2013-07-02T13:54:10-05:00 2012-12-31 450250958 Eide Bailly LLP 800 Nicollet Mall Suite 1300 Minneapolis MN 554027033 990 2012-01-01 410682405 Hazelden Foundation HAZE 6512134006 PO Box 11 Center City MN 55012 James Blaha 6512134006 2013-07-02 1 Kim Hunwardsen CPA P00484560 6122536500 2013-07-02 2012 2016-03-07 17:11:31Z Mark Mishek PO Box 11 Center City MN 55012 235690429 0 X www.hazelden.org X 1949 MN Hazelden helps restore hope, healing and health to people affected by addiction to alcohol and other drugs. 22 22 1316 444 94418 93418 4802358 6298255 120106815 126733227 4209194 5062325 1740208 2374612 130858575 140468419 540867 536232 0 0 66680809 73578078 0 0 2182324 49675787 49406952 116897463 123521262 13961112 16947157 277579634 311659868 66560273 74259552 211019361 237400316 X Hazelden Foundation's mission is to help restore hope, healing and health to people affected by addiction to alcohol and other drugs. This is accomplished through a commitment to treatment, publishing, higher education, research, public education and advocacy, and shared learning with other organizations. 0 0 76854684 103366487 Addiction Treatment for Adults, Youth, and Families The goal of addiction treatment at Hazelden is lifelong recovery for each patient. Hazelden approaches treatment for addiction and co-occurring mental health disorders in a holistic way. Treatment incorporates integrated clinical disciplines with individualized planning and care. Interdisciplinary care teams consist of addiction counselors, psychologists and psychiatrists, physicians and nurses, family specialists, spiritual care professionals, nutritionists, and wellness specialists. Addiction treatment is offered at Hazelden facilities in Center City, Chaska, Maple Grove, Plymouth, and St. Paul, Minnesota; Chicago, Illinois; Naples, Florida; New York, New York (in the Tribeca and Chelsea neighborhoods); and Beaverton and Springbrook, Oregon. In addition to addiction treatment, Hazelden provides assessment and evaluation services, intervention services, structured sober living, continuing care services, and mental health services. Hazelden also understands that recovery from addiction involves rebuilding relationships with family members and friends. Through Hazelden's family, parent, and sibling programs, loved ones receive education, guidance, and support to achieve a healthier way of life. Hazelden expanded its services in the Northwest to include Beaverton, Oregon. The services include intensive outpatient, outpatient detoxification from opiates and alcohol, and continuing care groups. Mental health services are also offered in a group setting as well as one-on-one. In 2012, the following number of people directly benefited from Hazelden addiction treatment and recovery programs: Primary Treatment Adult 3,168Family Program Adult 2,011Renewal Center and Lodge 1,472Family Program Youth 984Intensive Outpatient Adult 839Primary Treatment Youth 711Extended Treatment Adult 538Mental Health Adult 456Outpatient Treatment Adult 444Continuing Care Services 199Day Treatment Adult 175Intermediate Care Services 117Extended Treatment Youth 86Mental Health Youth 71Teen Intervene 51Day Treatment Youth 36Intensive Outpatient Youth 22 TOTAL PATIENTS SERVED 11,380 Additionally, patient aid is available as measured as gross charges foregone, and in 2012, $7,154,000 was provided to 2,763 qualifying patients and family members. 15914604 22036859 Publication of Educational Materials Hazelden's publishing division develops and distributes resources to help people recognize, understand, and overcome addiction and co-occurring mental health disorders and other closely related problems. As the leading publisher of evidence-based curricula and other materials for professionals who work to prevent and treat addiction, Hazelden's proven-effective resources are implemented in a variety of settings, including schools, other addiction treatment programs, correctional programs, government and military agencies, and mental health and counseling agencies. Hazelden publications, particularly its signature daily meditation books, are also known the world over for helping people learn to apply recovery principles and practices to daily life. Daily meditation books and other Hazelden materials provide much-needed inspiration, encouragement, guidance, and support for lifelong recovery from the disease of addiction. More than 17,700 recovery resources including books, pamphlets, and DVDs were distributed through Hazelden's BookAid program in 2012 to individuals as well as schools, prisons, treatment centers, and other nonprofit organizations. 