2019-11-12T11:56:03-06:00 2019-06-30 370818432 KEMPER CPA GROUP LLP 625 S DAN JONES ROAD AVON IN 46123 990 2018-07-01 351968268 AFFILIATED SERVICE PROVIDERS OF INDIANA INC AFFI 3174710000 850 N HARRISON STREET WARSAW IN 465803163 KATHY COOK CEO/PRESIDENT 3174710000 2019-11-12 1 CARRIE M HANNI CPA P00415262 3178399136 184.175.157.67 2019-11-12 09:27:42 US P 9C042AE4F53BF9AB56153812092339EDBBC93993 EBB4EC562B52AE5EB9B3AD85D8137F0A36B8BC83 2018 2020-01-14 16:20:31Z KATHY COOK 850 N HARRISON STREET WARSAW IN 46580 8758482 0 X WWW.ASPIN.ORG X 1995 IN BEHAVIORAL HEALTH CARE PROVIDER NETWORK 10 10 26 0 0 0 0 0 8127644 8555860 111074 129610 146675 66920 8385393 8752390 0 0 0 0 1155855 964537 0 0 0 7088919 7257332 8244774 8221869 140619 530521 6017950 4929431 2004359 476582 4013591 4452849 BEHAVIORAL HEALTH CARE PROVIDER NETWORK 0 0 7653279 8622780 FACILITATED THE PROVISION OF BEHAVIORAL HEALTH SERVICES BY QUALIFIED HEALTH CARE PROVIDERS TO RESIDENTS OF THE STATE OF INDIANA. CERTIFIED AS A MANAGED CARE PROVIDER FOR SERIOUSLY MENTALLY ILL ADULTS, CHRONICALLY ADDICTED PERSONS, AND SERIOUSLY EMOTIONALLY DISTURBED CHILDREN. 7653279 1 0 0 0 0 0 0 0 0 0 1 1 0 0 0 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 0 0 0 0 1 4 0 1 26 1 0 0 0 0 0 0 0 0 0 0 X 10 10 0 0 0 0 1 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 IN X KATHY COOK 3174710000 550 CONGRESSIONAL BLVD SUITE 120 CARMEL IN 46032 KURT CARLSON CHAIRMAN 2.00 X X 0 0 0 RICK CRAWLEY BOARD MEMBER 1.00 X 0 0 0 DR CARRIE CADWELL SECRETARY 2.00 X X 0 0 0 ROBB BACKMEYER VICE-CHAIRMAN 2.00 X X 0 0 0 JULIA SHAPIRO NEWBILL BOARD MEMBER 1.00 X 0 0 0 PAUL WILSON NON-VOTING BOARD MEMBER 1.00 X 0 0 0 MEL BURKS BOARD MEMBER 1.00 X 0 0 0 REVEREND KEN WEAVER BOARD MEMBER 1.00 X 0 0 0 SUSAN TYBON BOARD MEMBER 1.00 X 0 0 0 MATT OLIVER BOARD MEMBER 1.00 X 0 0 0 STEPHEN JARRELL NON-VOTING BOARD MEMBER 1.00 X 0 0 0 TOM GILLIOM TREASURER 1.00 X X 0 0 0 KATHY COOK NON-VOTING CEO/PRESIDENT 40.00 X 176508 0 0 176508 0 0 1 0 1 0 COMMUNITY HOWARD REGIONAL HEALTH INC 3500 S LAFOUNTAIN STREET KOKOMO IN 46904 MENTAL HEALTH SVCS 2331186 BOWEN CENTER 850 NORTH HARRISON STREET WARSAW IN 46580 MENTAL HEALTH SVCS 1501700 LIFE TREATMENT CENTER 1402 SOUTH MICHIGAN STREET SOUTH BEND IN 46613 MENTAL HEALTH SVCS 1103619 FOUR COUNTY COUNSELING CTR 1015 MICHIGAN AVENUE LOGANSPORT IN 46947 MENTAL HEALTH SVCS 707501 YWCA 1102 S FELLOWS STREET SOUTH BEND IN 46601 MENTAL HEALTH SVCS 537082 5 FEES AND CONTRACTS 900099 8059504 8059504 WORKSHOP FEES 624100 366356 366356 MEMBERSHIP FEES 900099 130000 130000 8555860 125607 125607 8500 1595 6092 0 2408 1595 4003 4003 OTHER 900099 66920 66920 66920 8752390 8622780 0 129610 189512 132658 56854 680594 476416 204178 16597 11618 4979 4114 2880 1234 73720 51604 22116 10976 2745 8231 10373 10373 43958 20876 23082 3283 3283 38807 11150 27657 76446 57335 19111 64004 48003 16001 10127 4557 5570 22602 16952 5650 PURCHASED SERVICES 6350854 6350854 DUES FEES AND LICENSES 441361 331021 110340 NETWORK AND MANAGEMENT 173558 121491 52067 MISCELLANEOUS 10983 2746 8237 8221869 7653279 568590 0 121190 75009 2094851 2295941 2167936 447868 19265 13636 24317 24317 0 0 1614708 2096977 6017950 4929431 1987879 476582 16480 0 2004359 476582 X 4013591 4452849 4013591 4452849 6017950 4929431 530521 -91263 0 X X 0 1 X 1 1 1 X 8612875 8313482 8500552 8116200 8189504 41732613 8612875 8313482 8500552 8116200 8189504 41732613 41732613 47669 57696 55319 64751 125607 351042 81874 105183 120155 146675 66920 520807 42604462 402874 0.97950 0.98160 X 24317 24317 0 0 MUTUAL FUNDS 1595079 F ANNUITIES 501898 F 2096977 X 