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HAMM MEMORIAL PSYCHIATRIC CLINIC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
HAMM MEMORIAL PSYCHIATRIC CLINIC (EIN 41-1649502)
Tax period
2012-07-01 to 2013-06-30
Filed
2013-09-23
IRS object ID
201312669349300156
Schema version
2012v2.1
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)
Timestamp2013-09-23T09:37:28-05:00Timestamp
Tax Period End Date2013-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN410746749EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1CLIFTONLARSONALLEN LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1220 SOUTH SIXTH STREET SUITE 300AddressLine1
CityMINNEAPOLISCity
StateMNState
ZIP Code55402ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN411649502EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1HAMM MEMORIAL PSYCHIATRIC CLINICBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlHAMMNameControl
Phone6512240614Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1408 ST PETER STREET NO 429AddressLine1
CityST PAULCity
StateMNState
ZIP Code55102ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameSTEPHEN DWYERName
TitleCHIEF OPERATING OFFICERTitle
Phone6512240614Phone
Date Signed2013-09-20DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameJENNIFER TINGLEYName
PTINP01485570PTIN
Phone6123764500Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonSTEPHEN DWYERNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1408 ST PETER STREET NO 429AddressLine1
CityST PAULCity
StateMNState
ZIP Code55102ZIPCode
FieldValueIRS element (for citing)
Gross Receipts2441515GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.HAMMCLINIC.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1989YearFormation
State Legal DomicileMNStateLegalDomicile
Activity Or Mission DescriptionTO PROVIDE QUALITY MENTAL HEALTH TREATMENT, REGARDLESS OF ABILITY TO PAY.ActivityOrMissionDescription
Nbr Voting Members Governing Body18NbrVotingMembersGoverningBody
Nbr Independent Voting Members18NbrIndependentVotingMembers
Total Nbr Employees34TotalNbrEmployees
Total Nbr Volunteers23TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year1691927ContributionsGrantsPriorYear
Contributions Grants Current Year1598888ContributionsGrantsCurrentYear
Program Service Revenue Prior Year854807ProgramServiceRevenuePriorYear
Program Service Revenue CY839790ProgramServiceRevenueCY
Investment Income Prior Year7873InvestmentIncomePriorYear
Investment Income Current Year2837InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year2554607TotalRevenuePriorYear
Total Revenue Current Year2441515TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year20000GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY20000GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year1913859SalariesEtcPriorYear
Salaries Etc Current Year1810993SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year37800TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year200137TotalFundrsngExpCurrentYear
Other Expense Prior Year434370OtherExpensePriorYear
Other Expenses Current Year519265OtherExpensesCurrentYear
Total Expenses Prior Year2406029TotalExpensesPriorYear
Total Expenses Current Year2350258TotalExpensesCurrentYear
Revenues Less Expenses Prior Year148578RevenuesLessExpensesPriorYear
Revenues Less Expenses CY91257RevenuesLessExpensesCY
Total Assets BOY1231490TotalAssetsBOY
Total Assets EOY1344805TotalAssetsEOY
Total Liabilities BOY901786TotalLiabilitiesBOY
Total Liabilities EOY870831TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY329704NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY473974NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionTO PROVIDE QUALITY MENTAL HEALTH TREATMENT, REGARDLESS OF ABILITY TO PAY.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense1193202Expense
Grants0Grants
Revenue817064Revenue
DescriptionCLINICAL 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. IN FY13, 800 PATIENTS WERE SERVED TOTALING 9,879 VISITS TO THE CLINIC.ELECTRONIC HEALTH RECORDS (EHR) PROGRAM: THE CLINIC TRANSITIONED TO AN ELECTRONIC HEALTH RECORDS SYSTEM.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense300911Expense
Grants20000Grants
Revenue22726Revenue
DescriptionTRAINING 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.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense74325Expense
Grants0Grants
Revenue0Revenue
DescriptionRESEARCH AND PUBLICATION: THE CLINIC CONDUCTS EFFECTIVENESS RESEARCH. EFFECTIVENESS RESEARCH SEEKS TO DETERMINE WHETHER THE TREATMENT AT THE CLINIC IS EFFECTIVE IN A COMMUNITY MENTAL HEALTH CENTER SETTING WITH A VARIETY OF CLIENTS.Description

