2023-11-13T15:24:41-06:00 2022-12-31 010448006 ALBIN RANDALL & BENNETT PO BOX 445 130 MIDDLE STREET PORTLAND ME 041120445 990 2022-01-01 232766661 COMMUNITY BEHAVIORAL HEALTH COMM 2154133100 801 MARKET STREET 7TH FLOOR PHILADELPHIA PA 191073126 ALEXANDER GAUTHIER INTERIM CFO 2154133100 2023-11-06 1 ALEXANDER GAUTHIER 888008888 1 JASON C LEBLANC P01212079 2077721981 2023-11-06 3 AAL1 IAL1 2022 2023-04-26 12:10:37Z FAITH DYSON-WASHINGTON 801 MARKET STREET 7TH FLOOR PHILADELPHIA PA 191073126 1283486052 0 X WWW.CBHPHILLY.ORG X 1994 PA COMMUNITY BEHAVIORAL HEALTH IS CONTRACTED BY THE CITY OF PHILADELPHIA TO MANAGE THE DELIVERY OF MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES FOR MEDICAID RECIPIENTS OF PHILADELPHIA COUNTY, AS PART OF THE COMMONWEALTH OF PENNSYLVANIA'S HEALTHCHOICES PROGRAM. 10 0 718 0 0 0 0 0 1178690654 1283303940 90441 182112 456798 0 1179237893 1283486052 0 0 0 0 57678018 62446738 0 0 0 1121103075 1221095665 1178781093 1283542403 456800 -56351 184418974 321266665 180707532 317611574 3711442 3655091 COMMUNITY BEHAVIORAL HEALTH IS CONTRACTED BY THE CITY OF PHILADELPHIA TO MANAGE THE DELIVERY OF MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES FOR MEDICAID RECIPIENTS OF PHILADELPHIA COUNTY, AS PART OF THE COMMONWEALTH OF PENNSYLVANIA'S HEALTHCHOICES PROGRAM. 0 0 1188023804 1283303940 COMMUNITY BEHAVIORAL HEALTH PROVIDED MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES TO 100,600 MEDICAID RECIPIENTS OF PHILADELPHIA COUNTY THROUGH A NETWORK OF 320 HEALTHCARE PROVIDERS. 1188023804 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 378 0 1 718 1 0 0 0 0 0 0 0 0 0 0 X 10 0 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X ALEXANDER GAUTHIER INTERIM CFO 2154133100 801 MARKET STREET 7TH FLOOR PHILADELPHIA PA 191073126 KIMBERLY ALI BOARD MEMBER 0.50 37.00 X 0 186385 57313 JEAN WRIGHT BOARD VICE PRESIDENT 0.50 37.00 X 0 143161 64189 EVA GLADSTEIN BOARD MEMBER 0.50 37.00 X 0 176485 59789 RICHARD HANEEFA BOARD MEMBER 0.50 X 0 0 0 KEISHA HUDSON BOARD MEMBER 0.50 X 0 0 0 ELIZABETH HERSH BOARD MEMBER 0.50 37.00 X 0 148820 67819 NICOLE MITCHELL BOARD MEMBER 0.50 X 0 0 0 JILL BOWEN BOARD PRESIDENT 0.50 37.00 X 0 181505 48255 TIERRA PRITCHETT BOARD SECRETARY/TREASURER 0.50 37.00 X 0 142726 40333 CHERLY BETTIGOLE BOARD MEMBER 0.50 37.00 X 0 188896 73938 JEFF BROWN CHIEF GROWTH OFFICER, STARTED 6/6/22 37.50 X 142072 0 13036 DONALD TAVAKOLI DEPUTY CHIEF MEDICAL OFFICER THROUGH 4/22/22 37.50 X 110516 0 18791 ANDREW DEVOS CHIEF PROGRAM OFFICER 37.50 X 275157 0 45186 PETER BEZRUCIK CHIEF ADMINISTRATIVE OFFICER 37.50 X 249081 0 23999 SHAWNA DANDRIDGE CHIEF OF STAFF AND OPERATIONS 37.50 X 163358 0 30458 DOLORES REAGAN CORRETINI CHIEF HUMAN RESOURCES/DIVERSITY OFFICER, STARTED 9 37.50 X 60636 0 7119 ROBERT BICKFORD CHIEF FINANCIAL OFFICER 37.50 X 210806 0 41388 TAMRA WILLIAMS CHIEF CLINICAL OFFICER THROUGH 11/4/22 37.50 X 214647 0 26181 DAVID HENLEY GENERAL COUNSEL STARTED 4/18/22 37.50 X 174232 0 16837 JULIA ZHOU CHIEF INFORMATION OFFICER 37.50 X 210676 0 22827 FAITH WASHINGTON-DYSON CHEIF EXECUTIVE OFFICER 37.50 X 254400 0 21990 ALAN SANDMAN PHYSICIAN ADVISOR 37.50 X 303158 0 42153 JOHN M BALAICUIS PHYSICIAN ADVISOR 37.50 