2014-05-13T06:26:32-05:00 2013-06-30 232932984 PARENTEBEARD LLC 1650 MARKET STREET SUITE 4500 PHILADELPHIA PA 19103 990 2012-07-01 231548822 PHILHAVEN PHIL 7172702414 283 SOUTH BUTLER ROAD PO BOX 550 MOUNT GRETNA PA 17064 MATTHEW ROGERS 7172702414 2014-05-12 1 JULIUS C GREEN P00350393 2159720701 2012 2015-11-30 17:44:51Z MATTHEW ROGERS 283 SOUTH BUTLER ROAD PO BOX 550 MOUNT GRETNA PA 17064 77906142 0 X WWW.PHILHAVEN.ORG X 1949 PA PHILHAVEN PROVIDES BEHAVIORAL HEALTH SERVICES TO INDIVIDUALS IN CENTRAL PA. 15 14 1283 115 615821 121942 1236852 1787368 55105205 57597460 284895 165024 1189120 1086164 57816072 60636016 0 0 0 0 44377603 47966615 30489 43429 238523 12924926 12859135 57333018 60869179 483054 -233163 33405234 33059790 9659611 9489918 23745623 23569872 X AS AN EXPRESSION OF CHRIST'S LOVE, PHILHAVEN PROMOTES HOPE, HEALING AND WHOLENESS THROUGH THE PROVISION OF BEHAVIORAL RESOURCES. 0 0 19088198 21628671 PHILHAVEN'S INPATIENT PSYCHIATRIC PROGRAM IS AVAILABLE TO INDIVIDUALS WHO ARE IN MOST SEVERE DISTRESS AND/OR DANGER OF HARMING THEMSELVES OR OTHERS. THE INPATIENT PROGRAM PROVIDES A 24-HOUR A DAY THERAPEUTIC MILIEU AND INTERVENTIONS THAT SERVE TO STABILIZE ACUTE PSYCHIATRIC SYMPTOMS. SERVICES ARE PROVIDED TO CHILDREN AND ADOLESCENTS AGES THREE TO 18 AND ADULTS OVER 18 YEARS OF AGE. TYPICAL LENGTH OF STAY IS APPROXIMATELY TEN DAYS FOR BOTH ADULTS AND CHILDREN/ADOLESCENTS. ADDITIONALLY, PHILHAVEN OFFERS EXTENDED ACUTE PSYCHIATRIC INPATIENT SERVICES FOR ADULTS THAT REQUIRE LONG-TERM INTENSIVE INTERVENTIONS TO STABILIZE THEIR SYMPTOMS. ONCE BEHAVIORAL STABILIZATION IS ACHIEVED, THE PATIENT IS THEN PREPARED FOR TRANSITION TO THE NEXT APPROPRIATE LEVEL OF CARE. THIS PROGRAM SERVED 2,385 INDIVIDUALS DURING THE JUNE 30, 2013 FISCAL YEAR. 14328760 14250339 PHILHAVEN'S CHILDREN'S/ADOLESCENTS' BEHAVIORAL HEALTH REHABILITATION SERVICE (BHRS) PROGRAM INCLUDES BOTH COMMUNITY BASED AND AFTER SCHOOL SERVICES. THE GOAL OF ALL BHRS SERVICES IS TO ENHANCE THE CHILD'S/ADOLESCENT'S ABILITY TO FUNCTION EMOTIONALLY, SOCIALLY, AND BEHAVIORALLY. INDIVIDUALIZED INTERVENTIONS SERVE TO FACILITATE YOUTH'S BEHAVIORAL STABILIZATION AND EMOTIONAL GROWTH. MENTAL HEALTH SPECIALISTS HELP YOUTH LEARN SKILLS AND COPING STRATEGIES, WHICH ENABLE THE YOUTH TO PREVENT DETERIORATION AND MORE RESTRICTIVE SERVICES. AFTER SCHOOL SERVICES ARE PROVIDED MONDAY - FRIDAY AFTER SCHOOL FOR CHILDREN AGES SIX TO 12 YEARS. COMMUNITY BASED SERVICES ARE PROVIDED IN SCHOOLS AND HOMES BY TRAINED THERAPEUTIC SUPPORT STAFF, MOBILE THERAPISTS, AND BEHAVIORAL SPECIALISTS/CONSULTANTS. THIS PROGRAM SERVED 1,492 INDIVIDUALS DURING THE JUNE 30, 2013 FISCAL YEAR. 12314492 9359915 PHILHAVEN'S OUTPATIENT PROGRAM PROVIDES THE LEAST RESTRICTIVE TYPE OF MENTAL HEALTH TREATMENT AVAILABLE AT PHILHAVEN. STAFF WHO ARE PROFESSIONALLY TRAINED IN PSYCHIATRY, PSYCHOLOGY, SOCIAL WORK, AND COUNSELING STRIVE TO PROVIDE OUTPATIENT SERVICES TO CLIENTS IN A CONSCIENTIOUS AND CARING MANNER AS THEY WORK TOWARD THEIR THERAPEUTIC GOALS. PHILHAVEN STRIVES TO PROVIDE INDIVIDUALS AND THEIR FAMILIES WITH THE SKILLS AND RESOURCES NECESSARY TO LIVE HEALTHY, FULFILLED LIVES WITHIN THEIR HOMES AND COMMUNITIES. SPECIFIC SERVICES OFFERED INCLUDE EVALUATIONS AND ASSESSMENTS, PSYCHIATRIC MEDICATION MANAGEMENT, PSYCHIATRIC CONSULTATION, INDIVIDUAL THERAPY, FAMILY THERAPY, GROUP THERAPY, AND MARRIAGE COUNSELING. THIS PROGRAM SERVED 14,838 INDIVIDUALS DURING THE JUNE 30, 2013 FISCAL YEAR. 8208068 12358535 OTHER PROGRAM SERVICES PRIMARILY INCLUDES THE DAY AND INTENSIVE OUTPATIENT PROGRAMS, WHICH ARE DESIGNED TO PROVIDE THERAPEUTIC INTERVENTIONS TO INDIVIDUALS WHO DEMONSTRATE SIGNIFICANT IMPAIRMENT IN THEIR DAILY FUNCTIONING DUE TO THEIR HIGH LEVEL OF EMOTIONAL DISTRESS. THESE PROGRAMS SERVE BOTH ADULT AND CHILD/ADOLESCENT POPULATIONS IN SEPARATE SETTINGS. SERVICES INCLUDE GROUP THERAPY TARGETING COPING SKILLS, ANGER MANAGEMENT AND STRESS MANAGEMENT, AS WELL AS INDIVIDUAL AND FAMILY THERAPY SESSIONS. OTHER PROGRAMS INCLUDE RESIDENTIAL PROGRAM FOR ADOLESCENTS AND ASSERTIVE COMMUNITY TREATMENT FOR ADULTS. THE OTHER PROGRAMS SERVED 3,470 INDIVIDUALS DURING THE JUNE 30, 2012 FISCAL YEAR. 8208068 12358535 53939518 1 1 0 1 0 0 0 0 0 1 1 0 0 0 0 1 1 0 0 0 0 0 0 1 1 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 123 0 1 1283 1 1 1 0 0 0 0 1 1 0 0 0 0 X 15 14 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 0 PA X MATTHEW D ROGERS CFO 7172702414 283 SOUTH BUTLER ROAD MOUNT GRETNA PA 17064 REBECCA BURKHOLDER 