Activity Other ActivityOther

FieldValueIRS element (for citing)
Expense31328Expense
Grants0Grants
Revenue0Revenue
DescriptionCOMMUNITY OUTREACH: THE CLINIC WORKS TO EDUCATE THE PUBLIC ABOUT MENTAL HEALTH ISSUES AND PROMOTES THE VALUE OF GOOD MENTAL HEALTH. IT ALSO WORKS TO BE A VOICE IN THE COMMUNITY FOR PERSONS WITH MENTAL ILLNESS AND TO IMPROVE PUBLIC AWARENESS OF THE SCOPE OF INFLUENCE ADULT MENTAL ILLNESS HAS ON THE COMMUNITY.Description
FieldValueIRS element (for citing)
Total Of Other Program Service Exp31328TotalOfOtherProgramServiceExp
Total Program Service Expense1599766TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities1ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
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 Individuals1GrantsToIndividuals
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 Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions1DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity0RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109612NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees34NumberOfEmployees
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 Members18NbrVotingGoverningBodyMembers
Number Independent Voting Members18NumberIndependentVotingMembers
Family Or Business Relationship1FamilyOrBusinessRelationship
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 FiledMNStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonRICHARD BOURMAN CONTROLLERNamePerson
Telephone Number6512240614TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1408 ST PETER STREET SUITE 429AddressLine1
CityST PAULCity
StateMNState
ZIP Code55102ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (24 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
ROGER OPP
BOARD PRESIDENT3.00XX000
ELIZABETH WITTENBERG
BOARD VICE PRESIDENT1.00XX000
ABBY DAWKINS
BOARD SECRETARY1.00XX000
J LAWRENCE MCINTYRE
BOARD TREASURER3.00XX000
DAVID W ALLEN JR
BOARD MEMBER1.00X000
MARILYN BROUSSARD
BOARD MEMBER1.00X000
VICTORIA COIFMAN
BOARD MEMBER1.00X000
ANNE R GEARITY
BOARD MEMBER1.00X000
EDWARD H HAMM
BOARD MEMBER1.00X000
EDWARD H HAMM III
BOARD MEMBER1.00X000
JAMES F HART MD
BOARD MEMBER1.00X000
JEREMY T LANG
BOARD MEMBER1.00X000
CHERYL J LEUNING
BOARD MEMBER1.00X000
MICKEY MULCAHY
BOARD MEMBER1.00X000
PAUL W MATTESSICH PHD
BOARD MEMBER1.00X000
JONATHAN H MORGAN
BOARD MEMBER1.00X000
KELLEY O'NEILL
BOARD MEMBER1.00X000
PAULA RICHEY
BOARD MEMBER1.00X000
KARI HUBBARD ROMINSKI
BOARD MEMBER1.00X000
BETH SULLIVAN
BOARD MEMBER1.00X000
MARK E SUNDBY PHD
BOARD MEMBER1.00X000
ROBERT NESHEIM MD
MEDICAL DIRECTOR32.00X118493015000
STEPHEN DWYER
CHIEF OPERATING OFFICER40.00X108429012200
RICHARD BOURMAN
CONTROLLER24.00X5988801800
FieldValueIRS element (for citing)
Total Reportable Comp From Org286810TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation29000TotalOtherCompensation
Number Individuals GT100 K2NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K0TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K
All Other Contributions1598888AllOtherContributions
Noncash Contributions83220NoncashContributions
Total Contributions1598888TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmount
PATIENT FEES621400817064$817,064
SEMINAR FEES/OTHER90009922726$22,726
FieldValueIRS element (for citing)
Total Program Service Revenue839790TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column2837TotalRevenueColumn
Exclusion$2,837ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column2441515TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$842,627ExclusionAmount

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total20000Total
Program Services20000ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total361122Total
Program Services91262ProgramServices
Management And General241282ManagementAndGeneral
Fundraising28578Fundraising

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total1160411Total
Program Services988673ProgramServices
Management And General74494ManagementAndGeneral
Fundraising97244Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total14017Total
Program Services12259ProgramServices
Management And General412ManagementAndGeneral
Fundraising1346Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total173639Total
Program Services134352ProgramServices
Management And General24391ManagementAndGeneral
Fundraising14896Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total101804Total
Program Services70793ProgramServices
Management And General21883ManagementAndGeneral
Fundraising9128Fundraising

