2014-10-20T13:44:21-05:00 2013-12-31 310800053 CLARK SCHAEFER HACKETT & CO 4449 EASTON WAY SUITE 400 COLUMBUS OH 43219 990 2013-01-01 341817218 OHIO PHYSICIANS HEALTH PROGRAM OHIO 6148419690 130 E CHESTNUT STREET NO 400 COLUMBUS OH 43215 KELLEY M LONG MBA EXECUTIVE DIRECTOR 6148419690 2014-08-22 1 SHARON R REISMAN P00280235 6148852208 2014-08-22 2013 2015-11-30 17:44:51Z KELLEY M LONG MBA 130 E CHESTNUT STREET NO 400 COLUMBUS OH 43215 991931 0 X WWW.OPHP.ORG X 1995 OH TO FACILITATE THE HEALTH & WELLBEING OF HEALTHCARE PROFESSIONALS IN ORDER TO ENHANCE PATIENT CARE AND SAFETY. 15 15 6 120 0 0 484533 470778 124444 125921 58492 38150 10200 3783 677669 638632 0 0 0 0 491665 483042 0 0 53011 254671 210751 746336 693793 -68667 -55161 1132677 1218753 35070 42606 1097607 1176147 TO FACILITATE THE HEALTH AND WELLBEING OF HEALTHCARE PROFESSIONALS IN ORDER TO ENHANCE PATIENT CARE AND SAFETY. 0 0 524967 125921 CONSULTATION & INTERVENTION: THE OHIO PHYSICIANS HEALTH PROGRAM (OPHP) IS A CONFIDENTIAL RESOURCE THAT ASSISTS PHYSICIANS AND OTHER HEALTHCARE PROFESSIONALS WHO MAY BE AFFECTED BY SUBSTANCE USE DISORDERS OR OTHER ISSUES IMPACTING THEIR HEALTH AND WELL-BEING. OPHP AIMS TO PROVIDE EDUCATION ON SUBSTANCE USE DISORDERS, STRESS/BURNOUT, REGULATORY GUIDELINES, AND OHIO'S "ONE-BITE" RULE. IN 2013, THERE WERE 462 ACTIVE CASES AND 168 NEW REFERRALS. PRINTED MATERIALS WERE MAILED OR DISTRIBUTED INCLUDING THE OPHP NEWSLETTER AND THE ANNUAL REPORT. 524967 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 5 0 1 6 1 0 0 0 0 0 1 1 0 0 0 0 X 15 15 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 FARSHID AFSARIFARD PHD TRUSTEE 1.00 X 0 0 0 MARTHA S BETHEA CPA SECRETARY/TREASURER 1.00 X X 0 0 0 CRAIG W ANDERSON MD TRUSTEE 1.00 X 0 0 0 STEVEN W CLAY DO 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 X 0 0 0 SYBIL MARSH MD TRUSTEE 1.00 X 0 0 0 RAYMOND R MAZZOTTA CPCU TRUSTEE 1.00 X 0 0 0 MARGARET L TONDOW MN TRUSTEE 1.00 X 0 0 0 BRUCE A WALL MD MMM TRUSTEE 1.00 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 DAVID D GOLDBERG DO MEDICAL DIRECTOR 40.00 X 176000 0 20130 KELLEY M LONG MBA EXECUTIVE DIRECTOR 40.00 X 80000 0 6400 256000 0 26530 1 0 1 0 0 350000 120778 470778 ADMINISTRATIVE FEES 561000 100065 100065 TOXICOLOGY FEES 541380 25856 25856 125921 28637 28637 360137 2675 348975 4324 11162 -1649 9513 9513 HONORARIA 900099 3783 3783 3783 638632 139217 0 28637 282530 231675 42379 8476 200512 164420 30077 6015 792 649 119 24 12526 10271 1879 376 12313 12313 2219 2219 54343 43309 9449 1585 28838 23647 4326 865 17265 14157 2590 518 8840 7249 1326 265 5653 4635 848 170 13767 11289 2065 413 RESOURCE DEVELOPMENT 35434 808 606 34020 CONTRACT LABOR 6480 6480 COMPUTER SERVICES 5672 4651 851 170 DUES AND SUBSCRIPTIONS 3160 3160 3449 2828 507 114 693793 524967 115815 53011 7848 2235 40849 69796 40379 18309 11343 7198 63016 50221 17871 12795 1009063 1102452 5324 5968 1132677 1218753 35070 42606 35070 42606 X 1096272 1174812 1335 1335 1097607 1176147 1132677 1218753 -55161 133701 0 X X 0 1 X 1 0 X 668742 672867 499829 484533 470778 2796749 668742 672867 499829 484533 470778 2796749 2796749 21933 29184 30944 35379 28637 146077 2800 6652 9250 10200 3783 32685 2975511 709526 0.93990 0.94320 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 63016 50221 12795 12795 INVESTMENTS 1102452 F 1102452 X 773982 133701 133701 640281 -1649 -1649 638632 693793 0 693793 0 693793 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 2010-2013. 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. PART XI, LINE 2D - OTHER ADJUSTMENTS: NET UNREALIZED GAIN/(LOSS) ON INVESTMENTS PART XI, LINE 4B - OTHER ADJUSTMENTS: LOSS ON SALE OF PROPERTY AND EQUIPMENT PART XI, LINE 2D: THIS IS THE NET UNREALIZED GAIN ON INVESTMENTS. PART XI, LINE 4B: THIS IS THE LOSS ON SALE OF PROPERTY AND EQUIPMENT. X X X X X 1 NICOLE L MOHAR 200 WESTWIND DRIVE AVON LAKE OH 44012 TO PROVIDE FUNDRAISING & FUND DEVELOPMENT SERVICES 0 110778 23477 87301 110778 23477 87301 OH X X 0 0 0 0 0 0 0 0 0 DAVID D GOLDBERG DO MEDICAL DIRECTOR 160000 0 16000 0 0 0 14080 0 6050 0 196130 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.