1.50 X X 0 0 0 KENNETH L MOORE 1.50 X X 0 0 0 JANET BRENEMAN 1.30 X 0 0 0 ROBERT FORTNA 1.30 X 0 0 0 JANET R STAUFFER 1.50 X X 0 0 0 SAM THOMAS 1.30 X 0 0 0 ROBERT HOFFMAN 1.30 X 0 0 0 GEORGE STOLTZFUS 1.50 X X 0 0 0 AARON GROFF 1.30 X 0 0 0 KYLE HORST 1.30 X 0 0 0 MONIQUA ACOSTA 1.30 X 0 0 0 DUANE BRITTON 1.30 X 0 0 0 AUDREY GROFF 1.30 X 0 0 0 JAMES HERR 1.30 X 0 0 0 DAVID WARREN 1.30 X 0 0 0 FRANCIS D SPARROW MD 52.00 X 311256 0 13442 PHILIP D HESS 50.00 X 187249 0 16988 MATTHEW ROGERS 50.00 X 108186 0 7736 OLANIYI I OLULEYE 41.00 X 262245 0 18538 RICHARD PAKOLA 40.00 X 270655 0 14071 THOMAS FOLEY 40.00 X 240722 0 13313 THOMAS FENSTERMACHER 40.00 X 242042 0 18494 JEREMY WALTERS 40.00 X 233692 0 17049 1856047 0 119631 25 0 1 0 STC SERVICES 4295 W TILGHMAN ST ALLENTOWN PA 18104 COMMUNICATION SYSTEM 365895 GLS ENTERPRISES PO BOX 673 LEBANON PA 17042 PHARMACY 351410 LOCUMTENENSCOM PO BOX 405547 ATLANTA GA 30384 TEMPORARY STAFFING 295531 ALLCARE FAMILY HEALTH PO BOX 1210 LEBANON PA 17042 PHYSICIAN SERVICES 269112 KE LLC 607 PINKERTON ROAD MTJOY PA 17552 OFFICE RENTAL 155729 12 31322 1023200 732846 5350 1787368 NET PATIENT SERVICE REVENUE 624100 57012583 57012583 EHR INCENTIVE REVENUE 624100 446250 446250 OTHER OPERATING REVENUE 624100 138627 138627 57597460 138423 9051 129372 4200 7753 -3553 -3553 -3553 17216720 41941 17210262 21798 6458 20143 26601 26601 22335 31322 30313 -7978 -7978 FARM INCOME 110000 606770 606770 CAFETERIA SALES 722210 218973 218973 INS. PREM. RECOVERY 624100 200000 200000 71952 71952 1097695 60636016 57597460 615821 635367 644863 322854 307794 14215 37461052 35295865 2069762 95425 261540 248455 12490 595 6930985 6827713 75649 27623 2668175 2513959 147419 6797 74086 74086 21280 21280 80485 13905 66580 96600 96600 43429 43429 19875 1840 18035 2441370 1700405 716797 24168 58808 58127 681 3076031 2709505 356861 9665 125657 125657 2341013 2107778 233235 435205 419753 15452 615474 502877 112597 239740 239740 1900064 339299 1560765 BAD DEBTS 446858 446858 FARM EXPENSES 251800 251800 BOOKS, DUES & SUBSCRIPT 173233 56382 116851 FEDERAL INCOME TAX 27102 27102 434454 153168 280813 473 60869179 53939518 6691138 238523 28685 26437 3111285 3271723 333838 278116 7891374 9162308 340000 340000 20045 27084 940609 982892 46849515 32003247 12135531 14846268 7212291 2669270 936422 926818 8122 6199 447032 522675 33405234 33059790 5842994 5469490 17819 3798798 4020428 9659611 9489918 X 22587131 22538246 690674 472678 467818 558948 23745623 23569872 33405234 33059790 -233163 57412 0 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 101698 101698 0 EXPLANATION OF LOBBYING ACTIVITIES: PART II-B, LINE 1: THE HOSPITAL ENGAGED A PROFESSIONAL LOBBYING FIRM TO ASSIST IN SECURING GOVERNMENTAL FUNDING FOR SPECIALIZED PROGRAMS ($96,600). IN ADDITION A PORTION OF THE DUES PAID TO THE HOSPITAL ASSOCIATION OF PENNSYVLANIA INCLUDES LOBBYING($5,098). 475713 80560 49609 605882 490269 -14556 475713 429302 60967 490269 401011 28291 429302 473539 -72528 401011 0.05000 0.95000 0 0 355952 355952 19027530 11034037 7993493 26489875 20930625 5559250 976158 38585 937573 14846268 X 60718809 57412 5350 62762 60656047 18035 -38066 -20031 60636016 60894560 5350 38066 43416 60851144 18035 18035 60869179 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: THE PURPOSE OF THESE DONOR RESTRICTED FUNDS IS TO PROVIDE A STABLE SOURCE OF PERPETUAL FINANCIAL SUPPORT FOR THE PHILHAVEN PROGRAMS. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: PHILHAVEN IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL INCOME TAXES ON THEIR EXEMPT INCOME UNDER SECTION 501(A) AS THE INTERNAL REVENUE CODE. THE FARM'S INCOME IS TAXABLE FOR FEDERAL PURPOSES OF UNRELATED BUSINESS INCOME. PHILHAVEN AND THE FARM PRESCRIBE A RECOGNITION THRESHOLD OF MORE-LIKELY-THAN-NOT TO BE SUSTAINED UPON EXAMINATION BY THE APPROPRIATE TAXING AUTHORITY IN RECORDING TAX LIABILITIES IN THE FINANCIAL STATEMENTS. MEASUREMENT AND RECOGNITION OF THE TAX UNCERTAINTY OCCURS IF THE RECOGNITION THRESHOLD HAS BEEN MET. MANAGEMENT DETERMINED THERE WERE NO TAX UNCERTAINTIES THAT MET THE RECOGNITION THRESHOLD FOR THE YEARS ENDED JUNE 30, 2013 AND 2012. THE ORGANIZATION'S FEDERAL EXEMPT ORGANIZATION BUSINESS INCOME TAX RETURNS FOR THE YEARS ENDED AFTER JUNE 30, 2009 REMAIN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE. PART XI, LINE 4B - OTHER ADJUSTMENTS: FUNDRAISING EVENT EXPENSE -30,313. RENTAL EXPENSES -7,753. PART XII, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EVENT