2016-09-29T07:58:13-05:00 2015-12-31 310800053 CLARK SCHAEFER HACKETT & CO 14 E MAIN STREET SUITE 500 SPRINGFIELD OH 45502 990 2015-01-01 223769296 OHIO ASSOCIATION OF FREE CLINICS OHIO 6149146458 35 NORTH FOURTH STREET NO 350 COLUMBUS OH 43215 DEBORAH MILLER EXECUTIVE DIRECTOR 6149146458 2016-09-29 1 JESSE YOUNG CPA P01236247 9373992000 2016-09-29 2015 2017-02-10 21:41:12Z DEBORAH MILLER 35 NORTH FOURTH STREET NO 350 COLUMBUS OH 43215 1049878 0 X WWW.OHIOFREECLINICS.ORG X 2002 OH TO IMPROVE ACCESS TO HEALTH CARE FOR THE UNINSURED AND UNDERINSURED PEOPLE IN OHIO, TO STRENGTHEN THE CAPACITY OF OHIO'S FREE CLINCS, TO BUILD A NETWORK AMONG FREE CLINICS AND TO BE AN ADVOCATE FOR FREE CLINICS AND THE PEOPLE THEY SERVE. 14 14 51 14 0 0 850561 1031044 2150 6935 0 243 3416 11656 856127 1049878 386805 377630 0 0 377727 540179 0 0 11593 71448 104299 835980 1022108 20147 27770 297380 304839 131403 111092 165977 193747 TO IMPROVE ACCESS TO HEALTH CARE FOR THE UNINSURED AND UNDERINSURED PEOPLE IN OHIO, TO STRENGTHEN THE CAPACITY OF OHIO'S FREE CLINICS, TO BUILD A NETWORK AMONG FREE CLINICS AND TO BE AN ADVOCATE FOR FREE CLINICS AND THE PEOPLE THEY SERVE. 0 0 377630 377630 10191 COLLECT AND DISTRIBUTE FUNDS TO FREE CLINICS. PROMOTE NETWORKING AND INFORMATION SHARING AMONG OHIO FREE CLINICS, TO ADVOCATE ON BEHALF OF FREE CLINICS AND THE PEOPLE THEY SERVE AND TO MANAGE THE FREE CLINIC DATA. 426110 NAVIGATOR PROGRAM: ASSISTING PATIENTS OF THE ASSOCIATION'S MEMBER CLINICS IN ISSUES RELATD TO OHIO'S HEALTH INSURANCE EXCHANGE. 107191 8400 VISTA PROGRAM: SERVICES TO STRENGTHEN AND SUPPLEMENT EFFORTS TO ELIMINATE POVERTY AND POVERTY-RELATED HUMAN, SOCIAL, AND ENVIRONMENTAL PROBLEMS. 910931 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 51 1 0 0 0 0 0 0 0 0 0 0 0 0 X 14 14 1 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X DEBORAH MILLER 6149146458 35 NORTH FOURTH STREET NO 350 COLUMBUS OH 43215 KATHRYN CLARK RN PRESIDENT 5.00 X X 0 0 0 ROBERT BAILY VICE PRESIDENT 5.00 X X 0 0 0 PAUL BAUMGARTNER PAST PRESIDENT 5.00 X 0 0 0 SUSAN LABUDA SCHROP PHD SECRETARY 5.00 X X 0 0 0 ANDREW MERRILL TREASURER 5.00 X X 0 0 0 STEPHANIE BAILY CPA DIRECTOR 5.00 X 0 0 0 HEATHER BAIRD RN JD MPH DIRECTOR 5.00 X 0 0 0 MELISSA CANNEY DIRECTOR 5.00 X 0 0 0 LEE ELMORE DIRECTOR 5.00 X 0 0 0 JUSTIN COBY DIRECTOR 5.00 X 0 0 0 SUE MEYER MD DIRECTOR 5.00 X 0 0 0 JOHANNA HENZ DIRECTOR 5.00 X 0 0 0 DR ANNE KLOOS PT PHD NSC DIRECTOR 5.00 X 0 0 0 ANN QUILLEN DIRECTOR 5.00 X 0 0 0 DEBORAH MILLER EXECUTIVE DIRECTOR 40.00 X 73581 0 0 73581 0 0 0 0 0 0 0 24075 996317 10652 1031044 EDUCATION EVENT 900099 6935 6935 6935 243 243 OTHER INCOME 900099 11656 11656 11656 1049878 18591 0 243 377630 377630 73581 44149 25753 3679 427318 410231 14951 2136 