2016-04-01T10:25:44-05:00 2015-06-30 420714325 RSM US LLP 1 SOUTH WACKER SUITE 600 CHICAGO IL 60606 990 2014-07-01 370646367 MENTAL HEALTH CENTERS OF CENTRAL ILLINOIS MENT 2175251064 710 NORTH EIGHTH STEET SPRINGFIELD IL 627026395 JANICE GAMBACH PRESIDENT 2175251064 2016-04-01 1 ZACHARY FORTSCH P00052725 3126343400 2014 2016-08-17 19:52:53Z JANICE GAMBACH 710 NORTH EIGHTH STEET SPRINGFIELD IL 627026395 13707348 0 5670 X WWW.MHCCI.ORG X 1962 IL TO IMPROVE THE HEALTH OF THE PEOPLE AND THE COMMUNITIES WE SERVE. 17 16 377 16 0 0 3594448 3465618 9675998 8878037 316078 308798 160224 123429 13746748 12775882 13106 3083 0 0 10195925 10660758 0 0 0 3060498 3244060 13269529 13907901 477219 -1132019 19689842 18047745 1550666 1167343 18139176 16880402 X TO IMPROVE THE HEALTH OF THE PEOPLE AND THE COMMUNITIES WE SERVE. 0 0 1860780 2144378 LOGAN-MASON REHAB CENTER (LMRC) PROVIDES DEVELOPMENTAL TRAINING SERVICES FOR DEVELOPMENTALLY DISABLED ADULTS. THE SERVICES ARE DESIGNED TO ENHANCE THE INDIVIDUAL'S SKILLS IN ACTIVITIES OF DAILY LIVING, TO LEAD THE INDIVIDUAL TO INDEPENDENCE AND ECONOMIC SELF-SUFFICIENCY THROUGH INSTRUCTION AND TRAINING. THE INDIVIDUAL IS PREPARED FOR LESS RESTRICTIVE INSTRUCTIONAL AND WORK SETTINGS. DEVELOPMENTAL TRAINING PROVIDES A THREE-FOLD APPROACH TO MEETING THE NEEDS OF THE DEVELOPMENTALLY DISABLED ADULT. THESE OBJECTIVES ARE (1) THERAPEUTIC DEVELOPMENTAL, (2) HUMAN INTERACTION DEVELOPMENT, AND (3) VOCATIONAL SKILLS. SERVICE UNITS ARE MEASURED BY CLIENT HOURS. LMRC OPERATED 240 DAYS AND PROVIDED 109,719 CLIENT HOURS OF SERVICE IN FISCAL YEAR 2015. 1231226 628974 THE PSYCHIATRIC LEADERSHIP SERVICES PROGRAM PROVIDES PSYCHIATRIC SERVICES FOR CHILDREN, ADOLESCENTS AND ADULTS. ITS PURPOSE IS TO DIAGNOSE AND TREAT SYMPTOMS OF MENTAL ILLNESSES, WHICH ARE KNOWN TO RESPOND TO PSYCHOTROPIC MEDICATION, TO MAINTAIN STABILITY AND PROMOTE OPTIMAL LEVELS OF CLIENT FUNCTIONING THROUGH THE UTILIZATION OF PSYCHOTROPIC MEDICATION, TO PROMOTE THE RECOVERY PROCESS BY PARTICIPATING IN A TEAM TREATMENT APPROACH WITH OTHER TREATMENT STAFF AND BY PROVIDING MEDICAL LEADERSHIP WHEN APPROPRIATE, AND TO ENSURE THAT PSYCHIATRIC SERVICES MEET ACCEPTED COMMUNITY AND PROFESSIONAL STANDARDS OF PRACTICE. SERVICE UNITS ARE MEASURED BY CLIENT HOURS. MENTAL HEALTH CENTERS OF CENTRAL ILLINOIS, (MHCCI) PROVIDED 6,817 CLIENT HOURS OF SERVICE IN FISCAL YEAR 2015. 