Region/Admin BFC 259963 0 59889 0 2764 0 28104 0 24287 0 375007 0 0 0 John Driscoll SR VP Recovery Services 271282 0 10713 0 646 0 24221 0 32662 0 339524 0 0 0 William Moyers VP Public Affairs & Comm Rel 214119 0 0 0 1437 0 15854 0 31224 0 262634 0 0 0 Elizabeth Farver-Smith VP Philanthropy & Alumni Relations 217167 0 3174 0 2426 0 13224 0 11846 0 247837 0 0 0 Joseph Jaksha VP Publisher 196307 0 42163 0 710 0 14557 0 29746 0 283483 0 0 0 Dr Joseph Lee Youth Continuum Medical Dir 316234 0 0 0 513 0 29567 0 37664 0 383978 0 0 0 Pamela Shultz Staff Physician 289693 0 0 0 2559 0 25549 0 13451 0 331252 0 0 0 Robert Poznanovich Exec Dir Bus Development 271566 0 0 0 2750 0 23183 0 4784 0 302283 0 0 0 Dr Jeffery Young Medical Director 274823 0 0 0 2924 0 15900 0 25341 0 318988 0 0 0 Dr Katarzyna Litak Psychiatrist 260997 0 0 0 981 0 15900 0 23439 0 301317 0 0 0 Mark Sheets Exec. Dir. Youth Continuum, Former k 221668 0 10011 0 2314 0 13668 0 33415 0 281076 0 0 0 Janice Vondrachek Executive Director Oregon, Former ke 217695 0 9422 0 1400 0 13075 0 13973 0 255565 0 0 0 Part I, Line 4b Mark Mishek,President and CEO,participated in a nonqualified retirement plan in the amount of $22,909. A City of Center City MN 416005039 151452AT6 2011-11-14 20095000 Expansion and renovation of Plymouth facility 0 0 0 B City of Center City MN 416005039 151452BM0 2014-07-23 41439310 Expansion and improvements at St. Paul and Center City locations 0 0 0 A 1235000 20210373 370556 19839807 2013 0 0 1 1 B 1200000 41441547 434310 18702237 22305000 2015 1 0 1 1 A 0 0 0 0 0 0 1 B 0 0 0 0 0 0 1 A 0 0 0 0 0 0 1 Credit Agricole Corp and Investment 1 0 1 B 0 0 0 0 0 0 0 0 1 A 1 B 1 Schedule K Supplental Information Bond A - Interest income of $115,373 is included in Part II, Line 3 Bond B - Interest income of $2,237 is included in Part II, Line 3 Schedule K, Part IV, Line 5C, Column A The guaranteed investment contract (GIC) expired in 2012 after the proceeds were spent. Recovery PartnersPC 100% owned by a key employee of Hazelden Betty Ford Foundation 297994 Reimbursable professional fees 0 X 23 179937 Gross selling price 0 1 1 Part I, Line 32b: Hazelden Betty Ford maintains a cash securities account with a brokerage firm for the sale of stocks and/or other securities received as charitable contributions by Hazelden Betty Ford. The stocks/securities are sent to the brokerage firm and are sold at fair market value with the gross proceeds deposited into Hazelden Betty Ford's cash account. Form 990, Part VI, Section A, line 2 A familial relationship exists between Hazelden Betty Ford Foundation board members Vaden Bales and Susan Ford Bales. Form 990, Part VI, Section B, line 11b Hazelden Betty Ford sent its Form 990, with Schedule B suppressed, via email to Board members for review and questions prior to filing. It was also reviewed by the CFO and General Counsel prior to filing. Form 990, Part VI, Section B, line 12c Hazelden Betty Ford requires an annual disclosure of any potential conflict of interest by Board members, officers and key employees. If a Board member discloses a potential conflict, that person then excuses him or herself from voting on that particular issue. All new board members are provided conflict of interest education and periodic training throughout their term. All board members sign an annual conflict of interest disclosure form. Form 990, Part VI, Section B, line 15 Hazelden Betty Ford has an established process for determining the compensation of the President and CEO, other officers and key employees. The Hazelden Betty Ford by-laws delegate responsibility for determining compensation for the President and CEO, other officers and key employees to the Executive Committee of the Board of Trustees. The Executive Committee develops, reviews, and modifies, as necessary, the compensation philosophy for Hazelden Betty Ford. Hazelden Betty Ford has the following processes in place: 1. Each year the Board members complete a conflict of interest disclosure. The documents are reviewed by Hazelden Betty Ford's General Counsel and if a Board member has a conflict of interest they are not involved in any compensation decisions. 2. The Executive Committee engages the use of an outside independent compensation consultant to identify comparable market data for comparable positions for the President and CEO and other disqualified individuals consistent with the approved compensation philosophy. Generally, the market analysis includes competitive data from published survey sources, supplemented with compensation data from custom 990 analyses. Where possible, competitive data are pulled from similarly sized organizations. The compensation consultant analyzes the pay packages of the President and CEO and other disqualified individuals by reviewing base salary, total cash compensation (salary plus annual incentive at both target and actual levels) and total direct compensation (salary plus annual and long-term incentive). In addition, every two to three years the Executive Committee reviews the total compensation package of the President and CEO and other disqualified individuals. The total compensation package includes total direct compensation plus severance, employee benefits, perquisites and any other pay. 3. Comparable market data are reviewed and discussed by the Executive Committee and minutes record those discussions and any resulting compensation decisions. A compensation review for the President and CEO was most recently done in February 2017. The compensation review for other officers and key employees will be completed in July 2017. Form 990, Part VI, Section C, line 19 Hazelden Betty Ford makes its annual report available to the public via its website at www.hazeldenbettyford.org. The governing documents and conflict of interest policy are not available for public inspection. Form 990, Part XI, line 9: Rounding 3,421. Net assets released intercompany transactions -9,309. Part VI, Section A: The Executive committee of the Board of Trustees has the authority to act on behalf of the Board between the Board's regular meetings, subject to the limitations of power listed below. The Executive committee consists of the Chair of the Board, the immediate past Chair, if still a member of the Board, Vice Chairs of the Board, President (ex-officio non-voting), Secretary, Treasurer, and the Chair of each standing committee. Limitations of Powers: The Executive committee does not have the power to elect a trustee, to alter fundamental policies approved by the Board, to make appropriations which are not in accordance with the general policies approved by the Board, to modify, revoke or renew any contract previously entered into by the Board or to change the person or persons specifically designated by the Board to enter into or execute on behalf of the organization a particular contract, obligation, agreement or writing authorized by action of the Board of Trustees. Hazelden Chicago PO Box 11 Center City MN 55012 364099403 Addiction recovery services, including outpatient, sober residence IL 501 (c)3 3 Hazelden Betty Ford Foundation 1 Hazelden New York PO Box 11 Center City MN 55012 133673215 Addiction recovery services, including outpatient, continuing care NY 501 (c)3 9 Hazelden Betty Ford Foundation 1 Charitable Remainder Trust Charitable Remainder Trust CA N/A T 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 1 0 0 Hazelden Chicago Q 1132979 Fair Market Value Hazelden New York Q 1865581 Fair Market Value