EXPENSES 30,313. RENTAL EXPENSES 7,753. X X 1 BENEVON 4528 EIGHT AVENUE NE SEATTLE WA 98105 FUNDRAISING PROGRAM CONSULTANT 0 129513 31231 98282 ENDOWMENT HORIZONS PO BOX 196 WATERVILLE OH 43566 CONSULTING ON PLANNED GIVING PROGRAM 0 78090 12198 65892 207603 43429 164174 PA GOLF TOURNAMENT 53657 31322 22335 610 23904 343 5456 53657 31322 22335 610 23904 343 5456 30313 -7978 1 1 1 X 1 X 1 0 0 321463 351882 -30419 0.00000 34388201 33504864 883337 0.01460 34709664 33856746 852918 0.01460 2674236 1768282 905954 0.01500 80340 80340 0.00130 2754576 1768282 986294 0.01630 37464240 35625028 1839212 0.03090 43355 43355 0.00070 43355 43355 0.00070 0 459441 0 2268361 2358042 -89681 X 1 1 1 KE LLC RENTAL PROPERTY 0.50000 2 ADVANCE MANAGEMENT SERVICES LLC OUTCOMES SOFTWARE DEVELOPMENT FOR THE HEALTHCARE COMMUNITY 0.22380 1 1 PHILHAVEN

283 SOUTH BUTLER ROAD PO BOX 550 MOUNT GRETNA PA 17064

X BEHAVIORAL HEALTH HOSPITAL PHILHAVEN 1 1 X X X X X X X X 12 1 0 1 X X X X 0 0 1 1 150.000000000000 1 300.000000000000 1 X X X 1 1 X X 1 1 X X X 0 X X 0 0 PART I, LINE 7: A COST TO CHARGE RATIO WAS USED TO DETERMINE THE AMOUNTS REPORTED IN THE CHARITY CARE AND MEANS-TESTED GOVERNMENT PROGRAMS ITEMS. COST ACCOUNTING WAS USED TO DETERMINE THE AMOUNTS REPORTED IN THE OTHER BENEFITS SECTION. BAD DEBT AND OTHER WRITE-OFFS ARE EXCLUDED IN THE DENOMINATOR WHICH, IF INCLUDED, WOULD INCREASE THE PERCENTAGE OF CHARITY CARE REPORTED. THE AMOUNT OF BAD DEBT NOT INCLUDED IN THE CALCULATION WAS $446,858. PART I, L7 COL(F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A) OF $446,858 IS SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN. PART II: PHILHAVEN PARTICIPATES IN THE FOLLOWING PROGRAMS IN THE COMMUNITY:CRISIS INTERVENTION /INFORMATION AND REFERRAL CENTER IS A CONFIDENTIAL SEVEN DAY / 24 HOUR SERVICE, PROVIDED BY PHILHAVEN. CRISIS COUNSELORS PROVIDE PSYCHOSOCIAL ASSESSMENT OF CRISIS SITUATIONS OVER THE PHONE AND IN THE COMMUNITY. CRISIS SERVICES ARE FUNDED THROUGH A CONTRACT BETWEEN THE COUNTY COMMISSIONERS AND PHILHAVEN ALONG WITH MEDICAL ASSISTANCE REIMBURSEMENT FOR IDENTIFIED INDIVIDUALS WITH MEDICAID. THIS CONTRACT ALLOWS FOR LIMITED REIMBURSEMENT OF OVERHEAD EXPENSE RESULTING IN SHORTFALLS. THE LANCASTER DIVERSION PROGRAM IS A COMMUNITY-BASED PROGRAM DESIGNED TO SERVE THE NEEDS OF INDIVIDUALS WHO HAVE A HISTORY OF SERIOUS AND PERSISTENT MENTAL ILLNESS AND LONG-TERM HOSPITALIZATION. IT IS ALSO DESIGNED TO SERVE INDIVIDUALS IDENTIFIED BY LANCASTER COUNTY CASE MANAGEMENT STAFF AS BEING AT RISK FOR INPATIENT OR STATE HOSPITAL SERVICES DUE TO SEVERELY ACUTE PSYCHIATRIC ILLNESS AND BEHAVIOR. THE DIVERSION PROGRAM IS FUNDED THROUGH A CONTRACT BETWEEN PHILHAVEN AND LANCASTER COUNTY. THIS CONTRACT PROVIDES LIMITED REIMBURSEMENT FOR OVERHEAD EXPENSE RESULTING IN SHORTFALLS. SUPPORTED HOUSING IS AN INNOVATIVE PROGRAM DESIGNED TO BENEFIT PERSONS WHO SUFFER FROM CHRONIC MENTAL ILLNESS BY ASSISTING THEM WITH BASIC HOUSING NEEDS. CLIENTS ARE ABLE TO LIVE INDEPENDENTLY IN THE COMMUNITY WHILE RECEIVING THE SUPPORTIVE ASSISTANCE THEY NEED THROUGH REGULAR IN-HOME VISITS. THE PROGRAM IS ADMINISTERED BY A MASTER'S LEVEL CLINICIAN AND IS A VOLUNTARY PROGRAM FUNDED BY LEBANON COUNTY MENTAL HEALTH AND MENTAL RETARDATION ASSOCIATION. THE STAFF ALSO ASSISTS WITH ASSESSMENT OF HOUSING NEEDS, PROCUREMENT OF HOUSING AND HOUSEHOLD GOODS, HOME MAINTENANCE SKILLS, LANDLORD/TENANT NEGOTIATIONS AND OTHER ISSUES RELATED TO MAINTAINING INDEPENDENT LIVING. THE FUNDING FROM LEBANON COUNTY IS LIMITED RESULTING IN SHORTFALLS.PARTNERS FOR PROGRESS IS A SERVICE DEVELOPED IN CONJUNCTION WITH THE LEBANON HOUSING AUTHORITY AND LEBANON MH/MR TO PROVIDE HOMES AND SUPPORT SERVICES TO TEN INDIVIDUALS WHO ARE HOMELESS AND WHO HAVE A HISTORY OF EXPERIENCING PERSISTENT MENTAL ILLNESS.THE AUTISM RESILIENCY PROGRAM IS DESIGNED TO HELP FAMILIES AND THE COMMUNITY TO ACHIEVE A GREATER UNDERSTANDING OF AUTISM SPECTRUM DISORDERS (ASD), IMPROVE SKILLS THAT WILL ALLOW PERSONS WHO EXPERIENCE ASD TO INTEGRATE MORE FULLY INTO THE COMMUNITY, AND CREATE GREATER COMMUNITY RESOURCES FOR SOCIAL AND RECREATIONAL ACTIVITIES FOR INDIVIDUALS WITH ASD. THIS WILL PROVIDE FAMILIES WITH TOOLS TO BUILD AND MAINTAIN THEIR PERSONAL RESILIENCY. CURRENTLY, THE PROGRAM REACHES LEBANON COUNTY AND NEARBY AREAS. IT INCLUDES A PHYSICAL SPACE IN PHILHAVEN'S GRACE M. POLLOCK TRAINING & COMMUNITY CENTER AND THE POTENTIAL FOR VIDEO CONFERENCING OF PRESENTATIONS. ADDITIONALLY THE PROGRAM PROVIDES TWO SERIES OF