Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for instructions and 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 |
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Calendar year (or fiscal year beginning in) ![]() |
(a) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | ||||||
| 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 | ||||||
| 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. | ||||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | ||||||
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | ||||||
| 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.).. | ||||||
| 11 | Total support. Add lines 7 through 10 | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | 124,936 | 137,248 | 283,904 | 119,200 | 112,492 | 777,780 |
| 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 | 4,242,761 | 4,343,181 | 4,234,372 | 4,255,597 | 4,561,200 | 21,637,111 |
| 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 | 4,367,697 | 4,480,429 | 4,518,276 | 4,374,797 | 4,673,692 | 22,414,891 |
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons | 0 | |||||
| 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. | 51,428 | 45,251 | 121,472 | 23,900 | 242,051 | |
| c | Add lines 7a and 7b.. | 51,428 | 45,251 | 121,472 | 23,900 | 242,051 | |
| 8 | Public support. (Subtract line 7c from line 6.) | 22,172,840 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 4,367,697 | 4,480,429 | 4,518,276 | 4,374,797 | 4,673,692 | 22,414,891 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 94 | 388 | 1,361 | 1,734 | 2,479 | 6,056 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | 94 | 388 | 1,361 | 1,734 | 2,479 | 6,056 |
| 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.).. | 4,367,791 | 4,480,817 | 4,519,637 | 4,376,531 | 4,676,171 | 22,420,947 |
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
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| 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) |
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| 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): |
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| 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 |
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| 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 2019 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-2019 |
(iii) Distributable Amount for 2019 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2019 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI). See instructions. |
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| 3 Excess distributions carryover, if any, to 2019: | ||||
| a From 2014....... | ||||
| b From 2015....... | ||||
| c From 2016....... | ||||
| d From 2017....... | ||||
| e From 2018....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2019 distributable amount | ||||
|
i
Carryover from 2014 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | ||||
| 4Distributions for 2019 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2019 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from 4. | ||||
|
5
Remaining underdistributions for years prior to 2019, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
6
Remaining underdistributions for 2019. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions. |
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7 Excess distributions carryover to 2020. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2015..... | ||||
| b Excess from 2016..... | ||||
| c Excess from 2017..... | ||||
| d Excess from 2018..... | ||||
| e Excess from 2019..... | ||||
| Facts And Circumstances Test |
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| Return Reference | Explanation |
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| 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 VI, Section A, line 8b | Individual committees do not have the authority to act on behalf of the governing board. |
| Form 990, Part VI, Section B, line 11b | It is NEMHC's policy that the board of directors receives a copy of the Form 990 that is filed on the organization's behalf within 30 days of it being filed with the IRS. A board resolution is required in order for the Form 990 to be filed. A copy of the Form 990 will be sent to each board member via mail or email. The Executive Director and Finance Director will review the Form 990 in detail with the finance committee. |
| Form 990, Part VI, Section B, line 12c | The conflict of interest policy applies to each member of the board, to each officer of Northeastern Mental Health Center, and to all persons employed by Northeastern Mental Health Center, regardless of position. Each board member, officer, and employee of Northeastern Mental Health Center shall be requested annually by Northeastern Mental Health Center to submit a disclosure statement listing all organizations with which he or she is affiliated and describing the nature of the affiliation as defined below. In the event there is any material change in the information contained in any disclosure statement, the person who submitted it shall promptly submit written notification of the change. All disclosures required under this policy and amendments thereto, if by directors, shall be directed in writing to the chair of the board, or if by employees, to the President. The chair of the board and the president shall be responsible for the administration of this policy. Issues under this policy concerning directors and officers shall be reported initially to the chair of the board for appropriate action; those concerning staff shall be referred initially to the President. Information disclosed under this policy shall be held in confidence by the persons authorized to receive and act upon it except where, in the judgment of any of such persons, the best interest of the organization requires further disclosure. This review process shall be reported annually to the board by the chair. A director or officer or a member of their immediate family who has declared or has been found to have a conflict-of-interest in any proposed transaction or other matter shall refrain from participating in consideration of the proposed transaction or other matter, unless for special reasons the Board of Directors requests information or interpretation from the person or persons involved. When such a situation presents itself, the director shall be excused from the meeting until discussion is over the matter resolved. With respect to restraint on participation by staff, the president, or, where applicable, the chair shall take such action as is necessary to assure that the transaction is completed in the best interests of Northeastern Mental Health Center without the substantive involvement of the person who has the possible conflict-of-interest. Any board member who is uncertain about possible conflict-of-interest in any matter may request the Executive Committee to determine whether a possible conflict exists; the Executive Committee shall resolve the question by majority vote. If required, the question of potential conflict might be referred to counsel for an opinion prior to the Executive Committee vote. |
| Form 990, Part VI, Section B, line 15a | The Personnel Committee and board shall consider the following in determining executive director compensation: - The mission of NEMHC, its responsibilities on behalf of its members, and the role of the executive director in carrying out that mission and those responsibilities, - Comparability of compensation received by executive directors of similar state-level health and social service trade or professional associations in South Dakota, community behavioral health trade or professional associations in surrounding states, - Performance goals for the executive director set by the board overall and for any particular year, - Benefit packages available to staff via NEMHC personnel policies or contract with the executive director, - The capacity of the NEMHC budget and expected revenues to support a particular compensation level, and - Any salary or compensation scale the NEMHC board may establish. Procedures: - Prior to the board meeting at which the annual NEMHC budget for each fiscal year is approved, the Personnel Committee shall devote a portion of its meetings to developing a recommended total compensation figure or level for the executive director. The committee shall consider the factors outlined in the philosophy above in making its recommendation. The executive director and other staff may assist in gathering information related to this process. Deliberations of the personnel committee shall be recorded as written minutes. - In addition to the compensation factors described in the philosophy above, the recommendation for any particular year shall take into account cost-of-living and the financial condition of NEMHC. In general, total compensation shall not exceed that indicated by responsibility, performance, comparability standards, and cost-of-living but it may be less than would otherwise be indicated because of the financial condition of NEMHC and its budget. - The Personnel Committee shall provide its recommendation of executive director compensation to the NEMHC CFO in sufficient time for it to be included in the development of the annual NEMHC budget. It shall also provide its recommendation to the board prior to the meeting at which the annual NEMHC budget for the fiscal year is approved. - Prior to or during the meeting at which the NEMHC budget for the fiscal year is approved, the board shall makes its final determination of the total compensation of the executive director for that particular fiscal year based on all the considerations described in this policy. That determination shall be included in the final budget for that particular fiscal year and in IRS Form 990, audits, and other public documents. The executive director shall consider the following in determining CFO compensation: - The mission of NEMHC, its responsibilities on behalf of its members, and the role of the CFO in carrying out that mission and those responsibilities. Comparability of compensation received by CFO's of similar state-level health and social service trade or professional associations in South Dakota, community behavioral health trade or professional associations in surrounding states, - Performance goals for the CFO set by the executive director overall and for any particular year, and - The capacity of the NEMHC budget and expected revenues to support a particular compensation level. Procedures: - On or before the anniversary date of the Finance Director, the executive director completes the Finance Director's performance evaluation. In addition to the compensation factors described in the philosophy above, the recommendation for an increase in any particular year shall take into account cost-of-living and the financial condition of NEMHC. In general, total compensation shall not exceed that indicated by responsibility, performance, comparability standards, and cost-of-living but it may be less than would otherwise be indicated because of the financial condition of NEMHC and its budget. |
| Form 990, Part VI, Section C, line 19 | These documents are available upon request. |
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| Software Version: |