2015-11-12T08:41:25-06:00 2014-12-31 310800053 CLARK SCHAEFER HACKETT & CO 4449 EASTON WAY SUITE 400 COLUMBUS OH 43219 990 2014-01-01 341817218 OHIO PHYSICIANS HEALTH PROGRAM OHIO 6148419690 130 E CHESTNUT STREET NO 400 COLUMBUS OH 43215 KELLEY M LONG MBA EXECUTIVE DIRECTOR 6148419690 2015-11-05 1 KATHY A PUGH CPA P00166045 6148852208 2015-11-05 2014 2016-03-07 17:11:31Z KELLEY M LONG MBA 130 E CHESTNUT STREET NO 400 COLUMBUS OH 43215 1348261 0 X WWW.OPHP.ORG X 1995 OH TO FACILITATE THE HEALTH & WELLBEING OF HEALTHCARE PROFESSIONALS IN ORDER TO ENHANCE PATIENT CARE AND SAFETY. 12 11 8 105 0 0 470778 578234 125921 144670 38150 143693 3783 5100 638632 871697 0 0 0 0 483042 509801 0 17425 49477 210751 206992 693793 734218 -55161 137479 1218753 1296749 42606 49359 1176147 1247390 TO FACILITATE THE HEALTH AND WELLBEING OF HEALTHCARE PROFESSIONALS IN ORDER TO ENHANCE PATIENT CARE AND SAFETY. 0 0 551519 149770 CONFIDENTIAL RESOURCE, MONITORING AND ADVOCACY SERVICES, AND EDUCATIONAL OUTREACH PROGRAMS: THE OHIO PHYSICIANS HEALTH PROGRAM, INC. (OPHP) IS A NONPROFIT ORGANIZATION WHICH OFFERS CONFIDENTIAL ASSISTANCE TO PHYSICIANS AND OTHER HEALTHCARE PROFESSIONALS WHO MAY BE AFFECTED BY MENTAL, EMOTIONAL AND BEHAVIORAL ILLNESS, SUBSTANCE-RELATED AND ADDICTIVE DISORDERS, OR OTHER ISSUES IMPACTING THEIR HEALTH AND WELL-BEING. OPHP COORDINATES EVALUATION AND TREATMENT, FACILITATES INTERVENTIONS, PROVIDES COMPREHENSIVE MONITORING SERVICES, AND DELIVERS EDUCATIONAL PRESENTATIONS THROUGHOUT OHIO. IN 2014, OPHP RECEIVED 171 NEW REFERRALS, HAD 466 ACTIVE CASES, AND PRESENTED 17 EDUCATIONAL OUTREACH PROGRAMS. 551519 1 1 0 0 0 0 0 0 0 0 1 1 0 0 0 1 1 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 4 0 1 8 1 0 0 0 0 0 1 1 0 0 0 0 X 12 11 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X KELLEY LONG 6148419690 130 E CHESTNUT STREET SUITE 400 COLUMBUS OH 43215 RONALD L MILLER MD FACP CHAIRMAN 1.00 X X 0 0 0 CRAIG W ANDERSON MD TRUSTEE 1.00 X 0 0 0 CHRISTINA DELOS-REYES MD TRUSTEE 1.00 X 0 0 0 R JEFFREY GOLDSMITH MD FASAM TRUSTEE 1.00 X 0 0 0 MARK HATCHER JD TRUSTEE 1.00 X 0 0 0 SYBIL MARSH MD TRUSTEE 1.00 X 0 0 0 MARGARET L TONDOW MN TRUSTEE 1.00 X 0 0 0 BRUCE A WALL MD MMM SECRETARY/TREASURER 1.00 X X 0 0 0 GEORGE HARDING IV MD TRUSTEE 1.00 X 0 0 0 RONALD F PAVLOVICH CPA CAPPM TRUSTEE 1.00 X 0 0 0 CRAIG T PRATT MD FASAM TRUSTEE 1.00 X 0 0 0 STEVEN W CRAWFORD MD TRUSTEE 1.00 X 0 0 0 FRANK A LAZAR TRUSTEE 1.00 X 0 0 0 DAVID D GOLDBERG DO MEDICAL DIRECTOR 32.00 X X 181500 0 22243 KELLEY M LONG MBA EXECUTIVE DIRECTOR 40.00 X 90640 0 6592 272140 0 28835 1 0 1 0 0 350000 228234 578234 ADMINISTRATIVE FEES 561000 113570 113570 TOXICOLOGY FEES 541380 31100 31100 144670 31885 31885 588372 476564 111808 111808 111808 HONORARIA 900099 5100 5100 5100 871697 149770 0 143693 300975 246800 45146 9029 208826 171237 31324 6265 11875 9738 1781 356 17425 17425 13512 13512 390 390 61833 49258 10772 1803 31110 25510 4667 933 21882 17944 3282 656 7616 