39280 35632 3192 456 6750 6750 4215 3921 294 5800 5800 17088 17088 19675 11946 7729 13675 8326 5349 1161 1161 2283 2283 CONTRACT SERVICES 13029 5028 2973 5028 DUES AND SUBSCRIPTIONS 9800 9800 EQUIPMENT 3618 3618 MISCELLANEOUS 3123 3123 4082 3489 593 1022108 910931 99584 11593 44654 35184 115676 115919 131902 147189 650 1830 10835 6118 4498 4717 297380 304839 118810 94260 12593 16832 131403 111092 X 165977 193747 165977 193747 297380 304839 27770 0 X X 0 1 X 1 0 X 461259 471660 512079 857062 1031044 3333104 43181 18158 20383 17285 0 99007 504440 489818 532462 874347 1031044 3432111 0 0 0 3432111 74 507 122 243 946 74 507 122 243 946 504514 490325 532584 874347 1031287 3433057 0.99970 0.99960 0.00030 0.00040 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 0 0 0 1 1 0 0 0 PART II-B, LINE 1: SECURED FUNDING IN THE STATE BIENNIAL BUDGET THROUGH MEETINGS WITH KEY MEMBERS OF THE OHIO GENERAL ASSEMBLY. 10445 5728 4717 390 390 0 4717 PAYROLL RELATED LIABILITIES 16832 16832 X 672248 0 672248 377630 377630 1049878 644478 0 644478 377630 377630 1022108 PART X, LINE 2: OHIO ASSOCIATION OF FREE CLINICS IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. HOWEVER, INCOME FROM CERTAIN ACTIVITIES NOT DIRECTLY RELATED TO THE ASSOCIAITON'S TAX-EXEMPT PURPOSE IS SUBJECT TO TAXATION AS UNRELATED BUSINESS INCOME. THE ASSOCIATION'S REPORTING RETURNS ARE SUBJECT TO AUDIT BY FEDERAL AND STATE TAXING AUTHORITIES. NO INCOME TAX PROVISION HAS BEEN INCLUDED IN THE FINANCIAL STATEMENTS AS THE ASSOCIATION HAS DETERMINED IT DOES NOT HAVE UNRELATED BUSINESS INCOME SUBJECT TO TAXATION. PART XI, LINE 4B - OTHER ADJUSTMENTS: AMOUNTS DESIGNATED FOR MEMBER CLINICS 377,630. PART XII, LINE 4B - OTHER ADJUSTMENTS: GRANTS DESIGNATED FOR MEMBER CLINICS 377,630. 1 ASHLAND CHRISTIAN HEALTH CENTER 380 E 4TH STREET ASHLAND OH 44805 421595274 501(C)(3) 7775 TO PROVIDE SERVICES TO UNINSURED PATIENTS ASIAN AMERICAN COMMUNITY SERVICES 2231 N HIGH STREET FIRST FLOOR COLUMBUS OH 43201 310898833 501(C)(3) 7775 TO PROVIDE SERVICES TO UNINSURED PATIENTS BY THE WAY INC 1029 S BROAD STREET LANCASTER OH 43130 262934275 501(C)(3) 6751 TO PROVIDE SERVICES TO UNINSURED PATIENTS COLUMBUS FREE CLINIC 2231 N HIGH STREET COLUMBUS OH 43201 010575698 501(C)(3) 8078 TO PROVIDE SERVICES TO UNINSURED PATIENTS LICKING COUNTY COMMUNITY HEALTH CLINIC 144 B W MAIN STREET NEWARK OH 43055 311340169 501(C)(3) 7775 TO PROVIDE SERVICES TO UNINSURED PATIENTS COMPASSION MEDICAL CLINIC OF WILLIAMS COUNTY 614 E EDGERTON ST BRYAN OH 43506 204352598 501(C)(3) 6448 TO PROVIDE SERVICES TO UNINSURED PATIENTS COMPASSIONATE CARE OF SHELBY COUNTY PO BOX 4835 SIDNEY OH 45365 208479583 501(C)(3) 12516 TO PROVIDE SERVICES TO UNINSURED PATIENTS GOOD NEIGHBOR HOUSE 627 E FIRST STREET