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total2415Total
Management And General2415ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total11419Total
Management And General11419ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total13892Total
Program Services9660ProgramServices
Management And General2986ManagementAndGeneral
Fundraising1246Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total38863Total
Program Services359ProgramServices
Fundraising38504Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total37799Total
Program Services20713ProgramServices
Management And General14511ManagementAndGeneral
Fundraising2575Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total100346Total
Program Services18644ProgramServices
Management And General81702ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total149826Total
Program Services131766ProgramServices
Management And General15033ManagementAndGeneral
Fundraising3027Fundraising

Travel Travel

FieldValueIRS element (for citing)
Total10117Total
Program Services4663ProgramServices
Management And General5454ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total19432Total
Program Services16711ProgramServices
Management And General2721ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total41140Total
Program Services20570ProgramServices
Management And General20570ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total40075Total
Program Services27868ProgramServices
Management And General8614ManagementAndGeneral
Fundraising3593Fundraising

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
PROGRAM EXPENSES1590315903
DUES1556515565
BAD DEBTS1069810698
EQUIPMENT MAINTENANCE37923792

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total7983Total
Program Services5ProgramServices
Management And General7978ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total2350258Total
Program Services1599766ProgramServices
Management And General550355ManagementAndGeneral
Fundraising200137Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY218358BOY
EOY119759EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY3090BOY
EOY4525EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY109272BOY
EOY103488EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY41583BOY
EOY77760EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY34505BOY
EOY26999EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis478704LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec351295LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY66764BOY
EOY127409EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY527767BOY
EOY595136EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY230151BOY
EOY289729EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY1231490BOY
EOY1344805EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY276828BOY
EOY317833EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY624958BOY
EOY552998EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY901786BOY
EOY870831EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY-47846BOY
EOY41171EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY38394BOY
EOY70074EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY339156BOY
EOY362729EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY329704BOY
EOY473974EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY1231490BOY
EOY1344805EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses91257ReconcilationRevenueExpenses
Reconciliation Unrealized Invest4667ReconciliationUnrealizedInvest
Reconcilation Other Changes48346ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement SeparateXFinancialStatementSeparate
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
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 Years1692347CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years1795730CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years1610996CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year1691927CurrentTaxYearMinus1Year
Current Tax Year1598888CurrentTaxYear
Total8389888Total

Total170 Total170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years1692347CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years1795730CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years1610996CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year1691927CurrentTaxYearMinus1Year
Current Tax Year1598888CurrentTaxYear
Total8389888Total
FieldValueIRS element (for citing)
Amounts Subst Contributors Total5798574AmountsSubstContributorsTotal
Public Support Total1702591314PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years30289CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years12700CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years14352CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year7873CurrentTaxYearMinus1Year
Current Tax Year2837CurrentTaxYear
Total68051Total
FieldValueIRS element (for citing)
Total Support8457939TotalSupport
Gross Receipts From Admissions Etc4523696GrossReceiptsFromAdmissionsEtc
Public Support Pertcentage1700.30640PublicSupportPertcentage170
Public Support Pertcent Prior Year0.39940PublicSupportPertcentPriorYear
Thirty Three Percnt Tests PY170XThirtyThreePercntTestsPY170

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

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance230151BeginningOfYearBalance
Contributions40538Contributions
Investment Earnings Or Losses44750InvestmentEarningsOrLosses
Grants Or Scholarships26082GrantsOrScholarships
Administrative Expenses2628AdministrativeExpenses
End Of Year Balance286729EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance215675BeginningOfYearBalance
Contributions18747Contributions
Investment Earnings Or Losses-3814InvestmentEarningsOrLosses
Administrative Expenses457AdministrativeExpenses
End Of Year Balance230151EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance0.00000BoardDesignatedEOYBalance
Permanent Endowment EOY Balance1.00000PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.00000TermEndowmentEOYBalance
Endowments Held By Unrelated Orgs1EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs0EndowmentsHeldByRelatedOrgs

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis15854OtherCostOrOtherBasis
Depreciation14300Depreciation
Book Value1554BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis413012OtherCostOrOtherBasis
Depreciation294422Depreciation
Book Value118590BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis49838OtherCostOrOtherBasis
Depreciation42573Depreciation
Book Value7265BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings127409TotalOfBookValueLandBuildings

Other Securities OtherSecurities (2 entries)

