MID-MICHIGAN DISTRICT HEALTH DEPARTMENT · 2016-04-27 · MID-MICHIGAN DISTRICT HEALTH DEPARTMENT An Accredited Local Public Health Department CLINTON Branch Office 1307 E. Townsend

MID-MICHIGAN DISTRICT HEALTH DEPARTMENT An Accredited Local Public Health Department www.mmdhd.org

CLINTON

Branch Office 1307 E. Townsend Rd.

St. Johns, MI 48879-9036 (989) 224-2195

GRATIOT Branch Office

151 Commerce Drive Ithaca, MI 48847-1627

(989) 875-3681

MONTCALM Branch Office

615 N. State St., Ste. 1 Stanton, MI 48888-9702

(989) 831-5237

ADMINISTRATIVE OFFICES 615 N. State St. Ste. 2

Stanton, MI 48888-9702 (989) 831-5237

MARK W. (MARCUS) CHEATHAM Health Officer JENNIFER MORSE, MD Medical Director

BOARD OF HEALTH George Bailey Bruce DeLong

Betty Kellenberger Tom Lindeman

Ken Mitchell Sam Smith

Your Public Health Team,

Connecting with our Communities to Achieve Healthier Outcomes.

BOARD OF HEALTH

FINANCE COMMITTEE MEETING

at

Mid-Michigan District Health Department

Montcalm Administrative Offices

615 N. State St., Ste. 2, Stanton,

Michigan

Wednesday, April 27, 2016

9:30 AM

AGENDA

We take action to assure the health and well being of our community and the environment

by responding to public health needs and providing a broad spectrum

of prevention and educational services.

COMMITTEE MEMBERS: George Bailey, Bruce DeLong, Tom Lindeman (Chair)

STAFF: Mark W. (Marcus) Cheatham, Ph.D., Health Officer; Melissa Bowerman,

Director of Administrative Services; and Cindy Partlo, Board Secretary

A. Mid-Michigan District Health Department's Expenses for March 21 - April 17, 2015 -

Attached.

3

B. Mid-Michigan District Health Department's Monthly Balance Sheet, Revenue and Expenditure

Report for March 2015 - Attached.

29

C. MMDHD Form 990 - Attached. 36

D. Montcalm County Branch Office Roof Expense - Attached. 73

E. Smoking Cessation Counseling Fees - Attached. 76

F. Local Appropriation Policy

G. New Fees for Primary Care Project - Attached. 78

http://www.mmdhd.org/

H. Increased Product Fee - Attached. 80

EV 1815 190,913.05$

EV 1816 219,632.22$

EV 1817 182,546.57$

TOTAL 593,091.84$

MONTHLY EXPENSES FORMarch 5, 2016 - April 15, 2016

3

CK# EV 1815 3/18/2016

Payables

102340

thru Quantum Checks & Direct Deposits 25,318.32$

102370

Payroll

AFLAC Employee Deduction 371.86$

MERS Employee Electronic Transfer 3,659.44$

Chemical Bank Payroll-Ameriprise NBS 200.00$

Chemical Bank Payroll-Nationwide 2,240.00$

Chemical Bank Payroll-MERS 457 365.00$

Chemical Bank Payroll Tax Electronic Transfer

Federal 31,712.74$

State 9,491.33$

MERS Employer Electronic Transfer 16-Feb 20,544.54$

Chemical E-Banking fee 16-Feb 75.35$

Chemical Bank Interest 16-Feb (2.39)$

Direct Deposit Payroll 96,936.86$

State of Michigan Unemployment 4Q FY15

TOTAL 190,913.05$


615 North State Street, Suite 2

Stanton MI 48888

(989) 831-5237

4

RUN DATE: MAR 16, 2016 - 16:05 Mid Michigan District Health Department PAGE 0001

ACCOUNTS PAYABLE CHECK REGISTER

CHECK CHECK\VOID REMIT-TO NAME INVOICE INVOICE VOUCH# P.O.-NO AMOUNT DISCOUNT CHECK

NO DATE VENDOR-# NO DATE PAID TAKEN AMOUNT

------------------------------------------------- -------------------------------------------- -------------- ------------- ------------

118 03/18/16 BAI102 BAILEY GEORGE 100443 02/24/16 13973 84.92$ -$ 84.92$

FEB 2016 TRAVEL/PER DIEM

DIRECT DEPOSIT

CHECK TOTALS: 84.92$ -$ 84.92$

119 03/18/16 KEL038 KELLENBERGER BETTY 100441 02/24/16 13971 287.36$ -$ 287.36$


DIRECT DEPOSIT

CHECK TOTALS: 287.36$ -$ 287.36$

120 03/18/16 LIN033 LINDEMAN TOM 100444 02/24/16 13974 112.46$ -$ 112.46$


DIRECT DEPOSIT

CHECK TOTALS: 112.46$ -$ 112.46$

102236 03/16/16 UPP016 Upp TECHNOLOGY, INC. INV-006010 12/31/15 13754 (625.00)$ -$ (625.00)$

CONSULTING (LOST CHECK)

VOID CHECK TRANSACTION

CHECK TOTALS: (625.00)$ -$ (625.00)$

102340 03/18/16 BAI014 BAILEY'S 16.10390 03/04/16 13943 094134-00 45.00$ -$ 45.00$

CHLORINE/QUAT TEST STRIPS

COMPUTER CHECK

CHECK TOTALS: 45.00$ -$ 45.00$

102341 03/18/16 CAP095 CAPITAL AREA UNITED WAY 100451 03/16/16 13993 40.00$ -$ 40.00$

3/18/16 EMPLOYEE DONATION

COMPUTER CHECK

CHECK TOTALS: 40.00$ -$ 40.00$

102342 03/18/16 CEN149 CENTURYLINK 1368336534 02/29/16 13953 17.42$ -$ 17.42$

ACCESS LINE FEES

COMPUTER CHECK

CHECK TOTALS: 17.42$ -$ 17.42$

102343 03/18/16 COH003 COHL, STOKER & TOSKEY 46275 03/04/16 13958 518.00$ -$ 518.00$

FEBURARY 2016 LEGAL

COMPUTER CHECK

CHECK TOTALS: 518.00$ -$ 518.00$

102344 03/18/16 DAI009 DAILY NEWS AMP01038334 02/29/16 13966 134.15$ -$ 134.15$

2016 BOH MTGS

COMPUTER CHECK

CHECK TOTALS: 134.15$ -$ 134.15$

102345 03/18/16 EAT029 EATON RESA 003989 03/02/16 13956 1,664.41$ -$ 1,664.41$

2Q FY16 OWEN DRUG FREE GRANT

COMPUTER CHECK

CHECK TOTALS: 1,664.41$ -$ 1,664.41$

5





------------------------------------------------- -------------------------------------------- -------------- ------------- ------------

102346 03/18/16 GIS055 GIS AUTHORITY FY15/16 02/29/16 13965 750.00$ -$ 750.00$

MEMBERSHIP DUES

COMPUTER CHECK

CHECK TOTALS: 750.00$ -$ 750.00$

102347 03/18/16 GRA009 GRATIOT COUNTY HERALD 100439 02/29/16 13964 142.50$ -$ 142.50$

EH SPECIALIST/2016 BOH MTGS

COMPUTER CHECK

2016 SUBSCRIPTI 03/03/16 13955 30.00$ -$ 30.00$

ONE YEAR ONLINE SUBSCRIPTION

CHECK TOTALS: 172.50$ -$ 172.50$

102348 03/18/16 HAZ107 HAZLE JUDY 31716 02/29/16 13961 80.00$ -$ 80.00$

AP6 #2 REFUND TEMP FOOD PERMIT

COMPUTER CHECK

CHECK TOTALS: 80.00$ -$ 80.00$

102349 03/18/16 HUC020 HUCH'S FINE JEWELRY 822 03/04/16 13967 70.00$ -$ 70.00$

FARQUHARSON RETIREMENT CLOCK

COMPUTER CHECK

CHECK TOTALS: 70.00$ -$ 70.00$

102350 03/18/16 LIN061 LINCOLN FINANCIAL GROUP 100450 04/01/16 13990 1,306.45$ -$ 1,306.45$

LIFE/VOLUNTARY LIFE & LTD

COMPUTER CHECK

CHECK TOTALS: 1,306.45$ -$ 1,306.45$

102351 03/18/16 MIC175 MICHIGAN.COM 2114072111 02/28/16 13963 1,001.75$ -$ 1,001.75$

EH SPECIALIST/2016 BOH MTGS

COMPUTER CHECK

CHECK TOTALS: 1,001.75$ -$ 1,001.75$

102352 03/18/16 MIS005 MiSDU/FRIEND OF COURT 100451 03/16/16 13992 234.68$ -$ 234.68$

3/18/16 EMPLOYEE DEDUCTION

COMPUTER CHECK

CHECK TOTALS: 234.68$ -$ 234.68$

102353 03/18/16 MNA004 MICHIGAN NURSES ASSOCIATION 100451 03/16/16 13991 607.75$ -$ 607.75$

DUES FOR MARCH

COMPUTER CHECK

CHECK TOTALS: 607.75$ -$ 607.75$

102354 03/18/16 NET026 NETSMART TECHNOLOGIES 56451 03/01/16 13960 249.36$ -$ 249.36$

4/1/16 - 3/31/17 CARECONNECT

COMPUTER CHECK

CHECK TOTALS: 249.36$ -$ 249.36$

6





------------------------------------------------- -------------------------------------------- -------------- ------------- ------------

102355 03/18/16 OFF001 OFFICEMAX INCORPORATED 308227 02/11/16 13946 094112-00 96.97$ -$ 96.97$

HANGING FILES,TABS

COMPUTER CHECK

316155 02/17/16 13945 094112-00 15.79$ -$ 15.79$

BATTERIES

422810 02/19/16 13942 094122-00 465.96$ -$ 465.96$

COPY PAPER,LABELS,BATTERIES

CHECK TOTALS: 578.72$ -$ 578.72$

102356 03/18/16 PAT052 PATTERSON DENTAL 575/3202458 03/04/16 13952 094130-00 651.84$ -$ 651.84$

PROENAMEL VARNISH

COMPUTER CHECK

586/2018246 03/04/16 13951 094130-00 568.00$ -$ 568.00$

PROENAMEL VARNISH

CHECK TOTALS: 1,219.84$ -$ 1,219.84$

102357 03/18/16 R&S005 R&S NORTHEAST LLC 94732 02/10/16 13949 094118-00 672.90$ -$ 672.90$

MEDROXY,ORTHO TRI-CYCLEN

COMPUTER CHECK

94933 02/11/16 13950 094118-00 4,168.30$ -$ 4,168.30$

MEDROXYPRO

CHECK TOTALS: 4,841.20$ -$ 4,841.20$

102358 03/18/16 SHA199 SHAFFER AMANDA 100440 03/01/16 13969 90.00$ -$ 90.00$

2/23 & 3/3 CSHCS PARENT LIASON

COMPUTER CHECK

CHECK TOTALS: 90.00$ -$ 90.00$

102359 03/18/16 SMI205 SMITH SAM 100442 02/24/16 13972 52.36$ -$ 52.36$


COMPUTER CHECK

CHECK TOTALS: 52.36$ -$ 52.36$

102360 03/18/16 SPE191 SPECTRUM HEALTH FINANCE IN00031797 01/31/16 13954 42.00$ -$ 42.00$

NEAR CPR TRAINING

COMPUTER CHECK

CHECK TOTALS: 42.00$ -$ 42.00$

102361 03/18/16 STA032 STATE OF MICHIGAN-MDHHS GRA0102182016 02/18/16 13968 17.67$ -$ 17.67$

LAB

COMPUTER CHECK

CHECK TOTALS: 17.67$ -$ 17.67$

7





------------------------------------------------- -------------------------------------------- -------------- ------------- ------------

102362 03/18/16 STA194 STAPLES ADVANTAGE 803813343 02/20/16 13941 094110-00 22.70$ -$ 22.70$

SELF INKING STAMP

COMPUTER CHECK

8037954783 02/06/16 13940 094110-00 182.13$ -$ 182.13$

PENS,BOX FILE,BULLETIN BOARD

8038245179 02/27/16 13944 094126-00 67.59$ -$ 67.59$

COSCO STAMP

CHECK TOTALS: 272.42$ -$ 272.42$

102363 03/18/16 TEA001 TEAMSTERS LOCAL 214 100451 03/16/16 13996 1,987.43$ -$ 1,987.43$

MARCH 2016 DUES

COMPUTER CHECK

CHECK TOTALS: 1,987.43$ -$ 1,987.43$

102364 03/18/16 UNI001 UNITED WAY OF MONTCALM CO 100451 03/16/16 13995 135.00$ -$ 135.00$


COMPUTER CHECK

CHECK TOTALS: 135.00$ -$ 135.00$

102365 03/18/16 UNI009 UNITED WAY OF GRATIOT CO 100451 03/16/16 13994 107.00$ -$ 107.00$


COMPUTER CHECK

CHECK TOTALS: 107.00$ -$ 107.00$

102366 03/18/16 UPP016 Upp TECHNOLOGY, INC. 006127 12/31/15 13987 500.00$ -$ 500.00$

DECEMBER 2015 CONTRACTING

COMPUTER CHECK

006266 01/31/16 13985 2,000.00$ -$ 2,000.00$

JANUARY 2016 CONSULTING

006431 02/29/16 13986 625.00$ -$ 625.00$

FEBRUARY 2016 CONSULTING

INV-006010 12/31/15 13754 625.00$ -$ 625.00$

CONSULTING (REPLACE LOST CHECK)

CHECK TOTALS: 3,750.00$ -$ 3,750.00$

102367 03/18/16 UPS002 UNITED PARCEL SERVICE 106 03/05/16 13959 6.69$ -$ 6.69$

MAILED FOOD TEST EXAMS

COMPUTER CHECK

CHECK TOTALS: 6.69$ -$ 6.69$

102368 03/18/16 VER004 VERIZON 9761069551 03/01/16 13962 222.67$ -$ 222.67$

2/24-3/23 MIHP BROADBAND

COMPUTER CHECK

CHECK TOTALS: 222.67$ -$ 222.67$

8





------------------------------------------------- -------------------------------------------- -------------- ------------- ------------

102369 03/18/16 WES058 WEST MICHIGAN ASSOCIATION 768 03/11/16 13970 95.00$ -$ 95.00$

MARTIN BREASFEEDING CONFERENCE

COMPUTER CHECK

CHECK TOTALS: 95.00$ -$ 95.00$

102370 03/18/16 FIR003 FIRST NATIONAL BANK OMAHA 100445 03/02/16 13975 27.93$ -$ 27.93$

RIC'S FOOD-R4Q SUPPLIES

COMPUTER CHECK

100446 03/02/16 13976 105.30$ -$ 105.30$

MIKESELL/DOAK TRAINING/PAGER

100447 03/02/16 13977 094109-00 46.25$ -$ 46.25$

CONCENTRATED SUDS 5LB

100449 03/02/16 13984 665.79$ -$ 665.79$

TRAINING/MED WASTE CERT/SUPPLY

100447-1 03/02/16 13978 941121-00 54.51$ -$ 54.51$

MMDHD.ORG DOMAIN RENEWAL

100447-2 03/02/16 13979 094084-00 894.65$ -$ 894.65$

3 CBO STAMPED ENVELOPES

100447-3 03/16/16 13981 094123-00 144.16$ -$ 144.16$

2 H/V CASES W/HANGING FOLDERS

100447-4 03/02/16 13982 094128-00 78.56$ -$ 78.56$

ACTIVITY GARDEN PLAYSET

100447-5 03/02/16 13983 3,131.96$ -$ 3,131.96$

TRAINING/SURVEY MONKEY/POSTAGE

CHECK TOTALS: 5,149.11$ -$ 5,149.11$

BANK CODE TOTALS: 25,318.32$ -$ 25,318.32$

31 COMPUTER CHECKS

0 MANUAL PAYMENT CHECKS

1 VOID CHECKS - TRX

0 VOID CHECKS - STUBS

0 VOID CHECKS - ERROR

0 VOID CHECKS - FORM ALIGNMENT

3 DIRECT DEPOSITS

35 CHECKS TOTAL

COMPANY TOTALS: 25,318.32$ -$ 25,318.32$

9

CK# EV 1816 4/1/2016

Payables

102371

thru Quantum Checks & Direct Deposits 81,121.86$

102401

Payroll







Federal 31,227.14$

State -$

MERS Employer Electronic Transfer 16-Feb -$

Chemical E-Banking fee 16-Feb -$

Chemical Bank Interest 16-Feb -$


State of Michigan Unemployment 4Q FY15 -$

TOTAL 219,632.22$



Stanton MI 48888

(989) 831-5237

10





------------------------------------------------- -------------------------------------------- -------------- ------------- ------------


MARCH TRAVEL/PER DIEM

DIRECT DEPOSIT

CHECK TOTALS: 59.54$ -$ 59.54$



DIRECT DEPOSIT

CHECK TOTALS: 242.68$ -$ 242.68$

123 04/01/16 LIN033 LINDEMAN TOM 100462 03/16/16 14025 106.52$ -$ 106.52$


DIRECT DEPOSIT

CHECK TOTALS: 106.52$ -$ 106.52$

124 04/01/16 MIT173 MITCHELL KEN 100461 03/16/16 14024 51.28$ -$ 51.28$


DIRECT DEPOSIT

CHECK TOTALS: 51.28$ -$ 51.28$

102371 04/01/16 AED AED PROFESSIONALS 42924 02/26/16 14031 094140-00 285.00$ -$ 285.00$

INFANT/CHILD ELECTRODE PADS

COMPUTER CHECK

CHECK TOTALS: 285.00$ -$ 285.00$

102372 04/01/16 AME020 AMERICAN PUBLIC HEALTH ASSOC 100458 03/15/16 14018 200.00$ -$ 200.00$

16/17 MEMBERSHIP

COMPUTER CHECK

CHECK TOTALS: 200.00$ -$ 200.00$

102373 04/01/16 BLU008 BLUE CROSS BLUE SHIELD OF MI 100464 03/08/16 14028 39,272.04$ -$ 39,272.04$

007013890 APRIL HEALTH INS

COMPUTER CHECK

CHECK TOTALS: 39,272.04$ -$ 39,272.04$

102374 04/01/16 BLU034 BLUE CARE NETWORK 160720059721 03/11/16 14029 6,900.48$ -$ 6,900.48$

00172881 APRIL HEALTH INS

COMPUTER CHECK

CHECK TOTALS: 6,900.48$ -$ 6,900.48$



COMPUTER CHECK

CHECK TOTALS: 40.00$ -$ 40.00$

102376 04/01/16 CAP194 CAPITAL AREA HEALTH ALLIANCE 20160219006 02/19/16 14020 357.00$ -$ 357.00$

JANUARY 2016 CONSULTING

COMPUTER CHECK

CHECK TOTALS: 357.00$ -$ 357.00$

102377 04/01/16 CDW016 CDW GOVERNMENT, INC. CGR8181 03/02/16 14003 094141-00 343.46$ -$ 343.46$

AUDIO HEADSET,CISCO CABLE

COMPUTER CHECK

11





------------------------------------------------- -------------------------------------------- -------------- ------------- ------------