3071269 536232 3685372 Higher Education and Professional Training Integral to Hazelden's mission is the education of addiction counselors and the training of other professionals who address addiction-related issues. Beginning in the 1960s, Hazelden's educational programs have consistently graduated professionals who provide extraordinary, expert care to people suffering with alcohol and other drug addiction. The Hazelden Graduate School of Addiction Studies, accredited by the Higher Learning Commission of the North Central Association of Colleges and Schools, graduates highly educated counselors well prepared to treat the complexities of addiction and co-occurring mental health disorders. The graduate school's innovative and comprehensive programs integrate direct clinical practice with academic training to build professional competency in the field of addiction counseling. In 2012, the school awarded 74 Masters of Arts degrees in Addiction Counseling and five certificates. Hazelden has a longstanding reputation for sharing knowledge about addiction treatment and recovery. Hazelden's Professionals in Residence (PIR) program is a case in point. The program brings physicians, psychiatrists, judges, social workers, clergy, school chemical health specialists, and other professionals to Hazelden for an intensive opportunity to learn about the challenges of addiction, the effectiveness of treatment, and how to recognize and respond appropriately to addiction-related issues. In 2012, 162 professionals participated in Hazelden's PIR program. Scholarship grants are provided to qualified participants of both the Graduate School (112 scholarships given) and professional education programs (80 scholarships given). Community Care and Community Benefit: In meeting Hazelden's commitment to our mission and the underlying charitable purpose of our organization, we invest our time, financial resources and energy helping people and communities understand and address addiction as a treatable disease, and we spread the word that recovery is possible. "Be of service" is an integral Hazelden value, which we demonstrate in a variety of ways. Perhaps the most obvious way we meet our commitment to community is by providing treatment services to individuals and families who seek and qualify for care but are unable to pay the full cost. Our patient aid awards totaled $7,154,000 in charges forgone in 2012. Our patient aid policy provides that Hazelden will annually establish a target amount of aid based on our actual net adjusted patient service revenue. In addition, the Foundation provides a variety of other benefits for the public good including:Graduate School of Addiction Studies: -The Hazelden Graduate School of Addiction Studies prepares future leaders in addiction counseling through the Master of Arts in Addiction Counseling and the Certificate in Addiction Counseling programs. The school emphasizes public engagement as a means of serving its constituent communities. In 2012 alone, students provided more than 8,000 hours of clinical services at agencies reaching underserved and economically disadvantaged populations. Students also volunteered their time to organizations reaching the homeless, serving individuals with HIV/AIDS, and education the public at large. The school offers a full scholarship each year to students from Chisago County Health and Human Services and provides continuing education to these Chisago County professionals at no cost. -Seventy-four students graduated with master's degrees from the school in 2012. Overall, more than 90 percent of graduates who seek careers in the addiction treatment field find employment in their home communities or at regional or national treatment agencies. Faculty and graduate school leaders participate in public service events throughout the United States and make research, educational and scholary contributions to the field of addiction treatment.Butler Center for Research: The Butler Center for Research is dedicated to improving recovery from addiction by conducting clinical and institutional research, collaborating with other research centers, and communicating scientific findings. It is the center's vision that sustained recovery for all who seek help will be achieved through advancements in knowledge and integration of research into practice. Among the department's many activities in 2012: -As part of Hazelden's commitment to evidence-based practice, over 20 data analysis projects were conducted to inform clinical care and academic programming, identify treatment needs, drive data-based decision-making, contribute to outcomes initiatives, and add to the field's knowledge of addiction treatment.