6245 1143 228 4050 3320 608 122 14398 11804 2159 435 CONTRACT LABOR 17230 17230 RESOURCE DEVELOPMENT 13231 698 523 12010 COMPUTER SERVICES 6692 5487 1004 201 DUES AND SUBSCRIPTIONS 1879 1879 1294 1209 71 14 734218 551519 133222 49477 2235 100737 69796 62566 18309 31315 7198 9576 63016 54271 12795 8745 1102452 1077842 5968 5968 1218753 1296749 42606 49359 42606 49359 X 1174812 1151055 1335 96335 1176147 1247390 1218753 1296749 137479 -66236 0 X X 0 1 X 1 0 X 672867 499829 484533 470778 578234 2706241 672867 499829 484533 470778 578234 2706241 2706241 29184 30944 35379 28637 31885 156029 6652 9250 10200 3783 5100 34985 2897255 617211 0.93410 0.93990 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 63016 54271 8745 0 8745 OTHER INVESTMENTS 1077842 F 1077842 X 805461 -66236 -66236 871697 0 871697 734218 0 734218 0 734218 PART X, LINE 2: THE ORGANIZATION HAS ADOPTED ACCOUNTING GUIDANCE FOR UNCERTAINTY IN INCOME TAXES WHICH CLARIFY THE ACCOUNTING AND RECOGNITION FOR INCOME TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN IN THE ORGANIZATION'S INCOME TAX RETURNS. THE ORGANIZATION'S INCOME TAX FILINGS ARE SUBJECT TO AUDIT BY VARIOUS TAXING AUTHORITIES. THE ORGANIZATION'S OPEN AUDIT PERIODS ARE 2011-2014. THE ORGANIZATION'S POLICY WITH REGARD TO INTEREST AND PENALTY IS TO RECOGNIZE INTEREST THROUGH INTEREST EXPENSE AND PENALTIES THROUGH OTHER EXPENSE. IN EVALUATING THE ORGANIZATION'S TAX PROVISIONS AND ACCRUALS, FUTURE TAXABLE INCOME, AND THE REVERSAL OF TEMPORARY DIFFERENCES, INTERPRETATIONS AND TAX PLANNING STRATEGIES ARE CONSIDERED. THE ORGANIZATION BELIEVES ITS ESTIMATES ARE APPROPRIATE BASED ON THE CURRENT FACTS AND CIRCUMSTANCES. X X X X X 1 MOHAR CONSULTING UNLIMITED 200 WESTWIND DRIVE AVON LAKE OH 44012 TO PROVIDE FUNDRAISING & FUND DEVELOPMENT SERVICES 0 123234 17425 105809 123234 17425 105809 OH X X 0 0 0 0 0 0 0 0 0 DAVID D GOLDBERG DO MEDICAL DIRECTOR 165000 0 16500 0 0 0 13200 0 9043 0 203743 0 0 0 FORM 990, PART VI, SECTION B, LINE 11 THE RETURN IS PREPARED BY CLARK, SCHAEFER, HACKETT & CO. OHIO PHYSICIANS HEALTH PROGRAM RECEIVES A DRAFT COPY WHICH IS GIVEN TO THE CHAIRMAN OF THE AUDIT/FINANCE COMMITTEE FOR REVIEW AND APPROVAL. ONCE APPROVED, A FINAL RETURN IS PREPARED AND FILED. FORM 990, PART VI, SECTION B, LINE 12C ALL OFFICERS, DIRECTORS, OR TRUSTEES KEEP THE OPERATIONS MANAGER UPDATED OF ANY EMPLOYMENT, MEMBERSHIP, AND COMMITTEE INVOLVEMENT THAT COULD COMPROMISE THE CONFLICT OF INTEREST POLICY AT EACH BOARD MEETING OR AS NEEDED. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION HAS A COMPENSATION COMMITTEE WITHIN THE BOARD OF TRUSTEES. THESE INDIVIDUALS MEET AND DISCUSS ANY CHANGES OR ADJUSTMENTS THAT NEED TO BE MADE AND PROVIDE THE CHANGE TO THE OPERATIONS MANAGER. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES THEIR GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XII, LINE 2C: THE PROCESS FOR OVERSIGHT OF THE AUDIT AND REVIEW OF THE 990 HAS NOT CHANGED FROM THE PRIOR YEAR.