102377 04/01/16 CDW016 CDW GOVERNMENT, INC. CKX8225 03/16/16 14000 094149-00 1,459.54$ -$ 1,459.54$

10 DESKTOP COMPUTER SCREENS FOR EH

CLB3799 03/17/16 13999 094149-00 2,798.14$ -$ 2,798.14$

5 DESKTOP COMPUTERS FOR EH

CHECK TOTALS: 4,601.14$ -$ 4,601.14$

102378 04/01/16 CEN021 CENTRAL MI DIST HEALTH DEPT 100457 03/11/16 14015 4,056.52$ -$ 4,056.52$

FEBRUARY 2016 MD

COMPUTER CHECK

CHECK TOTALS: 4,056.52$ -$ 4,056.52$

102379 04/01/16 CIT014 CITIZENS BANK 100453 04/01/16 14009 6,672.73$ -$ 6,672.73$

APRIL LEASE PAYMENT

COMPUTER CHECK

CHECK TOTALS: 6,672.73$ -$ 6,672.73$

102380 04/01/16 CLI092 CLINTON COUNTY ADMIN/ACCT AC2016006 03/01/16 14032 1,966.67$ -$ 1,966.67$

APRIL DENTAL RENT

COMPUTER CHECK

CHECK TOTALS: 1,966.67$ -$ 1,966.67$

102381 04/01/16 COV178 COVENANT MEDICAL CENTER 100454 03/06/16 14012 42.84$ -$ 42.84$

GRATIOT LABS

COMPUTER CHECK

100455 03/06/16 14013 117.20$ -$ 117.20$

CLINTON LABS

100456 03/06/16 14014 37.18$ -$ 37.18$

MONTCALM LABS

CHECK TOTALS: 197.22$ -$ 197.22$

102382 04/01/16 DEL007 DELTA DENTAL OF MICHIGAN 1054327 03/15/16 14027 4,538.36$ -$ 4,538.36$

APRIL DENTAL INSURANCE

COMPUTER CHECK

CHECK TOTALS: 4,538.36$ -$ 4,538.36$

102383 04/01/16 FRO027 FRONTIER 100466 03/13/16 14040 82.87$ -$ 82.87$

989-224-1646 3/13-4/12/16

COMPUTER CHECK

100467 03/19/16 14041 94.48$ -$ 94.48$

989-875-2952 3/19-4/18/16

102383 04/01/16 FRO027 FRONTIER 100468 03/20/16 14042 62.78$ -$ 62.78$

989-831-7707 2/20-3/19/16

CHECK TOTALS: 240.13$ -$ 240.13$

102384 04/01/16 GRE086 GREENVILLE COMMUNITY CHURCH APRIL 2016 04/01/16 14011 175.00$ -$ 175.00$

RENT FOR CHED CLINIC

COMPUTER CHECK

CHECK TOTALS: 175.00$ -$ 175.00$

12





------------------------------------------------- -------------------------------------------- -------------- ------------- ------------

102385 04/01/16 MCK032 MCKESSON MEDICAL 74512900 03/04/16 14005 094139-00 284.59$ -$ 284.59$

NEEDLES, SHARPS CONTAINER

COMPUTER CHECK

74516111 03/04/16 14004 094132-00 103.99$ -$ 103.99$

PRO TOWELS, GLOVES

CHECK TOTALS: 388.58$ -$ 388.58$

102386 04/01/16 MIC006 MICHIGAN DEPT OF AGRICULTURE 791-62660 03/16/16 14019 47.00$ -$ 47.00$

CLINTON/GRATIOT FOOD FEES

COMPUTER CHECK

CHECK TOTALS: 47.00$ -$ 47.00$

102387 04/01/16 MID166 MIDMICHIGAN HEALTH 100459 03/04/16 14021 820.00$ -$ 820.00$

41 CHED CPR TRAINING/BOOKS

COMPUTER CHECK

CHECK TOTALS: 820.00$ -$ 820.00$


913105050 4/1 EMPLOYEE DEDUCTION

COMPUTER CHECK

CHECK TOTALS: 234.68$ -$ 234.68$

102389 04/01/16 NAT016 NRFSP G1602290987 02/29/16 14007 500.00$ -$ 500.00$

GRATIOT/CLINTON FOOD TESTS

COMPUTER CHECK

CHECK TOTALS: 500.00$ -$ 500.00$

102390 04/01/16 NET001 NETWERKES 37480621 03/07/16 14016 58.49$ -$ 58.49$

FEBRUARY MAILED/EDI CLAIMS

COMPUTER CHECK

CHECK TOTALS: 58.49$ -$ 58.49$


DESK CALENDARS

COMPUTER CHECK


POCKET FOLDERS,MARKERS

CHECK TOTALS: 71.20$ -$ 71.20$

102392 04/01/16 POS043 POSTER COMPLIANCE CENTER 2664980-MI 11/24/15 14030 094846-00 195.42$ -$ 195.42$

3 POSTER COMPLIANCE PLAN

COMPUTER CHECK

CHECK TOTALS: 195.42$ -$ 195.42$


3/8-3/18-16 CSHCS PARENT LIASON

COMPUTER CHECK

CHECK TOTALS: 195.00$ -$ 195.00$

13





------------------------------------------------- -------------------------------------------- -------------- ------------- ------------

102394 04/01/16 SHR011 SHRED-IT USA LLC 9409703258 03/04/16 14010 95.04$ -$ 95.04$

GRATIOT CHED SHREDDING

COMPUTER CHECK

CHECK TOTALS: 95.04$ -$ 95.04$

102395 04/01/16 STA002 STATE OF MICHIGAN/DEQ 957785 03/01/16 14035 458.00$ -$ 458.00$

CLINTON WATER LABS

COMPUTER CHECK

957790 03/01/16 14022 866.00$ -$ 866.00$

MONTCALM WATER LABS

CHECK TOTALS: 1,324.00$ -$ 1,324.00$

102396 04/01/16 STA194 STAPLES ADVANTAGE DET 3293747372 02/20/16 14043 094129-00 26.36$ -$ 26.36$

CBO/GBO COFFEE & SUGAR PACKS

COMPUTER CHECK

CHECK TOTALS: 26.36$ -$ 26.36$

102397 04/01/16 TEA031 TEAM FINANCIAL GROUP, INC 132115 03/12/16 14017 3,801.23$ -$ 3,801.23$

APRIL XEROX/SUPPLY FEES

COMPUTER CHECK

CHECK TOTALS: 3,801.23$ -$ 3,801.23$



COMPUTER CHECK

CHECK TOTALS: 130.00$ -$ 130.00$



COMPUTER CHECK

CHECK TOTALS: 97.00$ -$ 97.00$

102400 04/01/16 VOI018 VOICES FOR HEALTH 59799 08/07/15 14034 437.70$ -$ 437.70$

JULY 2015 SIGN LANGUAGE/TRAVEL

COMPUTER CHECK

CHECK TOTALS: 437.70$ -$ 437.70$

102401 04/01/16 WINN73 WINN TELECOM 1930300CK 03/15/16 14033 2,737.85$ -$ 2,737.85$

MAR-APR MNTHLY 2/10-3/9 ACTUAL

COMPUTER CHECK

CHECK TOTALS: 2,737.85$ -$ 2,737.85$

BANK CODE TOTALS: 81,121.86$ -$ 81,121.86$

31 COMPUTER CHECKS


0 VOID CHECKS - TRX




4 DIRECT DEPOSITS

35 CHECKS TOTAL

COMPANY TOTALS: 81,121.86$ -$ 81,121.86$

14

CK# EV 1817 4/15/2016

Payables

102402

thru Quantum Checks & Direct Deposits & Voids 24,567.87$

102432

Payroll







Federal 32,053.92$

State -$

MERS Employer Electronic Transfer 16-Mar 20,274.30$

Chemical E-Banking fee 16-Mar 75.95$

Chemical Bank Interest 16-Mar (2.51)$


State of Michigan Unemployment 4Q FY15 -$

TOTAL 182,546.57$



Stanton MI 48888

(989) 831-5237

15

RUN DATE: APR 13, 2016 - 14:18 Mid Michigan District Health Department PAGE 0001




------------------------------------------------- -------------------------------------------- -------------- ------------- ------------

115 04/11/16 BAI102 BAILEY GEORGE 100395 01/27/16 13799 (62.08)$ -$ (62.08)$

JANUARY TRAVEL/PER DIEM


CHECK TOTALS: (62.08)$ -$ (62.08)$

116 04/11/16 KEL038 KELLENBERGER BETTY 100394 01/27/16 13798 (57.76)$ -$ (57.76)$



CHECK TOTALS: (57.76)$ -$ (57.76)$

117 04/11/16 LIN033 LINDEMAN TOM 100396 01/27/16 13800 (52.90)$ -$ (52.90)$



CHECK TOTALS: (52.90)$ -$ (52.90)$



DIRECT DEPOSIT

CHECK TOTALS: 62.08$ -$ 62.08$



DIRECT DEPOSIT

CHECK TOTALS: 57.76$ -$ 57.76$

127 04/15/16 LIN033 LINDEMAN TOM 100396 01/27/16 13800 52.90$ -$ 52.90$


DIRECT DEPOSIT

CHECK TOTALS: 52.90$ -$ 52.90$

102074 04/12/16 NEH002 NEHA TRAINING G1510310966 10/31/15 13408 (625.00)$ -$ (625.00)$

FOOD TRAINING CLASSES


CHECK TOTALS: (625.00)$ -$ (625.00)$

102402 04/15/16 ABR018 ABRAHAM & GAFFNEY, P.C. EL-24925 03/31/16 14063 1,500.00$ -$ 1,500.00$

FY14-15 FINAL AUDIT WORK

COMPUTER CHECK

CHECK TOTALS: 1,500.00$ -$ 1,500.00$

102403 04/15/16 ACU070 ACUITY 100472 04/11/16 14057 3,605.00$ -$ 3,605.00$

FY15-16 AUDIT BALANCE

COMPUTER CHECK

CHECK TOTALS: 3,605.00$ -$ 3,605.00$



COMPUTER CHECK

CHECK TOTALS: 40.00$ -$ 40.00$

102405 04/15/16 COU009 COUNTRYSIDE PHARMACY 3735 03/31/16 14066 50.00$ -$ 50.00$

1695977/1684486 JV SCRIPTS

COMPUTER CHECK

CHECK TOTALS: 50.00$ -$ 50.00$

16





------------------------------------------------- -------------------------------------------- -------------- ------------- ------------

102406 04/15/16 CRY023 CASAIR-CRYSTAL AUTO SYSTEM 255320 04/01/16 14067 800.00$ -$ 800.00$

APRIL WIRELESS/LIST SERV

COMPUTER CHECK

CHECK TOTALS: 800.00$ -$ 800.00$

102407 04/15/16 HER108 100473 04/11/16 14061 41.25$ -$ 41.25$

REFUND 2/8/16 PMT/MA CLIENT

COMPUTER CHECK

CHECK TOTALS: 41.25$ -$ 41.25$

102408 04/15/16 HOS101 HOSPITAL NETWORK HEALTHCARE 40865 03/31/16 14071 114.00$ -$ 114.00$

2 MONTCALM WASTE PICKUP

COMPUTER CHECK

CHECK TOTALS: 114.00$ -$ 114.00$

102409 04/15/16 IMP002 IMPREST CASH-MONTCALM 100475 04/04/16 14073 37.36$ -$ 37.36$

CBO CHED-SNACKS/HEADSET/PHONE JACK

COMPUTER CHECK

100476 03/31/16 14074 15.97$ -$ 15.97$

GBO CHED-WIC EXHIBIT

CHECK TOTALS: 53.33$ -$ 53.33$

102410 04/15/16 MCK032 MCKESSON MEDICAL 75542202 03/23/16 14090 094117-00 296.27$ -$ 296.27$

SURGICAL GLOVES

COMPUTER CHECK

75542331 03/23/16 14079 094160-00 455.43$ -$ 455.43$

NEEDLES,GLOVES,HAND SANITIZER

75685133 03/25/16 14084 094169-00 332.26$ -$ 332.26$

GLOVES,SPECULUMS,TOWELS

76303535 04/05/16 14088 094172-00 48.27$ -$ 48.27$

POTASSIUM HYDROXIDE

CHECK TOTALS: 1,132.23$ -$ 1,132.23$

102411 04/15/16 MIC007 MICHIGAN PUBLIC HEALTH INST 34297 03/25/16 14070 65.00$ -$ 65.00$

CURRIE TRAINING

COMPUTER CHECK

CHECK TOTALS: 65.00$ -$ 65.00$


4/15/16 EMPLOYEE DEDUCTION

COMPUTER CHECK

CHECK TOTALS: 234.68$ -$ 234.68$

102413 04/15/16 MLIVE MLIVE MEDIA GROUP 0007609163 03/31/16 14060 317.00$ -$ 317.00$

CBO EH SPECIALIST VACANCY

COMPUTER CHECK

CHECK TOTALS: 317.00$ -$ 317.00$

17





------------------------------------------------- -------------------------------------------- -------------- ------------- ------------

102414 04/15/16 MNA004 MICHIGAN NURSES ASSOCIATION 100479 04/12/16 14093 607.75$ -$ 607.75$

APRIL DUES

COMPUTER CHECK

CHECK TOTALS: 607.75$ -$ 607.75$

102415 04/15/16 NAC009 NACCHO ANNUAL 2016 REGISTER 787 04/11/16 14058 460.00$ -$ 460.00$

111906 KELLENBERGER TRAINING

COMPUTER CHECK

CHECK TOTALS: 460.00$ -$ 460.00$


BATTERIES,ENVELOPES,HIGHLIGHTERS

COMPUTER CHECK

826209 03/17/16 14099 094146-00 123.85$ -$ 123.85$

POSTCARD,DRY ERASE BOARD,CHALK

920267 03/23/16 14083 094164-00 324.47$ -$ 324.47$

COPY PAPER

963519 03/25/16 14091 094165-00 83.39$ -$ 83.39$

HEAVY DUTY TAPE,CC ROLLS,BOOK RINGS

CHECK TOTALS: 744.91$ -$ 744.91$

102417 04/15/16 PER009 PERSPECTIVE ENTERPRISES 50148 04/08/16 14077 094174-00 54.25$ -$ 54.25$

CIRCUMFERENCE MEASURING TAPES

COMPUTER CHECK

CHECK TOTALS: 54.25$ -$ 54.25$

102418 04/15/16 POL010 POLYMEDCO INC 1065286 04/05/16 14078 094162-00 177.24$ -$ 177.24$

POLYSTAT HCG KIT 25/BOX

COMPUTER CHECK

CHECK TOTALS: 177.24$ -$ 177.24$

102419 04/15/16 QUI003 QUILL CORPORATION 4425482 03/24/16 14082 094156-00 62.97$ -$ 62.97$

3 SELF INKING STAMPS

COMPUTER CHECK

CHECK TOTALS: 62.97$ -$ 62.97$

102420 04/15/16 R&S005 R&S NORTHEAST LLC 97985 03/24/16 14085 094163-00 2,476.80$ -$ 2,476.80$

NUVARING,ORTHO,RECLIPSEN

COMPUTER CHECK

CHECK TOTALS: 2,476.80$ -$ 2,476.80$

102421 04/15/16 SAN020 SANOFI PASTEUR INC 905991961 03/21/16 14080 094154-00 826.52$ -$ 826.52$

3 IMOVAX RABIES

COMPUTER CHECK

CHECK TOTALS: 826.52$ -$ 826.52$


3/22-3-24 CSHCS PARENT LIASON

COMPUTER CHECK

100477 03/31/16 14075 40.00$ -$ 40.00$

SHAFFER SIB-SHOP TRAINING

18





------------------------------------------------- -------------------------------------------- -------------- ------------- ------------

CHECK TOTALS: 80.00$ -$ 80.00$

102423 04/15/16 SHR011 SHRED-IT USA LLC 9409988704 03/25/16 14069 88.82$ -$ 88.82$

CLINTON SHREDDING

COMPUTER CHECK

9410047293 03/30/16 14068 93.94$ -$ 93.94$

MONTCALM SHREDDING

CHECK TOTALS: 182.76$ -$ 182.76$

102424 04/15/16 STA130 STATE OF MI - MI STATE POLICE 551-463727 03/23/16 14059 300.00$ -$ 300.00$

BREWER TRAINING

COMPUTER CHECK

CHECK TOTALS: 300.00$ -$ 300.00$

102425 04/15/16 STA194 STAPLES ADVANTAGE 8038349284 04/04/16 14087 094129-00 22.53$ -$ 22.53$

SELF INKING STAMP CSHCS LIASON

COMPUTER CHECK

CHECK TOTALS: 22.53$ -$ 22.53$

102426 04/15/16 TEA001 TEAMSTERS LOCAL 214 100479 04/12/16 14098 1,989.43$ -$ 1,989.43$

APRIL DUES

COMPUTER CHECK

CHECK TOTALS: 1,989.43$ -$ 1,989.43$

102427 04/15/16 TOT008 TOTAL ACCESS GROUP INC IN00185700 01/19/16 14089 094087-00 2,160.00$ -$ 2,160.00$

CONDOMS

COMPUTER CHECK

CHECK TOTALS: 2,160.00$ -$ 2,160.00$



COMPUTER CHECK

CHECK TOTALS: 130.00$ -$ 130.00$



COMPUTER CHECK

CHECK TOTALS: 97.00$ -$ 97.00$

102430 04/15/16 UPP016 Upp TECHNOLOGY, INC. INV-006484 03/31/16 14062 4,000.00$ -$ 4,000.00$

CREDENTIALING/CONTRACT REVIEWS

COMPUTER CHECK

CHECK TOTALS: 4,000.00$ -$ 4,000.00$

102431 04/15/16 VER004 VERIZON 9762543401 03/21/16 14064 1,147.03$ -$ 1,147.03$

3/22-4/21/16 BROADBAND

COMPUTER CHECK

9762718208 04/04/16 14065 222.98$ -$ 222.98$

3/24-4/23/16 MIHP BROADBAND

CHECK TOTALS: 1,370.01$ -$ 1,370.01$

19





------------------------------------------------- -------------------------------------------- -------------- ------------- ------------

102432 04/15/16 FIR003 FIRST NATIONAL BANK OMAHA 100469 04/04/16 14044 094143-00 84.39$ -$ 84.39$

CHALKBOARD EASEL

COMPUTER CHECK

100470 04/04/16 14049 094153-00 68.89$ -$ 68.89$

APPOINTMENT CARDS/DISTRICT

100471 04/04/16 14052 094145-00 58.28$ -$ 58.28$

2 BUSINESS CARDS

100478 04/04/16 14076 215.49$ -$ 215.49$

HOTEL/TRAINING/CPR TRAINING

100469-1 04/04/16 14045 094142-00 147.08$ -$ 147.08$

MOUSE PAD/ENVELOPES/CARTRIDGES

100469-2 04/04/16 14046 094135-00 36.00$ -$ 36.00$

EFAW BUSINESS CARDS - 2

100469-3 04/04/16 14047 094136-00 45.61$ -$ 45.61$

1 BUSINESS CARD, NAME PLATE

100469-5 04/04/16 14048 89.97$ -$ 89.97$

MARCH STAMPS.COM

100470-1 04/04/16 14051 094170-00 28.65$ -$ 28.65$

PERSONAL SAFETY EP BAG

100470-2 04/04/16 14050 094166-00 39.51$ -$ 39.51$

2 SENSAPHONE ALARM BATTERY

100471-1 04/04/16 14053 094147-00 22.99$ -$ 22.99$

PAPER FOR CREDIT CARD MACHINES

100471-2 04/04/16 14054 094151-00 80.55$ -$ 80.55$

3 BUSINESS CARDS

100471-4 04/04/16 14055 094148-00 24.37$ -$ 24.37$

1 BUSINESS CARDS

100471-5 04/04/16 14056 556.43$ -$ 556.43$

MEALS/HOTEL STAY FOR 3

CHECK TOTALS: 1,498.21$ -$ 1,498.21$

BANK CODE TOTALS: 24,567.87$ -$ 24,567.87$

31 COMPUTER CHECKS


4 VOID CHECKS - TRX




3 DIRECT DEPOSITS

38 CHECKS TOTAL

COMPANY TOTALS: 24,567.87$ -$ 24,567.87$

20

21

22

23

24

25

26

27

28


Monthly Balance Sheet, Revenue and Expenditure Report

March 2016

Summary and Special Notes

As of the end of March 2016, actual revenues and expenditures should be approximately 50% of the

$6,199,516 total budget. The total revenues through March were $2,729,909.98 and the total expenses

were $3,136,073.75. The overall actual revenues and expenditures (adjusting for in-kind space costs

and Vaccines for Children) were at 45% and 53% respectively representing a deficit of $406,163.77.

