MID-ERIE MENTAL HEALTH SERVICES INC: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
MID-ERIE MENTAL HEALTH SERVICES INC (EIN 16-1017709)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-05-15
IRS object ID
201231369349301563
Schema version
2011v1.2
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)
Timestamp2012-05-15T09:02:41-05:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN160765486EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1LUMSDEN & MCCORMICK LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1403 MAIN ST SUITE 430AddressLine1
CityBUFFALOCity
StateNYState
ZIP Code14203ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN161017709EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1MID-ERIE MENTAL HEALTH SERVICES INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlMID-NameControl
Phone7168957167Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11526 WALDEN AVENUE SUITE 400AddressLine1
CityCHEEKTOWAGACity
StateNYState
ZIP Code14225ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameELIZABETH L MAUROName
TitleEXECUTIVE DIRECTORTitle
Phone7168957167Phone
Date Signed2012-05-02DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameDONNA M GONSERName
PTINP01448922PTIN
Phone7168563300Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

Doing Business As DoingBusinessAs

FieldValueIRS element (for citing)
Business Name Line1MID ERIE COUNSELING AND TREATMENT SEBusinessNameLine1
FieldValueIRS element (for citing)
Name Of Principal Officer PersonELIZABETH L MAURONameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11526 WALDEN AVENUE SUITE 400AddressLine1
CityCHEEKTOWAGACity
StateNYState
ZIP Code14225ZIPCode
FieldValueIRS element (for citing)
Gross Receipts6972072GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.MID-ERIE.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1972YearFormation
State Legal DomicileNYStateLegalDomicile
Activity Or Mission DescriptionTHE MISSION OF MID-ERIE COUNSELING AND TREATMENT SERVICES IS TO COLLABORATE WITH CONSUMERS, FAMILIES AND COMMUNITIES TO PROMOTE WELLNESS AND RECOVERY THROUGH AN ARRAY OF MENTAL HEALTH AND CHEMICAL DEPENDENCY TREATMENT, EDUCATION AND SUPPORT SERVICES.ActivityOrMissionDescription
Nbr Voting Members Governing Body10NbrVotingMembersGoverningBody
Nbr Independent Voting Members9NbrIndependentVotingMembers
Total Nbr Employees148TotalNbrEmployees
Total Nbr Volunteers9TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year1849911ContributionsGrantsPriorYear
Contributions Grants Current Year2155594ContributionsGrantsCurrentYear
Program Service Revenue Prior Year4640610ProgramServiceRevenuePriorYear
Program Service Revenue CY4802987ProgramServiceRevenueCY
Investment Income Prior Year1376InvestmentIncomePriorYear
Investment Income Current Year1082InvestmentIncomeCurrentYear
Other Revenue Prior Year28029OtherRevenuePriorYear
Other Revenue Current Year12409OtherRevenueCurrentYear
Total Revenue Prior Year6519926TotalRevenuePriorYear
Total Revenue Current Year6972072TotalRevenueCurrentYear
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 Year4307046SalariesEtcPriorYear