DescriptionDescriptionBook ValueBookValueMethod Of ValuationMethodOfValuation
MONEY MARKET FUNDS AND CDS499712F
MUTUAL FUNDS95424F
FieldValueIRS element (for citing)
Total Of Book Value Securities595136TotalOfBookValueSecurities

Other Assets OtherAssets

FieldValueIRS element (for citing)
DescriptionFUNDS HELD BY THE SAINT PAUL FOUNDATIONDescription
Book Value289729BookValue
FieldValueIRS element (for citing)
Total Book Value Other Assets289729TotalBookValueOtherAssets

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionLIABILITY FOR PENSION BENEFITSDescription
Amount$552,998Amount
FieldValueIRS element (for citing)
Total Of Amounts552998TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII
Tot Revenue Etc Audited Fincl Stmt2466491TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments4667NetUnrealizedGainsInvestments
Other Revenues20309OtherRevenues
Revenue Not Rptd F99024976RevenueNotRptdF990
Revenue Subtotal2441515RevenueSubtotal
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form9902441515TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt2350258TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal2350258ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form9902350258TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS:PART V, LINE 4:TO PROVIDE SUPPORT TO ACCOMPLISH THE ORGANIZATION'S EXEMPT PURPOSE.
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X, LINE 2:THE CLINIC HAS BEEN CLASSIFIED AS A PUBLICLY SUPPORTED CLINIC, AND IS EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE CLINIC HAS ADOPTED GUIDANCE IN THE INCOME TAX STANDARD REGARDING THE RECOGNITION OF UNCERTAIN TAX POSITIONS. THE GUIDANCE PRESCRIBES RECOGNITION THRESHOLD PRINCIPLES FOR THE FINANCIAL STATEMENT RECOGNITION OF TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN ON A TAX FILING THAT ARE NOT CERTAIN TO BE REALIZED. THE IMPLEMENTATION OF THIS GUIDANCE HAD NO IMPACT ON THE CLINIC'S FINANCIAL STATEMENTS. THE CLINIC'S TAX FILINGS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL AND STATE AUTHORITIES. THE CLINIC IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE ITS TAX EXEMPT STATUS. THE CLINIC IS NOT AWARE OF ANY ACTIVITIES THAT ARE SUBJECT TO TAX ON UNRELATED BUSINESS INCOME, EXCISE OR OTHER TAXES. THE FILINGS FOR THE YEARS 2008 TO 2011 ARE OPEN TO EXAMINATION BY FEDERAL AND STATE AUTHORITIES.
PART XI, LINE 2D - OTHER ADJUSTMENTS:CHANGE IN VALUE - COMMUNITY FOUNDATION FUNDS 20,309.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Form990 Schedule I Part III Form990ScheduleIPartIII

FieldValueIRS element (for citing)
Type Of GrantGRANTS, IN THE FORM OF STIPENDS, ARE GIVEN TO PSYCHOLOGY STUDENTS IN BI-WEEKLY PAYMENTS OVER A PERIOD OF ONE YEAR.TypeOfGrant
Number Of Recipients3NumberOfRecipients
Amount Of Cash Grant20000AmountOfCashGrant
Amount Of Non Cash Assistance0AmountOfNonCashAssistance
Method Of ValuationN/AMethodOfValuation
Description Of Non Cash AssistanceN/ADescriptionOfNonCashAssistance

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierPROCEDURE FOR MONITORING GRANTS IN THE U.S.:Identifier
Return ReferencePART I, LINE 2:ReturnReference
ExplanationSCHEDULE I, PART I, LINE 2: GRANTS, IN THE FORM OF STIPENDS, ARE GIVEN TO PSYCHOLOGY STUDENTS IN BI-WEEKLY PAYMENTS OVER A PERIOD OF ONE YEAR. THE CLINIC HAS THREE TYPES OF STUDENT PLACEMENTS: MASTERS LEVEL SOCIAL WORK STUDENTS, POST-GRADUATE PSYCHOLOGY STUDENTS AND POST DOCTORAL FELLOWS. EACH YEAR THE CLINIC DECIDES HOW MANY OF WHICH TYPE OF STUDENT THAT WILL BE ADMITTED. AFTER DETERMINATIONS ARE MADE, THE CLINIC NOTIFIES THE LOCAL SCHOOLS WITH WHOM THE CLINIC HAS AN ONGOING WORKING RELATIONSHIP WITH AND THE AMERICAN PSYCHOLOGICAL ASSOCIATION. THE LOCAL SCHOOLS ADVERTISE THE SOCIAL WORK AND POST-DOCTORAL OPENINGS AND THE AMERICAN PSYCHOLOGICAL ASSOCIATION ADVERTISES THE POST-GRADUATE PSYCHOLOGY POSITIONS. APPLICANTS WHO ARE VETTED BY THEIR RESPECTIVE ORGANIZATIONS ARE ELIGIBLE TO APPLY FOR A STUDENT PLACEMENT. THE CLINIC REVIEWS ALL APPLICATIONS AND THEN ARRANGE INTERVIEWS. A STAFF COMMITTEE MAKES THE ULTIMATE DECISION WHO TO ADMIT.Explanation