The deficit is in part due from the payments for the new phone system which was not budgeted,

although the Board of Health authorized the use of fund balance to pay for the new system and also

due to timing of certain revenues.

Revenues

Food Fees (Line 3) – Fixed establishments pay their licenses once per year around April, so

this line will be low until that point.

Hearing/Vision (Lines 10/11) – The fees are received on a nine-month school year rather than

the full twelve months so the fees will be higher during the first part of the year.

MIHP Fees (Line 12) – The fees in this program continue to be lower than budgeted. Staffing

changes have been made in this program due to the lower caseload and visits from previous

years.

Family Planning Fees (Line 15) – The fees in this program are lower than budgeted. An

increase in funding for our program through grants replaced the lower than budgeted fee

amounts.

ELPHS (Line 26) – The hearing and vision portion of our ELPHS funding was increased due

to a reformulation at the state.

Expenses

Health Insurance (Line 4) – The agency paid for the Health Savings Account amounts in

March for the remainder of the year. If this lump sum is averaged out, we would be at about

30% of the budgeted amount.

Office Supplies (Line 12) – The line item is higher than budgeted year to date due to the

purchase of new vision screeners. These were purchased with the increase of ELPHS funding

as mentioned above. Anything that is under $5,000 is being listed as office supplies rather than

equipment.

Equipment (Line 34) – Related to the new phone system purchased.

29

1/4 4/21/2016

Mid-Michigan District Health Department MARCH 50% FY 2016 AP: 6

Revenue Revenue and Expenditure Report

Account Budget Current Month Year-To-Date Balance

% of

Budget

1 Onsite Sewage 136,200.00 14,698.00 67,832.00 68,368.00 50%

2 Groundwater Quality 133,998.00 7,644.00 46,842.00 87,156.00 35%

3 Food Service 274,740.00 29,813.00 47,673.00 227,067.00 17%

4 Campgrounds 3,264.00 357.00 459.00 2,805.00 14%

5 Swimming Pools 5,304.00 0.00 458.00 4,846.00 9%

6 Waste Haulers 7,833.00 83.00 2,274.00 5,559.00 29%

7 DHS Facility Inspections 25,000.00 955.00 10,967.00 14,033.00 44%

8 Body Art Fees 1,300.00 0.00 0.00 1,300.00 0%

9 EH Misc Fees 760.00 239.07 672.98 87.02 89%

10 Vision Fees 25,000.00 3,239.80 16,458.80 8,541.20 66%

11 Hearing Fees 21,000.00 2,805.60 15,485.20 5,514.80 74%

12 MIHP Fees 100,000.00 6,293.22 35,823.73 64,176.27 36%

13 Communicable Disease Fees 600.00 390.00 435.00 165.00 73%

14 Immunization Fees 130,000.00 2,722.85 63,846.97 66,153.03 49%

15 Family Planning/STD Fees 139,000.00 7,828.32 46,409.08 92,590.92 33%

16 Breast Cancer Fees 6,000.00 319.54 783.28 5,216.72 13%

17 Lead Fees 15,000.00 1,467.44 5,975.89 9,024.11 40%

18 Varnish Fees 15,000.00 2,831.69 15,908.68 -908.68 106%

19 WIC Varnish Fees 25,000.00 785.00 4,403.54 20,596.46 18%

20 Ched Miscellaneous Fees 600.00 0.00 0.00 600.00 0%

21 Miscellaneous Other Fees 100.00 0.00 0.00 100.00 0%

30

2/4 4/21/2016

22 Behavioral Health Primary Care Fees 55,100.00 4,276.17 21,515.37 33,584.63 39%

23 Deferred Revenues - Billing 0.00 -82,358.51 -72,297.47 72,297.47 0%

24 VFC/317 Vaccine Revenue 400,000.00 19,517.04 89,116.74 310,883.26 22%

25 MDHHS Grants 1,513,543.00 131,311.00 780,877.00 732,666.00 52%

26 Essential Local Public Health Services 726,412.00 62,061.00 372,352.00 354,060.00 51%

27 MDHHS Fee For Service Revenue 56,000.00 5,976.32 24,689.48 31,310.52 44%

28 DEQ Grants 76,255.00 9,596.75 33,877.50 42,377.50 44%

29 Other Grants/Community Support 471,280.00 63,853.51 174,526.91 296,753.09 37%

30 Medicaid Full Cost Reimbursement 385,175.00 23,659.11 236,037.89 149,137.11 61%

31 Interest 2,000.00 74.35 2,166.99 -166.99 108%

32 Donations 0.00 151.00 1,944.29 -1,944.29 0%

33 Cash Over/Short 0.00 0.00 3.13 -3.13 0%

34 Clinton Co - Appropriation 391,015.00 32,584.59 195,507.50 195,507.50 50%

35 Gratiot Co - Appropriation 297,300.00 25,525.37 149,401.00 147,899.00 50%

36 Montcalm Co - Appropriation 425,661.00 35,471.75 212,830.50 212,830.50 50%

37 Prior Year Adjustments 0.00 0.00 0.00 0.00 0%

38 Space Occupancy 250,570.00 20,774.00 124,653.00 125,917.00 50%

39 Deferred Revenues - Other 83,506.00 0.00 0.00 83,506.00 0%

TOTAL REVENUE: 6,199,516.00 434,945.98 2,729,909.98 3,469,606.02 44%

W/O SPACE & VFC 5,548,946.00 394,654.94 2,516,140.24 3,032,805.76 45%

31

3/4 4/21/2016

Mid-Michigan District Health Department MARCH 50% FY 2016 AP: 6

Expenditure Revenue and Expenditure Report

Account Budget Current Month Year-To-Date Balance

% of

Budget

1 Board of Health Per Diem 5,000.00 658.00 1,890.00 3,110.00 38%

2 Salaries 3,338,248.00 296,509.18 1,694,530.01 1,643,717.99 51%

3 FICA 247,587.00 22,191.27 125,907.05 121,679.95 51%

4 Health Insurance 680,703.00 45,228.36 372,349.29 308,353.71 55%

5 Dental Insurance 51,498.00 3,837.28 23,181.07 28,316.93 45%

6 Retirement 263,444.00 20,274.30 132,935.28 130,508.72 50%

7 Work Comp 52,139.00 2,185.00 16,347.00 35,792.00 31%

8 Unemployment Comp 6,000.00 0.00 733.59 5,266.41 12%

9 Life Insurance 4,647.00 431.99 2,363.50 2,283.50 51%

10 Printed Materials 6,300.00 0.00 1,884.32 4,415.68 30%

11 Postage 20,000.00 976.31 7,134.37 12,865.63 36%

12 Office Supplies 64,000.00 2,266.35 34,122.69 29,877.31 53%

13 Computer/Printer Supplies 8,500.00 4,655.65 8,087.99 412.01 95%

14 Medical Supplies 62,200.00 6,780.87 19,548.44 42,651.56 31%

15 CD Meds Biologics 70,000.00 0.00 24,125.55 45,874.45 34%

16 VFC Supplies 400,000.00 19,517.04 89,116.74 310,883.26 22%

17 Contractual Services 186,000.00 10,899.16 58,341.27 127,658.73 31%

18 Legal Expenses 4,000.00 518.00 1,317.67 2,682.33 33%

32

4/4 4/21/2016

19 Communications 69,950.00 4,057.07 32,490.91 37,459.09 46%

20 Travel 144,300.00 13,532.91 73,872.64 70,427.36 51%

21 Advertising & Recruitment 4,000.00 1,278.40 1,303.40 2,696.60 33%

22 Liability Insurance 32,000.00 2,821.75 16,930.50 15,069.50 53%

23 Equipment Maintenance/Lease 49,050.00 3,902.23 27,013.69 22,036.31 55%

24 Rent 29,100.00 2,536.50 13,862.00 15,238.00 48%

25 Space Occupancy 250,570.00 20,774.00 124,653.00 125,917.00 50%

26 Training 25,600.00 4,446.07 16,317.62 9,282.38 64%

27 Memberships/Certifications/Subscriptions 14,980.00 1,480.53 16,185.53 -1,205.53 108%

28 Tuition Reimbursement 2,000.00 0.00 0.00 2,000.00 0%

29 Laboratory 2,800.00 214.89 1,115.21 1,684.79 40%

30 Behavioral Risk Factor Survey 21,000.00 0.00 0.00 21,000.00 0%

31 Misc Other Expense 3,400.00 0.00 0.00 3,400.00 0%

32 Computer Support 75,500.00 249.36 46,663.62 28,836.38 62%

33 Service Charges 5,000.00 185.82 3,886.62 1,113.38 78%

34 Equipment 0.00 0.00 147,863.18 -147,863.18 0%

35 Facility Development 0.00 0.00 0.00 0.00 0%

TOTAL EXPENSES 6,199,516.00 492,408.29 3,136,073.75 3,063,442.25 51%

W/O SPACE & VFC 5,548,946.00 452,117.25 2,922,304.01 2,626,641.99 53%

Revenue Over Expenditures (Deficit) 0.00 -57,462.31 -406,163.77 406,163.77 0%

33

MMDHD BALANCE SHEET AS OF 3/31/2016

CURRENT ASSETS

CASH TO TREASURER $2,345,125.17

CASH ON DEPOSIT/IMPREST CASH 2,790.00

ACCOUNTS RECEIVABLE 197,151.30

DUE FROM GOVERNMENTAL AGENCIES 482,643.36

INVENTORY - VFC IMMS 73,028.28

PREPAIDS 28,128.25

TOTAL ASSETS 3,128,866.36

LIABILITIES AND FUND BALANCE

ACCOUNTS PAYABLE $16,392.24

PAYROLL DEDUCTIONS $2,055.43

PAYROLL PAYABLES $293,444.88

OTHER ACCRUED PAYABLES $319.00

TRUST FUNDS $18,138.76

DEFERRED REVENUE BILLING $144,597.96

DEFERRED REV DENTAL OUTREACH $109,989.21

DEFERRED REVENUE MCDC $213,000.00

DEFERRED REVENUE-VFC IMMS $73,028.28

DEFERRED REVENUE - DENTAL CENTER EXPANSION $25,297.69

FUND BALANCE PRIOR YEAR $892,041.43

FUND BALANCE $357,599.30

FUND BALANCE EQUIPMENT $179,752.67

FUND BALANCE FACILITY DEV $124,580.00

FUND BALANCE SELF INS BONDS $13,949.72

FUND BALANCE-FUTURE RETIREMENT $308,829.80

34

FUND BALANCE-COMPENSATED LEAVES $488,257.76

FUND BALANCE-UNEMPLOYMENT $55,000.00

FUND BALANCE-TRAINING $35,000.00

FUND BALANCE/BRFS $11,522.00

FUND BALANCE-HEALTH INSURANCE $160,000.00

FUND BALANCE-POTENTIAL CLAIMS $12,234.00

BALANCE SHEET NET INCOME ($406,163.77)

TOTAL LIABILITIES 3,128,866.36

TOTAL NET INCOME 0.00

35

Caution: Forms printed from within Adobe Acrobat products may not meet IRS or state taxing agencyspecifications. When using Acrobat 5.x products, uncheck the "Shrink oversized pages to paper size" anduncheck the "Expand small pages to paper size" options, in the Adobe "Print" dialog. When using Acrobat6.x and later products versions, select "None" in the "Page Scaling" selection box in the Adobe "Print" dialog.

CLIENT'S COPY

36

ABRAHAM & GAFFNEY, P.C.3511 COOLIDGE RD., SUITE 100

EAST LANSING, MI 48823(517) 351-6836(517) 351-6837

FEBRUARY 26, 2016

MID-MICHIGAN DISTRICT HEALTH DEPARTMENT615 NORTH STATE STREET NO. STE 2STANTON, MI 48888

MID-MICHIGAN DISTRICT HEALTH DEPARTMENT:

ENCLOSED IS THE ORGANIZATION'S 2014 EXEMPT ORGANIZATIONRETURN.

SPECIFIC FILING INSTRUCTIONS ARE AS FOLLOWS.

FORM 990 RETURN:

THIS RETURN HAS BEEN PREPARED FOR ELECTRONIC FILING. IF YOUWISH TO HAVE IT TRANSMITTED ELECTRONICALLY TO THE IRS, PLEASESIGN, DATE, AND RETURN FORM 8879-EO TO OUR OFFICE. WE WILLTHEN SUBMIT THE ELECTRONIC RETURN TO THE IRS. DO NOT MAIL APAPER COPY OF THE RETURN TO THE IRS.

A COPY OF THE RETURN IS ENCLOSED FOR YOUR FILES. WE SUGGESTTHAT YOU RETAIN THIS COPY INDEFINITELY.

VERY TRULY YOURS,

WILLIAM I. TUCKER, IV

37

OMB No. 1545-1878

Form

For calendar year 2014, or fiscal year beginning , 2014, and ending ,20

Department of the TreasuryInternal Revenue Service

42305109-29-14

Employer identification number

Enter five numbers, butdo not enter all zeros

ERO firm name

do not enter all zeros

| Do not send to the IRS. Keep for your records.

| Information about Form 8879-EO and its instructions is at

1a, 2a, 3a, 4a, 5a, 1b, 2b, 3b, 4b, 5b,Do not

1a

2a

3a

4a

5a

| b Total revenue, 1b

2b

3b

4b

5b

| b Total revenue,

| b Total tax

| b Tax based on investment income

| b Balance Due

(a) (b) (c)

Officer's PIN: check one box only

ERO's EFIN/PIN.

Pub. 4163,

For Paperwork Reduction Act Notice, see instructions.

e-file

Name of exempt organization

Name and title of officer

~~~

~~~~~~~~

Officer's signature | Date |

ERO's signature | Date |

Form (2014)

(Whole Dollars Only)

Check the box for the return for which you are using this Form 8879-EO and enter the applicable amount, if any, from the return. If you check the boxon line or below, and the amount on that line for the return being filed with this form was blank, then leave line orwhichever is applicable, blank (do not enter -0-). But, if you entered -0- on the return, then enter -0- on the applicable line below. complete morethan 1 line in Part I.

Form 990 check here

Form 990-EZ check here

Form 1120-POL check here

if any (Form 990, Part VIII, column (A), line 12)~~~~~~~

if any (Form 990-EZ, line 9) ~~~~~~~~~~~~~~

(Form 1120-POL, line 22) ~~~~~~~~~~~~~~~~

Form 990-PF check here

Form 8868 check here

(Form 990-PF, Part VI, line 5)

(Form 8868, Part I, line 3c or Part II, line 8c)

Under penalties of perjury, I declare that I am an officer of the above organization and that I have examined a copy of the organization's 2014electronic return and accompanying schedules and statements and to the best of my knowledge and belief, they are true, correct, and complete. Ifurther declare that the amount in Part I above is the amount shown on the copy of the organization's electronic return. I consent to allow myintermediate service provider, transmitter, or electronic return originator (ERO) to send the organization's return to the IRS and to receive from the IRS

an acknowledgement of receipt or reason for rejection of the transmission, the reason for any delay in processing the return or refund, and the date of any refund. If applicable, I authorize the U.S. Treasury and its designated Financial Agent to initiate an electronic funds withdrawal (directdebit) entry to the financial institution account indicated in the tax preparation software for payment of the organization's federal taxes owed on thisreturn, and the financial institution to debit the entry to this account. To revoke a payment, I must contact the U.S. Treasury Financial Agent at1-888-353-4537 no later than 2 business days prior to the payment (settlement) date. I also authorize the financial institutions involved in theprocessing of the electronic payment of taxes to receive confidential information necessary to answer inquiries and resolve issues related to thepayment. I have selected a personal identification number (PIN) as my signature for the organization's electronic return and, if applicable, theorganization's consent to electronic funds withdrawal.

I authorize to enter my PIN

as my signature on the organization's tax year 2014 electronically filed return. If I have indicated within this return that a copy of the returnis being filed with a state agency(ies) regulating charities as part of the IRS Fed/State program, I also authorize the aforementioned ERO toenter my PIN on the return's disclosure consent screen.

As an officer of the organization, I will enter my PIN as my signature on the organization's tax year 2014 electronically filed return. If I haveindicated within this return that a copy of the return is being filed with a state agency(ies) regulating charities as part of the IRS Fed/Stateprogram, I will enter my PIN on the return's disclosure consent screen.

Enter your six-digit electronic filing identification

number (EFIN) followed by your five-digit self-selected PIN.

I certify that the above numeric entry is my PIN, which is my signature on the 2014 electronically filed return for the organization indicated above. Iconfirm that I am submitting this return in accordance with the requirements of Modernized e-File (MeF) Information for Authorized IRS

Providers for Business Returns.

LHA

www.irs.gov/form8879eo.

Part I Type of Return and Return Information

Part II Declaration and Signature Authorization of Officer

Part III Certification and Authentication

ERO Must Retain This Form - See InstructionsDo Not Submit This Form To the IRS Unless Requested To Do So

8879-EO

IRS e-file Signature Authorizationfor an Exempt Organization8879-EO

2014

***** THIS IS NOT A FILEABLE COPY *****

OCT 1 SEP 30 15

MID-MICHIGAN DISTRICT HEALTH DEPARTMENT 38-1808049

MARCUS CHEATHAMHEALTH OFFICER

X 6,551,295.

X ABRAHAM & GAFFNEY, P.C. 48888

***** THIS IS NOT A FILEABLE COPY ***

38700377777

02/26/16

08490226 766504 1319 2014.05080 MID-MICHIGAN DISTRICT HEALT 1319___138

Checkifself-employed

OMB No. 1545-0047


Check ifapplicable:

AddresschangeNamechangeInitialreturn

Finalreturn/termin-ated Gross receipts $

AmendedreturnApplica-tionpending

Are all subordinates included?

