2011-03-25T15:51:49-05:00 2010-06-30 Blue & Co LLC ONE AMERICAN SQUARE 2200 INDIANAPOLIS IN 46282 990 2009-07-01 351140758 Hamilton Center Inc HAMI 8122318323 620 Eighth Avenue Terre Haute IN 47804 Sue Thompson 8122318323 2011-03-25 1 Carrie A Merrill CPA 3176334705 2009 2016-02-24 21:20:13Z Sue Thompson 620 Eighth Avenue Terre Haute IN 47804 34919534 0 X www.hamiltoncenter.org X 1966 IN hamilton center provides outpatient and day services to mentally ill and chronically addicted children and adults, residential and inpatient services to mentally ill adults, prevention and early intervention services to children and families and rehabilitation services to developmentally disabled adults. 19 16 835 22 0 0 15352568 14306560 18079094 19935339 723319 381789 298482 265421 34453463 34889109 99182 77764 0 26782701 27157690 0 0 7213944 7084962 34095827 34320416 357636 568693 43806974 45566646 5970916 7114970 37836058 38451676 Hamilton Center exists to provide quality behavioral healthcare, wellness, and human development services to our community. 0 0 19476249 77764 14162150 Hamilton Center provides outpatient counseling services in ten counties throughout central and west central Indiana including Vigo, Sullivan, Owen, Greene, Putnam, Clay, Parke, Vermillion, Hendricks and Marion. Services are provided by a variety of professional staff with various specialty areas some of whom include: psychiatrists, psychologists, social workers, licensed mental health counselors, addiction therapists, and licensed marriage and family therapists. Treatment is individualized and focuses on the goals of the person seeking help. Treatment is tailored to be as brief as necessary and is structured to cause as little disruption as possible to the person's daily life - work, school and family activities. Services include individual, marital, group and family therapy, as well as psychological testing, psychiatric evaluation/treatment and addiction services. Day services are intensive day treatment programs for persons with serious mental illnesses. These programs focus on activities that take place in various natural settings within the community. Small groups are used to encourage social integration. Emphasis is placed on the development of functional, practical and useable skills and improvement of personal habits. Services provide training and support to help clients become independent in their homes, jobs, and communities. Clients may learn how to prepare a meal, wash their clothes, ride a bus or obtain a job.During the current year, Hamilton Center provided 341,927 outpatient visits and 83,955 day services to 12,656 clients. 3348540 0 2756879 Hamilton Center's Residential Services are rooted in the belief that the treatment of persons in need of longer term care be based in an authentic and least restrictive environment which Is community-based and encourages interaction with others. Our goal is to assist clients in living in the community with independence, self-worth and dignity. Residential services include 24-hour supervised group homes, semi-independent living, 28-day addictions residential program, and supported living arrangements where a client obtains his/her own apartment and receives supervision from Hamilton Center's staff. Residential services are provided in Vigo and Marion counties. During the current year, Hamilton Center provided 24,524 Residential Days to 232 clients. 2483697 0 2286739 Hamilton Center operates a 24-hour adult psychiatric inpatient unit which is licensed by the Indiana Division of Mental Health and Addiction. Our 16-bed unit provides short-term stabilization and treatment for behavioral and addiction disorders. Inpatient treatment usually begins with a holistic assessment of the individual's physical health, emotional health, family life, social interaction and employment history. Treatment is conducted by a team of professionals which includes physicians, psychiatrists, social workers, nurses, activity therapists, psychiatric technicians, psychologists, case managers and other specialists. Staff psychiatrists make psychiatric evaluations and diagnoses, provide direct treatment and monitor individual progress. Treatment goals are individualized and developed by the client and the treatment team. Services take place in a supportive environment, which promotes understanding of the illness, improves self-esteem and communication skills, and helps the client's support system understand the illness and assist in care. The objective during a client's stay is to achieve stabilization so that he/she can return to a less restrictive environment as soon as possible with follow-up outpatient care. During the current year, Hamilton Center provided 5,573 Inpatient Days to 760 clients. 