WORKSHOPS FOR INTERESTED COMMUNITY MEMBERS. THE ASERT COLLABORATIVE IS A PARTNERSHIP OF MEDICAL CENTERS, CENTERS OF AUTISM RESEARCH AND SERVICES, UNIVERSITIES AND OTHER PROVIDERS OF SERVICES INVOLVED IN THE TREATMENT AND CARE OF INDIVIDUALS OF ALL AGES WITH AUTISM AND THEIR FAMILIES. THE ASERT COLLABORATIVE HAS BEEN DESIGNED TO BRING TOGETHER RESOURCES LOCALLY, REGIONALLY, AND STATEWIDE. THERE ARE THREE ASERT REGIONS (WESTERN, CENTRAL, AND EASTERN) WORKING TOGETHER TO STREAMLINE RESOURCES AND SHARE EXPERTISE ACROSS THE COMMONWEALTH. EACH ASERT REGION IS CHARGED WITH UNDERSTANDING THE NEEDS OF THEIR RESPECTIVE REGION, INCLUDING THE NEEDS OF THE MOST RURAL REGIONS OF THE STATE AND THE MOST UNDERSERVED POPULATIONS.INTEGRATION WITH PHYSICAL HEALTHCAREIN AN EFFORT TO ADDRESS THE IDENTIFIED COMMUNITY NEED OF INTEGRATION BETWEEN PHYSICAL AND BEHAVIORAL HEALTHCARE SERVICES, PHILHAVEN PROVIDES A VARIETY OF BEHAVIORAL HEALTHCARE SERVICES IN PHYSICAL HEALTHCARE SETTINGS. THESE SERVICES INCLUDE UNCOMPENSATED ACTIVITIES SUCH AS CARE COORDINATION BETWEEN PHILHAVEN AND THE OTHER HEALTHCARE PROVIDERS. AS A RESULT PHILHAVEN OPERATES THESE SERVICES AT A LOSS. BELOW ARE SPECIFIC EXAMPLES OF PHILHAVEN'S INTEGRATED HEALTHCARE SERVICES:HAMILTON HEALTH CENTERPHILHAVEN IS PARTICIPATING IN AN INTEGRATION PROJECT WITH THE HAMILTON HEALTH CENTER LOCATED IN HARRISBURG. THIS PROJECT WILL INTEGRATE PSYCHIATRIC SERVICES INTO THE FEDERALLY QUALIFIED HEALTH CENTER SETTING. SERVICES PROVIDED INCLUDE PSYCHOTHERAPY, PSYCHIATRIC CONSULTATION, AND CLINICAL SUPERVISION OF STAFF.CONSULTATIONSPHILHAVEN PROVIDES PSYCHIATRIC CONSULTATIONS IN THE EMERGENCY ROOM AND INPATIENT FACILITIES AT GOOD SAMARITAN HOSPITAL IN LEBANON.IN ADDITION, PHILHAVEN OFFERS A WIDE RANGE OF BEHAVIORAL HEALTH SERVICES TO NURSING HOMES AND LONG TERM CARE COMMUNITIES. SERVICES INCLUDE PSYCHIATRIC DIAGNOSTIC EVALUATIONS, MEDICATION MANAGEMENT, BEHAVIORAL INTERVENTIONS, AND PSYCHOTHERAPY TO ASSIST SENIOR ADULTS IN NAVIGATING MANY OF LIFE'S CHALLENGES AND TO STRENGTHEN THEIR ABILITY TO LIVE LIFE TO ITS FULLEST. IN ADDITION, PHILHAVEN STAFF PROVIDES EDUCATION FOR NURSING HOME STAFF TO BE ABLE TO UNDERSTAND AND MANAGE THEIR RESIDENTS' BEHAVIORAL CHALLENGES.PARENT TRAININGFINDING A BETTER WAY FOR MOMS AND DADS IS A FREE FOUR-SESSION PROGRAM THAT IS OFFERED TO PARENTS WHO ARE DEALING WITH DIFFICULT SITUATIONS WITH THEIR CHILDREN. THE PROGRAM FACILITATORS ARE CERTIFIED INSTRUCTORS IN THERAPEUTIC CRISIS INTERVENTION. THE PROGRAM, WHICH IS HELD AT DIFFERENT TIMES AND LOCATIONS, IS DESIGNED TO TEACH PARENTS SKILLS TO OPEN UP THE PATHWAY TO EFFECTIVE COMMUNICATION WITH THEIR CHILDREN, GAIN UNDERSTANDING INTO THEIR CHILDREN'S FEELINGS AND NEEDS, AND PROMOTE COOPERATION AND MANAGE UNCOOPERATIVE BEHAVIORS. PARENTS LEARN TO IDENTIFY TRIGGERS AND EARLY WARNING SIGNS OF CHALLENGING BEHAVIORS, THE BEHAVIOR SUPPORT STRATEGIES TO PREVENT AND MANAGE CHALLENGING BEHAVIORS AND CRISIS SITUATIONS, AND HOW TO RESTORE THEIR RELATIONSHIP WITH THEIR CHILDREN AFTER A CRISIS AND TRANSFORM IT INTO A LEARNING EXPERIENCE.OTHER COMMUNITY BUILDING ACTIVITIESPHILHAVEN'S COMMUNITY BUILDING ACTIVITIES INCLUDED CONTRIBUTIONS TO THE MT. GRETNA FIRE COMPANY AND THE CORNWALL POLICE DEPARTMENT. THESE CONTRIBUTIONS ALLOWED THE ORGANIZATIONS TO IMPROVE THE FACILITIES AND EQUIPMENT THEY USE TO MAINTAIN A SAFE COMMUNITY. ADDITIONALLY, REPORTED AS COMMUNITY BUILDING ACTIVITIES ARE CONTRIBUTIONS TO THE UNITED WAY OF LEBANON. THE UNITED WAY OF LEBANON PROVIDES ASSISTANCE TO SEVERAL PHYSICAL AND BEHAVIORAL HEALTHCARE PROVIDERS IN LEBANON COUNTY. PART III, LINE 4: PHILHAVEN RECOGNIZES THE PROVISION FOR BAD DEBTS AND THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED ON HISTORICAL EXPERIENCE. A COST CHARGE RATIO WAS USED TO DETERMINE THE AMOUNTS REPORTED AS BAD DEBT. BAD DEBT IS RECORDED BASED ON THE NET BALANCE OF THE AGED RECEIVABLES ACCOUNT. ALL DISCOUNTS AND PAYMENTS ARE RECORDED PRIOR TO THE ADJUSTMENT OF THE BAD DEBT ACCOUNT. A SAMPLE OF CHARITY CARE APPLICATIONS WAS REVIEWED TO DETERMINE A RATIO OF REQUESTED CHARITY CARE TO GRANTED CHARITY CARE. THIS PERCENTAGE WAS APPLIED TO THE BAD DEBT BALANCE. PART III, LINE 8: PHILHAVEN USES A COST TO CHARGE RATIO FOR APPLICABLE LEVELS OF CARE REIMBURSED BY MEDICARE. THESE INCLUDE INPATIENT, OUTPATIENT AND DAY/IOP PROGRAMS. PART III, LINE 9B: THE ORGANIZATION DOES NOT PURSUE COLLECTIONS AGAINST PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE. THIS POLICY, HOWEVER, IS NOT