432001 11-07-14

| Do not enter social security numbers on this form as it may be made public.

Beginning of Current Year

Paid

Preparer

Use Only

Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations)

Open to Public Inspection| Information about Form 990 and its instructions is at

A For the 2014 calendar year, or tax year beginning and ending

B C D Employer identification number

E

G

H(a)

H(b)

H(c)

F Yes No

Yes No

I

J

K

Website: |

L M

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7a

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a

b

Ac

tivi

tie

s &

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vern

an

ce

Prior Year Current Year

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Re

ven

ue

a

b

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pe

ns

es

End of Year

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Sign

Here

Yes No

For Paperwork Reduction Act Notice, see the separate instructions.

(or P.O. box if mail is not delivered to street address) Room/suite

)501(c)(3) 501(c) ( (insert no.) 4947(a)(1) or 527

|Corporation Trust Association OtherForm of organization: Year of formation: State of legal domicile:

|

|

Net

Ass

ets

orFu

nd B

alan

ces

Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is

true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.

Signature of officer Date

Type or print name and title

Date PTINPrint/Type preparer's name Preparer's signature

Firm's name Firm's EIN

Firm's address

Phone no.

Form

Name of organization

Doing business as

Number and street Telephone number

City or town, state or province, country, and ZIP or foreign postal code

Is this a group return

for subordinates?Name and address of principal officer: ~~

If "No," attach a list. (see instructions)

Group exemption number |

Tax-exempt status:

Briefly describe the organization's mission or most significant activities:

Check this box if the organization discontinued its operations or disposed of more than 25% of its net assets.

Number of voting members of the governing body (Part VI, line 1a)

Number of independent voting members of the governing body (Part VI, line 1b)

Total number of individuals employed in calendar year 2014 (Part V, line 2a)

~~~~~~~~~~~~~~~~~~~~

~~~~~~~~~~~~~~

~~~~~~~~~~~~~~~~

Total number of volunteers (estimate if necessary)

Total unrelated business revenue from Part VIII, column (C), line 12

Net unrelated business taxable income from Form 990-T, line 34

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

~~~~~~~~~~~~~~~~~~~~

��

Contributions and grants (Part VIII, line 1h) ~~~~~~~~~~~~~~~~~~~~~

Program service revenue (Part VIII, line 2g) ~~~~~~~~~~~~~~~~~~~~~

~~~~~~~~~~~~~Investment income (Part VIII, column (A), lines 3, 4, and 7d)

Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) ~~~~~~~~

Total revenue - add lines 8 through 11 (must equal Part VIII, column (A), line 12) ��

Grants and similar amounts paid (Part IX, column (A), lines 1-3)

Benefits paid to or for members (Part IX, column (A), line 4)

Salaries, other compensation, employee benefits (Part IX, column (A), lines 5-10)

~~~~~~~~~~~

~~~~~~~~~~~~~

~~~

Professional fundraising fees (Part IX, column (A), line 11e)

Total fundraising expenses (Part IX, column (D), line 25)

~~~~~~~~~~~~~~

Other expenses (Part IX, column (A), lines 11a-11d, 11f-24e)

Total expenses. Add lines 13-17 (must equal Part IX, column (A), line 25)

Revenue less expenses. Subtract line 18 from line 12

~~~~~~~~~~~~~

~~~~~~~

��

Total assets (Part X, line 16)

Total liabilities (Part X, line 26)

Net assets or fund balances. Subtract line 21 from line 20

~~~~~~~~~~~~~~~~~~~~~~~~~~~~

~~~~~~~~~~~~~~~~~~~~~~~~~~~

��

May the IRS discuss this return with the preparer shown above? (see instructions) ��

LHA Form (2014)

www.irs.gov/form990.

Part I Summary

Signature BlockPart II

990

Return of Organization Exempt From Income Tax990 2014

§

==

999

EXTENDED TO MAY 16, 2016

OCT 1, 2014 SEP 30, 2015

MID-MICHIGAN DISTRICT HEALTH DEPARTMENT38-1808049

615 NORTH STATE STREET STE 2 (989) 831-52376,551,295.

STANTON, MI 48888MARCUS CHEATHAM X

615 N. STATE STREET, SUITE 2, STANTON, MI 4X

WWW.MMDHD.ORGX HEALT 1966 MI

TO PROVIDE PUBLIC HEALTHSERVICES TO RESIDENTS OF MONTCALM, GRATIOT, AND CLINTON COUNTIES.

80

870

0.0.

4,039,883. 4,185,659.1,385,884. 2,304,943.

2,017. 1,314.35,864. 59,379.

5,463,648. 6,551,295.0. 0.0. 0.

4,349,169. 4,487,119.0. 0.

0.1,130,230. 1,172,131.5,479,399. 5,659,250.-15,751. 892,045.

2,542,795. 3,548,112.796,022. 909,294.

1,746,773. 2,638,818.

MARCUS CHEATHAM, HEALTH OFFICER

WILLIAM I. TUCKER, IV 02/26/16 P01078910ABRAHAM & GAFFNEY, P.C. 38-27711173511 COOLIDGE ROAD, SUITE 100EAST LANSING, MI 48823 (517)351-6836

X

39

Code: Expenses $ including grants of $ Revenue $



Expenses $ including grants of $ Revenue $

43200211-07-14

1

2

3

4

Yes No

Yes No

4a

4b

4c

4d

4e

Form 990 (2014) Page

Check if Schedule O contains a response or note to any line in this Part III ��

Briefly describe the organization's mission:

Did the organization undertake any significant program services during the year which were not listed on

the prior Form 990 or 990-EZ?

If "Yes," describe these new services on Schedule O.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Did the organization cease conducting, or make significant changes in how it conducts, any program services?

If "Yes," describe these changes on Schedule O.

~~~~~~

Describe the organization's program service accomplishments for each of its three largest program services, as measured by expenses.

Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and

revenue, if any, for each program service reported.

( ) ( ) ( )

( ) ( ) ( )

( ) ( ) ( )

Other program services (Describe in Schedule O.)

( ) ( )

Total program service expenses |

Form (2014)

2Statement of Program Service AccomplishmentsPart III

990


X

TO PROVIDE PUBLIC HEALTH SERVICES TO RESIDENTS OF MONTCALM, GRATIOT,AND CLINTON COUNTIES.

X

X

1,413,294. 577,430.ENVIRONMENTAL HEALTH PROGRAM CONDUCTS INVESTIGATION OF HEALTH HAZARDS,FOOD SERVICE INSPECTIONS, GROUND WATER QUALITY CONTROL, LAND USEEVALUATIONS, MOBILE HOME PARK INSPECTIONS,SEWAGE DISPOSAL INSPECTIONS,PUBLIC SWIMMING INSPECTIONS, CAMPGROUND INSPECTIONS, ETC.

1,015,990.WOMEN, INFANTS, AND CHILDREN PROGRAM (WIC) IS A SUPPLEMENTAL NUTRITIONAND NUTRITION EDUCATION PROGRAM FOR ELIGIBLE PREGNANT, BREASTFEEDING,AND POSTPARTUM WOMEN, INFANTS, AND CHILDREN TO AGE FIVE WHO HAVENUTRITIONAL AND FINANCIAL NEEDS AND ARE COUNTY RESIDENTS.

701,904. 135,833.IMMUNIZATION PROGRAM PROVIDES FLU VACCINATIONS AND IMMUNIZATIONSAGAINST A VARIETY OF DISEASES.

1,565,990. 1,651,059.4,697,178.

08490226 766504 1319 2014.05080 MID-MICHIGAN DISTRICT HEALT 1319___1 2

40

43200311-07-14

Yes No

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

1

2

3

4

5

6

7

8

9

10

Section 501(c)(3) organizations.

a

b

c

d

e

f

a

b

11a

11b

11c

11d

11e

11f

12a

12b

13

14a

14b

15

16

17

18

19

20a

20b

a

b

a

b

If "Yes," complete Schedule ASchedule B, Schedule of Contributors

If "Yes," complete Schedule C, Part I

If "Yes," complete Schedule C, Part II

If "Yes," complete Schedule C, Part III

If "Yes," complete Schedule D, Part I

If "Yes," complete Schedule D, Part IIIf "Yes," complete

Schedule D, Part III

If "Yes," complete Schedule D, Part IV

If "Yes," complete Schedule D, Part V

If "Yes," complete Schedule D,Part VI

If "Yes," complete Schedule D, Part VII

If "Yes," complete Schedule D, Part VIII

If "Yes," complete Schedule D, Part IXIf "Yes," complete Schedule D, Part X

If "Yes," complete Schedule D, Part XIf "Yes," complete

Schedule D, Parts XI and XII

If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optionalIf "Yes," complete Schedule E

If "Yes," complete Schedule F, Parts I and IV

If "Yes," complete Schedule F, Parts II and IV

If "Yes," complete Schedule F, Parts III and IV

If "Yes," complete Schedule G, Part I

If "Yes," complete Schedule G, Part IIIf "Yes,"

complete Schedule G, Part IIIIf "Yes," complete Schedule H


Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)?

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Is the organization required to complete ?

Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for

public office?

~~~~~~~~~~~~~~~~~~~~~~

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Did the organization engage in lobbying activities, or have a section 501(h) election in effect

during the tax year?

Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or

similar amounts as defined in Revenue Procedure 98-19?

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

~~~~~~~~~~~~~~

Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to

provide advice on the distribution or investment of amounts in such funds or accounts?

Did the organization receive or hold a conservation easement, including easements to preserve open space,

the environment, historic land areas, or historic structures?

Did the organization maintain collections of works of art, historical treasures, or other similar assets?

~~~~~~~~~~~~~~

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Did the organization report an amount in Part X, line 21, for escrow or custodial account liability; serve as a custodian for

amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services?

Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent

endowments, or quasi-endowments?

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

~~~~~~~~~~~~~~~~~~~~~~~~

If the organization's answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X

as applicable.

Did the organization report an amount for land, buildings, and equipment in Part X, line 10?

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Did the organization report an amount for investments - other securities in Part X, line 12 that is 5% or more of its total

assets reported in Part X, line 16?

Did the organization report an amount for investments - program related in Part X, line 13 that is 5% or more of its total

assets reported in Part X, line 16?

~~~~~~~~~~~~~~~~~~~~~~~~~

~~~~~~~~~~~~~~~~~~~~~~~~~

Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in

Part X, line 16?

Did the organization report an amount for other liabilities in Part X, line 25?

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

~~~~~~

Did the organization's separate or consolidated financial statements for the tax year include a footnote that addresses

the organization's liability for uncertain tax positions under FIN 48 (ASC 740)?

Did the organization obtain separate, independent audited financial statements for the tax year?

~~~~

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Was the organization included in consolidated, independent audited financial statements for the tax year?

~~~~~

Is the organization a school described in section 170(b)(1)(A)(ii)?

Did the organization maintain an office, employees, or agents outside of the United States?

~~~~~~~~~~~~~~

~~~~~~~~~~~~~~~~

Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business,

investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000

or more? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any

foreign organization?

Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to

or for foreign individuals?

~~~~~~~~~~~~~~~~~~~~~~~~~~~~

~~~~~~~~~~~~~~~~~~~~~~~~~~

Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX,

column (A), lines 6 and 11e? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines

1c and 8a? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a?

Did the organization operate one or more hospital facilities?

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

~~~~~~~~~~~~~~~~

If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return? ��

Form (2014)

3Part IV Checklist of Required Schedules

990


XX

X

X

X

X

X

X

X

X

X

X

X

XX

X

X

XXX

X

X

X

X

X

XX


41

43200411-07-14

Yes No

21

22

23

24

25

26

27

28

29

30

31

32

33

34

35

36

37

38

21

22

23

24a

24b

24c

24d

25a

25b

26

27

28a

28b

28c

29

30

31

32

33

34

35a

35b

36

37

38

a

b

c

d

a

b

Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations.

a

b

c

a

b


Note.

(continued)

If "Yes," complete Schedule I, Parts I and II

If "Yes," complete Schedule I, Parts I and III

If "Yes," completeSchedule J

If "Yes," answer lines 24b through 24d and completeSchedule K. If "No", go to line 25a

If "Yes," complete Schedule L, Part I

If "Yes," completeSchedule L, Part I

If "Yes,"complete Schedule L, Part II

If "Yes," complete Schedule L, Part III

If "Yes," complete Schedule L, Part IVIf "Yes," complete Schedule L, Part IV

If "Yes," complete Schedule L, Part IVIf "Yes," complete Schedule M

If "Yes," complete Schedule M

If "Yes," complete Schedule N, Part IIf "Yes," complete

Schedule N, Part II

If "Yes," complete Schedule R, Part IIf "Yes," complete Schedule R, Part II, III, or IV, and

Part V, line 1

If "Yes," complete Schedule R, Part V, line 2

If "Yes," complete Schedule R, Part V, line 2

If "Yes," complete Schedule R, Part VI


Did the organization report more than $5,000 of grants or other assistance to any domestic organization or

domestic government on Part IX, column (A), line 1? ~~~~~~~~~~~~~~

Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on

Part IX, column (A), line 2? ~~~~~~~~~~~~~~~~~~~~~~~~~~

Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5 about compensation of the organization's current

and former officers, directors, trustees, key employees, and highest compensated employees?

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the

last day of the year, that was issued after December 31, 2002?

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?

Did the organization maintain an escrow account other than a refunding escrow at any time during the year to defease

any tax-exempt bonds?

Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?

~~~~~~~~~~~

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

~~~~~~~~~~~

Did the organization engage in an excess benefit

transaction with a disqualified person during the year?

Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and

that the transaction has not been reported on any of the organization's prior Forms 990 or 990-EZ?

~~~~~~~~~~~~~~~~

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Did the organization report any amount on Part X, line 5, 6, or 22 for receivables from or payables to any current or

former officers, directors, trustees, key employees, highest compensated employees, or disqualified persons?

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial

contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member

of any of these persons? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV

instructions for applicable filing thresholds, conditions, and exceptions):

A current or former officer, director, trustee, or key employee? ~~~~~~~~~~~

A family member of a current or former officer, director, trustee, or key employee?

An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer,

director, trustee, or direct or indirect owner?

~~

~~~~~~~~~~~~~~~~~~~~~

Did the organization receive more than $25,000 in non-cash contributions?

Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation

contributions?

~~~~~~~~~

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Did the organization liquidate, terminate, or dissolve and cease operations?

Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets?

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Did the organization own 100% of an entity disregarded as separate from the organization under Regulations

sections 301.7701-2 and 301.7701-3?

Was the organization related to any tax-exempt or taxable entity?

~~~~~~~~~~~~~~~~~~~~~~~~

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Did the organization have a controlled entity within the meaning of section 512(b)(13)?

If "Yes" to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity

within the meaning of section 512(b)(13)?

~~~~~~~~~~~~~~~~~~

~~~~~~~~~~~~~~~~~~~

Did the organization make any transfers to an exempt non-charitable related organization?

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Did the organization conduct more than 5% of its activities through an entity that is not a related organization

and that is treated as a partnership for federal income tax purposes? ~~~~~~~~

Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19?

All Form 990 filers are required to complete Schedule O ��

Form (2014)

4Part IV Checklist of Required Schedules

990


X

X

X

X

X

X

X

X

XX

XX

X

X

X

X

XX

X

X

X


42

43200511-07-14

Yes No

1

2

3

4

5

6

7

a

b

c

1a

1b

1c

a

b

2a

Note.

2b

3a

3b

4a

5a

5b

5c

6a

6b

7a

7b

7c

7e

7f

7g

7h

8

9a

9b

a

b

a

b

a

b

c

a

b

Organizations that may receive deductible contributions under section 170(c).

a

b

c

d

e

f

g

h

7d

8

9

10

11

12

13

14

Sponsoring organizations maintaining donor advised funds.

Sponsoring organizations maintaining donor advised funds.

a

b


a

b

10a

10b


a

b

11a

11b

a

b

Section 4947(a)(1) non-exempt charitable trusts. 12a

12b

Section 501(c)(29) qualified nonprofit health insurance issuers.

Note.

a

b

c

a

b

13a

13b

13c

14a

14b

e-file

If "No," to line 3b, provide an explanation in Schedule O

If "No," provide an explanation in Schedule O

Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?

Form (2014)


Check if Schedule O contains a response or note to any line in this Part V ��

Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable ~~~~~~~~~~~

Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable ~~~~~~~~~~

Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming

(gambling) winnings to prize winners? ��

Enter the number of employees reported on Form W-3, Transmittal of Wage and Tax Statements,

filed for the calendar year ending with or within the year covered by this return ~~~~~~~~~~

If at least one is reported on line 2a, did the organization file all required federal employment tax returns?

If the sum of lines 1a and 2a is greater than 250, you may be required to (see instructions)

~~~~~~~~~~

~~~~~~~~~~~

Did the organization have unrelated business gross income of $1,000 or more during the year?

If "Yes," has it filed a Form 990-T for this year?

~~~~~~~~~~~~~~

~~~~~~~~~~

At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a

financial account in a foreign country (such as a bank account, securities account, or other financial account)?~~~~~~~

If "Yes," enter the name of the foreign country:

See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).

Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?

Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?

~~~~~~~~~~~~

~~~~~~~~~

If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit

any contributions that were not tax deductible as charitable contributions?

If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts

were not tax deductible?

~~~~~~~~~~~~~~~~~~~~~~~~

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

If "Yes," did the organization notify the donor of the value of the goods or services provided?

Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required

to file Form 8282?

~~~~~~~~~~~~~~~

��

If "Yes," indicate the number of Forms 8282 filed during the year

Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?

~~~~~~~~~~~~~~~~

~~~~~~~

~~~~~~~~~Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?

If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?

If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?

~

Did a donor advised fund maintained by the

sponsoring organization have excess business holdings at any time during the year? ~~~~~~~~~~~~~~~~~~~

Did the sponsoring organization make any taxable distributions under section 4966?

Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?

~~~~~~~~~~~~~~~~~~~

~~~~~~~~~~~~~

Enter:

Initiation fees and capital contributions included on Part VIII, line 12

Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities

~~~~~~~~~~~~~~~

~~~~~~

Enter:

Gross income from members or shareholders

Gross income from other sources (Do not net amounts due or paid to other sources against

amounts due or received from them.)

~~~~~~~~~~~~~~~~~~~~~~~~~~

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Is the organization filing Form 990 in lieu of Form 1041?

If "Yes," enter the amount of tax-exempt interest received or accrued during the year ��

Is the organization licensed to issue qualified health plans in more than one state?

See the instructions for additional information the organization must report on Schedule O.

~~~~~~~~~~~~~~~~~~~~~

Enter the amount of reserves the organization is required to maintain by the states in which the

organization is licensed to issue qualified health plans

Enter the amount of reserves on hand

~~~~~~~~~~~~~~~~~~~~~~

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Did the organization receive any payments for indoor tanning services during the tax year?