Schedule M IRS990ScheduleM

Securities Publicly Traded SecuritiesPubliclyTraded

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
Number Of Contributions1NumberOfContributions
Noncash Contribs Rptd F99083220NoncashContribsRptdF990
Method Of Determining RevenuesSTOCK MARKET QUOTESMethodOfDeterminingRevenues
FieldValueIRS element (for citing)
Number Of8283 Received0NumberOf8283Received
Any Property That Must Be Held0AnyPropertyThatMustBeHeld
Review Process Unusual NC Gifts0ReviewProcessUnusualNCGifts
Third Parties Used0ThirdPartiesUsed

Form990 Schedule M Part II Form990ScheduleMPartII

FieldValueIRS element (for citing)
IdentifierTHIRD PARTY USE:Identifier
Return ReferencePART I, LINE 32B:ReturnReference
ExplanationTHE CLINIC WILL APPROVE A GIFT ACCEPTANCE POLICY THAT REQUIRES REVIEW OF NON-STANDARD CONTRIBUTIONS DURING FISCAL YEAR 2014.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (7 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION A, LINE 1THE HAMM CLINIC EXECUTIVE COMMITTEE IS COMPRISED OF THE BOARD OF OFFICERS (PRESIDENT, VICE PRESIDENT, TREASURER AND SECRETARY); THE ASSISTANT SECRETARY; THE COMMITTEE CHAIRPERSONS; THE EXECUTIVE MEDICAL DIRECTOR AND THE CHIEF OPERATING OFFICER; AND ANY OTHER BOARD MEMBER THE PRESIDENT APPOINTS TO THE EXECUTIVE COMMITTEE. AD HOC RESPONSIBILITIES (PERFORMED ON AN AS NEEDED BASIS): - ADVISE EXECUTIVE MEDICAL DIRECTOR AND CHIEF OPERATING OFFICER ON PERSONNEL MATTERS, AS REQUESTED. - CONDUCT THE BUSINESS FOR THE BOARD, IF NECESSARY BEFORE THE FULL BOARD CAN MEET. - IMPLEMENT PROCESS AND PROCEDURES FOR SELECTION OF A NEW EXECUTIVE MEDICAL DIRECTOR AND THE CHIEF OPERATING OFFICER. - 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 2EDWARD H. HAMM AND EDWARD H. HAMM III, BOTH BOARD MEMBERS, HAVE A FAMILY RELATIONSHIP.
FORM 990, PART VI, SECTION B, LINE 11THE FINANCE COMMITTEE WILL MEET WITH THE AUDITORS ON OR BEFORE SEPTEMBER 12TH 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. THE CONTROLLER AND COO WILL ALSO REVIEW THE FORM 990. 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 12CBOARD 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 15THE PROCESS FOR DETERMINING THE COMPENSATION OF THE CHIEF OPERATING OFFICER 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 CHIEF OPERATING OFFICER, S. DWYER IN 2012. THE PROCESS FOR DETERMINING OTHER OFFICERS' COMPENSATION INCLUDED A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, CONTEMPORANEOUS SUBSTANTIATION, AND A REVIEW BY THE EXECUTIVE AND FINANCE COMMITTEES WITH THE CHIEF OPERATING OFFICER AND THE BOARD PRESIDENT. THE PROCESS WAS LAST UNDERTAKEN FOR THE CONTROLLER, R. BOURMAN IN 2012; AND MEDICAL DIRECTOR, R. NESHEIM IN 2012.
FORM 990, PART VI, SECTION C, LINE 19THE 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 20,309. CHANGE IN LONG-TERM PENSION OBLIGATION 28,037.CHANGES IN NET ASSETS OR FUND BALANCES: