2015-05-11T17:21:35-05:00 2014-09-30 341884125 CBIZ MHM LLC 3101 N CENTRAL AVE STE 300 PHOENIX AZ 85012 990 2013-10-01 860290033 SOUTHWEST BEHAVIORAL HEALTH SERVICES INC SOUT 6022854279 3450 N 3RD STREET PHOENIX AZ 85012 MICHAEL FETT VP OF FINANCE 6022854279 2015-04-30 1 AMY A O'LOUGHLIN P00869687 6022646835 2013 2016-02-25 16:41:14Z JEFF JORDE 3450 N 3RD STREET PHOENIX AZ 85012 56226399 0 X WWW.SBHSERVICES.ORG X 1970 AZ WE INSPIRE PEOPLE TO FEEL BETTER AND REACH THEIR POTENTIAL, THROUGH HELPING PEOPLE DISCOVER THEIR STRENGTHS, WE IMPROVE OUR COMMUNITIES. 12 12 1125 10 0 0 12857129 53296732 1874969 2787279 862 3603 44680 132410 14777640 56220024 64780 186101 0 0 10191521 40245230 0 0 0 4023986 14290292 14280287 54721623 497353 1498401 27629652 29488637 9628305 9988889 18001347 19499748 WE INSPIRE PEOPLE TO FEEL BETTER AND REACH THEIR POTENTIAL, THROUGH HELPING PEOPLE DISCOVER THEIR STRENGTHS, WE IMPROVE OUR COMMUNITIES. 0 0 48364791 186101 2787279 SBH PROVIDES SERVICES IN PREVENTION, OUTREACH SERVICES,COMMUNITY INTEGRATION, HOME-BASED COUNSELING, CASEMANAGEMENT, METHADONE MAINTENANCE, CRISIS RECOVERY,COMMUNITY HOUSING, RESIDENTIAL SERVICES AND OUTPATIENTCOUNSELING FOR CHILDREN AND ADULTS SUFFERING FROM VARIOUSBEHAVIORAL AND SUBSTANCE ABUSE PROBLEMS. 48364791 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 1 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 1 108 0 1 1125 1 0 0 0 0 0 0 0 0 0 0 X 12 12 0 0 0 0 0 0 0 1 1 0 1 1 0 1 1 1 1 1 1 0 0 AZ X MICHAEL FETT 6022854279 3450 N 3RD STREET PHOENIX AZ 85012 MICHAEL HARRIS DIRECTOR 0.30 X 0 0 0 RICHARD BEEMAN DIRECTOR 0.30 X 0 0 0 DONALD LOGUE DIRECTOR 0.30 X 0 0 0 ROGER MORRIS DIRECTOR 0.30 X 0 0 0 ADRIENNE SCHECK PHD DIRECTOR 0.30 X 0 0 0 PATRICIA VALADEZ DIRECTOR 0.30 X 0 0 0 TAHNJA WILSON DIRECTOR 0.30 X 0 0 0 TAMERA ZIVIC CHAIR 0.30 X X 0 0 0 LUCY TREIMAN DIRECTOR 0.30 X 0 0 0 KURT BRAATZ DIRECTOR 0.30 X 0 0 0 MICHAEL CYLKOWSKI DIRECTOR 0.30 X 0 0 0 SAUNDRA JOHNSON DIRECTOR 0.30 X 0 0 0 MICHAEL FETT VP OF FINANCE 40.00 X 164978 0 3645 JEFFREY JORDE PRESIDENT/CEO 40.00 X 271155 0 13649 ROBIN REESAL PSYCHIATRIST 40.00 X 202654 0 4494 RESUL OZBAYRAK CHIEF MEDICAL OFFICER 36.00 X 257116 0 7880 JOHN GAROFALO PSYCHIATRIST 40.00 X 195677 0 7190 BRUCE HOLZMAN PSYCHIATRIST 40.00 X 193649 0 3482 RAQUEL BALDERAS PSYCHIATRIST 40.00 X 225008 0 12876 1510237 0 53216 29 0 1 0 B'S CONTRACTORS 1601 LOUIS TRAIL PRESCOTT AZ 86305 CONSTRUCTION 112187 1 53271394 25338 5600 53296732 CLIENT FEES 900099 1215945 1215945 AGAVE HEALTH REV 900099 786770 786770 RENTAL INCOME 531120 342014 342014 MEDICARE 900099 170845 170845 MANAGEMENT FEES 900099 154674 154674 117031 117031 2787279 9978 9978 6375 -6375 -6375 -6375 INSURANCE REFUND 900099 109820 109820 SNACK BAR/VENDING 900099 20647 20647 MISCELLANEOUS 900099 1943 1943 132410 56220024 2787279 0 136013 186101 186101 442403 442403 32836255 29135607 3700648 138006 99796 38210 4454115 4069797 384318 2374451 2081564 292887 51983 15129 36854 84600 84600 149108 48310 100798 139840 136048 3792 302851 201166 101685 3401105 3172724 228381 1173260 1150125 23135 42270 30249 12021 3408 3408 1095265 923136 172129 199011 134961 64050 SUPPLIES 