2015-05-11T09:21:43-05:00 2014-06-30 450512128 Gibson LeClair LLC 150 Capitol Street Suite 3 Augusta ME 04330 990 2013-07-01 611419905 Kennebec Mental Health Associates KENN 2078732136 67 Eustis Parkway Waterville ME 04901 Thomas Mcadam Chief Executive Officer 2078732136 2015-05-08 Stephen L LeClair CPA P01370336 2076238401 2013 2016-02-25 16:41:14Z Thomas McAdam 67 Eustis Parkway Waterville ME 04901 3154921 0 X N/A X 2002 ME To coordinate, manage and support all of the administrative and other related activities, services and functions with respect to the operation of Kennebec Valley Mental Health Center d/b/a Kennebec Behavioral Health in connection with its delivery of behavioral health and other related services. 7 7 47 0 0 0 72977 148000 3078891 3002334 -18531 1687 0 2900 3133337 3154921 0 0 0 0 1977572 2151555 0 0 193821 988948 996981 2966520 3148536 166817 6385 1504346 1487178 527936 504383 976410 982795 X To coordinate, manage and support all of the administrative and other related activities, services and functions with respect to the operation of Kennebec Valley Mental Health Center (dba Kennebec Behavioral Health) and its related organizations, KMHA Real Estate and KMHA Foundation. 0 0 2954715 3005234 The coordination, management and support of administrative and other related activities with respect to Kennebec Valley Mental Health Center d/b/a Kennebec Behavioral Health and its related corporations, KMHA Real Estate and KMHA Foundation, in connection with the delivery of behavioral health and related services. 2954715 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 0 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 0 0 0 1 11 0 1 47 1 0 0 0 0 0 0 0 0 0 0 X 7 7 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X X Josee L Shelley CPA 2078732136 67 Eustis Parkway Waterville ME 04901 X Carol A Welch President/Secretary 2.00 X 0 0 0 Ronald A Ducharme Vice President 2.00 X 0 0 0 Leon A Duff Treasurer 2.00 X 0 0 0 Carol Axtell Director 1.00 X 0 0 0 Lisa Gibson Landry Director 1.00 X 0 0 0 Fred Olsen Director 1.00 X 0 0 0 Rosalie Curtis Williams Director 1.00 X 0 0 0 Thomas McAdam Chief Executive Officer 40.00 X 149189 0 25003 Josee Shelley CPA Chief Financial Officer 40.00 X 115796 0 16925 Robert T Anderson MD Medical Director 40.00 X 0 191080 7872 Janine D Taylor MD Psychiatrist 40.00 X 0 215328 25870 Teresa Hermida MD Psychiatrist 40.00 X 0 195955 25088 Arlene C Almazan MD Psychiatrist 40.00 X 0 181487 14995 Paige McInerney DO Psychiatrist 40.00 X 0 185042 22651 Sharon Marble MD Psychiatrist 40.00 X 0 179373 1711 264985 1148265 140115 2 0 1 0 Verizon Wireless PO Box 15062 Albany NY 122125062 Cellphone service 131237 1 146000 2000 148000 Management Fee Income 561000 3002334 3002334 3002334 1687 1687 Miscellaneous income 561000 2900 2900 2900 3154921 3005234 0 1687 275163 259348 15815 1386890 1292438 94452 29223 27534 1689 343818 322662 21156 116461 108735 7726 21528 21528 42499 8835 33664 7769 2222 5547 70423 66581 3842 60174 58963 1211 105128 103261 1867 54469 52728 1741 23725 23705 20 43 43 159313 159313 46371 43812 2559 Communications 271624 271624 Equipment expenses 97971 97971 Dues & Licenses 24598 22825 1773 11346 10587 759 3148536 2954715 0 193821 395603 231307 489641 586221 12623 13083 15288 11663 1433212 968461 323928 464751 267263 180153 1504346 1487178 458886 473186 69050 31197 527936 504383 X 976410 982795 976410 982795 1504346 1487178 6385 0 X X 0 1 X 1 0 X X 0 0 0 Kennebec Behavioral Health 010265559 509(A)(1) 1 1 1 2628979 KMHA Real Estate Inc 611419906 509(A)(3) 1 1 1 347736 KMHA Foundation Inc 611419904 509(A)(3) 1 1 1 25619 3 3002334 1433212 968461 464751 464751 Due From Affiliates 180153 180153 Due to Affiliates 31197 31197 3158483 3562 3562 3154921 0 3154921 3152098 3562 3562 3148536 0 3148536 X X X X 0 0 0 0 0 0 0 1 0 Thomas McAdam Chief Executive Officer 129284 0 10000 0 9905 0 