-The Huss Research Chair on Older Adults is a collaborative initiative that allows Hazelden researchers to partner with leading national experts on projects related to older adults with addiction. The current Huss Research study is examining the effects of naltrexone, an anti-craving agent for alcohol, on treatment outcomes among alcohol dependent adult residential patients. In addition, the study is assessing the degree to which a favorable response to naltrexone is associated with a particular mu opioid receptor genotype. Over 200 residential patients were successfully recruited into the study during 2012. One, six, and twelve month outcomes were also collected for the majority of study participants. -Two additional clinical research projects with adult residential patients were conducted in 2012. Recruitment and baseline data collection was completed for a pilot study examining biased cognitive processing among alcohol dependent patients. Follow up data collection for the one and six month outcomes surveys was completed. A follow up cognitive bias study focusing specifically on young adults was launched in 2012 and recruitment and baseline data collection was completed for 75% of participants. Data analyses for a study on the neurobiology of stimulant addiction and recovery among young adults were completed and study results were submitted for publication and presented at national conferences. This study was conducted in partnership with the University of Minnesota's Department of Psychiatry.-Research Updates were disseminated to professionals, educators, researchers, students, and other stakeholders. These two-page summaries of scientific findings from the field of addiction treatment research are provided at no cost as a community benefit to policymakers, treatment professionals, and the public at large.-The Butler Center for Research's Dan Anderson Award is conferred on an annual basis to recognize a published manuscript that has a significant impact on the field of addiction treatment research. In the fall of 2012, Roger D. Weiss, M.D., Chief, Division of Alcohol and Drug Abuse, McLean Hospital, earned the award for his study entitled "Adjunctive Counseling During Brief and Extended Buprenorphine-Naloxone Treatment for Prescription Opioid Dependence," published in 2011 in the Archives of General Psychiatry. This study examined the effectiveness of long term buprenorphine maintenance accompanied by adjunctive counseling in the treatment of prescription opioid drug dependence.-Seven research manuscripts were published in peer reviewed addictions journals in 2012. These papers focused on several different topics, including the role of self efficacy in promoting positive treatment outcomes among young adults, the impact of therapeutic alliance on treatment outcomes, the extent of attention and memory bias in alcohol dependent patients, and the relationship between usage of Hazelden's MORE program and substance use outcomes in the first six months following treatment. Professionals in Residence: The Professionals in Residence (PIR) program educates professionals from around the world on the diagnosis and treatment of the disease of addiction. Participants complete an intense one-week program that provides a broad foundation for understanding treatment and recovery. It teaches the latest research-based treatment methods in the field of addiction treatment and recovery. Participating professionals represent a wide variety of disciplines including medicine, nursing, psychiatry, mental health, professional counseling, family therapy, employee assistance, corrections, clergy and others. In 2012, Hazelden welcomed 162 professionals to our programs which are held in Minnesota and New York.Center for Public Advocacy: In 2012, Hazelden's Center for Public Advocacy focused on building greater public understanding of addiction and shaping public policy that supports treatment and recovery.-Key efforts included advocating for robust regulatory implementation of the new federal "parity" law, which expands access to treatment through private health care insurance, and preparing for full realization of the new law. The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act ends discrimination by insurance companies against people who need addiction treatment. The Center for Public Advocacy participated in drafting guidelines for the new law and continues to monitor implementation and advocate for favorable interpretations of these regulations. -Federal health care reform was also a key focus of the center's efforts. Working with other treatment providers, Hazelden ensured that addiction to alcohol and other drugs was included as a covered illness in the "essential benefits package" under the new health care reform law. The center has been very active in helping to define the benefit. Promoting awareness of the benefits for addiction consumers and providers in the new health care law is an ongoing priority.-In Minnesota, Hazelden launched a project to improve highway safety at a dangerous intersection leading to the main campus in Center City. Over the years, people have been killed or injured in several accidents at this intersection. The center brought the issue to key local, state and federal policy leaders, and steps were taken to address the problem. -Hazelden has played a leading role with state lawmakers in making the case for the efficacy and cost-effectiveness of substance abuse treatment in these tight budgetary times. -Throughout 2012, the Center's William C. Moyers spoke to national conventions, state trade associations, local civic and education groups and gatherings of people in recovery about the importance of standing up and speaking out for treatment and recovery. In 2012, Moyers and the Center also engaged the news media in this effort,serving as a key media contact on a wide variety of policy issues and being featured in newspapers, magazines and electronic media nationwide. In addition, Moyers authors a weekly, nationally syndicated column entitled "Beyond Addiction." Dean Peterson, former chief of staff to retired Congressman Jim Ramstad, joined the center in 2010 and has been an energetic presence on behalf of Hazelden and the wider treatment community in both Washington and Minnesota. He spoke to various groups in 2012 about treatment and recovery.