1016831 925779 THE CRISIS/ACCESS PROGRAM PROVIDES RAPID RESPONSE TO INDIVIDUALS IN MENTAL HEALTH CRISIS, TO MEMBERS OF HIS/HER SUPPORT SYSTEM, & THE COMMUNITY 24-HOURS/DAY. THE PROGRAM PROVIDES CRISIS INTERVENTION SERVICES, WALK-INS, & MOBILE SERVICES. SHORT-TERM CRISIS INTERVENTION OF THERAPY/COUNSELING & PSYCHIATRIC CARE IS DESIGNED TO ADDRESS THE PRESENTING SYMPTOMS OF A PSYCHIATRIC EMERGENCY & TO AMELIORATE A CLIENT'S DISTRESS SO THAT RESOURCES & SUPPORTS CAN BE MOBILIZED & PLANNING FOR FURTHER TREATMENT CAN OCCUR. CRISIS WALK-IN IS SUPPORT & INTERVENTION OFFERED AT AN IDENTIFIED LOCATION ON AN UNSCHEDULED BASIS FOR THE PURPOSE OF STABILIZING OR RESOLVING A CRISIS SITUATION. MOBILE CRISIS SERVICE IS DELIVERED WHERE & WHEN THE CRISIS OCCURS TO ASSURE SERVICE BY MH PROFESSIONALS. MHCCI PROVIDED 7,009 CLIENT HOURS IN FY15. 602932 3664 766285 OTHER DEVELOPMENTAL DISABILITY PROGRAMS 7101965 -581 4503402 OTHER MENTAL HEALTH PROGRAMS 49501 32648 HOUSING SERVICES 7754398 3083 5302335 11863235 1 1 0 1 0 0 0 0 0 0 1 0 0 0 0 1 0 1 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 1 0 0 0 1 30 0 1 377 1 0 0 0 0 0 0 0 0 X 17 16 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 0 1 1 IL X EMILY EBERT FINANCE DIRECTOR 2175251064 710 N EIGHTH STREET SPRINGFIELD IL 627026395 MICHAEL O'SHEA CHAIR 0.70 X X 0 0 0 JENNIFER MORRISON VICE CHAIR 0.70 X X 0 0 0 CATHERINE J GONZALEZ JD TREASURER 0.70 X X 0 0 0 SANDY ROBINSON II SECRETARY 0.70 X X 0 0 0 RANDALL S GERMERAAD DIRECTOR 0.70 X 0 0 0 BRENT BORAH DIRECTOR 0.70 X 0 0 0 GINA LATHAN DIRECTOR 0.70 X 0 0 0 JOHN MILHISER DIRECTOR 0.70 X 0 0 0 ANNE MORGAN DIRECTOR 0.70 X 0 0 0 WANDA LEE ROHLFS DIRECTOR 0.70 X 0 0 0 SCOTT SABIN DIRECTOR 0.70 X 0 0 0 LEIGH STEINER PHD DIRECTOR 0.70 X 0 0 3375 JANET S STOVER DIRECTOR 0.70 X 0 0 0 CYNTHIA THOMAS MD DIRECTOR 0.70 X 0 0 0 DOMINIC WATSON DIRECTOR 0.70 X 0 0 0 DANIEL WRIGHT DIRECTOR 0.70 X 0 0 0 RICHARD ALEXANDER MD DIRECTOR 0.40 X 0 159570 32434 CHARLES BEARD DIRECTOR 0.20 X 0 0 0 LINDA BOLLENSEN DIRECTOR 0.10 X 0 0 0 LILLIE JASPER DIRECTOR 0.70 X 0 0 0 LINDA MEYER DIRECTOR 0.70 X 0 0 0 JANICE GAMBACH PRESIDENT 55.00 X X 0 192168 36880 TIMOTHY SCHMITZ CFO 55.00 X 101175 0 14882 RAYMOND BLAND PSYCHIATRIST 40.00 X 165325 0 31603 CYNTHIA A BUTLER ADMINISTRATOR CLINICAL SERVICES 45.00 X 112025 0 16084 BETTEANNE MACINTOSH PSYCHIATRIST 40.00 X 126707 0 0 505232 351738 135258 4 0 1 0 0 22780 77314 2578338 787186 3465618 MENTAL HEALTH SERVICES 621400 6079237 6079237 DEVELOPMENTAL DISABILI 621400 2766152 2766152 HOUSING SERVICES 621400 32648 32648 8878037 253265 253265 874715 819182 