CURRENTLY DOCUMENTED. THE ORGANIZATION IS WORKING TO MAKE THE POLICY AGAINST COLLECTION EFFORTS FOR FINANCIALLY NEEDY PATIENTS MORE FORMALIZED IN THEIR WRITTEN PROCEDURES. PHILHAVEN PART V, SECTION B, LINE 3: TWO COMMUNITY FORUMS WERE CONDUCTED WITH COMMUNITY MEMBERS AND MENTAL HEALTH PROFESSIONALS. THERE WERE 76 PARTICIPANTS, REPRESENTING PUBLIC HEALTH AND MEDICAL SERVICES AND NON-PROFIT AND SOCIAL ORGANIZATIONS. UPON COMPLETION OF THE FORUMS, AN ADVISORY COMMITTEE WAS PUT INTO PLACE TO REVIEW THE RESULTS AND SHARE OBSERVATIONS AND INTERPRETATIONS OF THE DATA. THE ADVISORY COMMITTEE INCLUDED PHILHAVEN STAFF, PHILHAVEN BOARD MEMBERS AND COMMUNITY PARTICIPANTS INCLUDING: THE LEBANON COUNTY MH/ID/EI DEPUTY ADMINISTRATOR, THE DAUPHIN COUNTY MH/ID PROGRAM ADMINISTRATOR, THE MHA OF LEBANON EXECUTIVE DIRECTOR, THE LANCASTER COUNTY BH/DS EXECUTIVE DIRECTOR, AND THE VICE PRESIDENT OF MEDICAL AFFAIRS OF GOOD SAMARITAN HOSPITAL. THROUGH GROUP DIALOGUE, SEVEN KEY STRATEGIC ISSUES WERE IDENTIFIED. USING AN ANONYMOUS WIRELESS KEYPAD VOTING SYSTEM, EACH ATTENDEE WAS ASKED TO RATE EACH STRATEGIC ISSUE WITH REGARD TO HOW STRONGLY THEY FELT THE ISSUE SHOULD BE INCLUDED IN THE FINAL IMPLEMENTATION PLAN. THEY WERE EACH ALSO ASKED TO SELECT THE ONE ISSUE THAT THEY DEEMED MOST IMPORTANT. THIS PRIORITIZATION WAS THEN UTILIZED BY PHILHAVEN LEADERSHIP AND BOARD OF DIRECTORS IN ADOPTING THE THREE PRIORITY AREAS OF THE CHNA. PHILHAVEN PART V, SECTION B, LINE 7: A CRITERIA-DRIVEN APPROACH, WHICH INCLUDED ASSESSING THE SCOPE AND SERIOUSNESS OF THE IDENTIFIED NEEDS, PHILHAVEN'S EXPERTISE AND RESOURCES AVAILABLE TO ADDRESS THEM, AND A DISCUSSION OF WHAT NEEDS MAY BE ADDRESSED BY OTHERS, WENT INTO THE SELECTION OF PRIORITY ISSUES. WHILE THREE ISSUES, INTEGRATED TREATMENT MODELS, FOCUS ON PREVENTION, AND REDUCTION IN EMERGENCY DEPARTMENT USE, WERE PRIORITIZED AND ADOPTED BY PHILHAVEN FOR ITS IMPLEMENTATION PLAN, PHILHAVEN CONTINUES WORK ACROSS MANY OF THE OTHER IDENTIFIED COMMUNITY NEEDS. AS THE NEEDS THAT WERE IDENTIFIED ARE NOT MUTUALLY EXCLUSIVE FROM ONE ANOTHER, IT IS PHILHAVEN'S HOPE THAT BY ADEQUATELY ADDRESSING THE THREE PRIORITIZED NEEDS, THE OTHER NEEDS WILL BE INDIRECTLY IMPACTED AS WELL. THE NEEDS THAT WERE IDENTIFIED, BUT NOT ADDRESSED ARE:1.A LACK OF "HUMAN RESOURCES"PHILHAVEN WILL CONTINUE TO ADVOCATE FOR INCREASED FUNDING AND HIGHER LEVELS OF STAFFING IN THE MENTAL HEALTH PROFESSION. THROUGH ITS ROLE AS A NON-PROFIT ORGANIZATION IN SOUTH CENTRAL PENNSYLVANIA, PHILHAVEN WILL REPRESENT THE FIELD OF MENTAL AND BEHAVIORAL HEALTH AS ONE THAT IS FULFILLING, ATTRACTIVE AND WORTHWHILE TO PURSUE. WHILE PHILHAVEN WILL CONTINUE ITS EFFORTS WITH RECRUITMENT AND RETENTION IN THE FIELD, OTHERS ARE DOING THE SAME AND NEED TO DO THE SAME FOR THIS TO IMPROVE. PHILHAVEN ALONE AND EVEN IN PARTNERSHIP WITH OTHERS LOCALLY CANNOT ALONE IMPACT FUNDING CHANGES AND TRAINING OF MENTAL HEALTH PROFESSIONALS. THE BEST WORK IS DONE THROUGH STATE AND NATIONAL ASSOCIATIONS. FOR THIS REASON, IT WAS FELT THAT PHILHAVEN'S ABILITY TO DIRECTLY IMPACT THIS AS THE LOCAL LEVEL MAY BE LIMITED. 2.STIGMADESPITE THIS PARTICULAR COMMUNITY NEED NOT RISING TO THE TOP OF THE PRIORITIZE NEEDS, PHILHAVEN REMAINS COMMITTED TO REDUCING THE STIGMA OF MENTAL ILLNESS. PHILHAVEN HAS HAD A NUMBER OF OUTREACH INITIATIVES TO EDUCATE THE PUBLIC ON MENTAL HEALTH AND MENTAL WELLNESS AND WILL CONTINUE TO DO SO. 3.LACK OF A FORUM FOR COLLECTIVE ADVOCACYTHE ROLE OF A PROVIDER ORGANIZATION IS TO PARTICIPATE IN ADVOCACY ISSUES WITH ELECTED OFFICIALS, HOWEVER, IT WAS DETERMINED THAT PHILHAVEN'S HIGHEST CALLING FROM A COMMUNITY-HEALTH PERSPECTIVE, IS NOT TO TAKE THE LEAD WITH PENNSYLVANIA'S ADVOCACY EFFORTS. HAVING THE EXPERTISE OF RUNNING A NOT-FOR-PROFIT IS A VERY DIFFERENT SKILL SET THAN PULLING TOGETHER A STATEWIDE ADVOCACY INITIATIVE. THAT BEING SAID, PHILHAVEN WILL CONTINUE TO BE A VOICE FOR INCREASED FUNDING AND OTHER HIGH PRIORITY ISSUES IN THE MENTAL HEALTH FIELD. 