2023-12-07T14:18:33-06:00 2023-06-30 910189318 MOSS ADAMS LLP 2707 COLBY AVENUE SUITE 801 EVERETT WA 98201 990 2022-07-01 910869129 PENINSULA BEHAVIORAL HEALTH PENI 3604570431 118 EAST 8TH STREET PORT ANGELES WA 98362 WENDY SISK CHIEF EXECUTIVE OFFICER 3604570431 2023-12-06 1 WENDY SISK 999009999 0 COLLEEN RAMIRES P01251320 4252597227 2023-12-06 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z WENDY SISK 118 EAST 8TH STREET PORT ANGELES WA 98362 16306340 0 X WWW.PENINSULABEHAVIORAL.ORG X 1971 WA PROVIDE QUALITY COMPREHENSIVE BEHAVIORAL HEALTH SERVICES TO RESIDENTS IN CLALLAM COUNTY. 9 9 184 12 0 0 3466800 311659 15761691 15698095 5631 281786 4814 -28288 19238936 16263252 178230 192388 0 0 11473557 12301400 0 0 88170 3772682 3248500 15424469 15742288 3814467 520964 18628130 21409141 5328484 7588531 13299646 13820610 X PENINSULA BEHAVIORAL HEALTH IS CLALLAM COUNTY'S PRIMARY RESOURCE FOR BEHAVIORAL HEALTH AND CO-OCCURRING SUBSTANCE USE DISORDER COUNSELING. PBH BELIEVES THAT EVERYONE, DESERVES ACCESS TO QUALITY BEHAVIORAL HEALTHCARE. PBH IS PROUD TO MAKE BEHAVIORAL HEALTHCARE AND THERAPY AFFORDABLE AND ACCESSIBLE TO OUR COMMUNITY. IN 2020, PBH WAS AWARDED AN EXPANSION GRANT FROM SAMSHA, TRANSFORMING US INTO A CCBHC. 0 0 6762576 190897 10144514 CLINICAL OUTPATIENT SERVICES - A WIDE RANGE OF CARING SERVICES IS AVAILABLE TO MEET THE NEEDS OF PERSONS WITH SERIOUS MENTAL ILLNESS OR SUBSTANCE USE DISORDER. STAFF WITH A VARIETY OF SPECIALTIES OFFER EVALUATIONS, THERAPY AND PREVENTION STRATEGIES TO SUPPORT INDIVIDUALS IN THE COMMUNITY AT CRITICAL STAGES OF LIFE. KEY SERVICES INCLUDE ADULT OUTPATIENT THERAPY, COMMUNITY SUPPORT SERVICES, CARE NAVIGATION, YOUTH OUTPATIENT SERVICES, INCLUDING WISE SERVICES AND EVIDENCE BASED PRACTICES. 1991823 184 3722061 MEDICAL SERVICES - PSYCHIATRIC EVALUATIONS, CONSULTATION WITH PRIMARY CARE PROVIDERS AND PSYCHIATRIC MEDICATION MONITORING. 2020859 1307 1735301 CLINICAL INTENSIVE SERVICES - CRISIS INTERVENTION SERVICES, INCLUDING CRISIS RESPITE CARE, COMMUNITY RESPONSE TO CRISIS CALLS. SERVICES INCLUDE COMMUNITY OUTREACH SERVICES TO THOSE UNHOUSED IN THE COMMUNITY. 362957 96219 RESIDENTIAL SERVICES - THE QUALITY OF LIFE FOR MENTALLY ILL CITIZENS AND CAREGIVERS IS ENHANCED THROUGH RESIDENTIAL OPTIONS THAT INTEGRATE RECOVERY WITH PRACTICAL INDEPENDENT LIVING SKILLS. ADULT TRANSITION HOMES AND APARTMENTS WITH SUPPORTED LIVING ARRANGEMENTS ARE OFFERED WHEN LESS THAN A SUPERVISED ENVIRONMENT ARE REQUIRED. 