2013-11-14T14:03:11-06:00 2012-12-31 310800053 CLARK SCHAEFER HACKETT & CO 14 E MAIN STREET SUITE 500 SPRINGFIELD OH 45502 990 2012-01-01 223769296 OHIO ASSOCIATION OF FREE CLINICS OHIO 6149950485 37 WEST BROAD STREET NO 350 COLUMBUS OH 43215 DEBORAH MILLER 6149950485 2013-11-14 1 DEVESH KAMAL P00201226 9373992000 2013-11-14 2012 2016-02-25 16:41:14Z X DEBORAH MILLER 37 WEST BROAD STREET NO 350 COLUMBUS OH 43215 490325 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 CLINCIS, TO BUILD A NETWORK AMONG FREE CLINICS AND TO BE AN ADVOCATE FOR FREE CLINICS AND THE PEOPLE THEY SERVE. 16 16 1 0 0 0 461259 471660 42211 18158 11 507 970 0 504451 490325 393605 393592 0 0 0 58158 0 0 4065 106329 48773 499934 500523 4517 -10198 281004 375558 98398 203150 182606 172408 TO IMPROVE ACCESS TO HEALTH CARE FOR THE UNINSURED AND UNDERINSURED PEOPLE IN OHIO, TO STREGTHEN 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 457851 393592 18158 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. 457851 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 2 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 X 16 16 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X DEBORAH MILLER 6149950485 37 WEST BROAD STREET NO 350 COLUMBUS OH 43215 JOHN MORITZ 5.00 X X 0 0 0 STEPHANIE BAILY CPA 5.00 X X 0 0 0 SUSAN LABUDA SCHROP PHD 5.00 X X 0 0 0 LEE ELMORE 5.00 X 0 0 0 ROBERT BAILY 5.00 X 0 0 0 PAUL BAUMGARTNER 5.00 X 0 0 0 KATHRYN CLARK RN 5.00 X 0 0 0 ELAINE EWALD 5.00 X 0 0 0 GERALD H FEAGLES 5.00 X 0 0 0 DR ANNE KLOOS PT PHD NSC 5.00 X 0 0 0 ANDREW MERRILL 5.00 X 0 0 0 MELISSA CANNEY 5.00 X 0 0 0 THOMAS KERN JD 5.00 X 0 0 0 ANN QUILLEN 5.00 X 0 0 0 JOHANNA HENZ 5.00 X 0 0 0 JACK NEWTON MD 5.00 X 0 0 0 DEBORAH MILLER 40.00 X 17500 0 0 MICHELLE FITZGIBBON 40.00 X 38500 0 0 56000 0 0 0 0 0 0 0 23675 437326 10659 471660 CONFERENCE REGISTRATIO 900099 12158 12158 CONFERENCE SPONSORSHIP 900099 6000 6000 18158 507 507 490325 18158 0 507 393592 393592 56000 33600 19600 2800 2158 1295 755 108 4820 4820 1904 1544 315 45 1120 560 560 1250 1250 384 384 23299 23299 305 183 107 15 1600 1600 MISCELLANEOUS 7924 7924 TELEPHONE 2843 2132 711 CONTRACT SERVICES 2090 1253 732 105 BANK CHARGES 560 560 674 393 281 500523 457851 38607 4065 49012 41538 115045 115553 116389 218214 4455 4202 558 253 281004 375558 98398 196797 0 6353 98398 203150 X 177606 172408 5000 0 182606 172408 281004 375558 -10198 0 X X 0 1 X 1 0 X 672536 483256 486998 461259 471660 2575709 46468 90352 63442 43181 18158 261601 719004 573608 550440 504440 489818 2837310 0 0 0 2837310 3789 1227 415 74 507 6012 3789 1227 415 74 507 6012 722793 574835 550855 504514 490325 2843322 0.99790 0.99710 0.00210 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 0 0 0 0 0 0 0 0 EXPLANATION OF LOBBYING ACTIVITIES: PART II-B, LINE 1: SECURED FUNDING IN THE STATE BIENNIAL BUDGET THROUGH MEETINGS WITH KEY MEMBERS OF THE OHIO GENERAL ASSEMBLY. 