HEALTHSOURCE INTEGRATED SOLUTIONS INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
HEALTHSOURCE INTEGRATED SOLUTIONS INC (EIN 20-8498601)
Tax period
2012-07-01 to 2013-06-30
Filed
2014-05-15
IRS object ID
201431359349306918
Schema version
2012v2.1
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)
Timestamp2014-05-15T14:15:42-05:00Timestamp
Tax Period End Date2013-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN341857238EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1CBIZ MHM LLCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1990 SW FAIRLAWN ROADAddressLine1
CityTOPEKACity
StateKSState
ZIP Code66606ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN208498601EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1KANSAS HEALTH SOLUTIONS LLCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlKANSNameControl
Phone7852919122Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line12121 SW CHELSEA DRAddressLine1
CityTOPEKACity
StateKSState
ZIP Code66614ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NamePATRICK YANCEYName
TitleCEOTitle
Phone7852919122Phone
Date Signed2014-05-15DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameDOUGLAS W GLENNName
PTINP00451425PTIN
Phone7852723176Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Address ChangeXAddressChange
Name Of Principal Officer PersonPATRICK YANCEYNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line12121 SW CHELSEA DRAddressLine1
CityTOPEKACity
StateKSState
ZIP Code66614ZIPCode
FieldValueIRS element (for citing)
Gross Receipts99473828GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501cXOrganization501c
Web SiteWWW.KANSASHEALTHSOLUTIONS.ORGWebSite
Type Of Organization OtherXTypeOfOrganizationOther
Type Of Org Other DescriptionSMLLCTypeOfOrgOtherDescription
Year Formation2007YearFormation
State Legal DomicileKSStateLegalDomicile
Activity Or Mission DescriptionTO FUNCTION AS A PREPAID AMBULATORY HEALTH PLAN FOR PEOPLE WITH MEDICAID NEEDING MENTAL HEALTH SERVICES. WE ARE COMMITTED TO DELIVERING SERVICES THAT MEET OR EXCEED COMMUNITY STANDARDS OF ACCESSIBILITY, ACCEPTABILITY, VALUE, IMPACT, AND CULTURAL SENSITIVITY.ActivityOrMissionDescription
Nbr Voting Members Governing Body13NbrVotingMembersGoverningBody
Nbr Independent Voting Members13NbrIndependentVotingMembers
Total Nbr Employees103TotalNbrEmployees
Total Nbr Volunteers13TotalNbrVolunteers
Total Gross UBI296750TotalGrossUBI
Net Unrelated Business Txbl Income-37513NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year196810243ProgramServiceRevenuePriorYear
Program Service Revenue CY99162513ProgramServiceRevenueCY
Investment Income Prior Year178434InvestmentIncomePriorYear
Investment Income Current Year13671InvestmentIncomeCurrentYear
Other Revenue Prior Year296750OtherRevenuePriorYear
Other Revenue Current Year296750OtherRevenueCurrentYear
Total Revenue Prior Year197285427TotalRevenuePriorYear
Total Revenue Current Year99472934TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year6352000SalariesEtcPriorYear
Salaries Etc Current Year3449678SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year187044034OtherExpensePriorYear
Other Expenses Current Year90610287OtherExpensesCurrentYear
Total Expenses Prior Year193396034TotalExpensesPriorYear
Total Expenses Current Year94059965TotalExpensesCurrentYear
Revenues Less Expenses Prior Year3889393RevenuesLessExpensesPriorYear
Revenues Less Expenses CY5412969RevenuesLessExpensesCY
