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HEALTHSOURCE INTEGRATED SOLUTIONS INC: Form 990, tax year 2017

View the entire original 990 at ProPublica ↗

Organization
HEALTHSOURCE INTEGRATED SOLUTIONS INC (EIN 20-8498601)
Tax period
2017-07-01 to 2018-06-30
Filed
2019-05-14
IRS object ID
201911349349302866
Schema version
2017v2.3
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2019-05-14T09:46:59-05:00ReturnTs
Tax Period End2018-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN481066439PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1BERBERICH TRAHAN & CO PABusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1990 SW FAIRLAWN ROADAddressLine1Txt
CityTOPEKACityNm
State AbbreviationKSStateAbbreviationCd
ZIP66606ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2017-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN208498601EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1HEALTHSOURCE INTEGRATED SOLUTIONS INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlHEALBusinessNameControlTxt
Phone7852342423PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line12121 SW CHELSEA DRAddressLine1Txt
CityTOPEKACityNm
State AbbreviationKSStateAbbreviationCd
ZIP66614ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonPATRICK YANCEYPersonNm
Person TitleCEOPersonTitleTxt
Phone7852342423PhoneNum
Signature2019-05-13SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonMORGAN PADGETTPreparerPersonNm
PTINP00635687PTIN
Phone7852723176PhoneNum

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address70.184.229.195IPv4AddressTxt
FieldValueIRS element (for citing)
IP2019-05-13IPDt
IP Tm09:05:39IPTm
IP TimezoneCDIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdDA39A3EE5E6B4B0D3255BFEF95601890AFD80709AtSubmissionCreationDeviceId
At Submission Filing Device IdA6DBD3F414A49F7489B033F1810171C4467117A3AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2017TaxYr
Build TS2019-02-21 02:37:17ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerPATRICK YANCEYPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line12121 SW CHELSEA DRAddressLine1Txt
CityTOPEKACityNm
State AbbreviationKSStateAbbreviationCd
ZIP66614ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$3,841,994GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501cYes (X)Organization501cInd
Website AddressHTTP://WWW.HEALTHSRC.ORG/WebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2007FormationYr
Legal Domicile StateKSLegalDomicileStateCd
Activity Or MissionHEALTHSOURCE INTEGRATED SOLUTIONS' PURPOSE IS TO FUNCTION AS AN ADMINISTRATIVE SUPPORT ORGANIZATION, PROVIDING ESSENTIAL ADMINISTRATIVE AND EMPLOYER SUPPORTED SERVICES TO COMMUNITY MENTAL HEALTH CENTERS, GOVERNMENTAL PARTNERS AND PRIVATE ORGANIZATIONS.ActivityOrMissionDesc
Voting Members Governing Body6VotingMembersGoverningBodyCnt
Voting Members Independent6VotingMembersIndependentCnt
Total Employee48TotalEmployeeCnt
Total Volunteers6TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$4,255,826PYProgramServiceRevenueAmt
CY Program Service Revenue$3,841,994CYProgramServiceRevenueAmt
PY Investment Income-$651PYInvestmentIncomeAmt
CY Investment Income$0CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$4,255,175PYTotalRevenueAmt
CY Total Revenue$3,841,994CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$977,555PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$1,525,772CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$3,670,802PYOtherExpensesAmt
CY Other Expenses$2,709,679CYOtherExpensesAmt
PY Total Expenses$4,648,357PYTotalExpensesAmt
CY Total Expenses$4,235,451CYTotalExpensesAmt
PY Revenues Less Expenses-$393,182PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$393,457CYRevenuesLessExpensesAmt
Total Assets BOY$4,931,150TotalAssetsBOYAmt
Total Assets EOY$5,555,717TotalAssetsEOYAmt
Total Liabilities BOY$3,257,432TotalLiabilitiesBOYAmt
Total Liabilities EOY$4,275,456TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$1,673,718NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$1,280,261NetAssetsOrFundBalancesEOYAmt
MissionHEALTHSOURCE INTEGRATED SOLUTIONS' PURPOSE IS TO FUNCTION AS AN ADMINISTRATIVE SUPPORT ORGANIZATION, PROVIDING ESSENTIAL ADMINISTRATIVE AND EMPLOYER SUPPORTED SERVICES TO COMMUNITY MENTAL HEALTH CENTERS, GOVERNMENTAL PARTNERS AND PRIVATE ORGANIZATIONS.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$3,503,143ExpenseAmt
Revenue$3,841,994RevenueAmt
DescHEALTHSOURCE INTEGRATED SOLUTIONS, INC. WAS ORIGINALLY FORMED AS A NOT-FOR-PROFIT ORGANIZATION WHOSE PURPOSE IS FULFILLING THE FUNCTIONS AND OBLIGATIONS OF MANAGING A STATEWIDE SYSTEM OF BEHAVIORAL HEALTH SERVICES, AND OTHERWISE FUNCTIONING IN A MANNER COMPATIBLE WITH THE VALUES, MISSIONS AND GOALS OF THE MEMBERS OF ITS PARENT ORGANIZATION, THE ASSOCIATION OF COMMUNITY MENTAL HEALTH CENTERS OF KANSAS, INC. H.I.S. PROVIDES SUPPORT, ADMINISTRATIVE, AND IT SERVICES TO EMPLOYERS AND CLINICAL PROVIDERS ACROSS THE UNITED STATES OF AMERICA. THESE INTEGRATED SERVICES INCLUDE BEHAVIORAL HEALTHCARE MANAGEMENT, CRISIS HELPLINE SUPPORT, EMPLOYEE ASSISTANCE PROGRAMS, AND TECHNOLOGY MANAGED SERVICES.Desc
Total Program Service Expenses$3,503,143TotalProgramServiceExpensesAmt
Described In Section501c30DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (1)TransactionWithControlEntInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document72IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee48EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members6GoverningBodyVotingMembersCnt
Independent Voting Member6IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn Body0Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldKSStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonBRAD WOLTJEPersonNm
Phone7852919122PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line12121 SW CHELSEA DRIVEAddressLine1Txt
CityTOPEKACityNm
State AbbreviationKSStateAbbreviationCd
ZIP66614ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (7 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerInd
GREG HENNEN
MEMBER AT LARGE4.00Yes (X)$0$0$0
SHERMAN WES COLE
MEMBER AT LARGE4.00Yes (X)$0$0$0
DR LESLIE BJORK
CMHC DIRECTOR4.00Yes (X)$0$0$0Yes (X)
LAURA HOWARD
VICE-CHAIR4.00Yes (X)$0$0$0Yes (X)
KYLE KESSLER
OWNER REPRESENTATIVE, EX-OFFICIO4.00Yes (X)$0$158,396$45,119Yes (X)
KEITH RICKARD
CHAIRMAN4.00Yes (X)$0$0$0Yes (X)
PATRICK YANCEY
CEO40.00$119,634$0$21,866Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$119,634TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$158,396TotReportableCompRltdOrgAmt
Total Other Compensation$66,985TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K1IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (3 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
RELIAS LEARNING
DEPT CH 16894PALATINEIL60055ONLINE TRAINING SERVICE$150,100
FREEDOM BEHAVIORAL HOSPITAL
1334 SW BUCHANAN STTOPEKAKS66604MENTAL HEALTH SERVICES PROVIDER$145,600
COTTONWOOD SPRINGS
13351 S ARAPAHO DROLATHEKS66062MENTAL HEALTH SERVICES PROVIDER$136,800
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K3CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescSUPPORT SERVICESDesc
Business900099BusinessCd
Total Revenue Column$3,826,455TotalRevenueColumnAmt
Related Or Exempt Func Income$3,826,455RelatedOrExemptFuncIncomeAmt

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$15,539TotalRevenueColumnAmt
Related Or Exempt Func Income$15,539RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$3,841,994TotalProgramServiceRevenueAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$3,841,994TotalRevenueColumnAmt
Related Or Exempt Func Income$3,841,994RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$117,832TotalAmt
Program Services$110,750ProgramServicesAmt
Management And General$7,082ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$1,127,040TotalAmt
Program Services$1,064,045ProgramServicesAmt
Management And General$62,995ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$139,798TotalAmt
Program Services$127,673ProgramServicesAmt
Management And General$12,125ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$141,102TotalAmt
Program Services$133,602ProgramServicesAmt
Management And General$7,500ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$17,703TotalAmt
Program Services$1,797ProgramServicesAmt
Management And General$15,906ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$5,725TotalAmt
Program Services$581ProgramServicesAmt
Management And General$5,144ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$1,677,600TotalAmt
Program Services$1,488,136ProgramServicesAmt
Management And General$189,464ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$11,494TotalAmt
Program Services$7,663ProgramServicesAmt
Management And General$3,831ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$137,865TotalAmt
Program Services$127,070ProgramServicesAmt
Management And General$10,795ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$42,311TotalAmt
Program Services$40,590ProgramServicesAmt
Management And General$1,721ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$232,413TotalAmt
Program Services$154,942ProgramServicesAmt
Management And General$77,471ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$20,938TotalAmt
Program Services$19,483ProgramServicesAmt
Management And General$1,455ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$1,576TotalAmt
Program Services$1,051ProgramServicesAmt
Management And General$525ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$47,211TotalAmt
Management And General$47,211ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$77,590TotalAmt
Program Services$51,727ProgramServicesAmt
Management And General$25,863ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$72,004TotalAmt
Program Services$62,672ProgramServicesAmt
Management And General$9,332ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtManagement And GeneralManagementAndGeneralAmtProgram ServicesProgramServicesAmt
DISTRIBUTION TO PARENT$200,000$200,000
ESSENTIAL LEARNING$150,100$50,033$100,067
LANGUAGE LINE$9,633$9,633
SALES AND USE TAX$3,028$3,028