DAYTON OH 45402 311374154 501(C)(3) 5466 TO PROVIDE SERVICES TO UNINSURED PATIENTS HEALTH PARTNERS OF MIAMI COUNTY 1300 N COUNTY ROAD 25A TROY OH 45373 311596731 501(C)(3) 12516 TO PROVIDE SERVICES TO UNINSURED PATIENTS HELPING HANDS HEALTH & WELLNESS CENTER 1420 MORSE ROAD COLUMBUS OH 43229 205937457 501(C)(3) 9988 TO PROVIDE SERVICES TO UNINSURED PATIENTS JEFFERSON COUNTY 4TH STREET HEALTH CENTER 701 N 4TH STREET STEUBENVILLE OH 43952 203924355 501(C)(3) 10303 TO PROVIDE SERVICES TO UNINSURED PATIENTS LAKE COUNTY FREE CLINIC 54 SOUTH STATE STREET SUITE 302 PAINESVILLE OH 44077 341081191 501(C)(3) 12516 TO PROVIDE SERVICES TO UNINSURED PATIENTS LORAIN COUNTY FREE CLINIC INC 3323 PEARL AVENUE LORAIN OH 44055 341506180 501(C)(3) 12516 TO PROVIDE SERVICES TO UNINSURED PATIENTS MIDLOTHIAN FREE HEALTH CLINIC INC 388 E MIDLOTHIAN BLVD YOUNGSTOWN OH 44507 010887315 501(C)(3) 6448 TO PROVIDE SERVICES TO UNINSURED PATIENTS NORTH COAST HEALTH MINISTRY 16110 DETROIT AVENUE LAKEWOOD OH 44107 341536257 501(C)(3) 12516 TO PROVIDE SERVICES TO UNINSURED PATIENTS OPPORTUNITY PARISH ECUMENICAL NEIGHBORHOOD MINISTRY FREE CLINIC 941 PRINCETON AVENUE AKRON OH 44311 341046107 501(C)(3) 10303 TO PROVIDE SERVICES TO UNINSURED PATIENTS OUCOM COMMUNITY HEALTH PROGRAMS - FREE CLINIC 105 RESEARCH AND TECHNOLOGY CENTER ATHENS OH 45701 316402113 501(C)(3) 10303 TO PROVIDE SERVICES TO UNINSURED PATIENTS OXFORD COLLEGE CORNER CLINIC (DBA OXFORD FREE CLINIC) PO BOX 390 OXFORD OH 45056 204253386 501(C)(3) 7775 TO PROVIDE SERVICES TO UNINSURED PATIENTS PARMA HEALTH MINISTRY 7000 RIDGE ROAD PARMA OH 44129 341754340 501(C)(3) 5959 TO PROVIDE SERVICES TO UNINSURED PATIENTS PHYSICIANS CARECONNECTION 1390 DUBLIN ROAD COLUMBUS OH 43215 311373719 501(C)(3) 12516 TO PROVIDE SERVICES TO UNINSURED PATIENTS REACH OUT OF MONTGOMERY COUNTY INC 25 E FORAKER STREET DAYTON OH 45409 311434282 501(C)(3) 12516 TO PROVIDE SERVICES TO UNINSURED PATIENTS THE BREATHING ASSOCIATION FREE LUNG HEALTH CLINIC 1520 OLD HENDERSON ROAD COLUMBUS OH 432203639 314387540 501(C)(3) 10303 TO PROVIDE SERVICES TO UNINSURED PATIENTS THE CLINIC AT FAITH MISSION 245 N GRANT COLUMBUS OH 43215 314412586 501(C)(3) 9988 TO PROVIDE SERVICES TO UNINSURED PATIENTS TOLEDOLUCAS COUNTY CARENET INC 3231 CENTRAL PARK WEST DRIVE SUITE 200 TOLEDO OH 43617 431986672 501(C)(3) 6320 TO PROVIDE SERVICES TO UNINSURED PATIENTS TUSCARAWAS CLINIC FOR THE WORKING UNINSURED 420 REEVES AVENUE SUITE D DOVER OH 44622 208456793 501(C)(3) 9988 TO PROVIDE SERVICES TO UNINSURED PATIENTS VINEYARD FREE HEALTH CLINICS 6000 COOPER ROAD WESTERVILLE OH 43081 753210233 501(C)(3) 7775 TO PROVIDE SERVICES TO UNINSURED PATIENTS VINEYARD COMMUNITY CENTER 15187 PALMER ROAD ETNA OH 43068 310954398 501(C)(3) 8078 TO