X 233512 0 41072 NEIL M SANUCK PHYSICIAN ADVISOR 37.50 X 242747 0 47274 ROBIN HANSON MEDICAL DIR OF QUALITY MNGT THROUGH 11/10/22 37.50 X 255556 0 32696 VIOLET A HENIGHAN PHYSICIAN ADVISOR 37.50 X 229344 0 22827 3329898 1167978 865470 16 0 1 0 ALLCLOUD USA LLC 100 MIDDLE STREET PORTLAND ME 04101 CLOUD DATA CONSULTING SERVICES 3058683 XEOHEALTH CORPORATION 241 EAST FOURTH STREET SUITE 202 FREDERICK MD 21701 CLINICAL SYSTEM PROCESSING 2885276 GAVS TECHNOLOGIES INC 5166 CAMPUS DRIVE PLYMOUTH MEETING PA 19462 IT CONSULTING SERVICES 2605108 ASKESIS DEVELOPMENT GROUP INC 339 SIXTH AVE SUITE 1100 PITTSBURGH PA 15222 CLINICAL SYSTEM PROCESSING 2279657 YASH & LUJAN CONSULTING 5750 EPSILON SAN ANTONIO TX 78249 CONSULTING SERVICES 695246 55 MENTAL HEALTH/SUBSTANCE ABUSE 524114 1283303940 1283303940 1283303940 182112 182112 1283486052 1283303940 0 182112 X 3783731 3783731 42439107 42439107 2453995 2453995 10002386 10002386 3767519 3767519 400186 400186 282390 282390 5109039 5109039 3454868 3454868 15947720 15947720 82233 82233 215064 215064 400063 400063 860656 860656 5005913 5005913 1026003 1026003 MCO ASSESSMENT 222078879 222078879 INPATIENT PSYCHIATRIC 169896861 169896861 BEHAVIORAL HEALTH REHAB 162917675 162917675 OUTPATIENT PSYCHIATRIC 120562730 120562730 512855385 512567659 287726 1283542403 1188023804 95518599 0 1000 1000 33676804 11127806 1080312 859064 3572168 4162119 25650049 19718940 5897061 5931109 140191629 299185567 184418974 321266665 167655079 254440118 13052453 63171456 180707532 317611574 X 3711442 3655091 184418974 321266665 -56351 0 X X 0 1 X 1 0 X 977854618 993565983 1089286715 1179147452 1283303940 5523158708 977854618 993565983 1089286715 1179147452 1283303940 5523158708 5523158708 205951 453163 158516 90441 182112 1090183 5524248891 0.99980 0.99980 X 7065764 4595883 2469881 6884557 5149789 1734768 11699728 9973268 1726460 5931109 DUE FROM CITY OF PHILADELPHIA 249657550 DEFERRED OUTFLOWS - OTHER POST EMPLOYMENT BENEFITS 544813 RIGHT-TO-USE ASSET 48983204 299185567 RECIPIENT COVERAGE LIABILITY 8200000 DEFERRED INFLOWS - OTHER POST EMPLOYMENT BENEFITS 1482232 LEASE LIABILITY 52850095 OTHER LIABILITIES 639129 63171456 X 1283486052 0 1283486052 0 1283486052 1283542403 0 1283542403 0 1283542403 PART X, LINE 2: COMMUNITY BEHAVIORAL HEALTH (CBH) QUALIFIES AS A TAX-EXEMPT ORGANIZATION UNDER EXISTING PROVISIONS OF SECTION 501(C)(3) OF THE IRC. ACCORDINGLY, THERE IS NO PROVISION FOR INCOME TAXES REFLECTED IN THE ACCOMPANYING FINANCIAL STATEMENTS. CBH HAS NO UNCERTAIN TAX POSITIONS AND THERE ARE NO ACCRUALS FOR INTEREST OR PENALTIES IN THE ACCOMPANYING FINANCIAL STATEMENTS. MANAGEMENT BELIEVES THAT CBH IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS ENDED ON OR PRIOR TO DECEMBER 31, 2019. X X 0 0 0 0 0 0 0 0 0 ALAN SANDMAN PHYSICIAN ADVISOR 296402 0 0 0 6756 0 18000 0 24153 0 345311 0 0 0 ANDREW DEVOS CHIEF PROGRAM OFFICER 261342 0 0 0 13815 0 16185 0 29001 0 320343 0 0 0 NEIL M SANUCK PHYSICIAN ADVISOR 239805 0 0 0 2942 0 15986 0 31288 0 290021 0 0 0 ROBIN HANSON MEDICAL DIR OF QUALITY MNGT THROUGH 224564 0 0 0 30992 0 13667 0 19029 0 288252 0 0 0 FAITH WASHINGTON-DYSON CHEIF EXECUTIVE OFFICER 253089 0 0 0 1311 0 19605 0 2385 0 276390 