4.INCREASED NEED FOR CULTURAL COMPETENCYPHILHAVEN CURRENTLY HAS SEVERAL INITIATIVES TO PROVIDE SPECIFIC COMMUNITY-BASED MENTAL HEALTH SERVICES TO CERTAIN SUB-POPULATIONS. FOR EXAMPLE, PHILHAVEN PROVIDES CULTURALLY-COMPETENT SERVICES TO THE PLAIN COMMUNITY THAT ARE DEVELOPED AROUND THE UNIQUE BELIEFS AND NEEDS OF THAT POPULATION. THESE INITIATIVES WILL CONTINUE, MANY IN PARTNERSHIP WITH OTHER ORGANIZATIONS IN THE AREA. HOWEVER, PHILHAVEN AND THE CHNA ADVISORY COMMITTEE FELT THAT THE SCOPE AND SEVERITY OF THIS PARTICULAR ISSUE WAS NOT AS GREAT AS THE OTHER THREE THAT MADE THE FINAL PRIORITIZED LIST. PHILHAVEN PART V, SECTION B, LINE 18E: A MINIMUM OF THREE ATTEMPTS TO COLLECT PAYMENT FROM THE PATIENT IS REQUIRED PRIOR TO REFERRAL TO A CREDIT AGENCY. PHILHAVEN PART V, SECTION B, LINE 20D: AS DETAILED IN ITS CHARITY CARE POLICY, PHILHAVEN USES A SLIDING SCALE BASED ON HOUSEHOLD INCOME AND THE FEDERAL POVERTY GUIDELINES AS THE BASIS FOR CHARGES TO INDIVIDUALS QUALIFYING FOR FINANCIAL ASSISTANCE. THIS INCLUDES DISCOUNTS FROM 25% TO 100% OF THE USUAL AND CUSTOMARY CHARGES. PART VI, LINE 2: PHILHAVEN SENIOR MANAGEMENT REGULARLY MEETS WITH LEADERSHIP OF THE COUNTY GOVERNMENTS AND LEADERSHIP OF LOCAL COMMUNITY HOSPITALS, HEALTH SYSTEMS AND OTHER PHYSICAL HEALTHCARE PROVIDERS TO IDENTIFY HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES RELATED TO MENTAL HEALTH AND PSYCHIATRY. ADDITIONALLY PHILHAVEN REGULARLY SURVEYS ITS OWN PATIENTS TO GAIN A BETTER UNDERSTANDING OF THEIR NEEDS AND SATISFACTION WITH SERVICES PROVIDED. PART VI, LINE 3: THE "CHARITY CARE" POLICY IS POSTED IN ALL ADMISSIONS / WAITING AREAS. UPON ADMISSION THE PATIENT IS INFORMED, IN WRITING, OF THEIR LIABILITY. SHOULD A PATIENT BE IDENTIFIED UPON ADMISSION OR DURING THE COURSE OF TREATMENT AS HAVING NO INSURANCE COVERAGE A CHARITY CARE COORDINATOR WILL MEET WITH THEM OR THEIR RESPONSIBLE PARTY TO REVIEW THE "CHARITY CARE" POLICY AND ASSIST IN APPLICATION FOR FINANCIAL ASSISTANCE THROUGH THE CHARITY CARE POLICY AND/OR THROUGH AN APPLICATION TO MEDICAL ASSISTANCE. PART VI, LINE 4: PHILHAVEN PRIMARILY SERVES FOUR COUNTIES IN CENTRAL PENNSYLVANIA (LEBANON, LANCASTER, YORK AND DAUPHIN). THESE COUNTIES INCLUDE THE CITIES OF HARRISBURG, LANCASTER, LEBANON AND YORK ALOING WITH RURAL AREAS. FIFTY FOUR PERCENT OF THE PATIENTS WE SERVE ARE FEMALE AND FORTY SIX PERCENT ARE MALE. ADDITIONALLY SEVENTY TWO PERCENT OF THE PATIENTS WE SERVE ARE CAUCASIAN, NINE PERCENT ARE HISPANIC, FOUR PERCENT ARE AFRICAN-AMERICAN, AND FIFTEEN PERCENT IDENTIFY THEMSELVES AS ANOTHER RACE OR MIXED RACE. PART VI, LINE 5: PHILHAVEN MAKES MEMBERS OF ITS MEDICAL AND CLINICAL STAFF AVAILABLE TO VARIOUS COMMUNITY ORGANIZATIONS. INCLUDED IN THIS ARE PSYCHIATRIC: PHILHAVEN PROVIDES CONSULTATIONS FROM ITS MEDICAL STAFF MEMBERS TO LOCAL COMMUNITY AND ACUTE CARE HOSPITALS. ADDITIONALLY PHILHAVEN PROVIDES MEDICAL STAFF AND CLINICAL STAFF TO A LOCAL SCHOOL DISTRICT FOR PSYCHIATRIC AND THERAPEUTIC CONSULTATION OR DIRECT SERVICES AT NO CHARGE. PHILHAVEN ENCOURAGES ITS SENIOR MANAGEMENT AND EMPLOYEES TO VOLUNTEER THEIR TIME FOR LOCAL NON-PROFIT ORGANIZATIONS. THESE STAFF PROVIDE MENTAL HEALTH EXPERTISE TO NON-PROFIT AGENCIES PROVIDING SERVICES TO HOMELESS PERSONS, PERSONS WITH DEVELOPMENTAL DISABILITIES, AND PERSONS WITH MENTAL ILLNESS. ADDITIONALLY, PHILAHVEN ALLOWS SOME LOCAL NON-PROFIT ORGANIZATIONS USE OF ITS TRAINING FACILITIES AT NO CHARGE INCLUDING OTHER HEALTH CARE ORGANIZATIONS. TRAININGS SPONSORED BY PHILHAVEN ARE ALSO MADE AVAILABLE TO OTHER MENTAL HEALTH AND PHYSICAL HEALTHCARE PROVIDERS ON A VARIETY OF MENTAL HEALTH TOPICS IMPROVING THE OTHER HEALTHCARE PROVIDERS' ABILITY TO SERVE PATIENTS WITH MENTAL ILLNESS. PART VI, LINE 6: N/A REPORTS FILED WITH STATES PART VI, LINE 7 PA IMPLEMENTATION PLAN PART VI PHILHAVEN HAS ADOPTED THE FOLLOWING IMPLEMENTATION DETAILS TO SUPPORT ITS COMMUNITY-BASED WORK REGARDING THE THREE PRIORITY COMMUNITY NEEDS. THIS WORK WILL BE SPEARHEADED BY THE PHILHAVEN LEADERSHIP TEAM WITH ONGOING GUIDANCE FROM A COMMUNITY ADVISORY GROUP. ADDITIONALLY, PHILHAVEN WILL ENGAGE WITH AREA PARTNERS, MANY OF WHOM PARTICIPATED IN THE COMMUNITY FORUMS, TO ADVANCE THE WORK OF THE PRIORITIZED COMMUNITY NEEDS. INTEGRATED TREATMENT MODELSGOAL STATEMENT: TO IMPROVE THE DELIVERY OF COMMUNITY HEALTHCARE SERVICES THROUGH THE INTEGRATION OF PRIMARY CARE, MENTAL HEALTHCARE, AND OTHER RELATED SERVICES. OBJECTIVES:A. TO PROVIDE PATIENT SERVICES IN AT LEAST ONE INTEGRATED CARE MODEL BY JANUARY 1, 2014.B. TO MEET WITH IDENTIFIED PRIMARY HEALTHCARE PROVIDERS AT LEAST TWO TIMES PER YEAR IN ORDER TO IDENTIFY AND ENHANCE STRATEGIES THAT PROMOTE WELLNESS.C. TO DEVELOP AT LEAST ONE TRAINING SERIES OR COMMUNICATION CAMPAIGN ANNUALLY DESIGNED TO INCREASE INTERNAL AND COMMUNITY AWARENESS OF THE NEED FOR INTEGRATED TREATMENT MODELS TO MEET COMMUNITY HEALTHCARE NEEDS.IMPLEMENTATION STRATEGIES:1. ESTABLISH A WORKGROUP OF PRIMARY CARE AND MENTAL HEALTH PROFESSIONALS TO IDENTIFY POSSIBLE MODELS FOR INTEGRATED CARE; THIS