-The 2012 Minnesota State Fair was very well attended again, and the Center was there to welcome and educate the hundreds of visitors with knowledgeable Hazelden employees, family members, and friends serving as booth volunteers.-Under the direction of the Hazelden Speakers Bureau, 40 employees presented to more than 13,126 attendees at 116 events in 22 states and in York, U.K. on a broad range of subjects, including drug trends, prevention, treatment advances and co-occurring disorders. More than 46,000 people attended a Minnesota Twins baseball game during National Recovery Month in September. And a virtual audience of more than 400 heard from three nationally known speakers at Hazelden's fifth annual Youth & Addiction Professional Development Conference on November 15 in Minnetonka, Minnesota. The rise in the toxic and sometimes lethal synthetics-Spice, K2 and Bath Salts-was the topic at a Hazelden-sponsored panel discussion in St. Louis Park in December that drew more than 400 school officials, family practitioners, emergency department staff, psychologists, law enforcement officials, social workers and parents.Community Relations Services: -Through its community relations services, the Hazelden Visitors Program in Center City scheduled and conducted 42 tours for 764 individuals. Volunteers at facilities in Minnesota, Illinois, New York, Oregon and Florida donated 9,009 hours valued at $196,306.-Educational scholarships from Hazelden were awarded totaling $5,200 to students at six high schools in the Twin Cities and the surrounding Center City area. -Hazelden continues its involvement with the Partners for a Drug-Free Chisago County, providing expertise, hosting meetings and allowing staff to serve on the organization's board. Through generous funding from our donors, Hazelden also has a strong partnership with Washington County, providing educational materials, professional training, student leadership development, and patient aid. We also work with the Minneapolis Public Schools to implement prevention programs to reduce alcohol and other drug use. We continue to support local schools in implementing the Olweus Bullying Prevention Program and Lifelines, a comprehensive suicide prevention program. Publishing: -Hazelden publishes curricula, resources, and professional development tools for preventing, treating and managing addiction and related disorders. Translating research into practice, Hazelden is the leading publisher of evidence-based alcohol and other drug addiction prevention and treatment curricula. With 55 new releases in 2012, Hazelden publications continued to provide inspiration, guidance and encouragement in the lives of millions around the world every day. Hazelden also produced 332 electronic books and 20 applications for iPhone and eight for Android in 2012. If not for the Hazelden mission, much of this material would not be published and available to consumers because of its limited appeal to mainstream publishers. Publishing materials also reach underserved populations, including many customers in the community treatment, faith-based and corrections markets.-In 2012, through its BookAid program, Publishing sent 4,397 packages of 17,758 products that reached the lives of more than 200,000 people through 80 libraries serving programs and institutions in need. BookAid resources were sent to individuals and organizations around the world, including Israel, Mexico, Pakistan, Canada, and the United States. Publishing received more than $40,000 in donations for the BookAid program.Hazelden Web site: -Nearly 4 million visits were recorded to Hazelden's informational webiste at hazelden.org in 2012. New in 2012 was the launch of Hazelden's Social Community-a vibrant online site for people interested in recovery from drug and alcohol addiction. The site features blogs, discussion boards and online meetings that are accessible to those seeking help and support from anywhere in the world. More than 34,000 members were registered by year-end. Hazelden's Facebook, Twitter, YouTube, and LinkedIn pages also provide the community with quick and easy access to inspiration, information, career opportunities and news about Hazelden.Resource Center: -In 2012, Hazelden's Resource Center received a total of 138,762 calls and more than 10,000 online inquiries from people seeking information, assistance and products related to addiction issues. Part of the Resource Center's work is connecting people with the help they need, in the form of products, services and free information. For those in need of resources beyond what Hazelden provides, the Resource Center searches its database of more than 30,000 agencies to locate other possible assistance. 