55533 55533 55533 174971 112284 62687 62687 PROMPT PAY INTEREST 900099 43367 43367 RECORD FEES 900099 15400 15400 1975 1975 60742 12775882 9001466 0 308798 3083 3083 272876 5968 266908 8487832 7609234 878598 425928 415468 10460 812729 790967 21762 661393 592778 68615 14198 10527 3671 39050 36578 2472 1324 1324 709401 629483 79918 8948 8553 395 369271 297583 71688 168245 80992 87253 624203 556226 67977 222914 208355 14559 60920 36859 24061 331395 294886 36509 100231 99775 456 MANAGEMENT FEES 349595 349595 FOOD & DIETARY SUPPLIES 63431 63431 PUBLICATIONS & MEMBERSH 31128 31128 DRUGS 30476 30476 119330 92013 27317 13907901 11863235 2044666 0 899 899 4454598 4993712 4323578 2102248 279050 224384 11467792 7688548 3820333 3779244 6694591 6866238 116793 81020 19689842 18047745 1150151 961300 400515 206043 1550666 1167343 X 18139176 16880402 18139176 16880402 19689842 18047745 -1132019 -126755 0 X 0 1 X 1 1 1 X 3162337 3081725 3682304 3594448 3465618 16986432 3162337 3081725 3682304 3594448 3465618 16986432 16986432 196919 146138 155956 296161 253265 1048439 110841 315725 128982 100507 60742 716797 18751668 48140211 0.90590 0.90920 X SCH A, PART II, LINE 10, OTHER INCOME PARTNERSHIP INC ($35,773) PROMPT PAY INTEREST $43,367 TRAINING CONFERENCES $22,260 RECORD FEES $15,400 TRAINING FEES $8,173 NON-RECORD FEES $7,120 OTHER MISC REVENUE $195 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 1324 0 0 0 1324 0 PART II-B, LINE 1: MHCCI IS A DUES PAYING MEMBER OF THE ILLINOIS ASSOCIATION OF REHABILITATION FACILITIES, INC. (IARF). A PERCENTAGE OF MHCCI'S DUES TO IARF GO TOWARDS LOBBYING ACTIVITIES. 1012762 1012762 7514952 5130268 2384684 71876 39181 32695 2847004 2519099 327905 21198 21198 3779244 X PART X, LINE 2: MHCCI IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE UNITED STATES INTERNAL REVENUE CODE. MHCCI IS NOT CONSIDERED A PRIVATE FOUNDATION. IN ACCORDANCE WITH FASB ACS 740-10 WHICH ADDRESSES INCOME TAXES, MHCCI BELIEVES THERE ARE NO SIGNIFICANT UNCERTAIN TAX POSITIONS RESULTING IN LIABILITIES THAT WOULD HAVE BEEN REQUIRED FOR THE YEAR ENDED JUNE 30, 2015. THE MHCCI'S FORM 990 FOR 2012, 2013, AND 2014 ARE SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE (IRS), GENERALLY FOR THREE YEARS AFTER THEY WERE FILED. 