GROUP WOULD MEET ON A SEMIANNUAL BASIS.2. PROVIDE INTEGRATED COMMUNITY SERVICES WITH HAMILTON HEALTHCARE.3. SUPPORT EXISTING COMMUNITY GROUPS AND STAKEHOLDERS FOCUSED ON INTEGRATING TREATMENT MODELS TO IMPROVE THE DELIVERY OF HEALTHCARE SERVICES.4. DEVELOP TRAINING AND EDUCATION OPPORTUNITIES FOR STAFF, CLIENTS, AND THE COMMUNITY REGARDING HEALTHCARE DELIVERY MODELS AND MODALITIES. FOCUS ON PREVENTIONGOAL STATEMENT: TO IMPROVE THE COMMUNITY'S QUALITY OF LIFE THROUGH PREVENTION STRATEGIES.OBJECTIVES:A. TO ANNUALLY ENGAGE AND COLLABORATE WITH COMMUNITY PHYSICAL HEALTH PROVIDERS AND AGENCIES ON AT LEAST TWO COMMUNITY HEALTH PROMOTION AND PREVENTION PROJECTS.B. TO INCREASE COMMUNITY AWARENESS OF PREVENTION STRATEGIES AS EVIDENCED BY CIRCULATION OF HEALTHY LIVING LITERATURE IN 50% OF LEBANON COUNTY PRIMARY CARE PHYSICIAN OFFICES BY JANUARY 2015. C. TO PROMOTE HEALTHY LIFESTYLES BY PROVIDING AT LEAST ONE ANNUAL EDUCATION OPPORTUNITY FOR STAFF, CLIENTS AND THE COMMUNITY TO ADDRESS KEY PHYSICAL AND MENTAL HEALTH ISSUES BY JANUARY 2015. IMPLEMENTATION STRATEGIES:1. COLLABORATE ON PREVENTION FOCUSED ENDEAVORS SUCH AS HEALTH SCREENING PROJECTS, COMMUNITY HEALTH COUNCIL, COALITIONS, ETC. WITH COMMUNITY STAKEHOLDERS.2. PROVIDE INFORMATION TO CLIENTS AND THE COMMUNITY TO IMPROVE UNDERSTANDING OF KEY BEHAVIORAL HEALTHCARE ISSUES FACING THE COMMUNITY INCLUDING BUT NOT LIMITED TO SUICIDE, DOMESTIC VIOLENCE, TRAUMA AND SUBSTANCE ABUSE.3. PROVIDE MEDICAL/PHYSICAL HEALTH INFORMATION AND LITERATURE IN WAITING AREAS.4. WORK WITH COMMUNITY AGENCIES AND PROVIDERS TO IMPROVE UNDERSTANDING OF BEHAVIORAL HEALTHCARE SYSTEMS BY OFFERING ONGOING INFORMATION INCLUDING WHEN AND HOW TO ACCESS CARE, SYSTEM ENTRY POINTS, EVALUATIONS AND TREATMENT.5. DEVELOP PEDAGOGY TO PROMOTE HEALTH LITERACY USING HEALTHY PEOPLE 2020 AS A FRAMEWORK FOR NEEDS. REDUCTION OF THE USE OF THE EMERGENCY DEPARTMENT AS AN ACCESS POINT FOR PERSONS WITH A MENTAL ILLNESSGOAL STATEMENT: TO REDUCE THE USE OF EMERGENCY DEPARTMENTS AS AN ACCESS POINT FOR PERSONS WITH MENTAL ILLNESS. OBJECTIVES:A. MEET WITH REPRESENTATIVES FROM EMERGENCY DEPARTMENTS IN LANCASTER AND LEBANON COUNTIES AT LEAST TWO TIMES PER YEAR STARTING IN 2014 TO ADDRESS BEHAVIORAL HEALTH NEEDS OF "SUPER-UTILIZERS" IN ORDER TO ADDRESS ISSUES RELATED TO EMERGENCY DEPARTMENT OVERUSE.B. ENGAGE COMMUNITY STAKEHOLDERS IN SEMIANNUAL MEETINGS STARTING 2014 TO IDENTIFY DISCRETE BEHAVIORAL HEALTH SERVICES AND SUPPORTS NEEDED WITHIN EMERGENCY DEPARTMENTS TO MEET URGENT, NON-EMERGENCY BEHAVIORAL HEALTH NEEDS. IMPLEMENTATION STRATEGIES:1. PARTICIPATE IN MEETING WITH LOCAL EMERGENCY DEPARTMENT LEADERS TO IDENTIFY TACTICS TO REDUCE USE OF DEPARTMENTS AS AN ACCESS POINT FOR PERSONS WITH MENTAL ILLNESS.2. PARTICIPATE IN MEETINGS WITH LEADERS FROM LOCAL ADULT COMMUNITY BASED PSYCHIATRIC INPATIENT DIVERSION PROGRAMS TO DEVELOP STRATEGIES FOR REDUCING EMERGENCY DEPARTMENT USE BY CLIENTS SERVED IN THESE PROGRAMS. 3. PARTICIPATE IN REGULAR "SUPER-UTILIZER" MEETINGS WITH COMMUNITY STAKEHOLDERS TO ADDRESS ISSUES THAT LEAD MENTAL HEALTH CONSUMERS TO USE EMERGENCY DEPARTMENTS IN PLACE OF OTHER CARE OPTIONS. 4. PROVIDE EDUCATION AND INFORMATION TO THE COMMUNITY ON ALTERNATIVE OPTIONS TO EMERGENCY DEPARTMENT USE AS AN ACCESS POINT FOR PERSONS WITH MENTAL ILLNESS. MECHANISMS TO COMMUNICATE THIS INFORMATION INCLUDE BUT ARE NOT LIMITED TO LITERATURE AT PRIMARY CARE AND OTHER HEALTHCARE PROVIDER OFFICES AND SPEAKING ENGAGEMENTS BY PHILHAVEN STAFF. X X X X X 0 0 0 0 0 0 0 0 0 FRANCIS D SPARROW MD 311256 0 0 0 0 0 3179 0 10263 0 324698 0 0 0 PHILIP D HESS 187249 0 0 0 0 0 2125 0 14863 0 204237 0 0 0 OLANIYI I OLULEYE 262245 0 0 0 0 0 3675 0 14863 0 280783 0 0 0 RICHARD PAKOLA 270655 0 0 0 0 0 2833 0 11238 0 284726 0 0 0 THOMAS FOLEY 240722 0 0 0 0 0 3050 0 10263 0 254035 0 0 0 THOMAS FENSTERMACHER 242042 0 0 0 0 0 3631 0 14863 0 260536 0 0 0 JEREMY WALTERS 233692 0 0 0 0 0 3505 0 13544 0 250741 0 0 0 FORM 990, PART VI, SECTION A, LINE 1 THE EXECUTIVE COMMITTEE IS COMPRISED OF THE FOUR ELECTED OFFICERS OF THE BOARD, I.E., PRESIDENT, VICE PRESIDENT, TREASURER AND SECRETARY, AND A "FIFTH MEMBER" ELECTED BY THE BOARD. THE CHIEF EXECUTIVE OFFICER AND THE MEDICAL DIRECTOR ARE NON-VOTING MEMBERS OF THE EXECUTIVE COMMITTEE. ALL VOTING MEMBERS OF THE EXECUTIVE COMMITTEE ARE ON THE BOARD. THE NON-VOTING MEMBERS ARE NOT ON THE BOARD. THE SCOPE OF EXECUTIVE COMMITTEE AUTHORITY INCLUDES: (1) TO ACT ON BEHALF OF THE BOARD WHILE THAT BODY IS ADJOURNED