Salaries Etc Current Year4440610SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year2177395OtherExpensePriorYear
Other Expenses Current Year2140120OtherExpensesCurrentYear
Total Expenses Prior Year6484441TotalExpensesPriorYear
Total Expenses Current Year6580730TotalExpensesCurrentYear
Revenues Less Expenses Prior Year35485RevenuesLessExpensesPriorYear
Revenues Less Expenses CY391342RevenuesLessExpensesCY
Total Assets BOY1327303TotalAssetsBOY
Total Assets EOY1525127TotalAssetsEOY
Total Liabilities BOY1782616TotalLiabilitiesBOY
Total Liabilities EOY1589098TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY-455313NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY-63971NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionTHE MISSION OF MID-ERIE COUNSELING AND TREATMENT SERVICES IS TO COLLABORATE WITH CONSUMERS, FAMILIES AND COMMUNITIES TO PROMOTE WELLNESS AND RECOVERY THROUGH AN ARRAY OF MENTAL HEALTH AND CHEMICAL DEPENDENCY TREATMENT, EDUCATION AND SUPPORT SERVICES.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense2034420Expense
Revenue2256555Revenue
DescriptionADULT MENTAL HEALTH SERVICES - ADULT MENTAL HEALTH SERVICES ARE BASED ON THE PROMISE THAT INDIVIDUALS WHO SUFFER FROM SEVERE AND PERSISTENT MENTAL ILLNESS CAN, AND DO RECOVER THROUGH THE USE OF TREATMENT AND PSYCHIATRIC REHABILITATION INTERVENTIONS. INDIVIDUALS EXPERIENCING ACUTE MENTAL ILLNESS OR SITUATIONAL DIFFICULTIES UTILIZE SOLUTION-FOCUSED THERAPIES TO ACHIEVE PROBLEM RESOLUTION. ADULT MENTAL HEALTH PROGRAMMING FOCUSES ON THE FOLLOWING SERVICES: CLINIC TREATMENT, PERSONALIZED RECOVERY ORIENTED SERVICES (PROS), CASE MANAGEMENT, FORENSIC. (TOTAL 2011 VISITS - 19,041 PROS PARTICIPATION UNIT 25,302/85 AVERAGE CLIENTS PER MONTH)Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense922616Expense
Revenue790143Revenue
DescriptionCHEMICAL DEPENDENCY SERVICES - SERVICES ARE DESIGNED FOR ADULTS AND ADOLESCENTS WHOSE BASIC ATTACHMENTS (FAMILY, WORK, SCHOOL, ETC.) AND MANAGEMENT OF DAILY ACTIVITIES ARE IMPAIRED THROUGH THE ABUSIVE USE OF ALCOHOL AND/OR OTHER DRUGS. SERVICES INCLUDE: COUNSELING FOR INDIVIDUALS, FAMILIES AND GROUPS, CHEMICAL DEPENDENCY EDUCATION, AFTERCARE, MEDICAL EVALUATION, LINKING WITH OTHER SOCIAL AND COMMUNITY RESOURCES, AND SPECIALTY GROUPS. (TOTAL 2011 VISITS - 14,010)Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense2611994Expense
Revenue1756289Revenue
DescriptionCHILD MENTAL HEALTH SERVICES - THE CHILD MENTAL HEALTH PROGRAM PROVIDES A COMPREHENSIVE ARRAY OF COMMUNITY BASED TREATMENT AND SUPPORT SERVICES TO FAMILIES WITH CHILDREN AND/OR ADOLESCENTS WHO HAVE SERIOUS EMOTIONAL AND BEHAVIORAL DISORDERS. THROUGH THEIR INVOLVEMENT IN SERVICES, CHILDREN AND ADOLESCENTS STRIVE TO REACH THEIR OPTIMAL POTENTIAL WHILE REMAINING IN THE SAFEST AVAILABLE ENVIRONMENT. SERVICES INCLUDE: CLINIC TREATMENT, ENHANCED TREATMENT CENTER, ENHANCEMENT STEP DOWN/DIVERSION, CHILD INTENSIVE CARE COORDINATION, SCHOOL-BASED MENTAL HEALTH PROGRAM, HOME AND COMMUNITY BASED SERVICES WAIVER PROGRAM/CARE COORDINATION, CASE MANAGEMENT, GRANDPARENT ADVOCACY PROJECT, AND FAMILY SUPPORT. (TOTAL 2011 VISITS - 6,780)Description