If "Yes," has it filed a Form 720 to report these payments?

~~~~~~~~~~~~~~~~

��

5Part V Statements Regarding Other IRS Filings and Tax Compliance

990

J


170

X

87X

X

X

XX

X

X

X

X

X

X

XX

X


43

432006 11-07-14

Yes No

1a

1b

1

2

3

4

5

6

7

8

9

a

b

2

3

4

5

6

7a

7b

8a

8b

9

a

b

a

b

Yes No

10

11

a

b

10a

10b

11a

12a

12b

12c

13

14

15a

15b

16a

16b

a

b

12a

b

c

13

14

15

a

b

16a

b

17

18

19

20

For each "Yes" response to lines 2 through 7b below, and for a "No" responseto line 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.

If "Yes," provide the names and addresses in Schedule O(This Section B requests information about policies not required by the Internal Revenue Code.)

If "No," go to line 13

If "Yes," describein Schedule O how this was done

(explain in Schedule O)

If there are material differences in voting rights among members of the governing body, or if the governing

body delegated broad authority to an executive committee or similar committee, explain in Schedule O.

Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:

Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts?

Form (2014)


Check if Schedule O contains a response or note to any line in this Part VI ��

Enter the number of voting members of the governing body at the end of the tax year

Enter the number of voting members included in line 1a, above, who are independent

~~~~~~

~~~~~~

Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other

officer, director, trustee, or key employee? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Did the organization delegate control over management duties customarily performed by or under the direct supervision

of officers, directors, or trustees, or key employees to a management company or other person? ~~~~~~~~~~~~~~

Did the organization make any significant changes to its governing documents since the prior Form 990 was filed?

Did the organization become aware during the year of a significant diversion of the organization's assets?

Did the organization have members or stockholders?

~~~~~

~~~~~~~~~

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or

more members of the governing body?

Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or

persons other than the governing body?

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

The governing body?

Each committee with authority to act on behalf of the governing body?

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

~~~~~~~~~~~~~~~~~~~~~~~~~~

Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the

organization's mailing address? ��

Did the organization have local chapters, branches, or affiliates?

If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates,

and branches to ensure their operations are consistent with the organization's exempt purposes?

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

~~~~~~~~~~~~~

Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form?

Describe in Schedule O the process, if any, used by the organization to review this Form 990.

Did the organization have a written conflict of interest policy? ~~~~~~~~~~~~~~~~~~~~

~~~~~~

Did the organization regularly and consistently monitor and enforce compliance with the policy?

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Did the organization have a written whistleblower policy?

Did the organization have a written document retention and destruction policy?

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

~~~~~~~~~~~~~~~~~~~~~~

Did the process for determining compensation of the following persons include a review and approval by independent

persons, comparability data, and contemporaneous substantiation of the deliberation and decision?

The organization's CEO, Executive Director, or top management official

Other officers or key employees of the organization

If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).

~~~~~~~~~~~~~~~~~~~~~~~~~~

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a

taxable entity during the year? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation

in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization's

exempt status with respect to such arrangements? ��

List the states with which a copy of this Form 990 is required to be filed

Section 6104 requires an organization to make its Forms 1023 (or 1024 if applicable), 990, and 990-T (Section 501(c)(3)s only) available

for public inspection. Indicate how you made these available. Check all that apply.

Own website Another's website Upon request Other

Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial

statements available to the public during the tax year.

State the name, address, and telephone number of the person who possesses the organization's books and records: |

6Part VI Governance, Management, and Disclosure

Section A. Governing Body and Management

Section B. Policies

Section C. Disclosure

990

J


X

8

0

X

XXXX

X

X

XX

X

X

X

XX

XXX

XX

X

MI

X

MELISSA BOWERMAN, DIRECTOR OF ADMINISTRATIVE SERVICES - (989) 831-5237615 N. STATE STREET, SUITE 2, STANTON, MI 48888


44

Indi

vidu

al tr

uste

e or

dire

ctor

Inst

itutio

nal t

rust

ee

Offi

cer

Key

empl

oyee

Hig

hest

com

pens

ated

empl

oyee

Form

er

(do not check more than onebox, unless person is both anofficer and a director/trustee)

432007 11-07-14

current

Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees

1a

current

current

former

former directors or trustees

(A) (B) (C) (D) (E) (F)


Check if Schedule O contains a response or note to any line in this Part VII ��

Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization's tax year.

¥ List all of the organization's officers, directors, trustees (whether individuals or organizations), regardless of amount of compensation.Enter -0- in columns (D), (E), and (F) if no compensation was paid.

¥ List all of the organization's key employees, if any. See instructions for definition of "key employee."¥ List the organization's five highest compensated employees (other than an officer, director, trustee, or key employee) who received report-

able compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the organization and any related organizations.

¥ List all of the organization's officers, key employees, and highest compensated employees who received more than $100,000 ofreportable compensation from the organization and any related organizations.

¥ List all of the organization's that received, in the capacity as a former director or trustee of the organization,more than $10,000 of reportable compensation from the organization and any related organizations.

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest compensated employees; and former such persons.

Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.

PositionName and Title Average hours per

week (list any

hours forrelated

organizationsbelowline)

Reportablecompensation

from the

organization(W-2/1099-MISC)

Reportablecompensationfrom related

organizations(W-2/1099-MISC)

Estimatedamount of

othercompensation

from theorganizationand related

organizations

Form (2014)

7Part VII Compensation of Officers, Directors, Trustees, Key Employees, Highest Compensated

Employees, and Independent Contractors

990


(1) JACK ENDERLE 1.00BOARD MEMBER X 510. 0. 264.(2) TOM LINDEMAN 1.00BOARD MEMBER X 633. 0. 533.(3) BRUCE DELONG 2.00CHAIR X 68. 0. 22.(4) BETTY KELLENBERGER 2.00VICE CHAIR X 848. 0. 666.(5) LAURA MCCOLLUM 1.00BOARD MEMBER X 892. 0. 425.(6) KEN MITCHELL 1.00BOARD MEMBER X 0. 0. 0.(7) GEORGE BAILEY 1.00BOARD MEMBER X 0. 0. 0.(8) JANE KEON 1.00BOARD MEMBER X 465. 0. 333.(9) MARCUS CHEATHAM 40.00HEALTH OFFICER X 92,563. 0. 45,268.(10) MELISSA BOWERMAN 40.00DIRECTOR OF ADMIN SERVICES X 70,840. 0. 28,909.


45

Form

er

Indi

vidu

al tr

uste

e or

dire

ctor

Inst

itutio

nal t

rust

ee

Offi

cer

Hig

hest

com

pens

ated

empl

oyee

Key

empl

oyee

(do not check more than onebox, unless person is both anofficer and a director/trustee)

43200811-07-14

Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees

(B) (C)(A) (D) (E) (F)

1b

c

d

Sub-total

Total from continuation sheets to Part VII, Section A

Total (add lines 1b and 1c)

2

Yes No

3

4

5

former

3

4

5

Section B. Independent Contractors

1

(A) (B) (C)

2

(continued)

If "Yes," complete Schedule J for such individual

If "Yes," complete Schedule J for such individual

If "Yes," complete Schedule J for such person

Page Form 990 (2014)

PositionAverage hours per

week(list any

hours forrelated

organizationsbelowline)

Name and title Reportablecompensation

from the

organization(W-2/1099-MISC)

Reportablecompensationfrom related

organizations(W-2/1099-MISC)

Estimatedamount of

othercompensation

from theorganizationand related

organizations

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ |

~~~~~~~~~~ |

�� |

Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable

compensation from the organization |

Did the organization list any officer, director, or trustee, key employee, or highest compensated employee on

line 1a? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization

and related organizations greater than $150,000? ~~~~~~~~~~~~~

Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services

rendered to the organization? ��

Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from

the organization. Report compensation for the calendar year ending with or within the organization's tax year.

Name and business address Description of services Compensation

Total number of independent contractors (including but not limited to those listed above) who received more than

$100,000 of compensation from the organization |

Form (2014)

8Part VII

990


166,819. 0. 76,420.0. 0. 0.

166,819. 0. 76,420.

0

X

X

X

NONE

0


46

Noncash contributions included in lines 1a-1f: $

43200911-07-14

Total revenue.

(A) (B) (C) (D)

1 a

b

c

d

e

f

g

h

1

1

1

1

1

1

a

b

c

d

e

f

Co

ntr

ibu

tio

ns

, G

ifts

, G

ran

tsa

nd

Oth

er

Sim

ila

r A

mo

un

ts

Total.

Business Code

a

b

c

d

e

f

g

2

Pro

gra

m S

erv

ice

Re

ven

ue

Total.

3

4

5

6 a

b

c

d

a

b

c

d

7

a

b

c

8

a

b

9 a

b

c

a

b

10 a

b

c

a

b

Business Code

11 a

b

c

d

e Total.

Oth

er

Re

ven

ue

12

Revenue excludedfrom tax under

sections512 - 514

All other contributions, gifts, grants, and

similar amounts not included above

See instructions.

Form (2014)

Page Form 990 (2014)

Check if Schedule O contains a response or note to any line in this Part VIII ��

Total revenue Related orexempt function

revenue

Unrelatedbusinessrevenue

Federated campaigns

Membership dues

~~~~~~

~~~~~~~~

Fundraising events

Related organizations

~~~~~~~~

~~~~~~

Government grants (contributions)

~~

Add lines 1a-1f �� |

All other program service revenue ~~~~~

Add lines 2a-2f �� |

Investment income (including dividends, interest, and

other similar amounts)

Income from investment of tax-exempt bond proceeds

~~~~~~~~~~~~~~~~~ |

|

Royalties �� |

(i) Real (ii) Personal

Gross rents

Less: rental expenses

Rental income or (loss)

Net rental income or (loss)

~~~~~~~

~~~

~~

�� |

Gross amount from sales of

assets other than inventory

(i) Securities (ii) Other

Less: cost or other basis

and sales expenses

Gain or (loss)

~~~

~~~~~~~

Net gain or (loss) �� |

Gross income from fundraising events (not

including $ of

contributions reported on line 1c). See

Part IV, line 18 ~~~~~~~~~~~~~

Less: direct expenses~~~~~~~~~~

Net income or (loss) from fundraising events �� |

Gross income from gaming activities. See

Part IV, line 19 ~~~~~~~~~~~~~

Less: direct expenses

Net income or (loss) from gaming activities

~~~~~~~~~

�� |

Gross sales of inventory, less returns

and allowances ~~~~~~~~~~~~~

Less: cost of goods sold

Net income or (loss) from sales of inventory

~~~~~~~~

�� |

Miscellaneous Revenue

All other revenue ~~~~~~~~~~~~~

Add lines 11a-11d ~~~~~~~~~~~~~~~ |

|��

9Part VIII Statement of Revenue

990


4,183,322.

2,337.191,685.

4,185,659.

ENVIRONMENTAL, COMMUNI 900099 2,304,943.2,304,943.

2,304,943.

1,314. 1,314.

OTHER REVENUE 900099 59,379. 59,379.

59,379.6,551,295.2,364,322. 0. 1,314.


47

Check here if following SOP 98-2 (ASC 958-720)

432010 11-07-14

Total functional expenses.

Joint costs.

(A) (B) (C) (D)

1

2

3

4

5

6

7

8

9

10

11

a

b

c

d

e

f

g

12

13

14

15

16

17

18

19

20

21

22

23

24

a

b

c

d

e

25

26

Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).

Grants and other assistance to domestic organizations

and domestic governments. See Part IV, line 21

Compensation not included above, to disqualified

persons (as defined under section 4958(f)(1)) and

persons described in section 4958(c)(3)(B)

Pension plan accruals and contributions (include

section 401(k) and 403(b) employer contributions)

Professional fundraising services. See Part IV, line 17

(If line 11g amount exceeds 10% of line 25,

column (A) amount, list line 11g expenses on Sch O.)

Other expenses. Itemize expenses not covered above. (List miscellaneous expenses in line 24e. If line24e amount exceeds 10% of line 25, column (A)amount, list line 24e expenses on Schedule O.)

Add lines 1 through 24e

Complete this line only if the organization

reported in column (B) joint costs from a combined

educational campaign and fundraising solicitation.


Check if Schedule O contains a response or note to any line in this Part IX ��

Total expenses Program serviceexpenses

Management andgeneral expenses

Fundraisingexpenses

~

Grants and other assistance to domestic

individuals. See Part IV, line 22 ~~~~~~~

Grants and other assistance to foreign

organizations, foreign governments, and foreign

individuals. See Part IV, lines 15 and 16 ~~~

Benefits paid to or for members ~~~~~~~

Compensation of current officers, directors,

trustees, and key employees ~~~~~~~~

~~~

Other salaries and wages ~~~~~~~~~~

Other employee benefits ~~~~~~~~~~

Payroll taxes ~~~~~~~~~~~~~~~~

Fees for services (non-employees):

Management

Legal

Accounting

Lobbying

~~~~~~~~~~~~~~~~

~~~~~~~~~~~~~~~~~~~~

~~~~~~~~~~~~~~~~~

~~~~~~~~~~~~~~~~~~

Investment management fees

Other.

~~~~~~~~

Advertising and promotion

Office expenses

Information technology

Royalties

~~~~~~~~~

~~~~~~~~~~~~~~~

~~~~~~~~~~~

~~~~~~~~~~~~~~~~~~

Occupancy ~~~~~~~~~~~~~~~~~

~~~~~~~~~~~~~~~~~~~Travel

Payments of travel or entertainment expenses

for any federal, state, or local public officials

Conferences, conventions, and meetings ~~

Interest

Payments to affiliates

~~~~~~~~~~~~~~~~~~

~~~~~~~~~~~~

Depreciation, depletion, and amortization

Insurance

~~

~~~~~~~~~~~~~~~~~

~~

All other expenses

|

Form (2014)

Do not include amounts reported on lines 6b,

7b, 8b, 9b, and 10b of Part VIII.

10Part IX Statement of Functional Expenses

990


251,043. 208,366. 42,677.

3,075,528. 2,552,688. 522,840.

246,832. 204,871. 41,961.673,970. 559,395. 114,575.239,746. 198,989. 40,757.

10,373. 8,610. 1,763.

161,175. 133,775. 27,400.4,122. 3,421. 701.

560,549. 465,256. 95,293.134,355. 111,515. 22,840.

71,251. 59,138. 12,113.152,859. 126,873. 25,986.

25,362. 21,050. 4,312.

33,124. 27,493. 5,631.

MEMBERSHIPS AND SUBSCRI 14,307. 11,875. 2,432.REPAIRS AND MAINTENANCE 3,896. 3,234. 662.

758. 629. 129.5,659,250. 4,697,178. 962,072. 0.


48

43201111-07-14

(A) (B)

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

31

32

33

34

1

2

3

4

5

6

7

8

9

10c

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

a

b

10a

10b

As

se

ts

Total assets.

Lia

bil

itie

s

Total liabilities.

Organizations that follow SFAS 117 (ASC 958), check here and

complete lines 27 through 29, and lines 33 and 34.

27

28

29

Organizations that do not follow SFAS 117 (ASC 958), check here

and complete lines 30 through 34.

30

31

32

33

34

Ne

t A

ss

ets

or

Fu

nd

Ba

lan

ce

s


Check if Schedule O contains a response or note to any line in this Part X ��

Beginning of year End of year

Cash - non-interest-bearing

Savings and temporary cash investments

Pledges and grants receivable, net

~~~~~~~~~~~~~~~~~~~~~~~~~

~~~~~~~~~~~~~~~~~~

~~~~~~~~~~~~~~~~~~~~~

Accounts receivable, net ~~~~~~~~~~~~~~~~~~~~~~~~~~

Loans and other receivables from current and former officers, directors,

trustees, key employees, and highest compensated employees. Complete

Part II of Schedule L ~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Loans and other receivables from other disqualified persons (as defined under

section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing

employers and sponsoring organizations of section 501(c)(9) voluntary

employees' beneficiary organizations (see instr). Complete Part II of Sch L ~~

Notes and loans receivable, net

Inventories for sale or use

Prepaid expenses and deferred charges

~~~~~~~~~~~~~~~~~~~~~~~

~~~~~~~~~~~~~~~~~~~~~~~~~~

~~~~~~~~~~~~~~~~~~

Land, buildings, and equipment: cost or other

basis. Complete Part VI of Schedule D

Less: accumulated depreciation

~~~

~~~~~~

Investments - publicly traded securities

Investments - other securities. See Part IV, line 11

Investments - program-related. See Part IV, line 11

Intangible assets

~~~~~~~~~~~~~~~~~~~

~~~~~~~~~~~~~~

~~~~~~~~~~~~~

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Other assets. See Part IV, line 11 ~~~~~~~~~~~~~~~~~~~~~~

Add lines 1 through 15 (must equal line 34) ��

Accounts payable and accrued expenses

Grants payable

Deferred revenue

~~~~~~~~~~~~~~~~~~

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Tax-exempt bond liabilities

Escrow or custodial account liability. Complete Part IV of Schedule D

~~~~~~~~~~~~~~~~~~~~~~~~~

~~~~

Loans and other payables to current and former officers, directors, trustees,

key employees, highest compensated employees, and disqualified persons.

Complete Part II of Schedule L ~~~~~~~~~~~~~~~~~~~~~~~

Secured mortgages and notes payable to unrelated third parties ~~~~~~

Unsecured notes and loans payable to unrelated third parties ~~~~~~~~

Other liabilities (including federal income tax, payables to related third

parties, and other liabilities not included on lines 17-24). Complete Part X of

Schedule D ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Add lines 17 through 25 ��

|

Unrestricted net assets

Temporarily restricted net assets

Permanently restricted net assets

~~~~~~~~~~~~~~~~~~~~~~~~~~~

~~~~~~~~~~~~~~~~~~~~~~

~~~~~~~~~~~~~~~~~~~~~

|

Capital stock or trust principal, or current funds

Paid-in or capital surplus, or land, building, or equipment fund

Retained earnings, endowment, accumulated income, or other funds

~~~~~~~~~~~~~~~

~~~~~~~~

~~~~

Total net assets or fund balances ~~~~~~~~~~~~~~~~~~~~~~

Total liabilities and net assets/fund balances ��

Form (2014)

11Balance SheetPart X

990


7,532. 6,007.1,704,000. 2,929,274.

292,940. 179,363.184,263. 152,317.

213,000. 177,000.88,828. 53,265.52,232. 50,886.

2,542,795. 3,548,112.323,857. 478,842.

472,165. 430,452.

796,022. 909,294.

X

1,746,773. 2,638,818.0. 0.0. 0.

1,746,773. 2,638,818.2,542,795. 3,548,112.


49

43201211-07-14

1

2

3

4

5

6

7

8

9

10

1

2

3

4

5

6

7

8

9

10

Yes No

1

2

3

a

b

c

2a

2b

2c

a

b

3a

3b


Check if Schedule O contains a response or note to any line in this Part XI ��

Total revenue (must equal Part VIII, column (A), line 12)

Total expenses (must equal Part IX, column (A), line 25)

Revenue less expenses. Subtract line 2 from line 1

Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A))

~~~~~~~~~~~~~~~~~~~~~~~~~~

~~~~~~~~~~~~~~~~~~~~~~~~~~

~~~~~~~~~~~~~~~~~~~~~~~~~~~~

~~~~~~~~~~

Net unrealized gains (losses) on investments

Donated services and use of facilities

Investment expenses

Prior period adjustments

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Other changes in net assets or fund balances (explain in Schedule O)

Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33,

column (B))

~~~~~~~~~~~~~~~~~~~

��

Check if Schedule O contains a response or note to any line in this Part XII ��

Accounting method used to prepare the Form 990: Cash Accrual Other

If the organization changed its method of accounting from a prior year or checked "Other," explain in Schedule O.

Were the organization's financial statements compiled or reviewed by an independent accountant? ~~~~~~~~~~~~

If "Yes," check a box below to indicate whether the financial statements for the year were compiled or reviewed on a

separate basis, consolidated basis, or both:

Separate basis Consolidated basis Both consolidated and separate basis

Were the organization's financial statements audited by an independent accountant? ~~~~~~~~~~~~~~~~~~~

If "Yes," check a box below to indicate whether the financial statements for the year were audited on a separate basis,

consolidated basis, or both:

Separate basis Consolidated basis Both consolidated and separate basis

If "Yes" to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit,

review, or compilation of its financial statements and selection of an independent accountant?~~~~~~~~~~~~~~~

If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.

As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit

Act and OMB Circular A-133? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit

or audits, explain why in Schedule O and describe any steps taken to undergo such audits ��

Form (2014)

12Part XI Reconciliation of Net Assets

Part XII Financial Statements and Reporting

990


6,551,295.5,659,250.

892,045.1,746,773.

0.

2,638,818.

X

X SEE SCH O

X

X

X

X

X

X


50

OMB No. 1545-0047


432021 09-17-14

Information about Schedule A (Form 990 or 990-EZ) and its instructions is at

(i) (iii) (iv) (v) (vi)(ii) Name of supported

organization

Type of organization (described on lines 1-9 above or IRC section

(see instructions))

Is the organizationlisted in your

governing document?

Amount of monetary

support (see

Instructions)

Amount of

other support (see

Instructions)

EIN

(Form 990 or 990-EZ)Complete if the organization is a section 501(c)(3) organization or a section

4947(a)(1) nonexempt charitable trust.| Attach to Form 990 or Form 990-EZ.

|

Open to PublicInspection

Name of the organization Employer identification number

1

2

3

4

5

6

7

8

9

10

11

section 170(b)(1)(A)(i).

section 170(b)(1)(A)(ii).

section 170(b)(1)(A)(iii).

section 170(b)(1)(A)(iii).

section 170(b)(1)(A)(iv).

section 170(b)(1)(A)(v).

section 170(b)(1)(A)(vi).

section 170(b)(1)(A)(vi).

section 509(a)(2).

section 509(a)(4).

section 509(a)(1) section 509(a)(2) section 509(a)(3).

a

b

c

d

e

f

g

Type I.

You must complete Part IV, Sections A and B.

Type II.

You must complete Part IV, Sections A and C.

Type III functionally integrated.

You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated.

You must complete Part IV, Sections A and D, and Part V.

Yes No

Total

For Paperwork Reduction Act Notice, see the Instructions for

Form 990 or 990-EZ.

Schedule A (Form 990 or 990-EZ) 2014

(All organizations must complete this part.) See instructions.

The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)

A church, convention of churches, or association of churches described in

A school described in (Attach Schedule E.)

A hospital or a cooperative hospital service organization described in

A medical research organization operated in conjunction with a hospital described in Enter the hospital's name,

city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in

(Complete Part II.)

A federal, state, or local government or governmental unit described in

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in

(Complete Part II.)

A community trust described in (Complete Part II.)

An organization that normally receives: (1) more than 33 1/3% of its support from contributions, membership fees, and gross receipts from

activities related to its exempt functions - subject to certain exceptions, and (2) no more than 33 1/3% of its support from gross investment

income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975.

See (Complete Part III.)

An organization organized and operated exclusively to test for public safety. See

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or

more publicly supported organizations described in or . See Check the box in

lines 11a through 11d that describes the type of supporting organization and complete lines 11e, 11f, and 11g.

A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving

the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting

organization.

A supporting organization supervised or controlled in connection with its supported organization(s), by having

control or management of the supporting organization vested in the same persons that control or manage the supported

organization(s).

A supporting organization operated in connection with, and functionally integrated with,

its supported organization(s) (see instructions).

A supporting organization operated in connection with its supported organization(s)

that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness

requirement (see instructions).

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III

functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Provide the following information about the supported organization(s).

LHA


SCHEDULE A

Part I Reason for Public Charity Status

Public Charity Status and Public Support 2014


X


51

Subtract line 5 from line 4.

43202209-17-14

Calendar year (or fiscal year beginning in)

Calendar year (or fiscal year beginning in) |

2

(a) (b) (c) (d) (e) (f)

1

2

3

4

5

Total.

6 Public support.

(a) (b) (c) (d) (e) (f)

7

8

9

10

11

12

13

Total support.

12

First five years.

stop here

14

15

14

15

16

17

18

a

b

a

b

33 1/3% support test - 2014.

stop here.

33 1/3% support test - 2013.

stop here.

10% -facts-and-circumstances test - 2014.

stop here.

10% -facts-and-circumstances test - 2013.

stop here.

Private foundation.


|

Add lines 7 through 10

Schedule A (Form 990 or 990-EZ) 2014 Page

(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization

fails to qualify under the tests listed below, please complete Part III.)

2010 2011 2012 2013 2014 Total

Gifts, grants, contributions, and

membership fees received. (Do not

include any "unusual grants.") ~~

Tax revenues levied for the organ-

ization's benefit and either paid to

or expended on its behalf ~~~~

The value of services or facilities

furnished by a governmental unit to

the organization without charge ~

Add lines 1 through 3 ~~~

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) ~~~~~~~~~~~~

2010 2011 2012 2013 2014 Total

Amounts from line 4 ~~~~~~~

Gross income from interest,

dividends, payments received on

securities loans, rents, royalties

and income from similar sources ~

Net income from unrelated business

activities, whether or not the

business is regularly carried on ~

Other income. Do not include gain

or loss from the sale of capital

assets (Explain in Part VI.) ~~~~

Gross receipts from related activities, etc. (see instructions) ~~~~~~~~~~~~~~~~~~~~~~~

If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3)

organization, check this box and �� |

~~~~~~~~~~~~Public support percentage for 2014 (line 6, column (f) divided by line 11, column (f))

Public support percentage from 2013 Schedule A, Part II, line 14

%

%~~~~~~~~~~~~~~~~~~~~~

If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box and

The organization qualifies as a publicly supported organization ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ |

If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this box

and The organization qualifies as a publicly supported organization ~~~~~~~~~~~~~~~~~~~~~~~~~~~~ |

If the organization did not check a box on line 13, 16a, or 16b, and line 14 is 10% or more,

and if the organization meets the "facts-and-circumstances" test, check this box and Explain in Part VI how the organization

meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization ~~~~~~~~~~~~~~~ |

If the organization did not check a box on line 13, 16a, 16b, or 17a, and line 15 is 10% or

more, and if the organization meets the "facts-and-circumstances" test, check this box and Explain in Part VI how the

organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization ~~~~~~~~ |

If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see instructions �� |

Part II Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)

Section A. Public Support

Section B. Total Support

Section C. Computation of Public Support Percentage


4613990. 4129914. 4007276. 4039883. 4185659.20976722.

4613990. 4129914. 4007276. 4039883. 4185659.20976722.

20976722.

4613990. 4129914. 4007276. 4039883. 4185659.20976722.

7,588. 6,081. 1,776. 2,017. 1,314. 18,776.

58,787. 21,926. 37,959. 35,864. 59,379. 213,915.21209413.

98.9099.20

X


52

(Subtract line 7c from line 6.)

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

(Add lines 9, 10c, 11, and 12.)

432023 09-17-14



Total support.

3

(a) (b) (c) (d) (e) (f)

1

2

3

4

5

6

7

Total.

a

b

c

8 Public support

(a) (b) (c) (d) (e) (f)

9

10a

b

c11

12

13

14 First five years.

stop here

15

16

15

16

17

18

19

20

2014

2013

17

18

a

b

33 1/3% support tests - 2014.

stop here.

33 1/3% support tests - 2013.

stop here.

Private foundation.


Unrelated business taxable income

(less section 511 taxes) from businesses

acquired after June 30, 1975


(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to

qualify under the tests listed below, please complete Part II.)

2010 2011 2012 2013 2014 Total

Gifts, grants, contributions, and

membership fees received. (Do not

include any "unusual grants.") ~~

Gross receipts from admissions,merchandise sold or services per-formed, or facilities furnished inany activity that is related to theorganization's tax-exempt purpose

Gross receipts from activities that

are not an unrelated trade or bus-

iness under section 513 ~~~~~

Tax revenues levied for the organ-

ization's benefit and either paid to

or expended on its behalf ~~~~

The value of services or facilities

furnished by a governmental unit to

the organization without charge ~

~~~ Add lines 1 through 5

Amounts included on lines 1, 2, and

3 received from disqualified persons

~~~~~~

Add lines 7a and 7b ~~~~~~~

2010 2011 2012 2013 2014 Total

Amounts from line 6 ~~~~~~~Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources ~

~~~~

Add lines 10a and 10b ~~~~~~Net income from unrelated businessactivities not included in line 10b, whether or not the business is regularly carried on ~~~~~~~Other income. Do not include gainor loss from the sale of capitalassets (Explain in Part VI.) ~~~~

If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization,

check this box and �� |

Public support percentage for 2014 (line 8, column (f) divided by line 13, column (f))

Public support percentage from 2013 Schedule A, Part III, line 15

~~~~~~~~~~~~ %

%��

Investment income percentage for (line 10c, column (f) divided by line 13, column (f))

Investment income percentage from Schedule A, Part III, line 17

~~~~~~~~ %

%~~~~~~~~~~~~~~~~~~

If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not

more than 33 1/3%, check this box and The organization qualifies as a publicly supported organization ~~~~~~~~~~ |

If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3%, and

line 18 is not more than 33 1/3%, check this box and The organization qualifies as a publicly supported organization~~~~ |

If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions �� |

Part III Support Schedule for Organizations Described in Section 509(a)(2)

Section A. Public Support

Section B. Total Support

Section C. Computation of Public Support Percentage

Section D. Computation of Investment Income Percentage


53

432024 09-17-14

4

Yes No

1

2

3

4

5

6

7

8

9

10

1

2

3a

3b

3c

4a

4b

4c

5a

5b

5c

6

7

8

9a

9b

9c

10a

10b

a

b

c

a

b

c

a

b

c

a

b

c

a

b

Part VI

Type I or Type II only.

Substitutions only.


If "No" describe in how the supported organizations are designated. If designated byclass or purpose, describe the designation. If historic and continuing relationship, explain.

If "Yes," explain in how the organization determined that the supportedorganization was described in section 509(a)(1) or (2).

If "Yes," answer(b) and (c) below.

If "Yes," describe in when and how theorganization made the determination.

If "Yes," explain in what controls the organization put in place to ensure such use.If

"Yes" and if you checked 11a or 11b in Part I, answer (b) and (c) below.

If "Yes," describe in how the organization had such control and discretiondespite being controlled or supervised by or in connection with its supported organizations.

If "Yes," explain in what controls the organization usedto ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B)purposes.

If "Yes,"answer (b) and (c) below (if applicable). Also, provide detail in including (i) the names and EINnumbers of the supported organizations added, substituted, or removed, (ii) the reasons for each such action,(iii) the authority under the organization's organizing document authorizing such action, and (iv) how the actionwas accomplished (such as by amendment to the organizing document).

If "Yes," provide detail in

If "Yes," complete Part I of Schedule L (Form 990).

If "Yes," complete Part I of Schedule L (Form 990).




If "Yes," answer (b) below.(Use Schedule C, Form 4720, to

determine whether the organization had excess business holdings.)


(Complete only if you checked a box on line 11 of Part I. If you checked 11a of Part I, complete Sections A

and B. If you checked 11b of Part I, complete Sections A and C. If you checked 11c of Part I, complete

Sections A, D, and E. If you checked 11d of Part I, complete Sections A and D, and complete Part V.)

Are all of the organization's supported organizations listed by name in the organization's governing

documents?

Did the organization have any supported organization that does not have an IRS determination of status

under section 509(a)(1) or (2)?

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)?

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and

satisfied the public support tests under section 509(a)(2)?

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)

(B) purposes?

Was any supported organization not organized in the United States ("foreign supported organization")?

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign

supported organization?

Did the organization support any foreign supported organization that does not have an IRS determination

under sections 501(c)(3) and 509(a)(1) or (2)?

Did the organization add, substitute, or remove any supported organizations during the tax year?

Was any added or substituted supported organization part of a class already

designated in the organization's organizing document?

Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to

anyone other than (a) its supported organizations; (b) individuals that are part of the charitable class

benefited by one or more of its supported organizations; or (c) other supporting organizations that also

support or benefit one or more of the filing organization's supported organizations?

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial

contributor (defined in IRC 4958(c)(3)(C)), a family member of a substantial contributor, or a 35-percent

controlled entity with regard to a substantial contributor?

Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7?

Was the organization controlled directly or indirectly at any time during the tax year by one or more

disqualified persons as defined in section 4946 (other than foundation managers and organizations described

in section 509(a)(1) or (2))?

Did one or more disqualified persons (as defined in line 9(a)) hold a controlling interest in any entity in which

the supporting organization had an interest?

Did a disqualified person (as defined in line 9(a)) have an ownership interest in, or derive any personal benefit

from, assets in which the supporting organization also had an interest?

Was the organization subject to the excess business holdings rules of IRC 4943 because of IRC 4943(f)

(regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting

organizations)?

Did the organization have any excess business holdings in the tax year?

Part VI

Part VI

Part VI

Part VI

Part VI

Part VI,

Part VI.

Part VI.

Part VI.

Part VI.

Part IV Supporting Organizations

Section A. All Supporting Organizations



54

432025 09-17-14

5

Yes No

11

a

b

c

11a

11b

11c

Yes No

1

2

1

2

Yes No

1

1

Yes No

1

2

3

1

2

3

1

2

3

a

b

c

Yes No

a

b

a

b

2a

2b

3a

3b


If "Yes" to a, b, or c, provide detail in

If "No," describe in how the supported organization(s) effectively operated, supervised, orcontrolled the organization's activities. If the organization had more than one supported organization,describe how the powers to appoint and/or remove directors or trustees were allocated among the supportedorganizations and what conditions or restrictions, if any, applied to such powers during the tax year.

If "Yes," explain in how providing such benefit carried out the purposes of the supported organization(s) that operated,

supervised, or controlled the supporting organization.

If "No," describe in how controlor management of the supporting organization was vested in the same persons that controlled or managedthe supported organization(s).

If "No," explain in howthe organization maintained a close and continuous working relationship with the supported organization(s).

If "Yes," describe in the role the organization'ssupported organizations played in this regard.

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year Complete below.

Complete below.Describe in Part VI how you supported a government entity (see instructions).

If "Yes," then in how these activities directly furthered their exempt purposes,

how the organization was responsive to those supported organizations, and how the organization determinedthat these activities constituted substantially all of its activities.

If "Yes," explain in thereasons for the organization's position that its supported organization(s) would have engaged in theseactivities but for the organization's involvement.

the role played by the organization in this regard.


Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described in (b) and (c)

below, the governing body of a supported organization?

A family member of a person described in (a) above?

A 35% controlled entity of a person described in (a) or (b) above?

Did the directors, trustees, or membership of one or more supported organizations have the power to

regularly appoint or elect at least a majority of the organization's directors or trustees at all times during the

tax year?

Did the organization operate for the benefit of any supported organization other than the supported

organization(s) that operated, supervised, or controlled the supporting organization?

Were a majority of the organization's directors or trustees during the tax year also a majority of the directors

or trustees of each of the organization's supported organization(s)?

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the

organization's tax year, (1) a written notice describing the type and amount of support provided during the prior tax

year, (2) a copy of the Form 990 that was most recently filed as of the date of notification, and (3) copies of the

organization's governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization's officers, directors, or trustees either (i) appointed or elected by the supported

organization(s) or (ii) serving on the governing body of a supported organization?

By reason of the relationship described in (2), did the organization's supported organizations have a

significant voice in the organization's investment policies and in directing the use of the organization's

income or assets at all times during the tax year?

The organization satisfied the Activities Test.

The organization is the parent of each of its supported organizations.

The organization supported a governmental entity.

Activities Test.

Did substantially all of the organization's activities during the tax year directly further the exempt purposes of

the supported organization(s) to which the organization was responsive?

Did the activities described in (a) constitute activities that, but for the organization's involvement, one or more

of the organization's supported organization(s) would have been engaged in?

Parent of Supported Organizations.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or

trustees of each of the supported organizations? Provide details in

Did the organization exercise a substantial degree of direction over the policies, programs, and activities of each

of its supported organizations? If "Yes," describe in

Part VI.

Part VI

Part VI

Part VI

Part VI

Part VI

(see instructions):

line 2

line 3

Answer (a) and (b) below.

Part VI identify

those supported organizations and explain

Part VI

Answer (a) and (b) below.

Part VI.

Part VI

(continued)Part IV Supporting Organizations

Section B. Type I Supporting Organizations

Section C. Type II Supporting Organizations

Section D. Type III Supporting Organizations

Section E. Type III Functionally-Integrated Supporting Organizations



55

43202609-17-14

6

1 See instructions.

Section A - Adjusted Net Income

1

2

3

4

5

6

7

8

1

2

3

4

5

6

7

8Adjusted Net Income

Section B - Minimum Asset Amount

1

2

3

4

5

6

7

8

a

b

c

d

e

1a

1b

1c

1d

2

3

4

5

6

7

8

Total

Discount

Part VI

Minimum Asset Amount

Section C - Distributable Amount

1

2

3

4

5

6

7

1

2

3

4

5

6

Distributable Amount.



Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970. All

other Type III non-functionally integrated supporting organizations must complete Sections A through E.

(B) Current Year

(optional)(A) Prior Year

Net short-term capital gain

Recoveries of prior-year distributions

Other gross income (see instructions)

Add lines 1 through 3

Depreciation and depletion

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)

Other expenses (see instructions)

(subtract lines 5, 6 and 7 from line 4)

(B) Current Year

(optional)(A) Prior Year

Aggregate fair market value of all non-exempt-use assets (see

instructions for short tax year or assets held for part of year):

Average monthly value of securities

Average monthly cash balances

Fair market value of other non-exempt-use assets

(add lines 1a, 1b, and 1c)

claimed for blockage or other

factors (explain in detail in ):

Acquisition indebtedness applicable to non-exempt-use assets

Subtract line 2 from line 1d

Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount,

see instructions).

Net value of non-exempt-use assets (subtract line 4 from line 3)

Multiply line 5 by .035

Recoveries of prior-year distributions

(add line 7 to line 6)

Current Year

Adjusted net income for prior year (from Section A, line 8, Column A)

Enter 85% of line 1

Minimum asset amount for prior year (from Section B, line 8, Column A)

Enter greater of line 2 or line 3

Income tax imposed in prior year

Subtract line 5 from line 4, unless subject to

emergency temporary reduction (see instructions)

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see

instructions).

Part V Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations



56

43202709-17-14

7

Section D - Distributions Current Year

1

2

3

4

5

6

7

8

9

10

Part VI

Total annual distributions.

Part VI

(i)

Excess Distributions

(ii)

Underdistributions

Pre-2014

(iii)

Distributable

Amount for 2014Section E - Distribution Allocations (see instructions)

1

2

3

4

5

6

7

8

a

b

c

d

e

f

g

h

i

j

Total

a

b

c

Excess distributions carryover to 2015.

a

b

c

d

e



Amounts paid to supported organizations to accomplish exempt purposes

Amounts paid to perform activity that directly furthers exempt purposes of supported

organizations, in excess of income from activity

Administrative expenses paid to accomplish exempt purposes of supported organizations

Amounts paid to acquire exempt-use assets

Qualified set-aside amounts (prior IRS approval required)

Other distributions (describe in ). See instructions.

Add lines 1 through 6.

Distributions to attentive supported organizations to which the organization is responsive

(provide details in ). See instructions.

Distributable amount for 2014 from Section C, line 6

Line 8 amount divided by Line 9 amount

Distributable amount for 2014 from Section C, line 6

Underdistributions, if any, for years prior to 2014

(reasonable cause required-see instructions)

Excess distributions carryover, if any, to 2014:

From 2013

of lines 3a through e

Applied to underdistributions of prior years

Applied to 2014 distributable amount

Carryover from 2009 not applied (see instructions)

Remainder. Subtract lines 3g, 3h, and 3i from 3f.

Distributions for 2014 from Section D,

line 7: $

Applied to underdistributions of prior years

Applied to 2014 distributable amount

Remainder. Subtract lines 4a and 4b from 4.

Remaining underdistributions for years prior to 2014, if

any. Subtract lines 3g and 4a from line 2 (if amount

greater than zero, see instructions).

Remaining underdistributions for 2014. Subtract lines 3h

and 4b from line 1 (if amount greater than zero, see

instructions).

Add lines 3j

and 4c.

Breakdown of line 7:

Excess from 2013

Excess from 2014

(continued) Part V Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations



57

432028 09-17-14

8



Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; and Part III, line 12.

Also complete this part for any additional information. (See instructions).

Part VI Supplemental Information.



58

OMB No. 1545-0047


42345111-05-14

Schedule B (Form 990, 990-EZ, or 990-PF) (2014)

(Form 990, 990-EZ,or 990-PF)

| Attach to Form 990, Form 990-EZ, or Form 990-PF.| Information about Schedule B (Form 990, 990-EZ, or 990-PF) and

its instructions is at .


Organization type

Filers of: Section:

not

General Rule Special Rule.

Note.

General Rule

Special Rules

(1) (2)

General Rule

Caution.

must

For Paperwork Reduction Act Notice, see the Instructions for Form 990, 990-EZ, or 990-PF.

exclusively

exclusively exclusively

nonexclusively

(check one):

Form 990 or 990-EZ 501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust treated as a private foundation

527 political organization

Form 990-PF 501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the or a

Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or

property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33 1/3% support test of the regulations under

sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from

any one contributor, during the year, total contributions of the greater of $5,000 or 2% of the amount on (i) Form 990, Part VIII, line 1h,

or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor, during the

year, total contributions of more than $1,000 for religious, charitable, scientific, literary, or educational purposes, or for

the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor, during the

year, contributions for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box

is checked, enter here the total contributions that were received during the year for an religious, charitable, etc.,

purpose. Do not complete any of the parts unless the applies to this organization because it received

religious, charitable, etc., contributions totaling $5,000 or more during the year ~~~~~~~~~~~~~~~ | $

An organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990, 990-EZ, or 990-PF),

but it answer "No" on Part IV, line 2, of its Form 990; or check the box on line H of its Form 990-EZ or on its Form 990-PF, Part I, line 2, to

certify that it does not meet the filing requirements of Schedule B (Form 990, 990-EZ, or 990-PF).

LHA

www.irs.gov/form990

Schedule B Schedule of Contributors

2014


X 3

X

59

423452 11-05-14

Name of organization Employer identification number


(a)

No.

(b)

Name, address, and ZIP + 4

(c)

Total contributions

(d)

Type of contribution

Person

Payroll

Noncash

(a)

No.

(b)


(c)

Total contributions

(d)


Person

Payroll

Noncash

(a)

No.

(b)


(c)

Total contributions

(d)


Person

Payroll

Noncash

(a)

No.

(b)


(c)

Total contributions

(d)


Person

Payroll

Noncash

(a)

No.

(b)


(c)

Total contributions

(d)


Person

Payroll

Noncash

(a)

No.

(b)


(c)

Total contributions

(d)


Person

Payroll

Noncash

Schedule B (Form 990, 990-EZ, or 990-PF) (2014) Page

(see instructions). Use duplicate copies of Part I if additional space is needed.

$

(Complete Part II fornoncash contributions.)

$


$


$


$


$


2

Part I Contributors


1 CLINTON COUNTY X

100 E. STATE ST. 391,342.

ST JOHNS, MI 48879

2 GRATIOT COUNTY X

214 E. CENTER ST. 284,713.

ITHACA, MI 48847

3 MONTCALM COUNTY X

211 W. MAIN ST. 461,422.

STANTON, MI 48888

4MICHIGAN DEPARTMENT OF HEALTH ANDHUMAN SERVICES X

5303 S CEDAR ST. 2,124,891.

LANSING, MI 48911

5MICHIGAN DEPARTMENT OF HEALTH ANDHUMAN SERVICES

5303 S CEDAR ST. 191,685. X

LANSING, MI 48911

6 MID-MICHIGAN HEALTH PLAN X

2001 E GRAND AVE 215,000.

LANSING, MD 48912


60

423453 11-05-14



(a)

No.

from

Part I

(c)

FMV (or estimate)

(see instructions)

(b)

Description of noncash property given

(d)

Date received

(a)

No.

from

Part I

(c)

FMV (or estimate)

(see instructions)

(b)


(d)

Date received

(a)

No.

from

Part I

(c)

FMV (or estimate)

(see instructions)

(b)


(d)

Date received

(a)

No.

from

Part I

(c)

FMV (or estimate)

(see instructions)

(b)


(d)

Date received

(a)

No.

from

Part I

(c)

FMV (or estimate)

(see instructions)

(b)


(d)

Date received

(a)

No.

from

Part I

(c)

FMV (or estimate)

(see instructions)

(b)


(d)

Date received


(see instructions). Use duplicate copies of Part II if additional space is needed.

$

$

$

$

$

$

3

Part II Noncash Property


VACCINE SUPPLY INVENTORY FORIMMUNIZATION PROGRAM5

191,685. 09/30/15


61

(Enter this info. once.)

For organizations

completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year.

423454 11-05-14


religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 forthe year from any one contributor. (a) (e) and


(a) No.fromPart I

(b) Purpose of gift (c) Use of gift (d) Description of how gift is held

(e) Transfer of gift

Transferee's name, address, and ZIP + 4 Relationship of transferor to transferee

(a) No.fromPart I




(a) No.fromPart I




(a) No.fromPart I




Complete columns through the following line entry.


| $

Use duplicate copies of Part III if additional space is needed.

Exclusively

4

Part III



62

OMB No. 1545-0047


43205110-01-14

Held at the End of the Tax Year

(Form 990) | Complete if the organization answered "Yes" to Form 990,Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.

| Attach to Form 990.| Information about Schedule D (Form 990) and its instructions is at



(a) (b)

1

2

3

4

5

6

Yes No

Yes No

1

2

3

4

5

6

7

8

9

a

b

c

d

2a

2b

2c

2d

Yes No

Yes No

1

2

a

b

(i)

(ii)

a

b

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Schedule D (Form 990) 2014

Complete if the

organization answered "Yes" to Form 990, Part IV, line 6.

Donor advised funds Funds and other accounts

Total number at end of year

Aggregate value of contributions to (during year)

Aggregate value of grants from (during year)

Aggregate value at end of year

~~~~~~~~~~~~~~~

~~~~

~~~~~~

~~~~~~~~~~~~~

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds

are the organization's property, subject to the organization's exclusive legal control?~~~~~~~~~~~~~~~~~~

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only

for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring

impermissible private benefit? ��

Complete if the organization answered "Yes" to Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education)

Protection of natural habitat

Preservation of open space

Preservation of a historically important land area

Preservation of a certified historic structure

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last

day of the tax year.

Total number of conservation easements

Total acreage restricted by conservation easements

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

~~~~~~~~~~~~~~~~~~~~~~~~~~

Number of conservation easements on a certified historic structure included in (a)

Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure

listed in the National Register

~~~~~~~~~~~~

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the tax

year |

Number of states where property subject to conservation easement is located |

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of

violations, and enforcement of the conservation easements it holds? ~~~~~~~~~~~~~~~~~~~~~~~~~

Staff and volunteer hours devoted to monitoring, inspecting, and enforcing conservation easements during the year |

Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year | $

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i)

and section 170(h)(4)(B)(ii)? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and balance sheet, and

include, if applicable, the text of the footnote to the organization's financial statements that describes the organization's accounting for

conservation easements.


If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art,

historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII,

the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical

treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts

relating to these items:

Revenue included in Form 990, Part VIII, line 1

Assets included in Form 990, Part X

~~~~~~~~~~~~~~~~~~~~~~~~~~~~ | $

$~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ |

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide

the following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:

Revenue included in Form 990, Part VIII, line 1

Assets included in Form 990, Part X

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ | $

$~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ |

LHA


Part I Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts.

Part II Conservation Easements.

Part III Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.

SCHEDULE D Supplemental Financial Statements 2014



63

43205210-01-14

3

4

5

a

b

c

d

e

Yes No

1

2

a

b

c

d

e

f

a

b

Yes No

1c

1d

1e

1f

Yes No

(a) (b) (c) (d) (e)

1

2

3

4

a

b

c

d

e

f

g

a

b

c

a

b

Yes No

(i)

(ii)

3a(i)

3a(ii)

3b

(a) (b) (c) (d)

1a

b

c

d

e

Total.

Schedule D (Form 990) 2014

(continued)

(Column (d) must equal Form 990, Part X, column (B), line 10c.)

Two years back Three years back Four years back

Schedule D (Form 990) 2014 Page

Using the organization's acquisition, accession, and other records, check any of the following that are a significant use of its collection items

(check all that apply):

Public exhibition

Scholarly research

Preservation for future generations

Loan or exchange programs

Other

Provide a description of the organization's collections and explain how they further the organization's exempt purpose in Part XIII.

During the year, did the organization solicit or receive donations of art, historical treasures, or other similar assets

to be sold to raise funds rather than to be maintained as part of the organization's collection? ��

Complete if the organization answered "Yes" to Form 990, Part IV, line 9, orreported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not included

on Form 990, Part X?

If "Yes," explain the arrangement in Part XIII and complete the following table:

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Amount

Beginning balance

Additions during the year

Distributions during the year

Ending balance

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability?

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII

~~~~~

��


Current year Prior year

Beginning of year balance

Contributions

Net investment earnings, gains, and losses

Grants or scholarships

~~~~~~~

~~~~~~~~~~~~~~

~~~~~~~~~

Other expenditures for facilities

and programs

Administrative expenses

End of year balance

~~~~~~~~~~~~~

~~~~~~~~

~~~~~~~~~~

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment

Permanent endowment

Temporarily restricted endowment

The percentages in lines 2a, 2b, and 2c should equal 100%.

| %

| %

| %

Are there endowment funds not in the possession of the organization that are held and administered for the organization

by:

unrelated organizations

related organizations

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R?

Describe in Part XIII the intended uses of the organization's endowment funds.

~~~~~~~~~~~~~~~~~~~~~~

Complete if the organization answered "Yes" to Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property Cost or otherbasis (investment)

Cost or otherbasis (other)

Accumulateddepreciation

Book value

Land

Buildings

Leasehold improvements

~~~~~~~~~~~~~~~~~~~~

~~~~~~~~~~~~~~~~~~

~~~~~~~~~~

Equipment

Other

~~~~~~~~~~~~~~~~~

��

Add lines 1a through 1e. |��

2Part III Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets

Part IV Escrow and Custodial Arrangements.

Part V Endowment Funds.

Part VI Land, Buildings, and Equipment.


0.


64

(including name of security)

43205310-01-14

Total.

Total.

(a) (b) (c)

(a) (b) (c)

(a) (b)

Total.

(a) (b) 1.

Total.

2.


(Column (b) must equal Form 990, Part X, col. (B) line 15.)

(Column (b) must equal Form 990, Part X, col. (B) line 25.)

Description of security or category

(Col. (b) must equal Form 990, Part X, col. (B) line 12.) |

(Col. (b) must equal Form 990, Part X, col. (B) line 13.) |


Complete if the organization answered "Yes" to Form 990, Part IV, line 11b. See Form 990, Part X, line 12.

Book value Method of valuation: Cost or end-of-year market value

(1)

(2)

(3)

Financial derivatives

Closely-held equity interests

Other

~~~~~~~~~~~~~~~

~~~~~~~~~~~

(A)

(B)

(C)

(D)

(E)

(F)

(G)

(H)

Complete if the organization answered "Yes" to Form 990, Part IV, line 11c. See Form 990, Part X, line 13.Description of investment Book value Method of valuation: Cost or end-of-year market value

(1)

(2)

(3)

(4)

(5)

(6)

(7)

(8)

(9)

Complete if the organization answered "Yes" to Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

Description Book value

(1)

(2)

(3)

(4)

(5)

(6)

(7)

(8)

(9)

�� |

Complete if the organization answered "Yes" to Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

Description of liability Book value

(1)

(2)

(3)

(4)

(5)

(6)

(7)

(8)

(9)

Federal income taxes

�� |

Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the

organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII

3Part VII Investments - Other Securities.

Part VIII Investments - Program Related.

Part IX Other Assets.

Part X Other Liabilities.



65

43205410-01-14

1

2

3

4

5

1

a

b

c

d

e

2a

2b

2c

2d

2a 2d 2e

32e 1

a

b

c

4a

4b

4a 4b

3 4c.

4c

5

1

2

3

4

5

1

a

b

c

d

e

2a

2b

2c

2d

2a 2d

2e 1

2e

3

a

b

c

4a

4b

4a 4b

3 4c.

4c

5


(This must equal Form 990, Part I, line 12.)

(This must equal Form 990, Part I, line 18.)


Complete if the organization answered "Yes" to Form 990, Part IV, line 12a.

Total revenue, gains, and other support per audited financial statements

Amounts included on line 1 but not on Form 990, Part VIII, line 12:

~~~~~~~~~~~~~~~~~~~

Net unrealized gains (losses) on investments


Recoveries of prior year grants

Other (Describe in Part XIII.)

~~~~~~~~~~~~~~~~~~

~~~~~~~~~~~~~~~~~~~~~~

~~~~~~~~~~~~~~~~~~~~~~~~~

~~~~~~~~~~~~~~~~~~~~~~~~~~

Add lines through ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Subtract line from line ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Amounts included on Form 990, Part VIII, line 12, but not on line 1:

Investment expenses not included on Form 990, Part VIII, line 7b


~~~~~~~~

~~~~~~~~~~~~~~~~~~~~~~~~~~

Add lines and

Total revenue. Add lines and

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

��

Complete if the organization answered "Yes" to Form 990, Part IV, line 12a.

Total expenses and losses per audited financial statements

Amounts included on line 1 but not on Form 990, Part IX, line 25:

~~~~~~~~~~~~~~~~~~~~~~~~~~


Prior year adjustments

Other losses


~~~~~~~~~~~~~~~~~~~~~~

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

~~~~~~~~~~~~~~~~~~~~~~~~~~

Add lines through

Subtract line from line

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Amounts included on Form 990, Part IX, line 25, but not on line 1:

Investment expenses not included on Form 990, Part VIII, line 7b


~~~~~~~~

~~~~~~~~~~~~~~~~~~~~~~~~~~

Add lines and

Total expenses. Add lines and

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

��

Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part IV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI,

lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

4Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return.

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return.

Part XIII Supplemental Information.


6,840,033.

288,738.

288,738.6,551,295.

0.6,551,295.

5,947,988.

288,738.

288,738.5,659,250.

0.5,659,250.


66

OMB No. 1545-0047


43214108-12-14

Complete if the organizations answered "Yes" on Form 990, Part IV, lines 29 or 30.

Open To PublicInspection

Attach to Form 990.

Information about Schedule M (Form 990) and its instructions is at Employer identification number

(a) (b) (c) (d)

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

29

Yes No

30

31

32

33

a

b

30a

31

32a

a

b

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Schedule M (Form 990) (2014)

Name of the organization

Check ifapplicable

Number ofcontributions or

items contributed

Noncash contributionamounts reported on

Form 990, Part VIII, line 1g

Method of determiningnoncash contribution amounts

Art - Works of art

Art - Historical treasures

Art - Fractional interests

~~~~~~~~~~~~~

~~~~~~~~~

~~~~~~~~~~

Books and publications

Clothing and household goods

~~~~~~~~~~

~~~~~~

Cars and other vehicles

Boats and planes

Intellectual property

~~~~~~~~~~

~~~~~~~~~~~~~

~~~~~~~~~~~

Securities - Publicly traded

Securities - Closely held stock

~~~~~~~~

~~~~~~~

Securities - Partnership, LLC, or

trust interests

Securities - Miscellaneous

~~~~~~~~~~~~~~

~~~~~~~~

Qualified conservation contribution -

Historic structures

Qualified conservation contribution - Other

~~~~~~~~~~~~

~

Real estate - Residential

Real estate - Commercial

Real estate - Other