2137255 0 Infant and Toddler Services programs are early childhood programs for families with children from birth to three years of age. Their focus is to provide excellent supportive, educational and therapeutic services to enhance the lives of infants, young children and their families. Admission criteria is different for each program, but all services are free of charge to families. Infant and Toddler Services programs are preventative in nature and work with children and families to build on their strengths. We recognize that families with young children deal with challenging and often stressful situations. Our programs are designed to meet each family's interests and priorities as related to their child's growth and development. Services include written information, assistance in connecting with community services and/or extended support through home visits or group activities. Infant and Toddler Services consists of three programs including First Steps, Early Head Start and Healthy Families. Early Head Start is offered in Vigo county. Healthy Families is offered in Greene, Vermillion, Vigo and Sullivan counties in Indiana. First Steps is offered in Clay, Daviess, Greene, Knox, Martin, Owen, Parke, Putnam, Sullivan, Vermillion and Vigo counties. During the current year, First Steps served 1071 children, Early Head Start served 135 children, and Healthy Families served 389 Children. 1058768 0 988369 Spectrum Services is the name of Hamilton Center's rehabilitation division. This division provides services to adults living in Vigo county in Indiana with disabilities and social limitations with the ultimate goal of maximizing independent living and full community inclusion. Spectrum Services is accredited by CARF, the Rehabilitation Accreditation Commission. During the current year, Hamilton Center provided 16,470 Rehabilitation Services to 268 clients. 3196023 988369 28504509 1 1 0 1 0 0 0 1 1 1 0 1 0 0 0 0 0 0 1 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1 78 0 1 835 1 0 0 0 0 0 1 1 0 0 0 19 16 0 0 0 0 1 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 IN X Sue Thompson 8122318323 620 Eighth Avenue Terre Haute IN 47804 Rhonda Majors 1.00 X 0 0 0 Louise Anderson 1.00 X 0 0 0 James Clayton 1.00 X 0 0 0 Rebecca Porter 1.00 X 0 0 0 Terry Barr 1.00 X 0 0 0 Tony Brewer 1.00 X 0 0 0 John Hancewicz 1.00 X 0 0 0 James Jenkins 1.00 X 0 0 0 Mark Killion 1.00 X 0 0 0 Susan Goodman 1.00 X 0 0 0 Jim Luzar 1.00 X 0 0 0 Sharon Melloh 1.00 X 0 0 0 Max Miller 1.00 X 0 0 0 Rhonda Mundell 1.00 X 0 0 0 Richard Pittelkow 1.00 X 0 0 0 Susie Waymire 1.00 X 0 0 0 Galen Goode 40.00 X 190491 0 43917 Sue Thompson 40.00 X 90479 0 9736 David K Hilton 40.00 X 226494 0 23425 Ruthgayle D Stith 40.00 X 173359 0 20753 Shashikant S Patel 40.00 X 173196 0 29618 Mathews John 40.00 X 163443 0 34554 Patrick Zirnheld 40.00 X 145816 0 27448 Boguslaw Gluszak 40.00 X 139948 0 13056 1303226 0 202507 10 0 1 0 Staff Care Inc PO Box 281923 Atlanta GA 30384 Locum Tenen 171025 CDI Inc 200 S 8th St Terre Haute IN 47807 Bloomfield Office Addition 170500 Advantage Counseling 1005 E Main St Plainfield IN 46168 Contracted direct service provider 117505 MJV Group Inc PO Box 5076 Lafayette IN 47903 Janitorial 102358 4 14089954 216606 14306560 Net Patient Service Re 900099 19935339 19935339 19935339 391585 391585 9961 17049 2708 -17049 7253 -9796 -9796 17291 10668 6623 6623 Represt. Payee Fees 900099 91464 91464 167334 167334 258798 34889109 20194137 0 388412 77764 77764 306656 256088 50568 20325107 17767036 2558071 1040516 750212 290304 3957431 3264881 692550 1527980 1187240 340740 56397 20196 36201 132338 47390 84948 35592 12745 22847 182843 65476 117367 230386 106899 123487 1032643 821984 210659 1425949 1079443 346506 694260 584567 109693 201534 97744 103790 1348047 1085178 262869 550662 409142 141520 Purchased Services 584167 564305 19862 Dues and Susbsript 331528 152834 178694 Bad Debts -25892 -25892 304508 153385 151123 34320416 28504509 5815907 0 21581926 24552575 1612995 49629 3682911 2864097 179269 329131 29750840 15062105 13956240 14688735 565297 824066 2228336 2258413 43806974 45566646 3584667 4239780 28996 43521 2357253 2831669 5970916 7114970 X 36310679 36911350 1525379 1540326 37836058 38451676 43806974 45566646 X 0 1 1 X 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 5195 5195 0 Part II-B, Line 1i: Explanation of Other Lobbying Activities: Portion of dues attributed to lobbying paid to the following organizations: IN Association of Rehabilitation Facilities, Indiana Health and Hospital, IN council of Community Mental Health Centers and THE Chamber of Commerce. 