BETWEEN MEETINGS, SUBJECT TO REVIEW BY THE BOARD AT ITS NEXT MEETING; (2) TO DEVELOP A SYSTEM OF CORPORATE OBJECTIVES AND LONG-RANGE GOALS; (3) TO RECOMMEND TO THE BOARD THE APPOINTMENT AND REAPPOINTMENT OF MEDICAL STAFF MEMBERS AND THE GRANTING OF CLINICAL PRIVILEGES TO EACH MEMBER OF THE MEDICAL STAFF; (4) TO ENSURE APPROPRIATE BOARD REPRESENTATION AT ORGANIZATIONAL STRATEGIC PLANNING MEETINGS. FORM 990, PART VI, SECTION A, LINE 6 PHILHAVEN IS CONTROLLED BY THE LANCASTER CONFERENCE OF THE MENNONITE CHURCH. UNDER THE BYLAWS OF PHILHAVEN, CONTROL IS EXERCISED VIA CERTAIN RESERVE POWERS INCLUDING THE APPROVAL AND APPOINTMENT OF MEMBERS OF THE GOVERNING BODY, APPROVAL OF THE APPOINTMENT OF THE CHIEF EXECUTIVE OFFICER AND APPROVAL OF AMENDMENTS TO THE BYLAWS AND ARTICLES OF INCORPORATION. FORM 990, PART VI, SECTION A, LINE 7A THE LANCASTER MENNONITE CONFERENCE APPOINTS THREE MEMBERS OF THE BOARD OF DIRECTORS. ADDITIONALLY, THE LANCASTER MENNONITE CONFERENCE WILL APPROVE THE SELECTION OF ALL AT-LARGE MEMBERS OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B THE LANCASTER MENNONITE CONFERENCE MUST APPROVE ANY CHANGE TO THE EXISTING BY-LAWS. FORM 990, PART VI, SECTION B, LINE 11 THE FINANCE COMMITTEE OF THE BOARD OF DIRECTORS PERFORMS AN INITIAL REVIEW OF THE 990. UPON THE FINANCE COMMITTEE'S APPROVAL, THE 990 GETS DISTRIBUTED TO ALL BOARD MEMBERS ELECTRONICALLY. EACH BOARD MEMBER WILL THEN HAVE THE OPPORTUNITY TO REVIEW THE 990 BEFORE THE RETURN'S SUBMISSION TO THE IRS. FORM 990, PART VI, SECTION B, LINE 12C ALL MEMBERS OF THE BOARD OF DIRECTORS, EMPLOYEES WHO ARE DIRECTORS OR ABOVE, LICENSED PROFESSIONALS AND INDEPENDENT LICENSED PRACTITIONERS ARE SUBJECT TO PHILHAVEN'S CONFLICT OF INTEREST POLICIES. PHILHAVEN REQUIRES EACH MEMBER OF THE BOARD OF DIRECTORS TO DISCLOSE CONFLICTS OF INTEREST, OR POTENTIAL CONFLICTS OF INTEREST, TO THE PRESIDENT OF THE BOARD OF DIRECTORS ON AN ANNUAL BASIS. THE PRESIDENT MUST DISCLOSE CONFLICTS OF INTEREST, OR POTENTIAL CONFLICTS OF INTEREST, TO THE FULL BOARD OF DIRECTORS ON AN ANNUAL BASIS. IF A CONFLICT OF INTEREST IS IDENTIFIED THAT HAS NOT BEEN DECLARED THE BOARD MAY DISCLOSE BY RESOLUTION CARRIED BY TWO-THIRDS OF ITS MEMBERS PRESENT AT THE MEETING, THAT A CONFLICT OF INTEREST EXISTS AND THE MEMBER OF THE BOARD THUS FOUND TO BE IN CONFLICT SHALL WITHDRAW FROM THE MEETING OR REFRAIN FROM DISCUSSION OR VOTING IN RELATION TO THE MATTER. UPON HIRE AND ANNUALLY THEREAFTER ANY EMPLOYEE OR INDEPENDENT PRACTITIONER SUBJECT TO THE POLICIES IS REQUIRED TO COMPLETE A DISCLOSURE STATEMENT. ADDITIONALLY PHILHAVEN'S CHIEF LEGAL OFFICER IS REQUIRED TO REVIEW ALL CONTRACTS OR AGREEMENTS WITH OTHER CARE PROVIDERS OR FOR OTHER SERVICES TO IDENTIFY ANY CONFLICTS OF INTEREST. SHOULD A CONFLICT OF INTEREST WITH AN EMPLOYEE OR WITH AN AGREEMENT OR CONTRACT WITH A THIRD PARTY BE IDENTIFIED, THE CHIEF LEGAL OFFICE AND MEDICAL DIRECTOR SHALL REVIEW THE CIRCUMSTANCES TO MAKE A DECISION ON THE APPROPRIATE ACTION. FORM 990, PART VI, SECTION B, LINE 15 THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS SHALL DETERMINE AND APPROVE IN ADVANCE THE COMPENSATION ARRANGEMENTS FOR IDENTIFIED EXECUTIVE EMPLOYEES WHO ARE IN A POSITION TO EXERCISE SUBSTANTIAL INFLUENCE OVER PHILHAVEN'S AFFAIRS. EXECUTIVE EMPLOYEES SUBJECT TO THIS POLICY INCLUDE THE CHIEF EXECUTIVE OFFICER AND MEDICAL DIRECTOR. IN MAKING ITS DETERMINATION, THE EXECUTIVE COMMITTEE SHALL RELY UPON APPROPRIATE DATA AND INFORMATION AS TO THE COMPARABILITY OF COMPENSATION ARRANGEMENTS. RELEVANT FACTORS THAT MAY BE CONSIDERED INCLUDE, BUT ARE NOT LIMITED TO: 1. COMPENSATION PAID BY SIMILARLY SITUATED ORGANIZATIONS, BOTH TAXABLE AND TAX-EXEMPT, FOR FUNCTIONALLY COMPARABLE POSITIONS; 2. CURRENT COMPENSATION SURVEYS CONDUCTED BY INDEPENDENT FIRMS (SUCH AS NATIONAL ASSOCIATION OF ADDICTION TREATMENT (NAATP/NATIONAL COUNCIL FOR COMMUNITY BEHAVIORAL HEALTHCARE AND MENNONITE HEALTH SERVICES (MHS) ALLIANCE; 3. EXECUTIVE EMPLOYEE'S SALARY HISTORY WITH OTHER ORGANIZATIONS; 4. ACTUAL WRITTEN OFFERS FROM SIMILAR ORGANIZATIONS COMPETING FOR THE SERVICES OF THE EXECUTIVE; AND 5. AVAILABILITY OF SIMILARLY QUALIFIED EXECUTIVES IN THE GEOGRAPHIC AREA. THE EXECUTIVE COMMITTEE'S DECISION MUST BE CONTEMPORANEOUSLY DOCUMENTED IN WRITING. THE CEO DETERMINES THE COMPENSATION FOR THE CHIEF FINANCIAL OFFICER. FORM 990, PART VI, SECTION C, LINE 19 ANY OF THESE DOCUMENTS ARE AVAILABLE TO THE GENERAL PUBLIC UPON REQUEST. 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