362957 96219 11138215 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 22 0 1 184 1 0 0 0 0 0 1 1 0 0 0 0 0 0 X 9 9 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 X DAWN BROWN 3604570431 118 EAST 8TH STREET PORT ANGELES WA 98362 RUSS BRITTON PRESIDENT 2.00 X X 0 0 0 TOM O'DONNELL VICE PRESIDENT 2.00 X X 0 0 0 GRANT MUNRO TREASURER (THRU 6/30) 2.00 X X 0 0 0 DAVID ARAND SECRETARY 2.00 X X 0 0 0 MARCH PICKER BOARD MEMBER 2.00 X 0 0 0 ELIZABETH CHRISTIAN BOARD MEMBER 2.00 X 0 0 0 VICKI LOWE BOARD MEMBER 2.00 X 0 0 0 DESI LARSON BOARD MEMBER 2.00 X 0 0 0 JODY COPELAND BOARD MEMBER 2.00 X 0 0 0 JOSEPH REIS CHIEF MEDICAL OFFICER 40.00 X 214571 0 32608 WENDY SISK CHIEF EXECUTIVE OFFICER 40.00 X 213388 0 37579 DAWN BROWN CHEF FINANCIAL OFFICER 40.00 X 162468 0 18556 KATHY STEVENS CHIEF OPERATIONS OFFICER 40.00 X 149456 0 20836 MARGARET DEPEW PSYCHIATRIC ARNP 40.00 X 159714 0 28828 LINDA BOARDMAN PSYCHIATRIC ARNP 40.00 X 162081 0 18452 DANIELLE DEOLIVEIRA PSYCHIATRIC ARNP 36.00 X 135493 0 31594 CHRISTINE BURNELL PRIMARY CARE ARNP 40.00 X 146622 0 17714 TIMI IDDINGS PSYCHIATRICT ARNP 36.00 X 132095 0 17362 1475888 0 223529 14 0 1 0 0 53640 108009 150010 311659 FIMC CONTRACT 624100 12276647 12276647 LOCAL GOVERNMENT CONTRACTS 624100 2801122 2801122 PRIMARY CARE MEDICAL SERVICES 621110 565255 565255 RESIDENTIAL SUPPORTED LIVING CARE 623990 41769 41769 OTHER PATIENT REVENUE 621110 13302 13302 15698095 281786 281786 11888 0 11888 11888 11888 2912 108009 43088 -40176 -40176 16263252 15698095 0 253498 192388 192388 899884 412674 399040 88170 8547695 6632486 1915209 411849 258973 152876 1655483 1041905 613578 786489 569077 217412 4371 825 3546 82588 82588 233640 165336 68304 10743 10743 330450 246965 83485 377895 282465 95430 478003 247428 230575 65442 23044 42398 127802 55891 71911 577953 339014 238939 221751 221751 PROGRAM OPERATIONS 542200 525038 17162 TRAINING 79519 71604 7915 DUES, FEES, LICENSES 67701 57747 9954 48442 15355 33087 15742288 11138215 4515903 88170 3406377 3451000 279769 2727253 3579796 1672280 69467 124172 177860 215790 16124315 3590967 11090660 12533348 0 515331 24201 169967 18628130 21409141 1155237 990834 828228 772490 1329345 1297169 2015674 4528038 5328484 7588531 X 13299646 13820610 13299646 13820610 18628130 21409141 520964 0 X 0 1 X 1 0 X 330958 654517 2868958 3466800 311659 7632892 10290790 10684716 11707233 15761691 15698095 64142525 10621748 11339233 14576191 19228491 16009754 71775417 34490 16307 9210 10369 6227 76603 0 34490 16307 9210 10369 6227 76603 71698814 30627 43399 31524 16754 293674 415978 30627 43399 31524 16754 293674 415978 10652375 11382632 14607715 19245245 16303428 72191395 0.99320 0.99650 0.00580 0.00220 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 24201 2142 26343 28540 -4339 24201 23444 5138 42 28540 22563 881 23444 20250 2313 22563 1.00000 0.00000 0.00000 1 0 2012831 2012831 4662382 1038656 3623726 7824814 1679166 6145648 1619091 873145 745946 5197 5197 12533348 REFUNDABLE ADVANCE 4384414 LEASE LIABILITY 143624 4528038 X 16306340 43088 43088 16263252 0 16263252 15785376 43088 43088 15742288 0 15742288 PART V, LINE 4: FUNDS ARE HELD BY CLALLAM COMMUNITY FOUNDATION, CANNOT BE SPENT WITHOUT PENINSULA BEHAVIORAL HEALTH APPROVAL