95840557 1 1 0 1 0 0 0 1 0 1 1 1 0 1 1 1 0 1 0 0 1 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 0 0 1 879 0 1 1316 1 1 1 1 CJ 0 0 0 1 1 0 0 0 0 X 22 22 0 0 1 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 1 0 AL AK AZ AR CT FL IL KS KY LA MD MA MI MS MN NH NJ NM NY NC ND OH OK OR PA RI SC TN UT VA WA WV WI X James Blaha Chief Financial & Administrative Office 6512134006 15251 Pleasant Valley Road Center City MN 55012 Paul Gossling 5.00 1.00 X X 0 0 0 Hon Susan Fox Gillis 2.00 1.00 X X 0 0 0 Terry Rubenstein 2.00 0.00 X X 0 0 0 John Butler 1.00 0.00 X 0 0 0 William Cirone 1.00 0.00 X 0 0 0 Kelly WG Clark 1.00 0.00 X 0 0 0 Susan Engeleiter 1.00 0.00 X 0 0 0 Harve Ferrill 1.00 1.00 X 0 0 0 A John Huss Jr 1.00 0.00 X 0 0 0 Dr Andrew Jeon 1.00 0.00 X 0 0 0 Paul Karon 1.00 0.00 X 0 0 0 James Kowalski 1.00 0.00 X 0 0 0 William Lammers 1.00 0.00 X 0 0 0 Donald C MacMillan 1.00 0.00 X 0 0 0 Cheryl McKinley 1.00 0.00 X 0 0 0 Catherine Morley 1.00 0.00 X 0 0 0 Lester Munson 1.00 1.00 X 0 0 0 Fr Michael O'Connell 1.00 0.00 X 0 0 0 Cynthia Piper 1.00 0.00 X 0 0 0 Michael Sime 1.00 0.00 X 0 0 0 W Christopher White 1.00 5.00 X 0 0 0 Mary Whitney 1.00 0.00 X 0 0 0 Dr Frank Wilderson 1.00 0.00 X 0 0 0 James Blaha 50.00 6.00 X 286334 0 46671 Mark Mishek 50.00 10.00 X 658271 0 88006 Nicholas Motu 50.00 X 303678 0 57556 Ann Bray 50.00 X 262351 0 16578 Dr Marvin Seppala 50.00 X 397999 0 63176 Valerie Slaymaker 50.00 X 214955 0 32866 Mark Sheets 50.00 X 227901 0 48956 Jim Steinhagen 50.00 X 212863 0 36084 John Driscoll 50.00 X 225032 0 43421 Jan Vondrachek 50.00 X 214615 0 29564 Sharon Birnbaum 50.00 X 206844 0 42149 Jana Olslund 50.00 X 212145 0 10516 Dr Joseph Lee 40.00 X 231711 0 55497 Dr Stephen Delisi 40.00 X 207248 0 42986 Dr Vern Williams 40.00 X 204730 0 46666 Dr Pamela Shultz 40.00 X 206467 0 28800 Robert Poznanovich 40.00 X 232990 0 23312 William Moyers 40.00 X 211897 0 38919 4718031 0 751723 54 1 1 0 Sodexho Inc & Affilliates 4880 Paysphere Cir Chicago IL 60674 Food service 1574945 RR Donnelley 14100 Lear Blvd Reno NV 89506 Warehouse management 711423 Xerox Corporation 45 Glover Avenue Norwalk CT 068564505 Duplication services 645892 Nina Hale Consulting 100 S 5th St Ste 2000 Minneapolis MN 55402 Marketing services 392221 Oracle America Inc 500 Oracle Parkway Redwood Shores CA 94065 Computer services 353410 19 363596 5934659 414608 6298255 Addiction Treatment 623990 101482094 101482094 Publishing 511130 21636426 21636426 Higher Education 611600 3614707 3614707 126733227 1115680 1115680 98982193 24750 94984241 76057 3997952 -51307 3946645 3946645 86415 363596 161712 -75297 -75297 Corporate support fee 561000 2355491 2355491 Income from Partnerships 900003 77138 77138 Personal property rent 900002 17280 17280 2449909 140468419 129088718 94418 4987028 532744 532744 3488 3488 3916950 1643983 2082914 190053 52219593 41571613 9609068 1038912 2711216 2228645 434258 48313 10688982 8311663 2086119 291200 4041337 3172449 800185 68703 248334 1680 246654 79856 1560 78296 142752 142752 50000 50000 3609628 2371518 1233859 4251 3016633 2293235 578514 144884 4337860 3107928 1148622 81310 2983263 170595 2755162 57506 2425770 2425770 2582761 2015965 507330 59466 1637341 1159369 383981 93991 554318 489242 65076 753164 487904 259131 6129 11647268 9255592 2330629 61047 3150 3150 Cost of material sold 3316863 3316863 Food 2351840 2143382 208458 Medicine and drugs 1525782 1525782 MNCare Tax 1427310 1427310 6713059 6179127 497373 36559 123521262 95840557 25498381 2182324 3481027 5467094 1797881 2492134 13475928 12337312 144638 108237 2953254 3379110 1690194 1173987 220138849 107795255 92005816 112343594 81791035 67045338 32385584 61790887 47854277 45522175 277579634 311659868 12604281 13856140 652240 469329 48110000 47015000 5193752 12919083 66560273 74259552 X 186819522 210510337 2912963 5476015 21286876 21413964 211019361 237400316 277579634 311659868 X 16947157 9278582 -13804 169020 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 1 375 0 0 1 73112 1 516410 0 589897 0 Explanation of Lobbying Activities: Part II-B, Line 1: In 2012, the push for implementation of insurance "parity" and health care reform remained the cornerstone of Hazelden's focus on influencing public perception and awareness through education about addiction, treatment and recovery. By informing audiences and key stakeholders about these issues, Hazelden's goal is to improve the formulation of policy at its earliest stage, thereby improving access to treatment for people in need and supporting their continued recovery after treatment. These efforts are coordinated through the organization's Center for Public Advocacy. The Center also supports each Hazelden facility, its employees and other interested stakeholders by responding to requests and