Total Assets BOY36178043TotalAssetsBOY
Total Assets EOY26564003TotalAssetsEOY
Total Liabilities BOY30937430TotalLiabilitiesBOY
Total Liabilities EOY15908645TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY5240613NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY10655358NetAssetsOrFundBalancesEOY
Mission DescriptionTO FUNCTION AS A PREPAID AMBULATORY HEALTH PLAN FOR PEOPLE WITH MEDICAID NEEDING MENTAL HEALTH SERVICES. WE ARE COMMITTED TO DELIVERING SERVICES THAT MEET OR EXCEED COMMUNITY STANDARDS OF ACCESSIBILITY, ACCEPTABILITY, VALUE, IMPACT, AND CULTURAL SENSITIVITY.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense92959066Expense
Revenue99162513Revenue
DescriptionKANSAS HEALTH SOLUTIONS, LLC (KHS) IS A NOT-FOR-PROFIT ORGANIZATION FOR THE PURPOSE OF FULFILLING THE FUNCTIONS AND OBLIGATIONS OF A PREPAID HEALTH PLAN, MANAGING A STATEWIDE SYSTEM AS TO BEHAVIORAL HEALTH SERVICES AND OTHERWISE FUNCTIONING IN A MANNER COMPATIBLE WITH THE VALUES, MISSIONS, AND GOALS OF THE MEMBERS OF THE ASSOCIATION OF COMMUNITY MENTAL HEALTH CENTERS OF KANSAS, INC.Description
Total Program Service Expense92959066TotalProgramServiceExpense
Described In501 C30DescribedIn501C3
Schedule B Required0ScheduleBRequired
Political Activities0PoliticalActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity1TransactionRelatedEntity
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With1096497NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees103NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members13NbrVotingGoverningBodyMembers
Number Independent Voting Members13NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties1DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body0Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other0CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledKSStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonBRAD WOLTJE ACCOUNTING MANAGERNamePerson
Telephone Number7852919122TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line12121 SW CHELSEA DRAddressLine1
CityTOPEKACity
StateKSState
ZIP Code66614ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (16 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficer
SHERMAN COLE
MEMBER-AT-LARGE4.00X000
MARILYN COOK
MEMBER-AT-LARGE4.00X000
DOLORES FURTADO
MEMBER-AT-LARGE4.00X000
KERRY MILLER
CONSUMER REPRESENTATIVE4.00X000
MICHAEL HAMMOND
OWNER REPRESENTATIVE4.00X016570021346
LARRY GARRETT
ACMHCK PRESIDENT-ELECT4.00X000
DAVID JOHNSON
MEMBER-AT-LARGE4.00X000
BILLY PERSINGER
MEMBER-AT-LARGE4.00X000
ROBBIN COLE
VICE CHAIRMAN4.00X000X
ROBERT JACKSON
CHAIRMAN4.00X000X
KEITH RICKARD
SECRETARY/TREASURER4.00X000X
MYRON UNRUH
CEO40.00000X
ANITA STEFANICH
CFO40.00000X
PETER WEBB
CFO40.00000X
WILL WOODELL
CEO40.00000X
PATRICK YANCEY
CEO65.00000X
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs165700TotalReportableCompFrmRltdOrgs
Total Other Compensation21346TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (4 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
VALUEOPTIONS
100 SE 9TH STREET STE 510TOPEKAKS66612MANAGEMENT SERVICES820000
INFOMC INC
101 WEST ELM ST SUITE G10CONSHOHOCKENPA19428SOFTWARE SUPPORT633075
PRICE WATERHOUSE COOPERS
1100 WALNUT STKANSAS CITYMO64106AUDITING356853
SECURITY NATIONAL PROPERTIES
3050 WESTFORK DRBATON ROUGELA70816PROPERT RENT287515
FieldValueIRS element (for citing)
Number Of Contractors GT100 K4NumberOfContractorsGT100K