AND CURRENTLY ARE NOT BEING DRAWN FROM. THE INTENDED USE OF THE FUNDS IS TO HELP SUPPORT PROGRAM OPERATIONS. PART X, LINE 2: THE ORGANIZATION IS NOT SUBJECT TO INCOME TAX, BECAUSE IT IS A TAX-EXEMPT ORGANIZATION UNDER INTERNAL REVENUE CODE SECTION 501(C)(3). ACCORDINGLY, NO PROVISION FOR INCOME TAX IS INCLUDED IN THESE FINANCIAL STATEMENTS. FOR THE 2023 AND 2022 FINANCIAL STATEMENTS, THE ORGANIZATION HAS ACCOUNTED FOR UNCERTAIN TAX POSITIONS WHEREBY THE EFFECT OF THE UNCERTAINTY WOULD BE RECORDED IF THE OUTCOME WAS CONSIDERED PROBABLE AND WAS REASONABLY ESTIMABLE. AS OF JUNE 30, 2023 AND 2022, THE ORGANIZATION HAD NOT IDENTIFIED ANY UNCERTAIN TAX POSITIONS REQUIRING ACCRUAL OR DISCLOSURE. PART XI, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EVENT EXPENSES 43,088. PART XII, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EVENT EXPENSES 43,088. GALA 110921 108009 2912 11409 6000 25679 110921 108009 2912 11409 6000 25679 43088 -40176 1 PATIENT MEDICATION, TRANSPORTATION AND LIVING ASSISTANCE 49 192388 PART I, LINE 2: FUNDS ARE PROVIDED TO INDIGENT PATIENTS WHO ARE IN NEED OF ASSISTANCE WITH PAYING FOR PRESCRIBED MEDICATIONS, TRANSPORTATION AND OTHER LIVING NECESSITIES. SUBSTANTIATION IS REQUIRED TO BE PROVIDED BEFORE FUNDS ARE GIVEN. X X 0 0 0 0 0 0 0 0 0 WENDY SISK CHIEF EXECUTIVE OFFICER 172052 0 40636 0 700 0 13057 0 24522 0 250967 0 0 0 JOSEPH REIS CHIEF MEDICAL OFFICER 202429 0 11852 0 290 0 10849 0 21759 0 247179 0 0 0 MARGARET DEPEW PSYCHIATRIC ARNP 150314 0 9282 0 118 0 11006 0 17822 0 188542 0 0 0 DAWN BROWN CHEF FINANCIAL OFFICER 153932 0 8536 0 0 0 7858 0 10698 0 181024 0 0 0 LINDA BOARDMAN PSYCHIATRIC ARNP 152755 0 8979 0 347 0 7754 0 10698 0 180533 0 0 0 KATHY STEVENS CHIEF OPERATIONS OFFICER 141496 0 7960 0 0 0 10138 0 10698 0 170292 0 0 0 DANIELLE DEOLIVEIRA PSYCHIATRIC ARNP 126973 0 8323 0 197 0 7072 0 24522 0 167087 0 0 0 CHRISTINE BURNELL PRIMARY CARE ARNP 138032 0 8190 0 400 0 7016 0 10698 0 164336 0 0 0 A WASHINGTON HEALTHCARE FACILITIES AUTHORITY 911108929 2014-08-22 1292000 8TH STREET PROPERTY 0 0 0 A 471063 1292000 1292000 2004 1 0 1 1 A 0 1 0 0 0.01000 0.00000 0.01000 0 0 1 A 0 0 1 0 1 0 0 0 1 A 1 FORM 990, PART VI, SECTION B, LINE 11B THE PREPARED FORM 990 AND SCHEDULE B IS REVIEWED FIRST BY THE CHIEF FINANCIAL OFFICER, THEN THE CHIEF EXECUTIVE OFFICER FOR RECOMMENDATION TO THE BOARD FOR FORMAL APPROVAL BEFORE FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C ALL BOARD MEMBERS SHALL SUBMIT, UPON ASSUMING THEIR POSITIONS AND THEREAFTER, ANNUAL IN WRITING TO THE PRESIDENT OF THE PENINSULA BEHAVIORAL HEALTH BOARD, A LIST OF ALL BUSINESSES OR OTHER ORGANIZATIONS OF WHICH HE OR SHE IS AN OFFICER, MEMBER, OWNER OR EMPLOYEE, OR FOR WHICH HE OR SHE ACTS AS AN AGENCY WITH WHICH PENINSULA BEHAVIORAL HEALTH HAS ENTERED, OR MIGHT REASONABLY IN THE FUTURE ENTER INTO A