Activity Other ActivityOther

FieldValueIRS element (for citing)
Expense148431Expense
DescriptionKINSHIP GRANTS PROVIDE LEGAL SERVICES FOR HELPING TO PLACE FOSTER CHILDREN WITH FAMILY MEMBERS.Description
FieldValueIRS element (for citing)
Total Of Other Program Service Exp148431TotalOfOtherProgramServiceExp
Total Program Service Expense5717461TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
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 Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote0ReportFin48Footnote
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 Required0ScheduleJRequired
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 Rltnshp1OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109628NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees148NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members10NbrVotingGoverningBodyMembers
Number Independent Voting Members9NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledNYStatesWhereCopyOfReturnIsFiled
Other WebsiteXOtherWebsite
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1PATRICK MCINERNEYBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number7168957167TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11520 WALDEN AVENUEAddressLine1
CityCHEEKTOWAGACity
StateNYState
ZIP Code14225ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (12 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
BRIAN MURPHY
PRESIDENT2.00XX000
PAMELA GERMAIN
DIRECTOR2.00X000
FREDERIC COOK
DIRECTOR2.00X000
SANDRA SCHOFIELD
DIRECTOR2.00X000
JOHN GILEWICZ
DIRECTOR2.00X000
JOHN BOS
TREASURER2.00XX000
DR VICTORIA BROOKS
VICE PRESIDENT2.00XX000
BARBARA CHMIELEWSKI
SECRETARY2.00XX000
STEVEN RUBINSTEIN
DIRECTOR2.00X000
JOCELYN BOS
DIRECTOR2.00X000
ELIZABETH MAURO
EXECUTIVE DIRECTOR40.00X95299016485
PATRICK MCINERNEY
CFO40.00X96134011742
FieldValueIRS element (for citing)
Total Reportable Comp From Org191433TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation28227TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K0TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (3 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
BROADWAY OASIS LLC
298 MAIN STREETBUFFALONY14202CONTRACTOR219523
RANDAL BENDERSON 199
570 DELAWARE AVEBUFFALONY14202TRUST179650
UNIVERSITY PSYCHIATRIC PRACTICE
ECMC - 462 GRIDER STREET 11TH FLOOBUFFALONY14215CONSULTANT179431
FieldValueIRS element (for citing)
Number Of Contractors GT100 K3NumberOfContractorsGT100K
Government Grants1939231GovernmentGrants
All Other Contributions216363AllOtherContributions
Total Contributions2155594TotalContributions

Program Service Revenue ProgramServiceRevenue (4 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
MEDICAID62410037777613777761
THIRD PARTY INSURANCE624100727461727461
PATIENT FEES624100234665234665
MEDICARE6241006310063100
FieldValueIRS element (for citing)
Total Program Service Revenue4802987TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column1082TotalRevenueColumn
Exclusion$1,082ExclusionAmount

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionMISCELLANEOUSDescription
Business Code900099BusinessCode
Total Revenue Column12409TotalRevenueColumn
Exclusion$12,409ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue12409TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column6972072TotalRevenueColumn
Related Or Exempt Function Income4802987RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$13,491ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total229116Total
Management And General229116ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total3466323Total
Program Services3189893ProgramServices
Management And General276430ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total102151Total
Program Services86404ProgramServices
Management And General15747ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total380128Total
Program Services334880ProgramServices
Management And General45248ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total262892Total
Program Services225164ProgramServices
Management And General37728ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total70923Total
Program Services23106ProgramServices
Management And General47817ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total120745Total
Program Services92845ProgramServices
Management And General27900ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total285900Total
Program Services232560ProgramServices
Management And General53340ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total319445Total
Program Services242512ProgramServices
Management And General76933ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total72201Total
Program Services63864ProgramServices
Management And General8337ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total18703Total
Program Services8536ProgramServices
Management And General10167ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total512Total
Management And General512ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total44110Total
Program Services22053ProgramServices
Management And General22057ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total25420Total
Program Services23712ProgramServices
Management And General1708ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
TENANT DEPOSIT/WRAP EXP587485587485
CONSULTANTS417766417766
BUILDING MAINTENANCE AN80634760904544
PROGRAM SUPPLIES1471114711

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total81565Total
Program Services75880ProgramServices
Management And General5685ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total6580730Total
Program Services5717461ProgramServices
Management And General863269ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY593595BOY
EOY743861EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY24610BOY
EOY38613EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY447008BOY
EOY388339EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY30212BOY
EOY25840EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis1083986LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec763141LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY224249BOY
EOY320845EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY7629BOY
EOY7629EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY1327303BOY
EOY1525127EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY594484BOY
EOY487740EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY185700BOY
EOY126865EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY1002432BOY
EOY974493EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY1782616BOY
EOY1589098EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY-455313BOY
EOY-63971EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY-455313BOY
EOY-63971EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY1327303BOY
EOY1525127EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses391342ReconcilationRevenueExpenses
Reconcilation Other Changes0ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org170b1 AviXPubliclySupportedOrg170b1Avi

Gifts Grants Contrib Received170 GiftsGrantsContribReceived170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years1780588CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years1712944CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years1738029CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year1849911CurrentTaxYearMinus1Year
Current Tax Year2155595CurrentTaxYear
Total9237067Total

Total170 Total170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years1780588CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years1712944CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years1738029CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year1849911CurrentTaxYearMinus1Year
Current Tax Year2155595CurrentTaxYear
Total9237067Total
FieldValueIRS element (for citing)
Public Support Total1709237067PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years1836CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years3619CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years305CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year1376CurrentTaxYearMinus1Year
Current Tax Year1082CurrentTaxYear
Total8218Total
FieldValueIRS element (for citing)
Total Support9245285TotalSupport
Gross Receipts From Admissions Etc22954081GrossReceiptsFromAdmissionsEtc
Public Support Pertcentage1700.99910PublicSupportPertcentage170
Public Support Pertcent Prior Year0.99840PublicSupportPertcentPriorYear
Thirty Three Percnt Tests CY170XThirtyThreePercntTestsCY170

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis233635OtherCostOrOtherBasis
Depreciation101412Depreciation
Book Value132223BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis850351OtherCostOrOtherBasis
Depreciation661729Depreciation
Book Value188622BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings320845TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionREFUNDABLE ADVANCES AND AMOUNTS DUE TO FUNDING SOURCESDescription
Amount$974,493Amount
FieldValueIRS element (for citing)
Total Of Amounts974493TotalOfAmounts

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV

Name Of Interested Person NameOfInterestedPerson

FieldValueIRS element (for citing)
Name PersonSTEVEN RUBINSTEINNamePerson
FieldValueIRS element (for citing)
RelationshipMEMBER OF BOARD OF DIRECTORS OF MID-ERIE, PARTNER OF DAMON & MOREY LAW FIRMRelationship
Amount Of Transaction44175AmountOfTransaction
Description Of TransactionMID-ERIE UTILIZES DAMON & MOREY AS THEIR PRINCIPAL LEGAL COUNCIL.DescriptionOfTransaction
Sharing Of Revenues0SharingOfRevenues

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (5 entries)

Return ReferenceReturnReferenceExplanationExplanation
FORM 990, PART VI, SECTION B, LINE 11THE IRS FORM 990 IS REVIEWED IN DETAIL BY THE FINANCE COMMITTEE OF THE DIRECTORS. THE FINANCE COMMITTEE THEN REPORTS TO THE FOLLOWING DIRECTORS MEETING WHERE A COPY IS AVAILABLE FOR INSPECTION. IF NO MEETING IS SCHEDULED BETWEEN THE PREPARATION DATE AND THE DUE DATE, THE COMPLETE FORM IS DISTRIBUTED THROUGH EMAIL TO ALL DIRECTORS FOR COMMENT.
FORM 990, PART VI, SECTION B, LINE 12CCONFLICT OF INTEREST DISCLOSURES ARE SIGNED ANNUALLY BY ALL DIRECTORS AS WELL AS NEW MEMBERS JOINING THE BOARD DURING INTERIM PERIODS. THIS PROCEDURE IS A REGULAR AGENDA ITEM AT THE ANNUAL MEETING.
FORM 990, PART VI, SECTION B, LINE 15THE EXECUTIVE DIRECTOR'S COMPENSATION IS COMPARED TO OTHER LOCAL ORGANIZATIONS, SCALED FOR APPROPRIATE SIZE, AND ADJUSTED ACCORDING TO PERFORMANCE REVIEWS. ALL OTHER EMPLOYEE SALARIES ARE AT THE DISCRETION OF THE EXECUTIVE DIRECTOR.
FORM 990, PART VI, SECTION C, LINE 19DOCUMENTS ARE MADE AVAILABLE FOR INSPECTIONS AT THE ADMINISTRATIVE OFFICES. COPIES CAN BE OBTAINED AT THE REQUESTING PARTY'S EXPENSE.
FORM 990, PART XII, LINE 2C:THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1MID-ERIE FOUNDATION INCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11520 WALDEN AVENUEAddressLine1
CityCHEEKTOWAGACity
StateNYState
ZIP Code14225ZIPCode
FieldValueIRS element (for citing)
EIN161578172EIN
Primary ActivitiesTO SUPPORT THE PROGRAMS OF MID-ERIE MENTAL HEALTH SERVICES, INC.PrimaryActivities
Legal Domicile StateNYLegalDomicileState
Exempt Code Section501(C)(3)ExemptCodeSection
Public Charity Status11 TYPE IIPublicCharityStatus
Direct Controlling Entity NAN/ADirectControllingEntityNA
Controlled Org0ControlledOrg
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 Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
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 Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

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