4065 3812 253 390 390 0 253 PAYROLL RELATED LIABILITIES 6353 6353 X 96733 0 96733 393592 393592 490325 106931 0 106931 393592 393592 500523 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: 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 ORGANIZATION'S TAX-EXEMPT PURPOSE IS SUBJECT TO TAXATION AS UNRELATED BUSINESS INCOME. THE ORGANIZATION'S REPORTING RETURNS ARE SUBJECT TO AUDIT BY FEDERAL AND STATE TAXING AUTHORITIES. THE ORGANIZATION'S OPEN AUDIT PERIODS ARE 2009 THROUGH 2011. NO INCOME TAX PROVISION HAS BEEN INCLUDED IN THE FINANCIAL STATEMENTS AS THE ORGANIZATION HAS DETERMINED IT DOES NOT HAVE UNRELATED BUSINESS INCOME SUBJECT TO TAXATION. PART XI, LINE 4B - OTHER ADJUSTMENTS: AMOUNTS DESIGNATED FOR MEMBER CLINICS 393,592. PART XII, LINE 4B - OTHER ADJUSTMENTS: GRANTS DESIGNATED FOR MEMBER CLINICS 393,592. 0 ASHLAND CHRISTIAN HEALTH CENTER 380 E 4TH STREET ASHLAND OH 44805 421595274 501(C)(3) 7872 TO PROVIDE SERVICES TO UNINSURED PATIENTS ASIAN HEALTH CENTER 2231 N HIGH STREET FIRST FLOOR COLUMBUS OH 43201 310898833 501(C)(3) 7872 TO PROVIDE SERVICES TO UNINSURED PATIENTS BELMONT COUNTY DIVISION OF WHEELING HEALTH RIGHT INC 61 29TH STREET WHEELING WV 26003 311149085 501(C)(3) 12300 TO PROVIDE SERVICES TO UNINSURED PATIENTS BY THE WAY INC 1029 S BROAD STREET LANCASTER OH 43130 262934275 501(C)(3) 6857 TO PROVIDE SERVICES TO UNINSURED PATIENTS COLUMBUS FREE CLINIC 2231 N HIGH STREET COLUMBUS OH 43201 010575698 501(C)(3) 6857 TO PROVIDE SERVICES TO UNINSURED PATIENTS COMMUNITY HEALTH CLINIC 144 B W MAIN STREET NEWARK OH 43055 311340169 501(C)(3) 7872 TO PROVIDE SERVICES TO UNINSURED PATIENTS COMPASSION MEDICAL CLINIC OF WILLIAMS COUNTY 206 W BEMENT STREET BRYAN OH 43506 204352598 501(C)(3) 7872 TO PROVIDE SERVICES TO UNINSURED PATIENTS COMPASSIONATE CARE OF SHELBY COUNTY PO BOX 4835 SIDNEY OH 45365 208479583 501(C)(3) 12300 TO PROVIDE SERVICES TO UNINSURED PATIENTS FREE CLINIC OF CLINTON COUNTY INC PO BOX 961 WILMINGTON OH 45177 201109777 501(C)(3) 6857 TO PROVIDE SERVICES TO UNINSURED PATIENTS FREE CLINIC OF FULTON COUNTY PO BOX 173 WAUSEON OH 43567 020792665 501(C)(3) 6857 TO PROVIDE SERVICES TO UNINSURED PATIENTS FREE CLINIC OF PICKAWAY COUNTY 1280 N COURT STE CIRCLEVILLE OH 43113 331031454 501(C)(3) 6858 TO PROVIDE SERVICES TO UNINSURED PATIENTS FREE MEDICAL CLINIC OF GREATER CLEVELAND 12201 EUCLID AVENUE CLEVELAND OH 44106 237078501 501(C)(3) 12300 TO PROVIDE SERVICES TO UNINSURED PATIENTS GOOD NEIGHBOR HOUSE 844 S PATTERSON BLVD DAYTON OH 45402 311374154 501(C)(3) 12300 TO PROVIDE SERVICES TO UNINSURED PATIENTS HEALTH PARTNERS OF MIAMI COUNTY 1300 N COUNTY ROAD 25A TROY OH 45373 311596731 501(C)(3) 12300 TO PROVIDE SERVICES TO UNINSURED PATIENTS HELPING HANDS HEALTH & WELLNESS CENTER 1421 MORSE ROAD COLUMBUS OH 43229 205937457 501(C)(3) 7872 TO PROVIDE SERVICES TO UNINSURED PATIENTS ISSO SEVA HEALTH CLINICS 13354 PEARL ROAD STRONGSVILLE OH 44136 203548724 501(C)(3) 7872 TO PROVIDE SERVICES TO UNINSURED PATIENTS JEFFERSON COUNTY 4TH STREET HEALTH CENTER 701 N 4TH STREET STEUBENVILLE OH 43952 203924355 501(C)(3) 7872 TO PROVIDE SERVICES TO UNINSURED PATIENTS LAKE COUNTY FREE CLINIC 54 SOUTH STATE STREET SUITE 302 PAINESVILLE OH 44077 341081191 501(C)(3) 12300 TO PROVIDE SERVICES TO UNINSURED PATIENTS LORAIN COUNTY FREE CLINIC INC 3323 PEARL AVENUE LORAIN OH 44055 341506180 501(C)(3) 12300 TO PROVIDE SERVICES TO UNINSURED PATIENTS MADISON COUNTY HEALTH PARTNERS 210 N MAIN STREET LONDON OH 43140 202375865 501(C)(3) 7872 TO PROVIDE SERVICES TO UNINSURED PATIENTS MIDLOTHIAN FREE HEALTH CLINIC INC 388 E MIDLOTHIAN BLVD YOUNGSTOWN OH 44507 010887315 501(C)(3) 6857 TO PROVIDE SERVICES TO UNINSURED PATIENTS NEIGHBORHOOD CARE CENTER 17951 