2021-04-23T17:07:28-05:00 2020-06-30 410746749 CLIFTONLARSONALLEN LLP 220 S 6TH STREET SUITE 300 MINNEAPOLIS MN 55402 990 2019-07-01 411649502 HAMM MEMORIAL PSYCHIATRIC CLINIC HAMM 6512240614 408 ST PETER STREET NO 429 ST PAUL MN 55102 ANGELA LEWIS-DMELLO EXECUTIVE DIRECTOR 6512240614 2021-04-22 1 JENNIFER TINGLEY P01485570 6123764500 2021-04-22 2019 2022-09-23 18:48:47Z ANGELA LEWIS-DMELLO 408 ST PETER STREET NO 429 ST PAUL MN 55102 2700708 0 X WWW.HAMMCLINIC.ORG X 1989 MN TO PROVIDE QUALITY MENTAL HEALTH TREATMENT, REGARDLESS OF ABILITY TO PAY. 9 9 31 2 0 0 1612728 1629378 1072005 1061241 19682 10089 0 0 2704415 2700708 0 0 0 0 1935579 2050062 0 0 86342 643955 617996 2579534 2668058 124881 32650 2161845 2572246 173002 561332 1988843 2010914 X HAMM CLINIC'S MISSION IS TO PROVIDE HIGH-QUALITY, CULTURALLY RESPONSIVE OUTPATIENT MENTAL HEALTH CARE TO OUR COMMUNITY, ESPECIALLY FOR THOSE UNABLE TO ACCESS CARE DUE TO INABILITY TO PAY. 0 0 1620892 0 1019867 CLINICAL SERVICES: HAMM MEMORIAL PSYCHIATRIC CLINIC PROVIDES A VARIETY OF OUTPATIENT MENTAL HEALTH AND RELATED SERVICES TO ADULTS AND OPERATES IN THE TWIN CITIES METROPOLITAN AREA. THE CLINIC OFFERS A FULL SPECTRUM OF OUTPATIENT MENTAL HEALTH SERVICES IN ENGLISH AND SPANISH. THE CLINIC SEEKS TO TREAT SYMPTOMS AND ALSO TO HELP CLIENTS GAIN INSIGHT AND UNDERSTANDING INTO THEIR BEHAVIOR. THE CLINIC TEAM IS COMPRISED OF CLINICAL SOCIAL WORKERS, PSYCHOLOGISTS, AND PSYCHIATRISTS WORKING TOGETHER TO IMPROVE MENTAL HEALTH. 230467 0 7504 TRAINING AND PROFESSIONAL DEVELOPMENT: THE CLINIC'S TRAINING PROGRAM PROVIDES SPECIALIZED TRAINING AND EDUCATION FOR GRADUATES AND POST-GRADUATES IN CLINICAL SOCIAL WORK, PSYCHOLOGY, AND PSYCHIATRY. THE CLINIC'S COMPREHENSIVE APPROACH TO TRAINING ENABLES STUDENTS TO PROVIDE DIRECT CLIENT CARE UNDER CLOSE SUPERVISION. 32408 0 33870 PSYCHIATRY: PROVIDE PSYCHIATRIC ASSESSMENT, NURSING, AND MEDICATION TO OUR CLIENTS IN AN INTERDISCIPLINARY, CULTURALLY RESPONSIVE MANNER. 6897 0 0 COMMUNITY OUTREACH: THE CLINIC PARTICIPATES IN LOCAL MENTAL HEALTH AWARENESS EVENTS IN THE TWIN CITIES AREA. 6897 0 0 1890664 1 1 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 31 0 31 1 0 0 0 0 0 0 0 0 0 0 0 0 X 9 9 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 MN X CLIFTONLARSONALLEN LLP 6123764500 220 SOUTH SIXTH STREET SUITE 300 MINNEAPOLIS MN 55402 LOUISA D'ATILIA EXECUTIVE DIRECTOR 40.00 X 189874 0 6838 ANGELA LEWIS-DMELLO EXECUTIVE DIRECTOR 40.00 X 84843 0 4886 HENRY STOKMAN BOARD PRESIDENT 4.00 X X 0 0 0 MELANIE FERRIS BOARD VICE PRESIDENT 2.00 X X 0 0 0 KAREN NANCEKIVELL BOARD VICE PRESIDENT 2.00 X X 0 0 0 DAMON ANDERSON BOARD TREASURER 2.00 X X 0 0 0 RAEONE MAGNUSON