4034 0 20969 0 174192 0 0 0 Robert T Anderson MD Medical Director 0 185080 0 6000 0 0 0 4679 0 3193 0 198952 0 0 Janine D Taylor MD Psychiatrist 0 199032 0 4000 0 12296 0 5017 0 20853 0 241198 0 0 Teresa Hermida MD Psychiatrist 0 183034 0 5000 0 7921 0 5175 0 19913 0 221043 0 0 Arlene C Almazan MD Psychiatrist 0 176487 0 5000 0 0 0 4621 0 10374 0 196482 0 0 Paige McInerney DO Psychiatrist 0 171854 0 8188 0 5000 0 4846 0 17805 0 207693 0 0 Sharon Marble MD Psychiatrist 0 179373 0 0 0 0 0 0 0 1711 0 181084 0 0 Part I, Line 7 The key employee and some highest compensated employees received compensation based on personal productivity standards contained within their employment contracts. Form 990, Part VI, Section B, line 11 A copy of the 990 is provided to the Finance Committee prior to filing with the Internal Revenue Service. The Finance Committee meets bi-monthly and, at its discretion, can add discussion and review of the organization's 990 to its agenda. Form 990, Part VI, Section B, line 12c The conflict of interest policy requires that each Board member annually sign a statement that they will abide by the policy. Any potential conflict of interest is required to be disclosed by a Board member at a Board meeting with procedures for investigation and resolution being managed by the Board. On an annual basis the Board is reminded of the policy by senior staff. Form 990, Part VI, Section B, line 15 The compensation of the CEO is established by the Board of Directors based on industry-specific wage survey data. The CEO's performance is reviewed annually by the Board President and any increase in compensation is approved within the framework of salary adjustments approved by the Board for all staff. Compensation of senior managers of the organization is managed by the CEO using current wage survey data and within the framework of salary adjustments approved by the Board for all staff during the annual budget approval process. Form 990, Part VI, Section C, line 18 All governing documents, policies and audited financial statements are available to be viewed at the organization's administrative offices. An annual report reflecting a summary of its audited financial statements is available in printed format and on the website of Kennebec Behavioral Health (www.kbhmaine.org). Form 990, Part VI, Section C, line 19 The organization's annual form 990 return is available for viewing at the organization's administrative offices and also on www.guidestar.org. Form 1023 is available for public inspection at the administrative offices of the organization. Form 990, Part VII All employees of KMHA and KBH are eligible to participate in a Vacation Buy-out program, which is taxable income and increases base compensation. Included in the CFO, Dr. Taylor's and Dr. Hermida's reportable compensation are $6,313, $7,296 and $6,447 respectively in vacation buy-out. Form 990, Part XI, Line 2c The process of oversight of the audit has not changed from the previous year. Kennebec Behavioral Health 67 Eustis Parkway Waterville ME 04901 010265559 Promote the well-being of children, families and adults ME 501(c)(3) 170(b)(1)(A) 0 KMHA Real Estate Inc 67 Eustis Parkway Waterville ME 04901 611419906 Hold title to, manage and maintain properties for Kennebec Behavioral Health ME 501(c)(3) 509(a)(3) Type I Org 0 KMHA Foundation Inc 67 Eustis Parkway Waterville ME 04901 611419904 Hold, manage and invest funds and gifts for Kennebec Behavioral Health ME 501(c)(3) 509(a)(3) Type I Org 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 Kennebec Behavioral Health - management agreement L 2430229 Amount paid KMHA Foundation Inc - management agreementt L 25619 amount paid KMHA Real Estate Inc - Rental agreement for office space K 108690 Amount paid KMHA Real Estate Inc - management agreement L 347736 Amount paid Kennebec Behavioral Health L 198750 Amount paid