8649159 -91263 -91263 8740422 10373 1595 11968 8752390 8209901 0 8209901 10373 1595 11968 8221869 PART X, LINE 2: ASPIN IS EXEMPT FROM INCOME TAX UNDER INTERNAL REVENUE CODE SECTION 501 (C)(3) OF THE INTERNAL REVENUE CODE. HOWEVER, INCOME FROM CERTAIN ACTIVITIES NOT DIRECTLY RELATED TO ASPIN'S TAX-EXEMPT PURPOSE IS SUBJECT TO TAXATION AS UNRELATED BUSINESS INCOME. IN ADDITION, ASPIN QUALIFIES FOR THE CHARITABLE CONTRIBUTION DEDUCTION UNDER SECTION 170(B)(1)(A) AND HAS BEEN CLASSIFIED AS AN ORGANIZATION OTHER THAN A PRIVATE FOUNDATION UNDER SECTION 509(A)(2). PART XI, LINE 4B - OTHER ADJUSTMENTS: GAIN ON SALE OF EQUIPMENT PART XII, LINE 4B - OTHER ADJUSTMENTS: GAIN ON SALE OF EQUIPMENT 1 X 0 0 0 0 0 0 0 0 0 KATHY COOK NON-VOTING CEO/PRESIDENT 176508 0 0 0 0 0 0 0 0 0 176508 0 0 0 FORM 990, PART VI, SECTION A, LINE 6 THE CORPORATION'S MEMBERSHIP SHALL CONSIST OF THE SUBSCRIBING MEMBERS AND SUCH OTHER NATURAL PERSONS OR ENTITIES WHOM THE BOARD OF DIRECTORS SHALL FROM TIME TO TIME APPROVE FOR MEMBERSHIP. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS REVIEWED FIRST BY THE EXECUTIVE COMMITTEE AND SECONDLY BROUGHT BEFORE THE BOARD FOR REVIEW AND APPROVAL. AFTER APPROVAL BY THE BOARD THE CEO SIGNS THE 990. FORM 990, PART VI, SECTION B, LINE 12C INITIALLY AND ANNUALLY, AS PART OF THE MEMBERSHIP AGREEMENT, AND AS DIRECTORS CHANGE, THE CEO SHALL SEND TO ALL DIRECTORS, OFFICERS, EMPLOYEES AND AGENTS A COPY OF THIS RESOLUTION, TOGETHER WITH AN EXPLANATION AND A QUESTIONNAIRE TO BE COMPLETED, RETURNED AND KEPT ON FILE. AN APPROPRIATE REPORT SHALL BE SUBMITTED TO THE BOARD OF DIRECTORS CONCERNING ANY INTEREST SO DISCLOSED. ANY NEW DIRECTORS, OFFICERS, EMPLOYEES, AGENTS OR CONSULTANTS SHALL PARTICIPATE IN A SIMILAR PROCEDURE OR EXECUTE AN AGREEMENT CONCURRENT WITH ASSUMPTION OF THEIR RESPONSIBILITIES. BASED ON THE SOLE DISCRETION OF THE BOARD OF DIRECTORS, ANY VIOLATION OF THIS POLICY BY A DIRECTOR OR OFFICER MAY CALL FOR IMMEDIATE REMOVAL FROM THE BOARD OF DIRECTORS AND/OR ANY POSITION AS AN OFFICER. VIOLATION OF THE POLICY BY AN EMPLOYEE SHALL BE DEEMED TO BE A "MATERIAL BREACH AND A BASIS FOR TERMINATION OF EMPLOYMENT. FORM 990, PART VI, SECTION B, LINE 15 THE CHAIRMAN OF THE BOARD AND EXECUTIVE COMMITTEE WILL PROVIDE SUPERVISION AND OVERSIGHT FOR ASPIN'S CHIEF EXECUTIVE OFFICER. THE EXECUTIVE COMMITTEE WILL REVIEW AND APPROVE ON AN ANNUAL BASIS CORPORATE GOALS AND OBJECTIVES WITH RESPECT TO THE COMPENSATIONS FOR THE CHIEF EXECUTIVE OFFICER. TWO OF THE EXECUTIVE COMMITTEE OFFICERS WILL BE RESPONSIBLE FOR COLLECTING INPUT FROM THE FULL BOARD ON THE CEO PERFORMANCE AND CONDUCTING AN ANNUAL REVIEW. AT THE TIME OF THE ANNUAL REVIEW THEY WILL ALSO REVIEW THE CEO'S SALARY HISTORY AND OTHER COMPENSATION AND COLLECT BENCHMARK SALARY INFORMATION OF SIMILAR BEHAVIORAL HEALTH NETWORKS. CHAIRMAN OF THE BOARD OF THE EXECUTIVE COMMITTEE WILL SIGN OFF ON THE PROFESSIONAL STAFF MANAGEMENT FORMS FOR THE BOARD APPROVED CHANGE IN COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 THE FORM 990 AND AUDITED FINANCIAL STATEMENTS ARE FILED ANNUALLY. THE FINANCIALS ARE DISTRIBUTED TO THE BOARD, PROVIDED WITH THE ANNUAL DMHA APPLICATION, AND INCLUDED WITH GRANT AND GRANT CONTINUATION APPLICATIONS. GOVERNING DOCUMENTS WERE FILED UPON ESTABLISHMENT OF THE ORGANIZATION. CONFLICT OF INTEREST STATEMENTS ARE SIGNED ANNUALLY AND ARE AVAILABLE UPON REQUEST. FORM 990, PART XII, LINE 2C AN AUDIT COMMITTEE WAS APPOINTED BY THE ORGANIZATION AND THE GROUP SELECTED KEMPER CPA GROUP, LLP TO CONDUCT AN INDEPENDENT FINANCIAL AUDIT TO PROVIDE BASELINE FOR THE COMMITTEE TO REVIEW.