1 X X X X 0 0 0 0 0 0 0 1 0 RICHARD ALEXANDER MD DIRECTOR 0 110691 0 0 0 48879 0 15784 0 16650 0 192004 0 0 JANICE GAMBACH PRESIDENT 0 164950 0 25927 0 1291 0 13817 0 23063 0 229048 0 0 RAYMOND BLAND PSYCHIATRIST 164279 0 380 0 666 0 12680 0 18923 0 196928 0 0 0 PART I, LINE 7 MEMBERS OF SENIOR MANAGEMENT RECEIVE INCENTIVE COMPENSATION UNDER PLANS SPONSORED BY MEMORIAL HEALTH SYSTEM. THESE AMOUNTS ARE INCLUDED IN SCHEDULE J, PART II COLUMN (B)(II). THE PLANS ARE DESIGNED TO CONDITION A PORTION OF COMPENSATION ON PERFORMANCE AGAINST PREDETERMINED FINANCIAL, MISSION, AND INDIVIDUAL GOALS APPROVED IN ADVANCE BY THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS OF MEMORIAL HEALTH SYSTEM. THE LEADERSHIP COMPENSATION COMMITTEE OF THE BOARD HAS REVIEWED THE REASONABLENESS OF ALL SUCH PAYMENTS, AND HAS CONCLUDED, AS THE RESULT OF A PROCESS THAT IS DESIGNED TO QUALIFY FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS UNDER FEDERAL TAX LAW, THAT ALL SUCH AMOUNTS ARE REASONABLE AND DID NOT EXCEED FAIR MARKET VALUE FOR THE SERVICES RENDERED. FORM 990, PART VI, SECTION A, LINE 6 THE MEMBERSHIP OF THE CORPORATION CONSISTS OF ONE CORPORATE MEMBER, MEMORIAL HEALTH SYSTEM. FORM 990, PART VI, SECTION A, LINE 7A THE CORPORATE MEMBER OF THE CORPORATION ELECTS THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B THE BYLAWS OF THE CORPORATION REQUIRE THE ADVANCE APPROVAL OF THE CORPORATE MEMBER FOR CORPORATE, ADMINISTRATIVE AND OPERATIONAL ACTIONS WHICH INCLUDE, BUT ARE NOT LIMITED TO, THE APPROVAL OF ANY ANNUAL OR LONG-TERM CAPITAL OR OPERATING BUDGET, AMENDMENT, ALTERATION OR REPEAL OF THE ARTICLES OF INCORPORTATION OR BYLAWS, CREATION OR ELIMINATION OF A PROGRAM OR SERVICE, APPROVAL OF BORROWING WHICH EXCEEDS $250,000, APPROVAL OF ANY QUANTITY OF DEBT WHICH EXCEEDS $250,000, APPROVAL OF ANY DISSOLUTION, MERGER OR CONSOLIDATION OR SALE OF THE ASSETS OF THE CORPORATION WHICH EXCEEDS $250,000, APPROVAL OF THE ORGANIZATION OF AN AFFILIATE/SUBSIDIARY, APPROVAL FOR APPLICATION OF CERTIFICATE OF NEED, APPROVAL TO ADOPT ANY LONG-TERM OR MASTER INSTITUTIONAL PLAN, APPROVAL TO SELL OR PURCHASE REAL PROPERTY WHICH EXCEEDS $250,000, APPROVAL TO CHANGE INSURANCE SPECIFICATIONS OR LIMITS, APPROVAL TO SELECT OR CHANGE INDEPENDENT AUDITORS AND LEGAL COUNSEL, APPROVAL TO ENTER INTO, RENEW OR MODIFY CONTRACTS TO PROVIDE COVERED MENTAL HEALTH CARE SERVICES TO BENEFICIARIES OF HEALTH MAINTENANCE ORGANIZATIONS, HEALTH CARE SERVICE PLANS, INDEPENDENT PRACTICE ASSOCIATIONS, PREFERRED PROVIDER ORGANIZATIONS, INSURANCE COMPANIES AND OTHER PURCHASERS OF HEALTH SERVICES, APPROVAL TO ENTER INTO ANY CONTRACT OR AGREEMENT WHICH I)PROVIDES FOR THE PAYMENT OR PERFORMANCE BY EITHER PARTY EXCEEDING