RELATIONSHIP OR A TRANSACTION WHERE PENINSULA BEHAVIORAL HEALTH MIGHT COMPETE AGAINST SUCH ORGANIZATION AND IN WHICH THE BOARD MEMBER OR EXECUTIVE WOULD HAVE CONFLICTING INTERESTS. THE PRESIDENT OF THE BOARD SHALL BECOME FAMILIAR WITH THE STATEMENTS OF ALL BOARD MEMBERS IN ORDER TO GUIDE HIS OR HER CONDUCT IN CHAIRING MEETINGS SHOULD A CONFLICT ARISE. WHEN ANY MATTERS COMES BEFORE THE BOARD AND RAISES THE ISSUE OF A CONFLICT FOR BOARD MEMBERS, THE AFFECTED BOARD MEMBER SHALL MAKE KNOWN THE POTENTIAL CONFLICT, WHETHER DISCLOSED BY WRITTEN STATEMENT OR NOT. DISCLOSURE SHOULD BE MADE AS SOON AS POSSIBLE AS PRACTICABLE AS TO AVOID ANY ADVERTENT HARM TO PENINSULA BEHAVIORAL HEALTH. THE MEMBER SHALL ANSWER ANY QUESTIONS THAT MIGHT BE ASKED BY OTHER BOARD MEMBERS OR LEGAL COUNSEL. THE PRESIDENT, WITH THE ASSISTANCE OF LEGAL COUNSEL, MAY REQUEST THE BOARD MEMBER TO: 1. REFRAIN FROM PARTICIPATING IN THE DISCUSSION INVOLVING THE CONFLICT. 2. LEAVE THE ROOM WHILE THE MATTER IS BEING DISCUSSED. 3. REFRAIN FROM VOTING ON ANY MATTER RELATED TO THE ISSUE. FORM 990, PART VI, SECTION B, LINE 15A CEO COMPENSATION IS REVIEWED ANNUALLY UTILIZING SALARY SURVEY DATA SPECIFIC TO OUR INDUSTRY. THE HR DIRECTOR REVIEWS AND MAKES RECOMMENDATIONS FOR ANY CHANGES. THE BOARD PROVIDES A PERFORMANCE EVALUATION FOR THE CEO ALONG WITH APPROVING COMPENSATION INCREASES AND BONUSES. OTHER OFFICER AND KEY EMPLOYEE COMPENSATION INCREASES ARE DETERMINED ANNUALLY DURING THE BUDGETING PROCESS, ALONG WITH OTHER STAFF COMPENSATION INCREASES, AND APPROVED BY THE BOARD VIA THE BUDGET APPROVAL PROCESS. PERFORMANCE EVALUATIONS ARE COMPLETED AND THEN RAISE PERCENTAGES DETERMINED BY EXECUTIVE MANAGEMENT, STAYING WITHIN BUDGETED GUIDELINES APPROVED DURING THE BUDGET CYCLE. FORM 990, PART VI, SECTION C, LINE 18 COPIES OF THE ORGANIZATION'S FORM 990 AND FORM 1023 APPLICATION ARE MAINTAINED IN THE OFFICE OF THE CFO. THE DOCUMENTS ARE AVAILABLE FOR PUBLIC INSPECTION DURING REGULAR BUSINESS HOURS BY REQUESTING THE RECEPTIONIST TO CALL EXTENSION 199, OR BY MAIL DIRECTED TO THE CFO, 118 E. 8TH ST., PORT ANGELES, WA 98362 OR BY FAXING A REQUEST TO THE CFO AT FAX NUMBER (360) 457-0493. FORM 990, PART VI, SECTION C, LINE 19 COPIES OF THE AUDITED FINANCIAL STATEMENTS ARE MAINTAINED IN THE OFFICE OF THE CFO. THE INFORMATION IS AVAILABLE FOR PUBLIC INSPECTION DURING BUSINESS HOURS OF 9:00 A.M. TO 4:00 P.M. BY REQUESTING THE RECEPTIONIST TO CALL EXTENSION 199, OR BY MAIL DIRECTED TO THE CFO, 118 E. 8TH ST., PORT ANGELES, WA 98362 OR BY FAXING A REQUEST TO THE CFO AT FAX NUMBER (360) 457-0493. THE ORGANIZATION'S GOVERNING DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC BY CONTACTING THE CEO'S OFFICE AT (360) 457-0431, EXT. 154. THE ORGANIZATION'S CONFLICT OF INTEREST POLICY IS MADE AVAILABLE FOR PUBLIC VIEWING AND IS POSTED ON THE RECEPTION AREA BULLETIN BOARD.