1 155005 2024178 2055440 123743 0 1539336 111145 97225 32 1553224 1744308 -98725 120204 1525379 0.01000 0.99000 1 0 2494022 2494022 19477756 9721616 9756140 21263 21263 0 6988597 5319226 1669371 769202 769202 14688735 Estimated Third-Party Settlement 2831669 2831669 Part IV, Line 1b: Held funds for patients - representative payee accounts Part V, Line 4: Description of Intended Use of Endowment Funds: The majority of endowment funds are Temporarily restricted net assets. These funds are limited by donors to a specific time period or purpose. Restrictions primarily relate to utilizing assets for specific behavioral health and education programs. The remainder of the endowment funds are held by a community foundation trust on behalf of Hamilton Center with only the investment income available for the center's charitable purpose. Parts XI, XII, and XIII are not required as the organization is part of a consolidated financial statement. The consolidated financial statements are audited by an independent accounting firm and prepared in accordance with generally accepted accounting principles. Hamilton Center Golf Tournament 11170 11170 300 7770 1325 11170 11170 300 7770 1325 9395 1775 1 1 0 1 X 1 1 0 1 1 5834374 5834374 0.17000 19294396 14262157 5032239 0.14660 25128770 14262157 10866613 0.31660 199264 43000 156264 0.00460 199264 43000 156264 0.00460 25328034 14305157 11022877 0.32120 0 86317 0 981615 1016215 -34600 X 1 1 Hamilton Center Inc

620 Eighth Avenue Terre Haute IN 47804

X Inpatient Unit Part I, Line 3c: Eligibility is determined through the organization's Charity Care application process. The Charity Care Review Committee considers several factors when determining who may qualify for charity care including: health and medical insurance coverage; availability of payment under federal, state or other reimbursement programs; current federal poverty income guidelines; total household income; household size; medical and financial obligations and living expenses; and availability of all other assets. Part I, Line 7g: The subsidized health services are for the Access Center that provides 24 hour crisis response and referral assistance. The organization does not provide any subsidized health services attributable to physician clinics. Part III, Line 4: Section A. Bad Debt Expense. Line 2 Footnote to organization's financial statements that describes bad debt expenses: Management estimates an allowance for doubtful accounts receivable based on an evaluation of historical losses, current economic conditions, and other factors unique to its customer base.Part III, Line 4: Section A. Bad Debt Expense. Line 3 explanation for rational for including other bad debt amount in community benefit: No other bad debt amounts have been included as community benefit. The organization believes that it accurately captures all charity care deductions provided according to the financial assistance policy and the amount of bad debt expense attributable to patients eligible under the organization's charity care policy is negligible. Part III, Line 8: The source used to determine the amount of Medicare allowable costs reported for Part III, Section B, Medicare has been provided from the Year Ended June 30, 2010 report: Hospital Statement of Reimbursable Cost. Part III, Line 9b: Installment arrangements are available to patients qualifying for charity care or financial assistance. Collection of delinquent accounts start after 90 days unless financial arrangements are made. Any extenuating circumstances are evaluated by the Chief Fiscal Officer proceeding any legal or write-off action. Part V: The organization also operates SIX COMMUNITY BASED RESIDENTIAL HOMES, ONE SUBACUTE FACILITY, SEVENTEEN OUTPATIENT CLINICAL SERVICE CLINICS, AND TWO EARLY HEAD START DAYCARE CENTERS. Part VI, Line 2: The organization assess community needs through volunteer boards, community involvement, volunteering, and board service. Part VI, Line 3: The organization informs and educates patients about eligibility for assistance during the initial contact by phone or during the first "intake" meeting. During the initial meeting the individual receives an "affidavit for financial eligibility" form to complete which helps the organization determine eligibility for fee reductions. Also, individuals can obtain a brochure from the organization's website providing information about services, fees, and fee adjustment eligibility. Part VI, Line 4: Geographic Area:The organization community includes the following counties served: Clay, Green, Marion, Owen, Parke, Putnam, Sullivan, Vermillion, Vigo, and Hendricks. Demographics:Population served based on IncomeLess than $8,000 63%$8,000 - 9,999 3%$10,000 - 14,999 4%$15,000 - 19,999 4%$20,000 - 29,999 4%$30,000 + 10%Unknown 12%Population served base on AgeLess than 3 12%4 - 17 28%18 - 24 12%25 - 44 27%45 - 64 19%65 + 2% Part VI, Line 6: The organization furthers its exempt purpose by promoting health of the community through the following: The majority of the organization's governing body is comprised of persons who reside in the organization's primary service area. These volunteers are neither employees nor independent contractors of the organization, nor family members thereof. Any surplus funds are applied directly or indirectly to improve services.The organization has a presence on many community collaborative committees and groups such as the Terre Haute Homeless Coalition, Local Coordinating Councils on Drug Abuse in several communities, the statewide committee for disaster relief and emergency response, a sponsor and contributor for Terre Haute's Mini Medical School, and an active participant in Disabilities Awareness Month to name a few. Part VI, Line 7: Not applicable. The organization is not part of an affiliated health care system.Part VI, Line 8: not applicable. The organization does not file a community benefit report. 