4736718 4682472 54246 NURSING & PHYSICIAN SVS 1431617 1094677 336940 TELEPHONE 577236 507425 69811 EQUIP RENT/MAINTENANCE 432441 324572 107869 469579 367524 102055 54721623 48364791 6356832 0 2044218 2423249 2027130 2029801 2746875 3889557 12736 5887 382553 269472 30947608 14062688 17223849 16884920 2865312 3700129 15000 15000 311979 270622 27629652 29488637 4600392 4994781 0 2283 3800000 3800000 1215376 1165156 12537 26669 9628305 9988889 X 15335441 16872003 2665906 2627745 18001347 19499748 27629652 29488637 1498401 0 X 0 1 X 1 1 1 X 46401896 51067693 49491553 12857129 53296732 213115003 46401896 51067693 49491553 12857129 53296732 213115003 213115003 12627 4521 3186 862 9978 31174 105259 159291 258921 44680 132410 700561 213846738 8814086 0.99660 0.99670 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: MISCELLANEOUS INCOME - 2009 AMOUNT: $ 12,935. 2010 AMOUNT: $ 1,178. 2011 AMOUNT: $ 487. 2012 AMOUNT: $ 146. 2013 AMOUNT: $ 1,943. INSURANCE REFUND - 2009 AMOUNT: $ 74,597. 2010 AMOUNT: $ 143,011. 2011 AMOUNT: $ 239,421. 2012 AMOUNT: $ 39,462. 2013 AMOUNT: $ 109,820. SNACK BAR/VENDING - 2009 AMOUNT: $ 17,727. 2010 AMOUNT: $ 15,102. 2011 AMOUNT: $ 19,013. 2012 AMOUNT: $ 5,072. 2013 AMOUNT: $ 20,647. SCHEDULE A, SECTION A AND B, COLUMN D THE 2012 COLUMN REPRESENTS THE SHORT YEAR FROM 7/1/2013 TO 9/30/2013, RESULTING FROM A CHANGE IN THE ORGANIZATION'S FISCAL YEAR END FROM JUNE 30 TO SEPTEMBER 30. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 3909160 3909160 20526328 8498022 12028306 926321 679074 247247 5371176 4885592 485584 214623 214623 16884920 CAPITAL LEASES 26669 26669 X 71083272 30266 15822424 15852690 55230582 989442 989442 56220024 72891080 30266 19139494 19169760 53721320 1000303 1000303 54721623 PART X, LINE 2: THE ORGANIZATION EVALUATES ITS UNCERTAIN TAX POSITIONS, IF ANY, ON A CONTINUAL BASIS THROUGH REVIEW OF THEIR POLICIES AND PROCEDURES AND DISCUSSIONS WITH OUTSIDE EXPERTS. PART XI, LINE 2D - OTHER ADJUSTMENTS: REVENUE FROM RELATED ENTITIES 15,822,424. PART XI, LINE 4B - OTHER ADJUSTMENTS: ELIMINATING ENTRY 989,442. PART XII, LINE 2D - OTHER ADJUSTMENTS: EXPENSES FROM RELATED ENTITIES 19,139,494. PART XII, LINE 4B - OTHER ADJUSTMENTS: ELIMINATING ENTRY 1,000,303. 1 FLEX FUNDS & HOPWA EMERGENCY ASSISTANCE 185 186101 PART I, LINE 2: THE ORGANIZATION CONFIRMS THAT RECIPIENTS ARE ELIGIBLE TO RECEIVE ASSISTANCE AND THAT THEY DO NOT EXCEED THE MAXIMUM BENEFITS ALLOWANCE. CHECKS ARE WRITTEN DIRECTLY TO SERVICE VENDORS TO PAY FOR RECIPIENTS' EXPENSES. 0 0 0 0 0 0 0 1 0 MICHAEL FETT VP OF FINANCE 148888 0 13000 0 3090 0 3049 0 596 0 168623 0 0 0 JEFFREY JORDE PRESIDENT/CEO 184017 0 55540 0 31598 0 4600 0 9049 0 284804 0 0 0 ROBIN REESAL PSYCHIATRIST 201396 0 1000 0 258 0 0 0 4494 0 207148 0 0 0 RESUL OZBAYRAK CHIEF MEDICAL OFFICER 255451 0 0 0 1665 0 0 0 7880 0 264996 0 0 0 JOHN GAROFALO PSYCHIATRIST 194448 0 1000 0 229 0 0 0 7190 0 202867 0 0 0 BRUCE HOLZMAN PSYCHIATRIST 192340 0 1000 0 309 0 2955 0 527 0 197131 0 0 0 RAQUEL BALDERAS PSYCHIATRIST 223918 0 1000 0 90 0 3120 0 9756 0 237884 0 0 0 PART I, LINE 7 ANNUALLY THE BOARD CREATES AN AD HOC COMMITTEE IN CHARGE OF REVIEWING THE CEO'S AND CFO'S PERFORMANCE AND MAKING A RECOMMENDATION TO THE FULL BOARD REGARDING BONUS AND ANY PAY INCREASE. A THE ARIZONA HEALTH FACILITIES AUTHORITY 860453292 040507EM3 2004-12-07 5530000 TO FINANCE & CONSTRUCT BUILDINGS 0 0 0 A 1730000 5530000 201711 99111 4722646 597643 2005 0 0 1 1 A 0 0 0 0 0 0 1 A 0 0 0 0 1 0 0 0 0 A 0 MICHAEL HARRIS DIRECTOR 63516 MARKETING AND LEADERSHIP SERVICES PAID TO MICHAEL HARRIS GROUP, INC. 0 FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS PREPARED BY AN OUTSIDE ACCOUNTING FIRM AND IS REVIEWED BY THE ACCOUNTING MANAGER, THE CONTROLLER AND CFO BEFORE BEING SIGNED BY THE CEO. FORM 990, PART VI, SECTION B, LINE 12C THE MEMBERS OF THE SBH BOARD OF DIRECTORS AND SBH EXECUTIVE PERSONNEL ACKNOWLEDGE THE NEED FOR DISCLOSURE OF INTEREST(S), AND WILL COMPLETE A SBH DECLARATION OF INTEREST FORM ANNUALLY. ANY SITUATION IN WHICH A POSSIBLE CONFLICT OF INTEREST MIGHT ARISE WILL BE REPORTED PROMPTLY IN WRITING TO THE CORPORATION. ALL PERSONNEL ARE REQUIRED TO REPORT A REAL OR POTENTIAL CONFLICT OF INTEREST TO THEIR IMMEDIATE SUPERVISOR PRIOR TO ENGAGING IN ANY TRANSACTION THAT MAY BE PERCEIVED AS A CONFLICT OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15A ANNUALLY THE BOARD CREATES AN AD HOC COMMITTEE IN CHARGE OF REVIEWING THE CEO'S PERFORMANCE AND MAKING A RECOMMENDATION TO THE FULL BOARD REGARDING BONUS AND ANY PAY INCREASE. THE CEO'S EVALUATION IS BASED ON 20 MEASURABLE OBJECTIVES THAT ARE WEIGHTED AND TALLIED FOR A TOTAL SCORE. THE CEO'S SALARY IS COMPARED WITH SALARIES OF NOT-FOR-PROFIT COMPANIES NATIONWIDE - MEMBERS OF THE MENTAL HEALTH CORPORATION OF AMERICA. THE RECOMMENDATIONS OF THE AD HOC COMMITTEE ARE FORWARDED TO ALL BOARD MEMBERS FOR DISCUSSION AND FINAL RECOMMENDATION. REVIEWS WERE LAST PERFORMED DECEMBER 2014. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S ARTICLES OF INCORPORATION, BY-LAWS AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON WRITTEN REQUEST. VILLA AGAVE CORPORATION 7439 S 7TH ST PHOENIX AZ 85042 942902649 HOUSING AZ 501(C)(3) LINE 9 N/A 0 MIHALIC'S PROJECT 1408 E HIGHLAND AVE PHOENIX AZ 85014 860667653 HOUSING AZ 501(C)(3) LINE 9 N/A 0 VILLA DE CONFIANZA 2060 N 35TH AVE PHOENIX AZ 85009 742537585 HOUSING AZ 501(C)(3) LINE 9 N/A 0 TOBY HOUSE II 3450 NORTH THIRD STREET PHOENIX AZ 85012 742420528 HOUSING AZ 501(C)(3) LINE 9 N/A 0 TOBY HOUSE III 3450 NORTH THIRD STREET PHOENIX AZ 85012 860742062 HOUSING AZ 501(C)(3) LINE 9 N/A 0 TOBY HOUSE IV 3450 NORTH THIRD STREET PHOENIX AZ 85012 860897449 HOUSING AZ 501(C)(3) LINE 9 N/A 0 TOBY HOUSE V 3450 NORTH THIRD STREET PHOENIX AZ 85012 860950586 HOUSING AZ 501(C)(3) LINE 9 N/A 0 TOBY HOUSE VI 3450 NORTH THIRD STREET PHOENIX AZ 85012 860981650 HOUSING AZ 501(C)(3) LINE 9 N/A 0 TOBY HOUSE VII 3450 NORTH THIRD STREET PHOENIX AZ 85012 861025879 HOUSING AZ 501(C)(3) LINE 9 N/A 0 TOBY HOUSE VIII 3450 NORTH THIRD STREET PHOENIX AZ 85012 710931900 HOUSING AZ 501(C)(3) LINE 9 N/A 0 AGAVE HEALTH INC PO BOX 22489 SANTA FE NM 875022489 462971316 ADULT AND CHILDREN BEHAVIORAL HEALTH SERVICES NM 501(C)(3) LINE 9 SOUTHWEST BEHAVIORAL HEALTH SERVICES 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0