Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for the latest information.
| (i) Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 10 above (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
|
Total |
||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2014 | (b) 2015 | (c) 2016 | (d) 2017 | (e) 2018 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | 15,281 | 28,866 | 13,634 | 15,057 | 23,043 | 95,881 |
| 2 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.... | ||||||
| 3 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 4 | Total. Add lines 1 through 3 | 15,281 | 28,866 | 13,634 | 15,057 | 23,043 | 95,881 |
| 5 | The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f).. | ||||||
| 6 | Public support. Subtract line 5 from line 4. | 95,881 | |||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2014 | (b) 2015 | (c) 2016 | (d) 2017 | (e) 2018 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 15,281 | 28,866 | 13,634 | 15,057 | 23,043 | 95,881 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | 65 | 160 | 81 | 78 | 386 | 770 |
| 9 | Net income from unrelated business activities, whether or not the business is regularly carried on.. | ||||||
| 10 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.).. | 8,454 | 10,660 | 7,111 | 9,538 | 15,494 | 51,257 |
| 11 | Total support. Add lines 7 through 10 | 147,908 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2014 | (b) 2015 | (c) 2016 | (d) 2017 | (e) 2018 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | ||||||
| 2 | Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose | ||||||
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513 ..... | ||||||
| 4 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... | ||||||
| 5 | The value of services or facilities furnished by a governmental unit to the organization without charge | ||||||
| 6 | Total. Add lines 1 through 5 | ||||||
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons | ||||||
| b | Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year. | ||||||
| c | Add lines 7a and 7b.. | ||||||
| 8 | Public support. (Subtract line 7c from line 6.) | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2014 | (b) 2015 | (c) 2016 | (d) 2017 | (e) 2018 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | ||||||
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | ||||||
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | ||||||
| 11 | Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on. | ||||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) .. | ||||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | ||||||
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e |
Discount claimed for blockage or other factors (explain in detail in Part VI): |
|||||
| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). | 4 | ||||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | ||||
| 6 | Multiply line 5 by .035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | ||
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
||
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | ||
| 4 Amounts paid to acquire exempt-use assets | ||
| 5 Qualified set-aside amounts (prior IRS approval required) | ||
| 6 Other distributions (describe in Part VI). See instructions | ||
| 7Total annual distributions. Add lines 1 through 6. | ||
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
||
| 9 Distributable amount for 2018 from Section C, line 6 | ||
| 10 Line 8 amount divided by Line 9 amount | ||
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2018 |
(iii) Distributable Amount for 2018 |
|
|---|---|---|---|---|
|
1
Distributable amount for 2018 from Section C, line 6 |
||||
|
2
Underdistributions, if any, for years prior to 2018 (reasonable cause required-- explain in Part VI). See instructions. |
||||
| 3 Excess distributions carryover, if any, to 2018: | ||||
| a From 2013....... | ||||
| b From 2014....... | ||||
| c From 2015....... | ||||
| d From 2016....... | ||||
| e From 2017....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2018 distributable amount | ||||
|
i
Carryover from 2013 not applied (see instructions) |
||||
| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | ||||
| 4Distributions for 2018 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2018 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from 4. | ||||
|
5
Remaining underdistributions for years prior to 2018, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions. |
||||
|
6
Remaining underdistributions for 2018. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions. |
||||
|
7 Excess distributions carryover to 2019. Add lines 3j and 4c. |
||||
| 8 Breakdown of line 7: | ||||
| a Excess from 2014...... | ||||
| b Excess from 2015..... | ||||
| c Excess from 2016..... | ||||
| d Excess from 2017..... | ||||
| e Excess from 2018..... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|---|
| Schedule A, Part II, Line 10, Explanation of Other Income: | Other - 2014 Amount: $ 8,454. 2015 Amount: $ 10,660. 2016 Amount: $ 7,111. 2017 Amount: $ 9,538. 2018 Amount: $ 15,494. |
| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| Form 990, Part I, Line 1 | Key Human Services, Inc. (Key) is a non-profit, Connecticut corporation, established in Connecticut in 1989, that provides a variety of community based support programs intended to help people live as independently as possible in their local communities. Key Human Services, Inc. provides services in the central part of the state extending from the Massachusetts border to the Long Island Sound. Key Human Services, Inc. is supported primarily through contracts from governmental sources and other non-profit organizations. Key furthers its mission by providing services in four divisions or areas, which are Community Living Arrangements Division, Individual and Family Support Division, Birth to Three Area, and Key Nursing Services Area. The program service accomplishments of each division or area are described on Form 990, Part III, Statement of Program Accomplishments. |
| Form 990, Part VI, Section A, line 6 | Keystone Human Services (KHS), acting as the Parent, which is a Pennsylvania non-profit corporation, is the sole member of Key Human Services, Inc., the Corporation. The Parent shall have the chief duty to direct, oversee, and monitor the performance and mission of the Corporation. |
| Form 990, Part VI, Section A, line 7a | Officers of Keystone Human Services (KHS), the parent, may serve as voting members of the Board, at the direction of the Parent Corporation. Directors shall be appointed by the Parent for a term of one year commencing the first day of January. The Leadership Development Committee of KHS shall receive and consider recommendations of the associated subsidiaries for appointment of Board Members to subsidiary corporations and present the final slate of directors to the membership of the associated subsidiary. Based on the recommendation of the Leadership Development Committee, the President maintains the authority to appoint candidates to subsidiary boards. |
| Form 990, Part VI, Section A, line 7b | It is the policy of Keystone Human Services (KHS), the parent, to direct operations of its subsidiary agencies through Boards of Directors. Members of KHS subsidiary boards are responsible for the governance and stewardship of the subsidiary agency's resources, programs, services and capacity. Subsidiary Board Members are accountable to the Board of KHS and are responsible for implementing effectively the policies, strategy, mission and vision of KHS. |
| Form 990, Part VI, Section B, line 11b | The Form 990 is prepared by outside accountants. The form is reviewed by Keystone Human Service's (KHS, the parent company) VP of Finance and audit committee. The board of directors of the Corporation will also perform a detailed review of the form 990 prior to its filing. All board members will have an opportunity to ask questions. |
| Form 990, Part VI, Section B, line 12c | Directors and Officers shall timely disclose in writing to the VP of Quality and Corporate Integrity, all circumstances that constitute an actual, potential or perceived conflict of interest. In addition, the Compliance Department will circulate the Annual Disclosure Statement. All Board members, Directors and Officers must complete the Statement upon affiliation with the Organization and annually thereafter. Disclosure Statements shall be completed annually and forwarded to the Corporate Compliance Department. |
| Form 990, Part VI, Section B, line 15 | It is the policy of Keystone Human Services (KHS, the parent company) to use a compensation system for the KHS President and Officers that will determine the current market value of a position based on the skills, knowledge and behaviors required of a fully competent incumbent. The system and practice will be in compliance with Federal IRS "Intermediate Sanctions" regulations. KHS will use a professional compensation consultant and system recommended by executive management and approved by the Compensation Committee of the Board of Directors. The KHS Board shall set the position level, salary and benefit components of the total compensation package for the KHS President. Officers are executive positions identified and approved by the KHS Board of Directors. The KHS President shall set the position level, salary and benefit components of the total compensation package of officers designated by the Board of Directors. The compensation of the President and CEO of Key Human Services (the corporation) shall be set by the corporation's Board of Directors using comparative salary studies. The President and CEO of Key Human Services will determine the compensation of the corporation's employees. |
| Form 990, Part VI, Section C, line 19 | Key Human Services, Inc.'s governing documents (Article of Incorporation and By-Laws), policies, Form 990, and audited financial statements are available upon request. In addition, Key's current and prior 990's are available at www.guidestar.org. |
| Form 990, Part XII, Line 2C: | The process has not changed from prior years. |
| Software ID: | |
| Software Version: |