2017-05-12T13:16:59-05:00 2016-06-30 351178661 BLUE & CO LLC 500 N MERIDIAN ST SUITE 200 INDIANAPOLIS IN 46204 990 2015-07-01 351534713 ADULT & CHILD MENTAL HEALTH CENTER INC ADUL 3178825122 222 E OHIO ST INDIANAPOLIS IN 46204 JOSEPH BREYER CFO 3178825122 2017-05-12 1 AMBER KOCHER CPA P01286298 3176334705 2017-05-10 2015 2021-01-29 14:40:06Z ADULT & CHILD HEALTH ALLEN BROWN 222 E OHIO STREET INDIANAPOLIS IN 46204 44148881 0 X WWW.ADULTANDCHILD.ORG X 1982 IN PROVIDE STATE-OF-THE-ART MENTAL HEALTH SERVICES TO RESIDENTS OF MARION AND JOHNSON COUNTY, INDIANA. 11 11 870 13 104528 0 6389029 6796125 28787679 34565193 1104287 166187 883378 495753 37164373 42023258 0 0 0 0 25268472 31597441 0 0 0 8359794 10205504 33628266 41802945 3536107 220313 29207386 34418984 7338499 12643461 21868887 21775523 X WE PROVIDE STATE-OF-THE-ART SERVICES THAT EMPOWER ADULTS AND CHILDREN TO REACH THEIR FULL POTENTIAL WHILE EFFECTIVELY AND EFFICIENTLY MANAGING COMMUNITY AND CENTER RESOURCES. 1 0 35846709 34714505 THE ORGANIZATION IS A COMMUNITY MENTAL HEALTH CENTER WITH THE PURPOSE OF PROMOTING HEALTH AND WELLNESS BY ESTABLISHING, MAINTAINING AND PROMOTING A COMMUNITY ORGANIZATION THAT WILL PROVIDE HIGH QUALITY HEALTH CARE AND SOCIAL SERVICES, INCLUDING TO AN UNDERSERVED POPULATION. THE CENTER PROVIDES COMMUNITY HEALTH AND SOCIAL SERVICES SUCH AS MEDICAL SERVICES, MENTAL HEALTH SERVICES, ADDICTIVE DISEASE SERVICES, CHILD WELFARE SERVICES, LOW-INCOME SUPPORTIVE HOUSING SERVICES, AND SUPPORTIVE EMPLOYMENT SERVICES. ADDITIONALLY, THE CENTER ACCEPTS PATIENTS REGARDLESS OF THEIR INDIVIDUAL ABILITY TO PAY, THEIR RACE, AGE, SEX, CREED OR NATIONAL ORIGIN. FOR THE YEAR ENDED 6/30/16, THE CENTER PROVIDED UNCOMPENSATED CARE OF APPROXIMATELY $348,000. 35846709 1 1 0 0 0 0 0 0 1 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 45 0 1 870 1 1 1 0 0 0 0 0 0 0 0 0 X 11 11 0 0 1 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 IN X JOSEPH BREYER CFO 3178825122 222 E OHIO STREET INDIANAPOLIS IN 46204 SUE COLLINS RN PRESIDENT 1.00 X X 0 0 0 STEVE WOHLFORD VICE PRESIDENT 1.00 X X 0 0 0 DAWN SHIMP SECRETARY 1.00 X X 0 0 0 DUSTIN HUDDLESTON TREASURER 1.00 X X 0 0 0 TOM GAUNT MEMBER 1.00 X 0 0 0 ROBERT HURLEY MEMBER 1.00 X 0 0 0 ROBERT MARSHALL MEMBER 1.00 X 0 0 0 CAROLE MCKINNEY MEMBER 1.00 X 0 0 0 KELLIE MEYER MA MEMBER 1.00 X 0 0 0 JOE VILLANUEVA MEMBER 1.00 X 0 0 0 JUDY WARE MEMBER 1.00 X 0 0 0 NICK HOPKINS CPA CFP MEMBER TERM END NOV'2015 1.00 X 0 0 0 JERRY FRENCH MEMBER TERM END NOV'2015 1.00 X 0 0 0 ALLEN BROWN CHIEF EXECUTIVE OFFICER 40.00 X 225620 0 25500 JOSEPH BREYER CHIEF FINANCIAL OFFICER 40.00 X 136806 0 22609 STEPHANIE YODER CHIEF OPERATING OFFICER 40.00 X 126050 0 22129 CHARLES COATS MD MEDICAL DIRECTOR 40.00 X 236214 0 26812 TERRI PELLOW MD PSYCHIATRIST 40.00 X 199045 0 18415 YOLANDA BRAY APRN BEHAVIORAL HEALTH 40.00 X 120011 0 12624 STEVEN BERGER PSYCHIATRIST 40.00 X 127002 0 1192 MATT OLIVER CHIEF CLINICAL/INFO OFFICER 40.00 X 118377 0 19303 DAN ARENS DIRECTOR PRIMARE CARE/BUS. DEV. 40.00 X 115592 0 20100 