2013-09-03T09:08:47-05:00 2012-12-31 310800053 CLARK SCHAEFER HACKETT & CO 4449 EASTON WAY SUITE 400 COLUMBUS OH 43219 990 2012-01-01 341817218 OHIO PHYSICIANS HEALTH PROGRAM OHIO 6148419690 130 E CHESTNUT STREET NO 400 COLUMBUS OH 43215 KELLEY M LONG MBA 6148419690 2013-08-23 1 SHARON R REISMAN P00280235 6148852208 2013-08-23 2012 2016-02-24 21:20:13Z KELLEY M LONG MBA 130 E CHESTNUT STREET NO 400 COLUMBUS OH 43215 978682 0 X WWW.OPHP.ORG X 1995 OH TO FACILITATE THE HEALTH & WELLBEING OF HEALTHCARE PROFESSIONALS IN ORDER TO ENHANCE PATIENT CARE AND SAFETY. 14 14 8 100 0 0 499829 484533 105285 124444 50766 58492 9250 10200 665130 677669 0 0 0 0 373884 491665 22702 0 60231 306284 254671 702870 746336 -37740 -68667 1129622 1132677 12200 35070 1117422 1097607 TO FACILITATE THE HEALTH AND WELLBEING OF HEALTHCARE PROFESSIONALS IN ORDER TO ENHANCE PATIENT CARE AND SAFETY. 0 0 556824 124444 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 REGULATORY GUIDELINES AND OHIO'S "ONE-BITE" RULE. IN 2012, THERE WERE 456 ACTIVE CASES AND 165 NEW REFERRALS. PRINTED MATERIALS WERE MAILED OR DISTRIBUTED INCLUDING THE OPHP NEWSLETTER AND THE ANNUAL REPORT. 556824 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 8 1 0 0 0 0 0 1 1 0 0 0 0 X 14 14 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 OH X KELLEY LONG 6148419690 130 E CHESTNUT STREET SUITE 400 COLUMBUS OH 43215 RAYMOND MAZZOTTA 1.00 X X 0 0 0 FARSHID AFSARIFARD PHD 1.00 X 0 0 0 MARTHA BETHEA CPA 1.00 X X 0 0 0 GEORGE HARDING IV MD 1.00 X 0 0 0 MARGARET L TONDOW MSN 1.00 X 0 0 0 BRUCE WALL MD MMM 1.00 X 0 0 0 CHRISTINA DELOS-REYES MD 1.00 X 0 0 0 RONALD L MILLER MD 1.00 X X 0 0 0 STEVEN W CLAY DO 1.00 X 0 0 0 MARK HATCHER JD 1.00 X 0 0 0 CRAIG W ANDERSON MD 1.00 X 0 0 0 R JEFFREY GOLDSMITH MD FASAM 1.00 X 0 0 0 SYBIL MARSH MD 1.00 X 0 0 0 CRAIG T PRATT MD FASAM 1.00 X 0 0 0 DAVID D GOLDBERG DO 40.00 X 176000 0 43784 KELLEY M LONG MBA 40.00 X 81231 0 11097 257231 0 54881 1 0 1 0 0 350000 134533 484533 ADMINISTRATIVE FEES 561000 98210 98210 TOXICOLOGY FEES 541380 26234 26234 124444 35379 35379 324126 301013 23113 23113 23113 HONORARIA 900099 10200 10200 10200 677669 157757 0 35379 312112 255932 46817 9363 179553 147233 26933 5387 9421 7725 1413 283 10370 8503 1556 311 11454 11454 913 913 62583 50289 10455 1839 28455 23333 4268 854 27937 22908 4191 838 10588 8682 1588 318 7828 6419 1174 235 19422 15926 2913 583 RESOURCE DEVELOPMENT 41670 950 713 40007 CONTRACT LABOR 14740 14740 COMPUTER SERVICES 6820 5592 1023 205 DUES AND SUBSCRIPTIONS 1299 1299 1171 1120 43 8 746336 556824 129281 60231 29223 7848 24304 40849 38853 40379 11262 11343 74704 56833 21049 17871 999607 1009063 5324 5324 1129622 1132677 12200 35070 12200 35070 X 1116087 1096272 1335 1335 1117422 1097607 1129622 1132677 -68667 48852 0 X X 0 1 X 1 0 X 679581 668742 672867 499829 484533 3005552 679581 668742 672867 499829 484533 3005552 3005552 29659 21933 29184 30944 35379 147099 4950 2800 6652 9250 10200 33852 3186503 890559 0.94320 0.94690 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 4218 1319 2899 70486 55514 14972 17871 INVESTMENTS 1009063 F 1009063 X 726521 48852 48852 677669 0 677669 746336 0 746336 0 746336 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: 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 2009-2012. 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 2D: THIS IS THE NET UNREALIZED GAIN ON INVESTMENTS X X X X X 1 NICOLE L MOHAR 200 WESTWIND DRIVE AVON LAKE OH 44012 TO PROVIDE FUNDRAISING & FUND DEVELOPMENT SERVICES 0 114533 25623 88910 114533 25623 88910 OH X X 0 0 0 0 0 0 0 0 0 DAVID D GOLDBERG DO 160000 0 16000 0 0 0 14080 0 29704 0 219784 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. 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. THE PROCESS FOR OVERSIGHT OF THE AUDIT AND REVIEW OF THE 990 HAS NOT CHANGED FROM THE PRIOR YEAR.