~~~~~~~~~

~~~~~~~~~

~~~~~~~~~~~~

Collectibles

Food inventory

Drugs and medical supplies

Taxidermy

~~~~~~~~~~~~~~~~

~~~~~~~~~~~~~~

~~~~~~~~

~~~~~~~~~~~~~~~~

Historical artifacts

Scientific specimens

Archeological artifacts

~~~~~~~~~~~~

~~~~~~~~~~~

~~~~~~~~~~

Other ( )

Other ( )

Other ( )

Other ( )

Number of Forms 8283 received by the organization during the tax year for contributions

for which the organization completed Form 8283, Part IV, Donee Acknowledgement ~~~~

During the year, did the organization receive by contribution any property reported in Part I, lines 1 through 28, that it

must hold for at least three years from the date of the initial contribution, and which is not required to be used for

exempt purposes for the entire holding period? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

If "Yes," describe the arrangement in Part II.

Does the organization have a gift acceptance policy that requires the review of any non-standard contributions? ~~~~~~

Does the organization hire or use third parties or related organizations to solicit, process, or sell noncash

contributions? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

If "Yes," describe in Part II.

If the organization did not report an amount in column (c) for a type of property for which column (a) is checked,

describe in Part II.

LHA


SCHEDULE M(Form 990)

Part I Types of Property

Noncash Contributions2014J

J J

JJJJ


X 1 191,685. PRICE OF VACCINE INV

X

X

X


67

432142 08-12-14

2

Schedule M (Form 990) (2014)

Schedule M (Form 990) (2014) Page

Provide the information required by Part I, lines 30b, 32b, and 33, and whether the organizationis reporting in Part I, column (b), the number of contributions, the number of items received, or a combination of both. Also completethis part for any additional information.

Part II Supplemental Information.



68

OMB No. 1545-0047


43221108-27-14

Information about Schedule O (Form 990 or 990-EZ) and its instructions is at

Complete to provide information for responses to specific questions onForm 990 or 990-EZ or to provide any additional information.

| Attach to Form 990 or 990-EZ.|

(Form 990 or 990-EZ)



For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ. Schedule O (Form 990 or 990-EZ) (2014)

Name of the organization

LHA


SCHEDULE O Supplemental Information to Form 990 or 990-EZ 2014


FORM 990, ITEM K, OTHER FORM OF ORGANIZATION:

HEALTH DEPARTMENT

FORM 990, PART III, LINE 4D, OTHER PROGRAM SERVICES:

MATERNAL SUPPORT AND INFANT SUPPORT SERVICE PROGRAM (MSS/ISS) PROVIDES

NON-MEDICAL PROFESSIONAL SERVICES OF PUBLIC HEALTH NURSES, REGISTERD

NURSES, DIETICIANS, AND SOCIAL WORKERS; CHILDBIRTH EDUCATION CLASSES

AND TRANSPORTATION FOR MEDICAID ELIGIBLE, HIGH RISK PREGNANT WOMEN.

FAMILY PLANNING PROGRAM IS A COMPREHENSIVE FAMILY PLANNING SERVICE

PROGRAM WHICH INCLUDES PHYSICAL EXAMINATION, SPECIFIC LABORATORY

SERVICES, PAP TESTS, CONTRACEPTIVE CONSULTATION, AND PREGNANCY TESTING

WITH HEALTH EDUCATION AS A MAJOR COMPONENT.

CHILDREN'S SPECIAL HEALTH CARE SERVICES (CSHCS) PROVIDES DIAGNOSTIC

EVALUATION, FAMILY ASSESSMENT, FINANCIAL ASSESSMENT, AND CASE

MANAGEMENT FOR CHILDREN TO THE AGE OF 21 WITH ACUTE CATASTROPHIC OR

CHRONIC ILLNESS.

HEARING & VISION SCREENING ARE PROVIDED TO PRE-SCHOOL AND SCHOOL

GRADES. HEARING AND VISION SCREENING AND REFERRALS FOR PRE-SCHOOL AND

GRADES K, 2, 4, AND 6 FOR HEARING AND GRADES K, 1, 3, 5, 7, AND 9 FOR

VISION.

COMMUNICABLE DISEASES PROVIDES TESTING, TREATMENT, AND DATA COLLECTION

OF VARIOUS COMMUNICABLE DISEASES AND STD'S.


69

43221208-27-14

2


Schedule O (Form 990 or 990-EZ) (2014)

Schedule O (Form 990 or 990-EZ) (2014) Page

Name of the organizationMID-MICHIGAN DISTRICT HEALTH DEPARTMENT 38-1808049

AIDS COUNSELING & TESTING IS ANONYMOUS PRE/POST - HIV COUNSELING - AIDS

TESTING AND COUNSELING.

MEDICAID OUTREACH, ENROLLMENT, AND COORDINATION IS A MICH-CARE PROGRAM

WHICH PROVIDES SUPPORT SERVICES FOR MEDICAID ELIGIBLE MOTHERS, INFANTS,

AND CHILDREN.

COMMUNITY HEALTH ASSESSMENT IS A PROGRAM DESIGNED TO PLAN AND REPORT

REGIONAL HEALTH ISSUES.

BREAST AND CERVICAL CANCER CONTROL PROGRAM PROVIDES PHYSICAL

EXAMINATIONS INCLUDING PAP SMEARS AND MAMMOGRAMS TO QUALIFIED WOMEN.

ACCESS TO CARE PROVIDES INFORMATION AND CARE COORDINATION FOR UNINSURED

CLIENTS.

BIOTERRORISM IS DESIGNED FOR EMERGENCY PREPAREDNESS.

A VARIETY OF OTHER MISCELLANEOUS WELLNESS AND HEALTH RELATED PROGRAMS

ARE PROVIDED AT THE LOCAL LEVEL.

EXPENSES $ 1,565,990. INCLUDING GRANTS OF $ 0. REVENUE $ 1,651,059.

FORM 990, PART VI, SECTION B, LINE 11:

THE FORM 990 IS REVIEWED AND APPROVED BY THE FINANCE DEPARTMENT AFTER BEING

RECEIVED FROM THE AUDITORS AND PRIOR TO SUBMISSSION. THE BOARD RECEIVES

THE FORM 990 FOR EXAMINATION SUBSEQUENT TO ITS SUBMISSION.


70

43221208-27-14

2


Schedule O (Form 990 or 990-EZ) (2014)

Schedule O (Form 990 or 990-EZ) (2014) Page

Name of the organizationMID-MICHIGAN DISTRICT HEALTH DEPARTMENT 38-1808049

FORM 990, PART VI, SECTION B, LINE 12C:

EACH EMPLOYEE IS REQUIRED TO FILE A SUPPLEMENTAL EMPLOYMENT FORM WITH THE

HEALTH DEPARTMENT THAT ADDRESSES CONFLICTS OF INTEREST. MANAGEMENT, THE

BOARD, AND THE HEALTH OFFICER ANNUALY REVIEW THE POLICY AND DETERMINE

ADHERENCE TO THE GUIDELINES.

FORM 990, PART VI, SECTION B, LINE 15:

THE SALARY FOR EACH POSITION WITHIN THE HEALTH DEPARTMENT IS DETERMINED BY

THE BOARD OF PUBLIC HEALTH. SALARIES ARE REVIEWED AND COMPARED TO OTHER

HEALTH DEPARTMENTS WHICH IS COMPILED BY THE MICHIGAN ASSOCIATION FOR LOCAL

PUBLIC HEALTH (MALPH).

FORM 990, PART VI, SECTION C, LINE 19:

GOVERNING DOCUMENTS, POLICIES, AND FINANCIAL STATEMENTS ARE ALL PRESENTED

TO THE BOARD OF HEALTH FOR REVIEW AT A PUBLIC MEETING, THEREFORE BECOMING

AVAILABLE TO THE PUBLIC AT THAT TIME. THESE DOCUMENTS ARE DISTRIBUTED UPON

REQUEST.

FORM 990, PART XII, LINE 1

THE FORM 990 WAS PREPARED ON THE MODIFIED ACCRUAL BASIS OF ACCOUNTING

IN AGREEMENT WITH THE AUDITED FINANCIAL STATEMENTS PREPARED FOR THE

FISCAL YEAR ENDED SEPTEMBER 30, 2015.

FORM 990, PART XII, LINE 2B

THE PROCESS FOR OVERSIGHT ON THE AUDIT AND SELECTION OF THE INDEPENDENT

ACCOUNTANT HAS NOT CHANGED FROM THE PRIOR YEAR.


71


File by thedue date forfiling yourreturn. Seeinstructions.

42384105-01-14

| File a separate application for each return.

| Information about Form 8868 and its instructions is at .

Automatic 3-Month Extension, complete only Part I

Additional (Not Automatic) 3-Month Extension, complete only Part II

Electronic filing .

Enter filer's identifying number

Type or

print

Application

Is For

Return

Code

Application

Is For

Return

Code

1

2

3a

b

c

3a

3b

3c

$

$

$

Balance due.

Caution.

For Privacy Act and Paperwork Reduction Act Notice, see instructions. 8868

www.irs.gov/efile e-file for Charities & Nonprofits.

All other corporations (including 1120-C filers), partnerships, REMICs, and trusts must use Form 7004 to request an extension of timeto file income tax returns.

Form

(Rev. January 2014)OMB No. 1545-1709

¥ If you are filing for an and check this box ~~~~~~~~~~~~~~~~~~~ |

¥ If you are filing for an (on page 2 of this form).

you have already been granted an automatic 3-month extension on a previously filed Form 8868.

You can electronically file Form 8868 if you need a 3-month automatic extension of time to file (6 months for a corporation

required to file Form 990-T), or an additional (not automatic) 3-month extension of time. You can electronically file Form 8868 to request an extension

of time to file any of the forms listed in Part I or Part II with the exception of Form 8870, Information Return for Transfers Associated With Certain

Personal Benefit Contracts, which must be sent to the IRS in paper format (see instructions). For more details on the electronic filing of this form,

visit and click on

A corporation required to file Form 990-T and requesting an automatic 6-month extension - check this box and complete

Part I only ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ |

Name of exempt organization or other filer, see instructions. Employer identification number (EIN) or

Number, street, and room or suite no. If a P.O. box, see instructions.

City, town or post office, state, and ZIP code. For a foreign address, see instructions.

Social security number (SSN)

Enter the Return code for the return that this application is for (file a separate application for each return) ~~~~~~~~~~~~~~~~~

Form 990 or Form 990-EZ

Form 990-BL

Form 4720 (individual)

Form 990-PF

01

02

03

04

05

06

Form 990-T (corporation) 07

08

09

10

11

12

Form 1041-A

Form 4720 (other than individual)

Form 5227

Form 6069

Form 8870

Form 990-T (sec. 401(a) or 408(a) trust)

Form 990-T (trust other than above)

¥ The books are in the care of |

Telephone No. | Fax No. |

¥ If the organization does not have an office or place of business in the United States, check this box~~~~~~~~~~~~~~~~~ |

¥ If this is for a Group Return, enter the organization's four digit Group Exemption Number (GEN) . If this is for the whole group, check this

box . If it is for part of the group, check this box and attach a list with the names and EINs of all members the extension is for.| |

I request an automatic 3-month (6 months for a corporation required to file Form 990-T) extension of time until

, to file the exempt organization return for the organization named above. The extension

is for the organization's return for:

|

|

calendar year or

tax year beginning , and ending .

If the tax year entered in line 1 is for less than 12 months, check reason: Initial return Final return

Change in accounting period

If this application is for Forms 990-BL, 990-PF, 990-T, 4720, or 6069, enter the tentative tax, less any

nonrefundable credits. See instructions.

If this application is for Forms 990-PF, 990-T, 4720, or 6069, enter any refundable credits and

estimated tax payments made. Include any prior year overpayment allowed as a credit.

Subtract line 3b from line 3a. Include your payment with this form, if required,

by using EFTPS (Electronic Federal Tax Payment System). See instructions.

If you are going to make an electronic funds withdrawal (direct debit) with this Form 8868, see Form 8453-EO and Form 8879-EO for paymentinstructions.

LHA Form (Rev. 1-2014)

www.irs.gov/form8868

Do not complete Part II unless

(e-file)

Part I Automatic 3-Month Extension of Time. Only submit original (no copies needed).

8868 Application for Extension of Time To File anExempt Organization Return

X


615 NORTH STATE STREET, NO. STE 2

STANTON, MI 48888

0 1

MELISSA BOWERMAN, DIRECTOR OF ADMINISTRATIVE SERVICES615 N. STATE STREET, SUITE 2 - STANTON, MI 48888

(989) 831-5237

MAY 15, 2016

X OCT 1, 2014 SEP 30, 2015

0.

0.

0.


72



MARK W. (MARCUS) CHEATHAM, Ph.D. Health Officer

JENNIFER MORSE, MD

Medical Director

www.mmdhd.org




ADMINISTRATIVE OFFICES 615 N. State St., Ste. 2

Stanton, MI 48888-9702 (989) 831-5237

CLINTON COUNTY Branch Office

1307 E. Townsend Rd. Saint Johns, MI 48879-9036

(989) 224-2195

GRATIOT COUNTY Branch Office

151 Commerce Dr. Ithaca, MI 48847-1627

(989) 875 3681

MONTCALM COUNTY Branch Office

615 N. State St., Ste.1 Stanton, MI 48888-9702

(989) 831-5237

Board of Health Action Sheet

Date: April 20, 2016 Administrator: Marcus Cheatham, Ph.D. Health Officer

Subject: Montcalm Branch Office Roof Expense

☐ Information Only ☒ Action Needed

I. Authority For This Action:

☒ Local Policy Mid-Michigan District Health Department (MMDHD) Intergovernmental

Agreement, Section VII

☒ Law or Rule Public Health Code, Act 368 of 1978, MCL 333.2417

II. Summary:

(Previous board action relating to this item? Background information and if any future action anticipated.)

In March, the roof of the Mid-Michigan District Health Department (MMDHD) Montcalm Branch Office facility in Stanton, which includes the MMDHD Administrative Offices, was found to be in need of urgent replacement. The shingles were badly worn and coming loose. Leaks were occurring on a regular basis damaging the interior of the structure. The County moved swiftly to replace the roof and that job is complete.

III. Strategic Objective, Health Issue, or other Need Addressed: (What priority should be given in relation to goals? Include reason for recommending change in priorities and how the need will be introduced into planning process.)

It is my belief that the Health Department should pay for part of the new roof. The reason is that the administrative headquarters we all share is located in that facility. When the district was formed, Montcalm County was selected as our agency’s administrative headquarters. Our Administrative Offices serve all of the counties within the district providing administrative functions such as Human Resources, Finance, Management Information Systems, Emergency Preparedness, and Management. These services benefit all of the counties equally.

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The square footage (14,000 square feet) of the Montcalm Branch Office building is by far the largest because of the need to house the Administrative Offices. The Clinton Branch Office is 11,000 square feet and the Gratiot Branch Office is 10,000 square feet.

IV. Fiscal Impact and Cost: (Immediate, ongoing, and future impact.)

Montcalm County expected to pay about $70,000 for the new roof. The lowest bid was actually only $43,466.24 and the vendor was deemed reliable and the bid accepted.

Montcalm County, suffering a dire financial crisis, was very concerned about the impact of this sudden cost on their budget. Melissa and I discussed paying for a share of the roof and offered to do so without waiting to be asked by them.

The Administrative Offices comprise about 28.6 percent of the health department’s part of the facility, or almost exactly 4,000 square feet. Therefore, MMDHD pays 28.6 percent of the $6,672.73 monthly payment for the facility or $1,906.50 per month. Using this arithmetic which has been acceptable to the Board of Health, it is my contention that MMDHD should pay 28.6 percent of the cost for the new roof - $12,431.34. It is possible for the Department to make a payment like this for our share of the roof because we currently have $124,580 in our fund for facility development.

V. Alternatives Considered: (Scope of options reviewed. Reasons for rejecting alternatives.)

No agreement of any kind has been signed or approved by you; therefore, MMDHD is not legally obligated to take this action. The Board of Health could choose to take no action thereby having the full cost of the new roof borne by Montcalm County.

VI. Recommendation: (Advantages/benefits of proposal. Expected results. Possible problems or disadvantages of proposal. Effect of action on agency. Consequences of not approving recommendation or taking action.)

The new roof is already in place and keeping the staff and contents of the Montcalm Branch Office dry. I recommend that the Finance Committee propose the full Board authorize the transfer of $12,431.34 to Montcalm County for the administrative headquarters portion of the new roof.

VII. Monitoring and Reporting Time Line: (Evaluation method and timeline. Next report to the Board.)

If approved, the transfer would appear in the monthly Revenue and Expenditure Report for Board of Health verification and approval at a future Board meeting, as well as the annual audit.

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CLINTON


St. Johns, MI 48879-9036 (989) 224-2195



(989) 875-3681



(989) 831-5237


Stanton, MI 48888-9702 (989) 831-5237








Date: April 18, 2016 Administrator: Melissa Bowerman Director of Administrative Services

Subject: Smoking Cessation Counseling Fees ☐ Information Only ☒ Action Needed


☐ Local Policy ____________________________ ☒ Law or Rule Public Act 368 of 1978, §333.2444 Fees for Services

II. Summary:


While attending a billing conference, staff learned that it was possible to bill Medicaid for smoking cessation counseling services offered in conjunction with our programs.


Billing for smoking cessation counseling services that we provide as part of other program services would allow us to capture additional revenue.


99406 Smoking and tobacco use cessation counseling visit; intermediate, greater than 3 minutes up to 10

minutes - $8.00 99407 Smoking and tobacco use cessation counseling visit; intensive, greater than 10 minutes - $16.00


There are no reasons that MMDHD should not bill Medicaid for smoking cessation counseling services.

VI. Recommendation:

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(Advantages/benefits of proposal. Expected results. Possible problems or disadvantages of proposal. Effect of action on agency. Consequences of not approving recommendation or taking action.)

I request that the Finance Committee recommend that the full Board of Health approve the smoking cessation counseling fees as proposed retroactive to April 1, 2016.


The smoking cessation counseling fees will be reported in the program where the service is completed, such as Family Planning or STD.

77


CLINTON


St. Johns, MI 48879-9036 (989) 224-2195



(989) 875-3681



(989) 831-5237


Stanton, MI 48888-9702 (989) 831-5237









Subject: New Fees for Primary Care Project ☐ Information Only ☒ Action Needed



II. Summary:


As this is a relatively new program in collaboration with the Montcalm Care Network, there are going to be new services and fees that need to be approved. I wanted to start off with a smaller base of services and fees, and then add new ones as needed.


Vision Priority #5 from the agency’s Strategic Plan states that: We effectively manage our fiscal resources while expanding opportunities for financial growth. It is necessary for us to recover our costs to effectively manage our fiscal resources.


Description Billed Unit Cost Albuterol and Ipratropium Bromide Non-compounded Sulfate 2.5mg/0.5mg $13.99

Depo-Medrol (Methylprednisolone) 80mg $19.89

Depo Provera 1mg $194.00

Epinephrine 1mg $5.49

Lasix 20mg $5.79

Marcaine HCL 30ml $72.89

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Description Billed Unit Cost Ipratropium Bromide (non-compounded) 1mg $14.49

Nitrostat 1 tablet/ 0.4mg $29.49

Lidocaine HCL 10mg $3.15

Lidocaine with Epinephrine 10mg $66.49

Ketorolac (Toradol) 15mg $79.89

Norflex (Orphenadrine Citrate) 60mg $133.40

Health Risk Assessment n/a $75.00

Blood by glucose monitoring device n/a $25.00

Drug Screen - Class List A n/a $75.00

Wound Care n/a $50.00

V. Alternatives Considered:

(Scope of options reviewed. Reasons for rejecting alternatives.)

There are no reasons that the Mid-Michigan District Health Department (MMDHD) should not add these new fees for the primary care program.


I request that the Finance Committee recommend the full Board of Health approve the new fees for primary care as proposed, retroactive to October 1, 2015.


The new fees for the primary care project will be reported on line 22 of the monthly Revenue and Expenditure Reports.

79


CLINTON


St. Johns, MI 48879-9036 (989) 224-2195



(989) 875-3681



(989) 831-5237


Stanton, MI 48888-9702 (989) 831-5237









Subject: Increased Product Fee ☐ Information Only ☒ Action Needed



II. Summary:


When ordering condoms last month, the cost had increased significantly. In order to recoup the cost of the increase, the fee associated with this product needs to be increased.


Vision Priority #5 from the agency’s Strategic Plan states that: We effectively manage our fiscal resources while expanding opportunities for financial growth. It is necessary for us to recover our costs to effectively manage our fiscal resources.


We can recoup our costs for condoms with a fee increase from $.25 to $.30 each.


There are no reasons that MMDHD should not increase the billing rate.


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I request that the Finance Committee recommend that the full Board of Health approve the increased fee of $.30 each for condoms as proposed effective May 1, 2016.


The number of condoms distributed will be tracked in Insight on a quarterly basis.

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Documents

MID-MICHIGAN DISTRICT HEALTH DEPARTMENT · 2016-04-27 · MID-MICHIGAN DISTRICT HEALTH DEPARTMENT An Accredited Local Public Health Department CLINTON Branch Office 1307 E. Townsend