1 St Ann's Clinic 1436 Locust Street Terre Haute IN 47804 351947580 501c3 12383 cost Payment of office space Payment of office space To serve clients at the clinic. St Ann's Clinic 1436 Locust Street Terre Haute ID 47804 351947580 501c3 19469 Cost Staff Therapy Time Staff are provided to assist the clinic with therapy time a couple hours each week. Mental Health Association in Vigo County inc 620 8th Avenue Terre Haute IN 47804 208762173 501c3 45912 Cost Office Space, copy machine, production of newsletter To make assets available for the use by the association. 1 0 Procedure for Monitoring Grants in the U.S.: Part I, Line 2: Schedule I, Part I, Line 2: No grant funds were awarded to the recipients included on Schedule I. The assistance provided were one time contributions to other organizations that do not require monitoring of the recipient's use by Hamilton Center. X X X X 0 0 0 0 0 1 0 0 0 Galen Goode 172883 0 11433 0 6175 0 25897 0 18020 0 234408 0 0 0 David K Hilton 220462 0 5618 0 414 0 15826 0 7599 0 249919 0 0 0 Ruthgayle D Stith 172945 0 0 0 414 0 12176 0 8577 0 194112 0 0 0 Shashikant S Patel 171977 0 0 0 1219 0 13754 0 15864 0 202814 0 0 0 Mathews John 163263 0 0 0 180 0 12892 0 21662 0 197997 0 0 0 Patrick Zirnheld 145636 0 0 0 180 0 10195 0 17253 0 173264 0 0 0 Boguslaw Gluszak 139813 0 0 0 135 0 0 0 13056 0 153004 0 0 0 Part I, Line 6 Hamilton Center has a performance based evaluation system that includes individual goal setting and evaluation annually. If thresholds for performance are met and HCI has income in excess of budgeted levels employees share in the excess and are paid as a percentage of salary. Form 990, Part VI, Section A, line 6 The organization is organized as a not-for-profit corporation with a board of directors. Form 990, Part VI, Section B, line 11 The Administrative Committee of the Board of Directors were provided with a copy and reviewed the completed Form 990 as presented by Blue and Co., LLC. The Administrative Committee reported to the Full Board their understanding and acceptance of the documented information. The review is recorded in the Administrative Committee meeting minutes. Form 990, Part VI, Section B, line 12c Hamilton Center regularly and consistently monitors and enforces compliance with the written Conflict of Interest policy as follows: 1. Completion of a Uniform Conflict of Interest Disclosure Statement as designated in the corporate policy. 2. Notifications to supervisors and Board President as conflicts are determined. 3. Barring action by the employee or recusing from activities Board members until the conflict is resolved. 4. Alternatives are investigated and decisions are made to satisfactorily resolve the conflict up to and including termination of employment or Board resignation. The Chief Executive Officer has final decision authority when employees are involved and the Board President has final decision authority when Board Members are involved. Form 990, Part VI, Section B, line 15 Compensation for the Chief Executive Officer, Executive Directors, and Medical Director are determined by a committee of the Board of Directors as follows: 1. Comparability data is gathered based on similar organizations, similar circumstances, geographical applicability, education, and experience. 2. Only independent members of the Board are allowed to review and establish compensation. 3. Compensation decisions are documented concurrently during the decision making process and are reflected in the Board minutes. Form 990, Part VI, Section C, line 19 Upon written request received via U.S. Mail to 620 Eighth Avenue, Terre Haute, IN 47804, Hamilton Center makes its governing documents, conflict of interest policy, and financial statements available to the public by return mail. Form 990, Part XI, Line 2c Oversight of Audit The board of directors assumes responsibility for oversight of the audit of the financial statements and selection of the independent accountant; no processes have changed from prior year. HCI Property Development Lange Apartments 620 Eighth Avenue Terre Haute IN 47804 800077891 Low income housing IN HCI Property Development Organization Inc related -52512 0 1 HCI Property Development Organization Inc 620 Eighth Avenue Terre haute IN 47804 562396950 Real Estate IN N/A C -86 -51528 1.00000 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0