AN AGGREGATE VALUE OF $250,000 II) IS NOT TERMINABLE WITHOUT PAYMENT OR PENALTY OF 60 DAYS OR LESS NOTICE III) IS BETWEEN THE CORPORATION OR AN AFFILIATE AND AN OFFICER, DIRECTOR OR KEY EMPLOYEE THEREOF. FORM 990, PART VI, SECTION B, LINE 11 MANAGEMENT PREPARES AND REVIEWS THE RETURN. AN OUTSIDE TAX ADVISOR THEN REVIEWS THE RETURN, PROVIDING COMMENTS AND GUIDANCE AS NEEDED. MHCCI BOARD MEMBERS ARE THEN PROVIDED WITH A FINAL COPY OF FORM 990 AND ITS SUPPORTING SCHEDULES FOR REVIEW AT A REGULARLY SCHEDULED BOARD MEETING. REVIEW, DISCUSSION, AND RATIFICATION OF THE FORM IS AN AGENDA ITEM. FORM 990, PART VI, SECTION B, LINE 12C MHCCI BOARD MEMBERS RECEIVE A COPY OF THE CONFLICT OF INTEREST POLICY ANNUALLY. BOARD MEMBERS COMPLETE CONFLICT OF INTEREST STATEMENTS ON AN ANNUAL BASIS; BOARD MEMBERS ARE REMINDED TO UPDATE THEIR STATEMENTS IF CIRCUMSTANCES CHANGE. BOARD MEMBERS ARE REMINDED OF THE NEED TO ABSTAIN FROM VOTING WHEN BOARD RESOLUTIONS REQUIRE SUCH ACTION. BOARD MEMBERS ARE APPRAISED BY MANAGEMENT OF POTENTIAL CONFLICTS WITH MEETING AGENDA ITEMS. FORM 990, PART VI, SECTION B, LINE 15A MHCCI'S CEO IS AN EMPLOYEE OF MEMORIAL HEALTH SYSTEM. THE HEALTH SYSTEM ANNUALLY ENGAGES A CONSULTING FIRM TO CONDUCT A COMPENSATION REVIEW, WHICH INCLUDES A COMPARABILITY STUDY,FOR ALL EXECUTIVES. THE COMPENSATION COMMITTEE OF THE HEALTH SYSTEM BOARD OF DIRECTORS REVIEWS THE CONSULTANT REPORT. COMPENSATION COMMITTEE DECISIONS AND REPORTS ARE CONTEMPORANEOUSLY DOCUMENTED IN THE BOARD OF DIRECTOR AND COMPENSATION COMMITTEE MINUTES, AS APPROPRIATE. THE COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES OF MHCCI IS REVIEWED ANNUALLY BY THE HR DEPARTMENT. THIS REVIEW INCLUDES A COMPARABILITY STUDY AND BENEFITS ANALYSIS. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS OF MENTAL HEALTH CENTER OF CENTRAL ILLINOIS, SUCH AS ARTICLES OF INCORPORATION AND ANY AMENDMENTS THERETO, ARE AVAILABLE TO THE GENERAL PUBLIC THROUGH THE ILLINOIS SECRETARY OF STATE'S OFFICE. THESE GOVERNING DOCUMENTS, AS WELL AS THE BYLAWS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS, ARE AVAILABLE UPON REQUEST FROM THE CORPORATION. THESE DOCUMENTS ARE AVAILABLE FOR THE SAME PERIOD OF TIME AS SET FORTH IN IRC SECTION 6104(D). SPRINGFIELD RESIDENTIAL SERVICES 710 NORTH EIGHTH STREET SPRINGFIELD IL 62702 371298589 RESIDENTIAL HUD HOUSING PROJECT FOR MENTALLY ILL IL 501(C)(3) 509(A)(2) MENTAL HEALTH CENTERS OF CENTRAL ILLINOIS 1 MEMORIAL HEALTH SYSTEM 701 NORTH FIRST ST SPRINGFIELD