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$2,488TotalAmt
Program Services$1,661ProgramServicesAmt
Management And General$827ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$4,235,451TotalAmt
Program Services$3,503,143ProgramServicesAmt
Management And General$732,308ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$1,778,273BOYAmt
EOY$2,533,816EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$447,499BOYAmt
EOY$299,953EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$85,907BOYAmt
EOY$67,301EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$91,868BOYAmt
EOY$105,925EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$2,299,950LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$891,445LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$1,469,792BOYAmt
EOY$1,408,505EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$1,057,811BOYAmt
EOY$1,140,217EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$4,931,150BOYAmt
EOY$5,555,717EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$3,257,432BOYAmt
EOY$4,275,456EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$3,257,432BOYAmt
EOY$4,275,456EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,673,718BOYAmt
EOY$1,280,261EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$1,673,718BOYAmt
EOY$1,280,261EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$4,931,150BOYAmt
EOY$5,555,717EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$393,457ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule D IRS990ScheduleD

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,303,661OtherCostOrOtherBasisAmt
Depreciation$55,712DepreciationAmt
Book Value$1,247,949BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$192,494OtherCostOrOtherBasisAmt
Depreciation$141,087DepreciationAmt
Book Value$51,407BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$803,795OtherCostOrOtherBasisAmt
Depreciation$694,646DepreciationAmt
Book Value$109,149BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$1,408,505TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp

FieldValueIRS element (for citing)
DescINVESTMENT IN SUBSIDIARYDesc
Book Value$1,140,217BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Other Assets$1,140,217TotalBookValueOtherAssetsAmt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp

FieldValueIRS element (for citing)
PersonKYLE KESSLERPersonNm
TitleOWNER REPRESENTATIVE, EX-OFFICIOTitleTxt
Base Compensation Filing Org$0BaseCompensationFilingOrgAmt
Compensation Based On Rltd Orgs$141,479CompensationBasedOnRltdOrgsAmt
Bonus Filing Organization$0BonusFilingOrganizationAmount
Bonus Related Organizations$16,917BonusRelatedOrganizationsAmt
Other Compensation Filing Org$0OtherCompensationFilingOrgAmt
Other Compensation Rltd Orgs$0OtherCompensationRltdOrgsAmt
Deferred Compensation Flng Org$0DeferredCompensationFlngOrgAmt
Deferred Comp Rltd Orgs$7,445DeferredCompRltdOrgsAmt
Nontaxable Benefits Filing Org$0NontaxableBenefitsFilingOrgAmt
Nontaxable Benefits Rltd Orgs$37,674NontaxableBenefitsRltdOrgsAmt
Total Compensation Filing Org$0TotalCompensationFilingOrgAmt
Total Compensation Rltd Orgs$203,515TotalCompensationRltdOrgsAmt
Comp Report Prior990 Filing Org$0CompReportPrior990FilingOrgAmt
Comp Report Prior990 Rltd Orgs$0CompReportPrior990RltdOrgsAmt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (8 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 6THE ASSOCIATION OF COMMUNITY MENTAL HEALTH CENTERS OF KANSAS, INC (ACMHCKS), A KANSAS NOT-FOR-PROFIT CORPORATION, IS THE SOLE MEMBER OF HEALTHSOURCE INTEGRATED SOLUTIONS, INC.
FORM 990, PART VI, SECTION A, LINE 7AACMHCKS, THE SOLE MEMBER OF HEALTHSOURCE INTEGRATED SOLUTIONS, INC HAS THE RIGHT TO APPOINT THE BOARD MEMBERS.
FORM 990, PART VI, SECTION A, LINE 7BTHE OPERATING AGREEMENT OF HEALTHSOURCE INTEGRATED SOLUTIONS, INC REQUIRES APPROVAL BY ACMHCKS, THE SOLE MEMBER, FOR THE FOLLOWING: (1) A MERGER, DISSOLUTION, SALE, TRANSFER, EXCHANGE, OR OTHER CONVEYANCE OF A SUBSTANTIAL PORTION (MORE THAN 50%) OF THE ASSETS OF THE COMPANY; (2) ANY FINANCIAL DECISIONS INVOLVING A DOLLAR AMOUNT IN EXCESS OF THAT SPECIFIED BY THE MEMBER; AND (3) ANY OTHER DECISION OF THE TYPE SPECIFIED IN ADVANCE BY THE MEMBER IN WRITING TO THE COMPANY.
FORM 990, PART VI, SECTION B, LINE 11BTHE 990 IS REVIEWED BY THE CFO PRIOR TO FILING. THE 990 IS PREPARED BY AN OUTSIDE CPA FIRM.
FORM 990, PART VI, SECTION B, LINE 12CTHE ORGANIZATION SENDS OUT QUESTIONNAIRES ON AN ANNUAL BASIS TO IDENTIFY CONFLICTS TO ALL BOARD OF DIRECTORS, MEMBERS, OFFICERS, AND EMPLOYEES. IF THE HEALTHSOURCE INTEGRATED SOLUTIONS, INC COMPLIANCE OFFICER DETERMINES A CONFLICT OF INTEREST EXISTS, THE PARTY INVOLVED ABSTAINS FROM THE VOTE.
FORM 990, PART VI, SECTION B, LINE 15ATHE COMPENSATION OF THE CEO IS DETERMINED BY THE BOARD OF DIRECTORS. AN AD HOC COMMITTEE REVIEWS THE CEO'S CONTRACT ANNUALLY AT ITS MAY MEETING AND THAT COMMITTEE NEGOTIATES WITH THE CEO. THE COMMITTEE USES COMPARABLE DATA TO EVALUATE THE COMPENSATION LEVEL. THIS PROCESS IS NOTED IN THE BOARD OF DIRECTORS EXECUTIVE COMMITTEE MINUTES. THE COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES IS NOT REVIEWED BY THE BOARD OF DIRECTORS. THE COMPANY'S HUMAN RESOURCES DEPARTMENT, IN CONJUNCTION WITH THE CEO, IS RESPONSIBLE FOR SETTING COMPENSATION RANGE, THIS IS DONE THROUGH YEARLY REVIEW AND USAGE OF SALARY ASSESSOR SOFTWARE. ANY SALARY INCREASES ARE DONE WITH SUPERVISOR INPUT BASED ON PERFORMANCE AND WITH FINAL APPROVAL BY THE CEO.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST
FORM 990, PART IX, LINE 11GPAYROLL, SHREDDING & OTHER: PROGRAM SERVICE EXPENSES 7,400. MANAGEMENT AND GENERAL EXPENSES 65,494. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 72,894. IT SERVICES: PROGRAM SERVICE EXPENSES 14,007. MANAGEMENT AND GENERAL EXPENSES 123,970. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 137,977. CALL CENTER: PROGRAM SERVICE EXPENSES 154,679. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 154,679. OSH PROGRAM: PROGRAM SERVICE EXPENSES 1,312,050. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,312,050.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1ASSOCIATION OF COMMUNITY MENTAL HEALTH OF KSBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1720 SE JACKSONAddressLine1Txt
CityTOPEKACityNm
State AbbreviationKSStateAbbreviationCd
ZIP66603ZIPCd
FieldValueIRS element (for citing)
EIN480876205EIN
Primary ActivitiesHEALTHCAREPrimaryActivitiesTxt
Legal Domicile StateKSLegalDomicileStateCd
Exempt Code Section501(C)(4)ExemptCodeSectionTxt
Public Charity StatusN/APublicCharityStatusTxt
Direct Controlling NAN/ADirectControllingNACd
Controlled Organization0ControlledOrganizationInd

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1COMPLIANCEONE INCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1515 S KANSAS AVE STE 301AddressLine1Txt
CityTOPEKACityNm
State AbbreviationKSStateAbbreviationCd
ZIP66603ZIPCd
FieldValueIRS element (for citing)
EIN208115687EIN
Primary ActivitiesDRUG/ALCOHOL TESTING & EMPLOYEE ASSISTANCEPrimaryActivitiesTxt
Legal Domicile StateKSLegalDomicileStateCd
Direct Controlling NAN/ADirectControllingNACd
Entity TypeCEntityTypeTxt
Share Of Total Income$132,416ShareOfTotalIncomeAmt
Share Of EOY Assets$1,252,714ShareOfEOYAssetsAmt
Ownership1.00000OwnershipPct
Controlled Organization0ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (1)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp

Other Organization Name OtherOrganizationName

FieldValueIRS element (for citing)
Business Name Line1ASSOC OF COMMUNITY MENTAL HEALTH OF KSBusinessNameLine1Txt
FieldValueIRS element (for citing)
Transaction TypeBTransactionTypeTxt
Involved$200,000InvolvedAmt
Method Of Amount DeterminationFMVMethodOfAmountDeterminationTxt

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