BOARD SECRETARY 2.00 X X 0 0 0 ELIZABETH WITTENBERG BOARD SECRETARY 2.00 X X 0 0 0 JULIE BLUHM BOARD MEMBER 2.00 X 0 0 0 KEN EBEL BOARD MEMBER 2.00 X 0 0 0 ANNE R GEARITY BOARD MEMBER 2.00 X 0 0 0 EDWARD H HAMM BOARD MEMBER 2.00 X 0 0 0 EDWARD H HAMM JR BOARD MEMBER 2.00 X 0 0 0 KELLEY O'NEILL BOARD MEMBER 2.00 X 0 0 0 DINA RAUKER BOARD MEMBER 2.00 X 0 0 0 MARK SUNDBY BOARD MEMBER 2.00 X 0 0 0 274717 0 11724 1 0 1 0 0 1629378 94746 1629378 PATIENT FEES 621400 1019867 1019867 SEMINAR FEES/OTHER 900099 41374 41374 1061241 10089 10089 2700708 1061241 0 10089 262675 6269 256406 1423145 1320642 78028 24475 25726 25053 140 533 232848 181269 47785 3794 105668 81350 22603 1715 25429 19577 5439 413 9125 9125 110145 110145 100413 68359 32054 19536 261 19275 50503 26004 24015 484 68349 35522 32803 24 148975 131098 14897 2980 6296 6296 4698 2619 2079 721 721 7838 3919 3919 33077 25465 7075 537 PROGRAM EXPENSES 9783 9783 DUES & SUBSCRIPTIONS 9412 9412 MISCELLANEOUS 6938 6125 755 58 EQUIPMENT MAINTENANCE 6758 6758 2668058 1890664 691052 86342 819112 1495094 301627 400400 2402 30010 122786 159701 43408 50821 504581 493310 19108 11271 399390 454012 424949 2161845 2572246 168889 229450 0 10000 0 313200 4113 8682 173002 561332 X 1534581 1557173 454262 453741 1988843 2010914 2161845 2572246 X 32650 610 -11189 X 0 1 X 1 0 X 1744925 1855113 3221278 1612728 1629378 10063422 1744925 1855113 3221278 1612728 1629378 10063422 2389804 7673618 4913 7369 10694 19682 10089 52747 10116169 4908271 0.75850 0.76110 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 454010 250 -11189 17223 899 424949 451870 2700 21074 17768 2866 454010 431160 7350 34252 17227 3665 451870 375493 17745 57088 15915 3251 431160 392323 10070 -7404 16341 3150 375493 0.00000 1.00000 0.00000 1 0 15854 15854 0 149003 137802 11201 339724 339654 70 11271 FUNDS HELD BY THE SAINT PAUL FOUNDATION 424949 424949 LIABILITY FOR CAPITAL LEASE 8682 8682 X 2690129 610 -11189 -10579 2700708 0 2700708 2668058 0 2668058 0 2668058 PART V, LINE 4: TRAINING PSYCHIATRY RESIDENTS AND OTHER INTERNS. PART X, LINE 2: THE CLINIC IS A PUBLICLY SUPPORTED TAX-EXEMPT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE "CODE") AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME. THE CLINIC IS ALSO EXEMPT FROM STATE INCOME TAXES UNDER SIMILAR PROVISIONS OF THE MINNESOTA STATUTES. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN VALUE - COMMUNITY FOUNDATION FUNDS -11,189. X X X 1 0 0 0 0 0 0 0 0 LOUISA D'ATILIA EXECUTIVE DIRECTOR 99093 0 0 0 90781 0 4892 0 1946 0 196712 0 0 0 PART I, LINE 4A LOUISA D'ALTILLIA RECEIVED A LUMP SUM SEVERANCE PAYMENT IN 2019 OF $75,104. MARY HORNER RECEIVED BIWEEKLY SEVERANCE PAYOUTS IN 2019 AND 2020 TOTALING $36,057 THAT ENDED IN JUNE 2020. X 1 94746 FMV 0 0 0 0 PART I, COLUMN (B): NUMBER OF CONTRIBUTORS FORM 990, PART VI, SECTION A, LINE 1 THE HAMM CLINIC EXECUTIVE COMMITTEE IS COMPRISED OF THE BOARD OF OFFICERS (PRESIDENT, VICE PRESIDENT, TREASURER AND SECRETARY). AD HOC RESPONSIBILITIES (PERFORMED ON AN AS NEEDED BASIS): - CONDUCT THE BUSINESS FOR THE BOARD, IF NECESSARY BEFORE THE FULL BOARD CAN MEET. - MONITOR THE PERFORMANCE OF THE BOARD COMMITTEES. TAKE ACTION TO CORRECT ANY DEFICIENCIES. - REVIEW OPERATIONAL RESULTS AND STATISTICS. - REVIEW INFORMATION ABOUT EXTERNAL TRENDS AND DEVELOPMENTS. FORM 990, PART VI, SECTION A, LINE 2 EDWARD H. HAMM, EDWARD H. HAMM JR., AND KELLEY O'NEILL, ALL BOARD MEMBERS, HAVE A FAMILY RELATIONSHIP. FORM 990, PART VI, SECTION B, LINE 11B THE EXECUTIVE DIRECTOR WILL PROVIDE COPY TO THE FINANCE COMMITTEE TO REVIEW THE AUDIT RESULTS AND FINANCIAL REPORTS. THE FORM 990 WILL BE EMAILED TO ALL FINANCE COMMITTEE MEMBERS FOR THEIR REVIEW AND EDIT COMMENTS. A COPY OF THE 990 WILL BE PROVIDED TO THE WHOLE BOARD BEFORE IT IS FILED WITH IRS. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS FILL OUT AN ANNUAL DISCLOSURE FORM. IN THE CASE OF A CONFLICT, OR THE APPEARANCE THEREOF, BOARD MEMBERS ARE EXPECTED TO DISCLOSE THE CONFLICT PRIOR TO THE CLINIC'S MAKING ANY RELATED DECISIONS. IF A CONFLICT OF INTEREST IS PRESENT, THE DIRECTOR INVOLVED MUST IDENTIFY THE CONFLICT AND MAY, AT THE REQUEST OF THE BOARD OR COMMITTEE, REMAIN IN THE ROOM TO ANSWER QUESTIONS OF A FACTUAL NATURE THAT MAY ASSIST THE BOARD OR COMMITTEE IN ITS DELIBERATION AND DETERMINATION OF WHETHER OR NOT AN ACTUAL CONFLICT OF INTEREST EXISTS. BOARD MEMBERS HAVING A CONFLICT OF INTEREST ON A GIVEN ISSUE DO NOT VOTE ON THAT ISSUE. PROCEEDINGS RELATED TO CONFLICTS OF INTEREST ARE DOCUMENTED IN THE MEETING MINUTES. FORM 990, PART VI, SECTION B, LINE 15 THE PROCESS FOR DETERMINING THE COMPENSATION OF THE EXECUTIVE DIRECTOR INCLUDED A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA AND CONTEMPORANEOUS SUBSTANTIATION. THE EXECUTIVE COMMITTEE ALSO REVIEWS THE COMPENSATION AND BONUS PLAN. THE PROCESS WAS LAST UNDERTAKEN FOR THE EXECUTIVE DIRECTOR, ANGELA LEWIS-DMELLO, IN MAY OF 2020. THE PROCESS FOR DETERMINING OTHER OFFICERS' COMPENSATION INCLUDED A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, CONTEMPORANEOUS SUBSTANTIATION, AND A REVIEW BY THE FINANCE COMMITTEE. THE PROCESS WAS LAST UNDERTAKEN IN FEBRUARY OF 2020. FORM 990, PART VI, SECTION C, LINE 19 THE CLINIC'S CONFLICT OF INTEREST POLICY, GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: CHANGE IN VALUE - COMMUNITY FOUNDATION FUNDS -11,189.