IL 627810001 371110690 UMBRELLA IL 501(C)(3) 509(A)(3) TYPE II N/A 0 MEMORIAL MEDICAL CENTER 701 NORTH FIRST ST SPRINGFIELD IL 627810001 370661220 HOSPITAL SERVICES IL 501(C)(3) 170(B)(1)(A) (III) MEMORIAL HEALTH SYSTEM 0 MEMORIAL HEALTH VENTURES 701 NORTH FIRST ST SPRINGFIELD IL 627810001 363492266 HEALTHCARE ACTIVITIES IL 501(C)(3) 509(A)(3) TYPE II MEMORIAL HEALTH SYSTEM 0 ABRAHAM LINCOLN MEMORIAL HOSPITAL 315 EIGHTH ST LINCOLN IL 62656 370723793 HOSPITAL SERVICES IL 501(C)(3) 170(B)(1)(A) (III) MEMORIAL HEALTH SYSTEM 0 TAYLORVILLE MEMORIAL HOSPITAL 201 EAST PLEASANT TAYLORVILLE IL 62568 370661250 HOSPITAL SERVICES IL 501(C)(3) 170(B)(1)(A) (III) MEMORIAL HEALTH SYSTEM 0 MEMORIAL HOME SERVICES 720 NORTH BOND SPRINGFIELD IL 627024915 370714225 HOME HEALTH, HOSPICE, AND CONTINUOUS CARE SERVICES IL 501(C)(3) 509(A)(2) MEMORIAL HEALTH SYSTEM 0 MEMORIAL PHYSICIAN SERVICES 701 NORTH FIRST ST SPRINGFIELD IL 627810001 371181194 HEALTH CLINICS IL 501(C)(3) 509(A)(3) TYPE II MEMORIAL HEALTH SYSTEM 0 MEMORIAL MEDICAL CENTER FOUNDATION 1 MEMORIAL PLAZA SPRINGFIELD IL 62781 371110301 GRANTS TO HOSPITALS, OTHER CHARITABLE ORGANIZATIONS, AND SCHOLARSHIPS IL 501(C)(3) 170(B)(1)(A) (V) MEMORIAL MEDICAL CENTER 0 TAYLORVILLE MEMORIAL HOSPITAL FOUNDATION INC 201 EAST PLEASANT TAYLORVILLE IL 62568 371337485 GRANTS TO OTHER CHARITABLE ORGANIZATIONS AND HOSPITALS IL 501(C)(3) 509(A)(3)TYPE III-FI N/A 0 ABRAHAM LINCOLN HEALTHCARE FOUNDATION 315 EIGHTH ST LINCOLN IL 62656 363492268 GRANTS TO OTHER CHARITABLE ORGANIZATIONS AND HOSPITALS IL 501(C)(3) 170(B)(1)(A) (VI) MEMORIAL HEALTH SYSTEM 0 PASSAVANT MEMORIAL AREA HOSPITAL ASSOCIATION 1600 WEST WALNUT STREET JACKSONVILLE IL 62650 370661230 HOSPITAL SERVICES IL 501(C)(3) 170(B)(1)(A) (III) MEMORIAL HEALTH SYSTEM 0 PASSAVANT AREA HOSPITAL FOUNDATION 1600 WEST WALNUT STREET JACKSONVILLE IL 62650 461037396 SUPPORTING THE HOSPITAL IL 501(C)(3) 170(B)(1)(A) (III) PASSAVANT MEMORIAL AREA HOSPITAL 0 JACKSONVILLE CRNA'S INC 1600 WEST WALNUT STREET JACKSONVILLE IL 62650 273093265 CRNA SERVICES IL 501(C)(3) 509(A)(3) TYPE II N/A 0 MEMORIAL HOME SERVICES OF CENTRAL ILLINOIS 701 NORTH FIRST STREET SPRINGFIELD IL 62781 371190216 PROVIDE DURABLE MEDICAL EQUIPMENT AND SUPPLIES TO PATIENTS IL MEMORIAL HOMES SERVICES NFP C 1.00000 0 PASSAVANT PHYSICIAN ASSOCIATION 1600 WEST WALNUT STREET JACKSONVILLE IL 62650 261200566 PHYSICIAN SERVICES IL PASSAVANT MEMORIAL AREA HOSPITAL ASSOCIATION C 1.00000 0 0 1 0 0 0 0 0 0 0 0 1 1 0 1 1 1 1 0 0