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
ADMINISTRATIVE SERVICES5610009645041096450410
MISCELLANEOUS90009927121032712103
FieldValueIRS element (for citing)
Total Program Service Revenue99162513TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column13571TotalRevenueColumn
Exclusion$13,571ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other994Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other894Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other100Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column100TotalRevenueColumn
Exclusion$100ExclusionAmount

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionMANAGEMENT FEESDescription
Business Code541610BusinessCode
Total Revenue Column296750TotalRevenueColumn
Unrelated Business Revenue296750UnrelatedBusinessRevenue
FieldValueIRS element (for citing)
Total Other Revenue296750TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column99472934TotalRevenueColumn
Related Or Exempt Function Income99162513RelatedOrExemptFunctionIncome
Unrelated Business Revenue296750UnrelatedBusinessRevenue
Exclusion$13,671ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total67874Total
Program Services67874ProgramServices

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total2533913Total
Program Services2533913ProgramServices

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total55873Total
Program Services55873ProgramServices

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total474330Total
Program Services474330ProgramServices

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total317688Total
Program Services317688ProgramServices

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total82317Total
Program Services82317ProgramServices

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total390500Total
Program Services390500ProgramServices

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total1181773Total
Program Services80874ProgramServices
Management And General1100899ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total6135Total
Program Services6135ProgramServices

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total850437Total
Program Services850437ProgramServices

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total750437Total
Program Services750437ProgramServices

Occupancy Occupancy

FieldValueIRS element (for citing)
Total347250Total
Program Services347250ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total32482Total
Program Services32482ProgramServices

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total8219Total
Program Services8219ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total229232Total
Program Services229232ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total57337Total
Program Services57337ProgramServices

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServices
MEDICAL EXPENSE8403424984034249
PAHP SCREENS22173292217329
NON-PAHP SCREENS16200001620000
CBST CODES362115362115

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total-1559525Total
Program Services-1559525ProgramServices

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total94059965Total
Program Services92959066ProgramServices
Management And General1100899ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY8224420BOY
EOY23030376EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY22259069BOY
EOY149545EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY3183607BOY
EOY894082EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
EOY254028EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis2766471LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec2476082LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY514307BOY
EOY290389EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY1996640BOY
EOY1945583EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY36178043BOY
EOY26564003EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY29885627BOY
EOY15952088EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY1051803BOY
EOY-43443EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY30937430BOY
EOY15908645EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY4021455BOY
EOY9432736EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY1219158BOY
EOY1222622EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY5240613BOY
EOY10655358EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY36178043BOY
EOY26564003EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses5412969ReconcilationRevenueExpenses
Reconciliation Unrealized Invest1776ReconciliationUnrealizedInvest
Reconcilation Other Changes0ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule D IRS990ScheduleD

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis212172OtherCostOrOtherBasis
Depreciation212172Depreciation
Book Value0BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis2554299OtherCostOrOtherBasis
Depreciation2263910Depreciation
Book Value290389BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings290389TotalOfBookValueLandBuildings

Other Assets OtherAssets (4 entries)

DescriptionDescriptionBook ValueBookValue
A/R PROVIDER & OTHER679
INVESTMENT IN SUBSIDIARY682228
OTHER ASSETS40054
ASSETS LIMITED AS TO USE1222622
FieldValueIRS element (for citing)
Total Book Value Other Assets1945583TotalBookValueOtherAssets

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionLIABILITIES UNDER SRS CONTRACTDescription
Amount-$43,443Amount
FieldValueIRS element (for citing)
Total Of Amounts-43443TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII

Form990 Schedule D Part XIII Form990ScheduleDPartXIII

FieldValueIRS element (for citing)
IdentifierDESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:Identifier
Return ReferencePART X, LINE 2:ReturnReference
ExplanationTHERE HAS BEEN NO INTEREST OR PENALTIES RECOGNIZED NEITHER IN THE STATEMENT OF OPERATIONS NOR IN THE BALANCE SHEET RELATED TO UNCERTAIN TAX POSITIONS. IN ADDITION, NO TAX POSITIONS EXIST FOR WHICH IT IS REASONABLY POSSIBLE THAT THE TOTAL AMOUNTS OF UNRECOGNIZED TAX BENEFITS WILL SIGNIFICANTLY INCREASE OR DECREASE WITHIN THE NEXT TWELVE MONTHS. TAX YEARS WITH OPEN STATUTES OF LIMITATIONS ARE 2009 AND FORWARD.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII

FieldValueIRS element (for citing)
Name PersonMICHAEL HAMMONDNamePerson
TitleOWNER REPRESENTATIVETitle
Base Compensation Filing Org0BaseCompensationFilingOrg
Comp Based On Related Orgs158200CompBasedOnRelatedOrgs
Bonus Filing Org0BonusFilingOrg
Bonus Related Orgs7500BonusRelatedOrgs
Other Compensation Filing Org0OtherCompensationFilingOrg
Other Compensation Related Orgs0OtherCompensationRelatedOrgs
Deferred Comp Filing Org0DeferredCompFilingOrg
Deferred Comp Related Orgs10960DeferredCompRelatedOrgs
Nontaxable Benefits Filing Org0NontaxableBenefitsFilingOrg
Nontaxable Benefits Related Orgs10386NontaxableBenefitsRelatedOrgs
Total Compensation Filing Org0TotalCompensationFilingOrg
Total Compensation Related Orgs187046TotalCompensationRelatedOrgs
Comp Report Prior990 Filing Org0CompReportPrior990FilingOrg
Comp Report Prior990 Related Orgs0CompReportPrior990RelatedOrgs

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (8 entries)

Return ReferenceReturnReferenceExplanationExplanation
FORM 990, PART VI, SECTION A, LINE 3THE ACTING CFO AND CEO WERE EMPLOYED BY A MANAGEMENT COMPANY FOR A PORTION OF FISCAL YEAR ENDING JUNE 30, 2013.
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 KANSAS HEALTH SOLUTIONS, LLC.
FORM 990, PART VI, SECTION A, LINE 7AACMHCKS, THE SOLE MEMBER OF KANSAS HEALTH SOLUTIONS, LLC HAS THE RIGHT TO APPOINT THE BOARD MEMBERS.
FORM 990, PART VI, SECTION A, LINE 7BTHE OPERATING AGREEMENT OF KANSAS HEALTH SOLUTIONS, LLC 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 11THE 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 KANSAS HEALTH SOLUTIONS, LLC COMPLIANCE OFFICER DETERMINES A CONFLICT OF INTERES 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

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1ASSOCIATION OF COMMUNITY MENTAL HEALTH OF KSBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1720 SE JACKSONAddressLine1
CityTOPEKACity
StateKSState
ZIP Code66603ZIPCode
FieldValueIRS element (for citing)
EIN480876205EIN
Primary ActivitiesHEALTHCAREPrimaryActivities
Legal Domicile StateKSLegalDomicileState
Exempt Code Section501(C)(4)ExemptCodeSection
Public Charity StatusN/APublicCharityStatus
Direct Controlling Entity NAN/ADirectControllingEntityNA
Controlled Org0ControlledOrg

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1TMHC SERVICES INCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1515 S KANSAS AVE STE 301AddressLine1
CityTOPEKACity
StateKSState
ZIP Code66603ZIPCode
FieldValueIRS element (for citing)
EIN208115687EIN
Primary ActivityDRUG/ALCOHOL TESTING & EMPLOYEE ASSISTANCEPrimaryActivity
Legal Domicile StateKSLegalDomicileState
Direct Controlling Entity NAN/ADirectControllingEntityNA
Type Of EntityCTypeOfEntity
Share Of Total Income198375ShareOfTotalIncome
Share Of EOY Assets790216ShareOfEOYAssets
Percentage Ownership1.00000PercentageOwnership
Controlled Org1ControlledOrg
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org1LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Dividends Related Organization0DividendsRelatedOrganization
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs1PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

FieldValueIRS element (for citing)
Business Name Line1TMHC SERVICESBusinessNameLine1
FieldValueIRS element (for citing)
Transaction TypeLTransactionType
Amount Involved296750AmountInvolved
Method Of Amt DeterminationFMVMethodOfAmtDetermination

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