1404717 0 168684 11 0 1 0 LOCUMTENENSCOM PO BOX 405547 ATLANTA GA 30384 CONTRACT PRESCIBERS I.E. PSYCHIATRISTS, 503174 CONSILIUM STAFFING 6225 N STATE HIGHTWAY 161 IRVING TX 75038 CONTRACT PRESCIBERS I.E. PSYCHIATRISTS, 247824 PINNACLE PARTNERS 9515 DELEGATES ROW INDIANAPOLIS IN 46240 IT CONTRACTORS 137234 3 6791391 4734 6796125 NET PATIENT REVENUE 900099 30225243 30225243 MEDICARE/MEDICAID PMTS 900099 3281279 3281279 BEHAVIORAL HEALTH, PRIMARY CARE, 900099 1058671 1058671 34565193 163413 163413 774229 41361 564479 44680 209750 -3319 206431 149312 37046 20073 1519238 1516464 2774 2774 2774 MISCELLANEOUS REVENUE 900099 221840 221840 PROPERTY MANAGEMENT 531310 67482 67482 289322 42023258 34714505 104528 408100 740132 740132 24412493 21499593 2912900 394322 333281 61041 4015513 3393912 621601 2034981 1719966 315015 84735 84735 36886 36886 1758057 1485910 272147 69586 58814 10772 1164988 984648 180340 1516330 1281602 234728 94688 80030 14658 867470 733186 134284 51452 43487 7965 1066763 901628 165135 360866 305004 55862 RESIDENTIAL SERVICES 2122243 2122243 STAFF RECRUITMENT AND D 402634 340306 62328 CLIENT EXPENSES 315007 315007 DUES AND MEMBERSHIPS 108964 92096 16868 184835 155996 28839 41802945 35846709 5956236 0 1380 466412 11457735 3613316 2690862 885869 1932908 3705622 283797 408025 29933551 12423484 7138006 17510067 5096296 5143377 120000 120000 486402 2566296 29207386 34418984 3083038 2870372 1886 5598997 47539 2278383 2082820 1977078 2041847 7338499 12643461 X 21868887 21775523 21868887 21775523 29207386 34418984 X 220313 -119084 -194593 X X 0 1 X 1 1 1 X PART I, LINE 3 ADULT & CHILD MENTAL HEALTH CENTER, INC. HAS BEEN DETERMINED BY THE IRS TO BE A PUBLIC CHARITY UNDER IRS CODE SECTION 170(B)(1)(A)(III). THE ORGANIZATION PROVIDES A COMPREHENSIVE NETWORK OF PREVENTATIVE, DIAGNOSTIC, THERAPEUTIC AND REHABILITATIVE MEDICAL AND MENTAL HEALTH SERVICES, BUT DOES NOT MAINTAIN AN INPATIENT UNITY, AND IS NOT REQUIRED TO BE LICENSED AS A HOSPITAL FOR THE STATE OF INDIANA. SCHEDULE H IS NOT REQUIRED AS ONLY ORGANIZATIONS THAT OPERATE AT LEAST ONE FACILITY THAT IS, OR IS REQUIRED TO BE, LICENSED, REGISTERED, OR SIMILARLY RECOGNIZED BY THE STATE AS A HOSPITAL. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 2896000 385053 3281053 9853363 8322700 7880733 10295330 372593 362316 10277 905019 6144280 4180435 2868864 1054543 1054543 17510067 RENT RECEIVABLE 135276 457 PLAN ASSETS 148529 OTHER RECEIVABLES 715282 MENTAL HEALTH FUNDS RECOVERY RECEIVABLE 1567209 2566296 DEFERRED COMPENSATION 148529 DERIVATIVE LIABILITY 194593 ESTIMATED THIRD PARTY SETTLEMENTS 1698725 2041847 X 42318739 -119084 -194593 -313677 42632416 -609158 -609158 42023258 42412103 609158 609158 41802945 0 41802945 PART IV, LINE 2B: THE ORGANIZATION IS AN AGENT FOR SOCIAL SECURITY FUNDS HELD FOR PATIENTS - REPRESENTATIVE PAYEE ACCOUNTS. THERE IS A CORRESPONDING ASSET REPORTED IN FORM 990, PART X. PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE COMPANY AND RECOGNIZE A TAX LIABILITY IF THE COMPANY HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY VARIOUS FEDERAL AND STATE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE COMPANY, AND HAS CONCLUDED THAT AS OF JUNE 30, 2016 AND 2015, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE ACCOMPANYING FINANCIAL STATEMENTS. THE COMPANY IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. PART XI, LINE 2D - OTHER ADJUSTMENTS: UNREALIZED LOSS ON DERIVATIVE -194,593. PART XI, LINE 4B - OTHER ADJUSTMENTS: RENTAL EXPENSES -609,158. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES 609,158. X X X 0 0 0 0 0 0 0 0 0 ALLEN BROWN CHIEF EXECUTIVE OFFICER 177743 0 30024 0 17853 0 6112 0 19388 0 251120 0 0 0 JOSEPH BREYER CHIEF FINANCIAL OFFICER 122416 0 0 0 14390 0 4509 0 18100 0 159415 0 0 0 CHARLES COATS MD MEDICAL DIRECTOR 214744 0 0 0 21470 0 7357 0 19455 0 263026 0 0 0 TERRI PELLOW MD PSYCHIATRIST 187169 0 0 0 11876 0 6020 0 12395 0 217460 0 0 0 A INDIANA FINANCE AUTHORITY 351602316 2016-02-25 6835000 SEE PART VI 0 0 0 A 6835000 90620 6744380 0 0 0 1 A 0 1 1 1 0 0.13650 0.09180 0.22830 0 0 0 A 0 1 0 0 1 1 PNC 10.000000000000 0 0 0 0 1 A 1 PART I, LINE A, COLUMN F THE PROCEEDS OF THE PROJECT BONDS WILL BE LOANED TO THE BORROWER FOR THE PURPOSE OF FINANCING, REFINANCING OR REIMBURSING ALL OR A PORTION OF: (I) THE ACQUISITION, CONSTRUCTION, RENOVATION AND EQUIPPING OF APPROXIMATELY 77,145 SQUARE FOOT HEALTH CARE FACILITY LOCATED AT 603 E. WASHINGTON STREET, INDIANAPOLIS, IN 46204, TOGETHER WITH THE PURCHASE OF EQUIPMENT AND FURNISHINGS TO BE LOCATED HEREIN; (II) THE RENOVATION OF APPROXIMATELY 5,550 SQUARE FEET OF AN APPROXIMATELY 56,400 SQUARE FOOT HEALTH CARE FACILITY LOCATED AT 222 E. OHIO STREET, INDIANAPOLIS, IN 46204 TOGETHER WITH THE PURCHASE OF EQUIPMENT AND FURNISHINGS TO BE LOCATED HEREIN; (III) THE RENOVATION OF APPROXIMATELY 7,434 SQUARE FEET OF AN APPROXIMATELY 14,900 SQUARE FOOT HEALTH CARE FACILITY LOCATED AT 1860 AND 1866 NORTHWOOD PLAZA DRIVE, FRANKLIN, IN 46131 TOGETHER WITH THE PURCHASE OF EQUIPMENT AND FURNISHINGS TO BE LOCATED HEREIN. FORM 990, PART I, ITEM C DBA: ADULT AND CHILD CENTER FORM 990, PART III, LINE 2 THE GOVERNING BODY APPROVED UPDATED ARTICLES OF INCORPORATION EXPANDING THE ORGANIZATION'S PURPOSE TO INCLUDE OPERATING A FEDERALLY QUALIFIED HEALTH CORPORATION AND INDIANA LICENSED CHILD PLACING AGENCY. FORM 990, PART VI, SECTION A, LINE 4 SIGNIFICANT CHANGES INCLUDED THE FOLLOWING: 1) THE ARTICLES OF INCORPORATION AND BYLAWS OF THE ORGANIZATION WERE UPDATED IN FEBRUARY 2016 TO REFLECT SEVERAL SIGNIFICANT CHANGES INCLUDING: EXPANSION OF EXEMPT PURPOSE AND MISSION: PROMOTION OF HEALTH AND WELLNESS; INCLUDE HEALTH AND SOCIAL SERVICES SUCH AS MEDICAL SERVICES, MENTAL HEALTH SERVICES, ADDICTIVE DISEASE SERVICES, CHILD WELFARE SERVICES; LOW-INCOME SUPPORTIVE HOUSING SERVICES, AND SUPPORTIVE EMPLOYMENT SERVICES; AND, OPERATIONS OF FEDERALLY QUALIFIED HEALTH CENTER AND CHILD PLACING AGENCY. 2) ADDITION OF "DOING BUSINESS AS" NAME: ADULT & CHILD HEALTH. 