0 0 0 JOHN M BALAICUIS PHYSICIAN ADVISOR 232411 0 0 0 1101 0 16174 0 24898 0 274584 0 0 0 PETER BEZRUCIK CHIEF ADMINISTRATIVE OFFICER 188189 0 0 0 60892 0 3984 0 20015 0 273080 0 0 0 CHERLY BETTIGOLE BOARD MEMBER 0 188896 0 0 0 0 0 39246 0 34692 0 262834 0 0 ROBERT BICKFORD CHIEF FINANCIAL OFFICER 210806 0 0 0 0 0 15890 0 25498 0 252194 0 0 0 VIOLET A HENIGHAN PHYSICIAN ADVISOR 228395 0 0 0 949 0 10800 0 12027 0 252171 0 0 0 KIMBERLY ALI BOARD MEMBER 0 185175 0 0 0 1210 0 37926 0 19387 0 243698 0 0 TAMRA WILLIAMS CHIEF CLINICAL OFFICER THROUGH 11/4/ 177079 0 0 0 37568 0 14108 0 12073 0 240828 0 0 0 EVA GLADSTEIN BOARD MEMBER 0 176485 0 0 0 0 0 36785 0 23004 0 236274 0 0 JULIA ZHOU CHIEF INFORMATION OFFICER 210676 0 0 0 0 0 10800 0 12027 0 233503 0 0 0 JILL BOWEN BOARD PRESIDENT 0 180356 0 0 0 1149 0 37277 0 10978 0 229760 0 0 ELIZABETH HERSH BOARD MEMBER 0 148820 0 0 0 0 0 30686 0 37133 0 216639 0 0 JEAN WRIGHT BOARD VICE PRESIDENT 0 143161 0 0 0 0 0 29242 0 34947 0 207350 0 0 SHAWNA DANDRIDGE CHIEF OF STAFF AND OPERATIONS 163358 0 0 0 0 0 6305 0 24153 0 193816 0 0 0 DAVID HENLEY GENERAL COUNSEL STARTED 4/18/22 162677 0 0 0 11555 0 0 0 16837 0 191069 0 0 0 TIERRA PRITCHETT BOARD SECRETARY/TREASURER 0 142454 0 0 0 272 0 28824 0 11509 0 183059 0 0 JEFF BROWN CHIEF GROWTH OFFICER, STARTED 6/6/22 142072 0 0 0 0 0 0 0 13036 0 155108 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION'S CHIEF FINANCIAL OFFICER WORKS WITH A CERTIFIED PUBLIC ACCOUNTING FIRM TO PREPARE FORM 990. ONCE FORM 990 HAS BEEN PREPARED, THE CHIEF FINANCIAL OFFICER ISSUES COPIES OF FORM 990 TO EACH BOARD MEMBER FOR REVIEW. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS A CONFLICT OF INTEREST DECLARATION FORM THAT MUST BE COMPLETED BY ALL EMPLOYEES ANNUALLY. EMPLOYEES MUST DISCLOSE ALL EMPLOYMENT EXTERNAL TO THE ORGANIZATION, ANY UNCOMPENSATED LEADERSHIP POSITION IN ANY EXTERNAL ORGANIZATION AND CLINICAL PRACTICUMS OR INTERNSHIPS HELD OUTSIDE OF THE ORGANIZATION. ALL EMPLOYEE CONFLICT OF INTEREST FORMS ARE REVIEWED AND APPROVED BY THE CHIEF OPERATING OFFICER. ALL BOARD MEMBERS ARE ALSO REQUIRED TO COMPLETE A CONFLICT OF INTEREST DECLARATION FORM DISCLOSING EMPLOYMENT AND MEMBERSHIPS ON OTHER BOARDS. THIS IS DONE ANNUALLY. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION OF THE ORGANIZATION'S CEO IS DETERMINED BY THE COMMUNITY BEHAVIORAL HEALTH'S BOARD. THE ORGANIZATION'S CEO REVIEWS THE COMPENSATION OF OTHER CBH OFFICERS AND MAKES RECOMMENDATIONS TO THE BOARD FOR APPROVAL. INDEPENDENT COMPENSATION STUDIES ARE REVIEWED BY THE CEO AND THE BOARD ALONG WITH COMPARISONS TO FORM 990 OF OTHER ORGANIZATIONS AS COMPONENTS IN THE DETERMINATION OF COMPENSATION FOR THE CEO AND COMMUNITY BEHAVIORAL HEALTH OFFICERS. DISCUSSIONS AND DECISIONS REGARDING THIS COMPENSATION ARE DOCUMENTED IN THE CBH BOARD MINUTES. FORM 990, PART VI, SECTION C, LINE 19 ALL GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE FOR PUBLIC INSPECTION UPON WRITTEN REQUEST TO THE SECRETARY/TREASURER OF THE ORGANIZATION. INFORMATION ON HOW TO REQUEST THESE DOCUMENTS IS AVAILABLE ON THE ORGANIZATION'S WEBSITE. FORM 990, PART IX, LINE 24E NON - HOSPITAL D&A: PROGRAM SERVICE EXPENSES 119,785,975. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 119,785,975. OTHER MEDICAL EXPENSES: PROGRAM SERVICE EXPENSES 98,371,383. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 98,371,383. OUTPATIENT DRUG AND ALCOHOL: PROGRAM SERVICE EXPENSES 75,945,140. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 75,945,140. COMMUNITY SUPPORT: PROGRAM SERVICE EXPENSES 67,233,104. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 67,233,104. COMMUNITY PSYCHIATRIC SUPPORTIVE TREATMENT: PROGRAM SERVICE EXPENSES 31,471,598. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 31,471,598. ASSERTIVE COMMUNITY TREATMENT: PROGRAM SERVICE EXPENSES 30,405,259. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 30,405,259. RESIDENTIAL TREATMENT FACILITIES: PROGRAM SERVICE EXPENSES 22,918,978. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 22,918,978. COVID-19 ALTERNATIVE PAYMENT ARRANGEMENT: PROGRAM SERVICE EXPENSES 21,603,606. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 21,603,606. BEHAVIORAL HEALTH SHORT-TERM RESIDENTIAL: PROGRAM SERVICE EXPENSES 13,164,919. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 13,164,919. PAY PER PERFORMANCE: PROGRAM SERVICE EXPENSES 7,870,942. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,870,942. OTHER PROGRAM EXPENSES: PROGRAM SERVICE EXPENSES 5,027,403. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,027,403. VALUE BASED PAYMENT INCENTIVE: PROGRAM SERVICE EXPENSES 4,558,148. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,558,148. INPATIENT DRUG AND ALCOHOL: PROGRAM SERVICE EXPENSES 3,919,424. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,919,424. INTENSIVE OUTPATIENT DRUG AND ALCOHOL: PROGRAM SERVICE EXPENSES 3,450,000. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,450,000. MEMBER TRANSPORTATION: PROGRAM SERVICE EXPENSES 2,990,729. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,990,729. ANCILLARY SUPPORT: PROGRAM SERVICE EXPENSES 1,839,484. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,839,484. PROVIDER TRAINING: PROGRAM SERVICE EXPENSES 1,634,815. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,634,815. CHILDREN HI FIDELITY WRAPAROUND EXPENSE: PROGRAM SERVICE EXPENSES 376,752. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 376,752. DUES AND SUBSRIPTIONS: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 287,726. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 287,726. FORM 990, PART XII, LINE C THE ORGANIZATION HAS NOT CHANGED EITHER ITS OVERSIGHT PROCESS OR SELECTION PROCESS DURING THE TAX YEAR. CITY OF PHILADELPHIA 1401 JOHN F KENNEDY BLVD PHILADELPHIA PA 19102 236003047 CITY GOVERNMENT PA 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 CITY OF PHILADELPHIA C 1283542403 ACTUAL COST FORM 990 PART V TRANSACTIONS WITH RELATED ORGANIZATIONS COMMUNITY BEHAVIORAL HEALTH IS A COMPONENT UNIT OF THE CITY OF PHILADELPHIA. THE CITY OF PHILADELPHIA FULLY COMPENSATES COMMUNITY BEHAVIORAL HEALTH FOR THE COSTS OF SERVICES PROVIDED UNDER THE COMMONWEALTH OF PENNSYLVANIA'S DEPARTMENT OF PUBLIC WELFARE'S HEALTH CHOICES BEHAVIORAL HEALTH PROGRAM. THE MAJORITY OF THE BOARD OF COMMUNITY BEHAVIORAL HEALTH MUST BE OFFICIALS OF THE CITY OF PHILADELPHIA.