providing them with information on relevant federal, state and local legislation. Hazelden focused much of its advocacy and policy efforts on the roll-out of historic federal legislation to expand access to addiction and mental illness treatment through private health insurance. Hazelden worked as a member of the Parity Implementation Coalition (PIC) to provide input on how the interim parity regulations were written and are being enforced by the U.S. Departments of Labor, Treasury, and Health and Human Services. Ahead of implementation, Hazelden's Center for Public Advocacy produced an 8-page consumer brochure to inform patients, their families, businesses (large and small) and civic organizations about the changes in coverage. Hazelden also provided input to the PIC on the writing of a comprehensive parity "toolkit," which is now available on Hazelden's webpage, to help patients understand their rights under the new law. The Center for Public Advocacy will continue to monitor compliance with the law and any changes to the rules, as federal agencies have said they will issue final regulatory guidance by the end of 2013. Hazelden was also active in the implementation of the Affordable Care Act (ACA). The new law, which remains in the process of being implemented across the country, contains a number of benefits for addiction consumers and providers. Hazelden is part of the Coalition for Whole Health, a group of addiction and mental health organizations that raised awareness of substance abuse treatment and recovery issues in the debate and during the implementation phase, as well as of state-based groups working to implement the federal law at the state level. Hazelden regularly receives requests for information on addiction, treatment and recovery issues from federal, state and local legislatures and governments. Membership in associations related to the addiction field and the preservation of the services we provide allows Hazelden to join forces with others sharing similar concerns and interests. Hazelden tapped its resources to influence policy and public attitudes by engaging the news media and collaborating with grassroots community-based organizations across the country on local, state and federal policy issues. Hazelden's Center for Public Advocacy advances these Guiding Principles: Addiction to alcohol and other drugs is a chronic illness and a public health problem affecting all Americans; addiction is a treatable illness with measurable outcomes of success, and Hazelden's treatment modality offers people the best opportunity to find lifelong recovery; standardized treatment outcomes are integral to ensuring that people receive proper care. These outcome standards must also help to define the treatment field's role in the continuum of health care services at the state and federal level; all people with addiction disease deserve to find recovery through a level of treatment and related services that is appropriate to meet their individual needs; the stigma of addiction is a major barrier to recovery; access to care will improve by ending discrimination against people with this illness. 570881 X X 0 20241452 385331 2484179 833978 22276984 21560549 71978 -548143 842932 20241452 20187298 117515 2160784 905048 21560549 15281356 2986682 2887634 968374 20187298 22684940 435000 -6895539 943045 15281356 0.13930 0.86070 0 0 7158810 7158810 121762964 57862579 63900385 696392 210075 486317 55892906 44626921 11265985 34627777 5095680 29532097 112343594 1699470 F Q-Blk Strategic Partner 2008 Series 1 12929333 F PIMCO Stockplus Limited Partner 16560739 F ABS Offshore SPC Global 5211173 F AT MLP Fund, LLC 6097450 F Rimrock High Income Plus Fund LTD 5806535 F Commingled International Investors-International Value Equity Trust 13486187 F 61790887 Intercompany Receivables 35645397 Film and Video Costs, net 120568 CSV Life Insurance 181546 Capitalized Finance Costs, net 708755 Curriculum Costs, net 43467 Collections 570881 Goodwill-Springbrook 2187766 610 Development Florida Loan 542334 Bond Trust Fund-Plymouth Expansion 4787301 Healthworks NW Receivable 3139 Long Term Receivable-Irrevocable Trust 150000 Non-compete Agreement-Beaverton 581021 45522175 Interest Rate Exchange Agreement Liability 4396069 Asset Retirement Obligation 499093 Intercompany Payables 8023921 12919083 X Part III, Line 4: Hazelden maintains a collection of historically significant books and archives on recovery and addiction which can be used for research as well as being on public display. Description of Intended Use of Endowment Funds: Part V, Line 4: Earnings from the endowment funds are used for the purposes as specified by donor restrictions, including patient aid, operations, research, student aid, prevention programs and special projects. Description of Uncertain Tax Positions Under FIN 48: Part X, Line 2: In accordance with the accounting standard on Accounting for Uncertainty in Income Taxes, the Foundation addresses the determination of whether tax benefits claimed on a tax return should