3) UPDATED BOARD MEMBERSHIP QUALIFICATIONS: ALIGN QUALIFICATIONS WITH INDIANA CODE SECTION 440 IAC 4.1-2-2; SET MINIMUM VOTING MEMBERS TO NOT LESS THAN ELEVEN; REQUIRE MAJORITY OF MEMBERS TO BE PATIENT MEMBERS (MEMBER CURRENTLY SERVED BY THE ORGANIZATION OR REPRESENTING THOSE SERVED BY THE ORGANIZATION IN THE PAST 24 MONTHS); NO MORE THAN 50% OF NON-PATIENT MEMBERS CAN DERIVE MORE THAN 10% OF ANNUAL INCOME FROM HEALTH CARE INDUSTRY; 1 HOUSING AND/OR HOMELESS SERVICES REPRESENTATIVE REQUIRED; AND, EMPLOYEES OR IMMEDIATE FAMILY MEMBERS OF EMPLOYEES ARE NOT ALLOWED TO SERVE AS DIRECTORS. 4) UPDATE BOARD MEMBER AUTHORITY, FUNCTIONS, AND RESPONSIBILITIES: REVIEW AND APPROVE APPLICATIONS RELATED TO FQHC OR FQHC LAL QUALIFICATIONS AND FUNDING. 5) UPDATED OFFICER COMPOSITION, DUTIES, AND QUALIFICATIONS: DESCRIPTIONS FOR CHIEF EXECUTIVE OFFICER AND CHIEF FINANCIAL OFFICER WERE ADDED. 6) ADDED CONFLICT OF INTEREST POLICY DETAILS INTO THE BYLAWS. 7) UPDATED PROVISIONS TO AMEND THE ORGANIZATION BYLAWS: TWO-THIRDS OF THE ENTIRE BOARD OF DIRECTORS MUST VOTE TO ADOPT, ALTER, AMEND, MODIFY, CHANGE OR REPEAL. FORM 990, PART VI, SECTION B, LINE 11 THE PROCESS OF REVIEWING THE FORM 990 INCLUDES A DETAILED REVIEW OF THE FORMS AND REQUESTED SCHEDULES BY THE CHIEF FINANCIAL OFFICER. ADDITIONALLY, EACH VOTING MEMBER OF THE ORGANIZATION'S GOVERNING BODY IS PROVIDED WITH A COPY OF THE FORM 990 INCLUDING REQUESTED SCHEDULES, AS ULTIMATELY FILED WITH THE IRS, FOR REVIEW AND APPROVAL PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C EACH BOARD MEMBER AND OFFICER ARE REQUIRED TO SUBMIT ANNUALLY INFORMATION REGARDING CONFLICTS OF INTEREST AND POSSIBLE CONFLICTS OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION PACKAGE FOR THE CEO IS SET BY THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS AND APPROVED BY THE ENTIRE BOARD. THE EXECUTIVE COMMITTEE USES THE ANNUAL SALARY SURVEY CONDUCTED BY THE INDIANA COUNCIL OF COMMUNITY MENTAL HEALTH CENTERS AND OTHER APPLICABLE SALARY SURVEYS. SALARIES OF OTHER OFFICERS AND KEY EMPLOYEES ARE SET IN A SIMILAR FASHION BY THE CEO. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE BY REQUEST. THE ORGANIZATION'S ANNUAL REPORT IS AVAILABLE ON ITS WEB PAGE AT WWW.ADULTANDCHILD.ORG IN "ANNUAL REPORTS" SECTION UNDER THE "ABOUT US DROP DOWN MENU. THE ARTICLES OF INCORPORATION CAN BE VIEWED ON THE INDIANA SECRETARY OF STATE WEBPAGE. FORM 990, PART XI, LINE 9: UNREALIZED LOSS ON DERIVATIVE -194,593. FORM 990, PART XII, LINE 2C, OVERSIGHT OF AUDIT: THE BUDGET AND FINANCE COMMITTEE ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE FINANCIAL STATEMENTS AUDIT AND PROVIDES RECOMMENDATIONS TO THE BOARD OF DIRECTORS FOR APPROVAL. LIKEWISE THE COMMITTEE ASSUMES RESPONSIBILTY FOR THE SELECTION OF THE INDEPENDENT AUDITORS BY REVIEWING POSSIBLE PROPOSALS AND MAKING RECOMMENDATIONS FOR APPROVAL TO THE BOARD OF DIRECTORS. NO PROCESSES HAVE CHANGED FROM PRIOR YEAR. ADULT & CHILD RESIDENTIAL PROPERTIES LLC 222 E OHIO STREET STE 400 INDIANAPOLIS IN 46204 475591352 RESIDENTIAL RENTAL PROPERTY IN -24764 1872992 ADULT & CHILD MENTAL HEALTH CENTER