JEFFERSON PARK DRIVE MIDDLEBURG HEIGHTS OH 44130 340753531 501(C)(3) 12300 TO PROVIDE SERVICES TO UNINSURED PATIENTS NORTH COAST HEALTH MINISTRY 16110 DETROIT AVENUE LAKEWOOD OH 44107 341536257 501(C)(3) 12300 TO PROVIDE SERVICES TO UNINSURED PATIENTS OPPORTUNITY PARISH ECUMENICAL NEIGHBORHOOD MINISTRY FREE CLINIC 941 PRINCETON AVENUE AKRON OH 44311 341046107 501(C)(3) 12300 TO PROVIDE SERVICES TO UNINSURED PATIENTS OUCOM COMMUNITY HEALTH PROGRAMS - FREE CLINIC 105 RESEARCH AND TECHNOLOGY CENTER ATHENS OH 45701 316402113 501(C)(3) 7872 TO PROVIDE SERVICES TO UNINSURED PATIENTS OXFORD COLLEGE CORNER CLINIC (DBA OXFORD FREE CLINIC) PO BOX 390 OXFORD OH 45056 204253386 501(C)(3) 7872 TO PROVIDE SERVICES TO UNINSURED PATIENTS PARMA HEALTH MINISTRY 7000 RIDGE ROAD PARMA OH 44129 341754340 501(C)(3) 6857 TO PROVIDE SERVICES TO UNINSURED PATIENTS PHYSICIANS CARECONNECTION 431 E BROAD STREET COLUMBUS OH 43215 311373719 501(C)(3) 12300 TO PROVIDE SERVICES TO UNINSURED PATIENTS REACH OUT OF MONTGOMERY COUNTY INC 25 E FORAKER STREET DAYTON OH 45409 311434282 501(C)(3) 12300 TO PROVIDE SERVICES TO UNINSURED PATIENTS THE BREATHING ASSOCIATION FREE LUNG HEALTH CLINIC 1520 OLD HENDERSON ROAD COLUMBUS OH 432203639 314387540 501(C)(3) 12300 TO PROVIDE SERVICES TO UNINSURED PATIENTS THE CLINIC AT FAITH MISSION 315 E LONG STREET COLUMBUS OH 43215 314412586 501(C)(3) 7872 TO PROVIDE SERVICES TO UNINSURED PATIENTS THE MEDINA HEALTH MINISTRY PO BOX 30 MEDINA OH 44258 300092944 501(C)(3) 7872 TO PROVIDE SERVICES TO UNINSURED PATIENTS TOLEDOLUCAS COUNTY CARENET INC 3231 CENTRAL PARK WEST DRIVE SUITE 200 TOLEDO OH 43617 431986672 501(C)(3) 12300 TO PROVIDE SERVICES TO UNINSURED PATIENTS TOTAL LIVING CENTER FREE MEDICAL CLINIC 2221 9TH STREET SW CANTON OH 44706 341387834 501(C)(3) 6858 TO PROVIDE SERVICES TO UNINSURED PATIENTS TOWNHALL II MEDICAL CLINIC 155 N WATER STREET KENT OH 44240 300024882 501(C)(3) 7872 TO PROVIDE SERVICES TO UNINSURED PATIENTS TUSCARAWAS CLINIC FOR THE WORKING UNINSURED 420 REEVES AVENUE SUITE D DOVER OH 44622 208456793 501(C)(3) 7872 TO PROVIDE SERVICES TO UNINSURED PATIENTS UNIVERSITY OF CINCINNATI PHYSICIANS COMPANY PO BOX 670582 CINCINNATI OH 452670582 311405915 501(C)(3) 3280 TO PROVIDE SERVICES TO UNINSURED PATIENTS VINEYARD FREE HEALTH CLINICS 6000 COOPER ROAD WESTERVILLE OH 43081 753210233 501(C)(3) 7872 TO PROVIDE SERVICES TO UNINSURED PATIENTS VINEYARD FREE MEDICAL CLINIC 15187 PALMER ROAD REYNOLDSBURG OH 43068 310954398 501(C)(3) 6858 TO PROVIDE SERVICES TO UNINSURED PATIENTS VIOLA STARTZMAN FREE CLINIC 1874 CLEVELAND ROAD WOOSTER OH 44691 341758151 501(C)(3) 12300 TO PROVIDE SERVICES TO UNINSURED PATIENTS WASHINGTON COUNTY FREE CLINIC PO BOX 804 MARIETTA OH 45750 452512931 501(C)(3) 6858 TO PROVIDE SERVICES TO UNINSURED PATIENTS WESTERN STARK MEDICAL CLINIC 820 AMHERST ROAD NE MASSILLON OH 44646 341887206 501(C)(3) 12300 TO PROVIDE SERVICES TO UNINSURED PATIENTS XENOS FREE CLINICS 3434 STONEVISTA LANE COLUMBUS OH 43221 310996318 501(C)(3) 6858 TO PROVIDE SERVICES TO UNINSURED PATIENTS 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 WILL RESEARCH AND DOCUMENT THEIR DELIBERATIONS REGARDING COMPENSATION FOR THE EXECUTIVE DIRECTOR AND EMPLOYEES. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE UPON REQUEST. THIS PROCESS HAS NOT CHANGED.