be recorded in the financial statements. Under this guidance, the Foundation may recognize the tax benefit from an uncertain tax position only if it is more likely than not that the tax position will be sustained on examination by taxing authorities, based on the technical merit of the position. Examples of tax positions include the tax-exempt status of the Foundation and various positions related to the potential sources of unrelated business taxable income. There were no unrecognized tax benefits identified or recorded as liabilities during fiscal year 2012. Open tax years subject to examination by the U.S and state taxing authorities are for the years 2010 to 2012, which statutes expire in 2013 to 2015, respectively. Central America and the Caribbean 0 0 Program services Publishing sells and distributes books and related items East Asia and the Pacific 0 0 Program services Publishing sells and distributes books and related items Europe 0 0 Program services Publishing sells and distributes books and related items Middle East and North Africa 0 0 Program services Publishing sells and distributes books and related items North America 0 0 Program services Publishing sells and distributes books and related items Russia and Independent States 0 0 Program services Publishing sells and distributes books and related items South America 0 0 Program services Publishing sells and distributes books and related items South Asia 0 0 Program services Publishing sells and distributes books and related items Sub-Saharan Africa 0 0 Program services Publishing sells and distributes books and related items 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Dinner and Auction 336331 289300 47031 21747 21079 5311 69583 Golf Tournament and Auction 69080 36116 32964 18406 5992 2679 1 44600 38180 6420 8910 6061 1944 450011 363596 86415 40153 35981 11372 74206 161712 -75297 1 Scholarships for Graduate School of Addiction Studies 110 408744 Book Scholarships for Professionals in Residence Training 80 118800 Book Educational assistance for local high school students 6 5200 Book Procedure for Monitoring Grants in the U.S.: Part I, Line 2: Schedule I, Part I, Line 2: Hazelden Foundation provides the assistance as part of its program services activity. All scholarships are provided to individuals and monitored through the Graduate School of Addiction Studies, the Professionals in Residence training program and the Community Relations department to ensure the monies are used for the purpose intended. The tuition paid for those programs and the funds given to assist with the tuition is tracked by each individual. X X X X X 0 1 0 0 0 0 0 0 0 James Blaha 252900 0 31905 0 1529 0 26944 0 20746 0 334024 0 0 0 Mark Mishek 529111 0 125733 0 3427 0 66190 0 23496 0 747957 0 0 0 Nicholas Motu 265930 0 36139 0 1609 0 28701 0 29882 0 362261 0 0 0 Ann Bray 235780 0 25852 0 719 0 16578 0 935 0 279864 0 0 0 Dr Marvin Seppala 354097 0 41669 0 2233 0 34500 0 29947 0 462446 0 0 0 Valerie Slaymaker 193520 0 21065 0 370 0 18300 0 15400 0 248655 0 0 0 Mark Sheets 198605 0 27490 0 1806 0 21001 0 28831 0 277733 0 0 0 Jim Steinhagen 189491 0 22274 0 1098 0 18818 0 18114 0 249795 0 0 0 John Driscoll 200434 0 24335 0 263 0 19717 0 24565 0 269314 0 0 0 Jan Vondrachek 192164 0 21869 0 582 0 19045 0 11363 0 245023 0 0 0 Sharon Birnbaum 182529 0 23261 0 1054 0 13194 0 29787 0 249825 0 0 0 Jana Olslund 211877 0 0 0 268 0 3098 0 8349 0 223592 0 0 0 Dr Joseph Lee 231382 0 0 0 329 0 23926 0 32609 0 288246 0 0 0 Dr Stephen Delisi 206935 0 0 0 313 0 15031 0 28892 0 251171 0 0 0 Dr Vern Williams 203390 0 0 0 1340 0 17811 0 29699 0 252240 0 0 0 Dr Pamela Shultz 205117 0 0 0 1350 0 8497 0 21262 0 236226 0 0 0 Robert Poznanovich 205444 0 26257 0 1289 0 15894 0 8342 0 257226 0 0 0 William Moyers 189602 0 22170 0 125 0 19329 0 20476 0 251702 0 0 0 Part I, Line 4b Mark Mishek, President and CEO participated in a nonqualified retirement plan in the amount of $31,690. A City of Center City MN 416005039 151452AC3 2005-10-13 13190000 Women's Recovery Center construction and other capital improvements. 0 0 0 B City of Center City MN 416005039 151452AT6 2011-11-14 20095000 Expansion and renovation of Plymouth facility 0 0 0 A 870000 13190000 290432 12899568 2007 0 0 1 1 B 20210373 4787301 370566 15052561 4671873 0 0 0 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 A 0 0 1 0 1 1 Piper Jaffray 3.000000000000 0 0 0 0 0 B 0 0 0 0 0 0 1 Credit Agricole Corp and Investment 1.500000000000 0 0 0 A 0 B 0 X 13 130107 Gross selling price X 1 284500 Fair market value 1 0 1 1 Third Party Use: Part I, Line 32b: Hazelden Foundation maintains a cash securities account with a brokerage firm for the sale of stocks and/or other securities received as charitable contributions by Hazelden. The stocks/securities are sent to the brokerage firm and are sold at fair market value with the gross proceeds deposited into Hazelden's cash account. Form 990, Part VI, Section A, line 4 The Bylaws were revised to permit a majority of Trustees to take action