PROVIDE SERVICES TO UNINSURED PATIENTS VIOLA STARTZMAN FREE CLINIC 1874 CLEVELAND ROAD WOOSTER OH 44691 341758151 501(C)(3) 12516 TO PROVIDE SERVICES TO UNINSURED PATIENTS WASHINGTON COUNTY FREE CLINIC PO BOX 804 MARIETTA OH 45750 452512931 501(C)(3) 7575 TO PROVIDE SERVICES TO UNINSURED PATIENTS XENOS FREE CLINICS 3434 STONEVISTA LANE COLUMBUS OH 43221 310996318 501(C)(3) 6751 TO PROVIDE SERVICES TO UNINSURED PATIENTS HARTVILLE MIGRANT COUNCIL PO BOX 682 HARTVILLE OH 44632 340899100 501(C)(3) 7775 TO PROVIDE SERVICES TO UNINSURED PATIENTS LIVING WELL CLINIC 215 S ALLISON AVE PO BOX 15 XENIA OH 45385 274307745 501(C)(3) 6087 TO PROVIDE SERVICES TO UNINSURED PATIENTS MEDINA HEALTH MINISTRY 970 E WASHINGTON STREET SUITE 104 MEDINA OH 44256 300092944 501(C)(3) 6751 TO PROVIDE SERVICES TO UNINSURED PATIENTS PREGNANCY SUPPORT CENTER OF STARK COUNTY 4500 22ND ST NW CANTON OH 44706 341461765 501(C)(3) 9988 TO PROVIDE SERVICES TO UNINSURED PATIENTS VICTORY MINISTRIES 4142 WESTERVILLE ROAD COLUMBUS OH 43224 311117522 501(C)(3) 6751 TO PROVIDE SERVICES TO UNINSURED PATIENTS TRIHEALTH 619 OAK STREET CINCINNATI OH 45206 311438846 501(C)(3) 6320 TO PROVIDE SERVICES TO UNINSURED PATIENTS FAITHFUL SERVANTS FREE CLINIC 65 COMMUNITY ROAD SUITE F TALLMADGE OH 44278 454734159 501(C)(3) 9988 TO PROVIDE SERVICES TO UNINSURED PATIENTS FREE CLINIC OF FULTON COUNTY PO BOX 173 WAUSEON OH 43567 020792665 501(C)(3) 5415 TO PROVIDE SERVICES TO UNINSURED PATIENTS GOOD SAMARITAN FREE HEALTH CENTER 619 OAK STREET -ACCOUNTING 3 WEST CINCINNATI OH 45206 273893817 501(C)(3) 6195 TO PROVIDE SERVICES TO UNINSURED PATIENTS GRACE CLINIC OF DELAWARE 40 S FRANKLIN ST DELAWARE OH 43015 270415624 501(C)(3) 9988 TO PROVIDE SERVICES TO UNINSURED PATIENTS LINWORTH ROAD CHURCH 5400 LINWORTH ROAD COLUMBUS OH 43235 310881670 501(C)(3) 9262 TO PROVIDE SERVICES TO UNINSURED PATIENTS FORM 990, PART VI, SECTION A, LINE 2 THE ORGANIZATION'S BOARD PRESIDENT AND OUR BOARD TREASURER ARE HUSBAND AND WIFE. FORM 990, PART VI, SECTION A, LINE 6 THE MEMBERS ELECT THE MEMBERS OF THE GOVERNING BODY. FORM 990, PART VI, SECTION A, LINE 7A THE MEMBERS ELECT THE MEMBERS OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11 BOARD MEMBERS RECEIVE A COPY OF THE 990 AND APPROVE IT BEFORE FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C ANNUALLY, THE BOARD OF DIRECTORS AND ITS OFFICERS, WILL COMPLETE A QUESTIONNAIRE TO ASSIST THE ORGANIZATION WITH DETERMINING THAT THEY ARE IN COMPLIANCE WITH THE POLICY. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD OFFICERS RESEARCH, DELIBERATE, AND APPROVE COMPENSATION FOR THE EXECUTIVE DIRECTOR. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE UPON REQUEST. FORM 990, PART XII, LINE 2C THIS PROCESS HAS NOT CHANGED.