without a meeting via written assent in most circumstances, including when making future amendments to the Bylaws. Form 990, Part VI, Section B, line 11 Hazelden Foundation sent its Form 990, with Schedule B suppressed, via email to Board members for review and questions prior to filing. It was also reviewed by the CFO and Associate Counsel prior to filing. Form 990, Part VI, Section B, line 12c Hazelden Foundation requires an annual disclosure of any potential conflict of interest by Board members, officers and key employees. If a Board member discloses a potential conflict, that person then excuses him or herself from voting on that particular issue. All new board members are provided conflict of interest education and periodic training throughout their term. All board members sign an annual conflict of interest disclosure form. Form 990, Part VI, Section B, line 15 Hazelden has an established process for determining the compensation of the CEO, other officers and key employees that starts with the Board of Trustees. The Hazelden Foundation by-laws delegate responsibility for determining compensation for the CEO, other officers and key employees to the Executive Committee of the Board of Trustees. The Executive Committee develops, reviews, and modifies, as necessary, the compensation philosophy for Hazelden Foundation. Hazelden has the following processes in place: 1. Each year the Board members complete a conflict of interest disclosure. The documents are reviewed by Hazelden's general counsel and if a Board member has a conflict of interest they are not involved in any compensation decisions. 2. The Executive Committee engages the use of an outside independent compensation consultant to identify comparable market data for comparable positions for the CEO and other disqualified individuals consistent with the approved compensation philosophy. Generally the market analysis includes competitive data from published survey sources, supplemented with compensation data from custom 990 analyses. Where possible, competitive data are pulled from similarly sized organizations. The compensation consultant analyzes the pay packages of the CEO and other disqualified individuals by reviewing base salary, total cash compensation (salary plus annual incentive at both target and actual levels) and total direct compensation (salary plus annual and long-term incentive). In addition, every two to three years the Executive Committee reviews the total compensation package of the CEO and other disqualified individuals. The total compensation package includes total direct compensation plus severance, employee benefits, perquisites and any other pay. 3. Comparable market data are reviewed and discussed by the Executive Committee and minutes record those discussions and any resulting compensation decisions. A compensation review for the CEO was most recently done in January 2013. The compensation review for other officers and key employees was completed in May 2013. Form 990, Part VI, Section C, line 19 Hazelden Foundation makes its annual report available to the public via its website at www.hazelden.org. The governing documents and conflict of interest policy are not available for public inspection. Changes in Net Assets or Fund Balances: Form 990, Part XI, line 9: Gain on Interest Rate Swap Agreements 164,760. Other Gains 6,355. Rounding -2,095. Governing body Executive committee Part VI, Section A: The Executive committee of the Board of Trustees has the authority to act on behalf of the Board between the Board's regular meetings, subject to the limitations of power listed below. The Executive committee consists of the Chair of the Board, the immediate past Chair, if a member of the Board, Vice Chairs of the Board, President (ex-officio non-voting), Secretary, Treasurer, and the Chair of each standing committee. Limitations of Powers: The Executive committee does not have the power to elect a trustee, to alter fundamental policies approved by the Board, to make appropriations which are not in accordance with the general policies approved by the Board, to modify, revoke or renew any contract previously entered into by the Board or to change the person or persons specifically designated by the Board to enter into or execute on behalf of the organization a particular contract, obligation, agreement or writing authorized by action of the Board of Trustees. 615 Drake Street LLC PO Box 11 Center City MN 55012 272969681 Land purchased for future expansion of the Foundation's St. Paul, MN site MN 0 3195046 Hazelden Foundation Hazelden Chicago PO Box 11 Center City MN 55012 364099403 Addiction recovery services, including outpatient, sober residence IL 501 (c)3 3 Hazelden Foundation 1 Hazelden New York PO Box 11 Center City MN 55012 133673215 Addiction recovery services, including outpatient, continuing care NY 501 (c)3 7 Hazelden Foundation 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 1 0 0 Hazelden Chicago Q 1029452 Fair Market Value Hazelden New York Q 1235030 Fair Market Value