Department of the Treasury Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
Attach to Form 990 or Form 990-EZ. See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
EPILEPSY FOUNDATION OF CENTRAL OHIO
Employer identification number
31-0731310
Part I
Reason for Public Charity Status
(All organizations must complete this part.) See instructions
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).
f
If the organization received a written determination from the IRS that it is a Type I, Type II or Type III supporting organization, check this box
..................................................
g
Since August 17, 2006, has the organization accepted any gift or contribution from any of the following persons?
(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the the supported organization?
................
11g(i)
(ii)
a family member of a person described in (i) above?
......................
11g(ii)
(iii)
a 35% controlled entity of a person described in (i) or (ii) above?
................
11g(iii)
h
Provide the following information about the supported organization(s).
(i) Name of supported organization
(ii) EIN
(iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions))
(iv) Is the organization in col. (i) listed in your governing document?
(v) Did you notify the organization in col. (i) of your support?
(vi) Is the organization in col. (i) organized in the U.S.?
(vii) Amount of support?
Yes
No
Yes
No
Yes
No
Total
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 2
Part II
Support Schedule for Organizations Described in IRC 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi) (Complete only if you checked the box on line 5, 7, or 8 of Part I or if the
organization failed to qualify under Part III. If the organization fails to
qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year(or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
303,416
263,011
194,634
249,560
168,493
1,179,114
2
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
3
The value of services or facilities furnished by a governmental unit to the organization without charge..
4
Total. Add lines 1 through 3..
303,416
263,011
194,634
249,560
168,493
1,179,114
5
The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included
on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
339,155
6
Public Support. Subtract line 5 from line 4.
839,959
Section B. Total Support
Calendar year(or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(f) Total
7
Amounts from line 4..
303,416
263,011
194,634
249,560
168,493
1,179,114
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
10,184
12,818
5,306
2,525
3,022
33,855
9
Net income from unrelated business activities, whether or not the business is regularly carried on..
10
Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..
4,080
5,001
1,025
321
10,427
11
Total support (Add lines 7 through 10).
1,223,396
12
Gross receipts from related activities, etc. (See instructions.)
..................
12
1,012,600
13
First Five Years
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here..........................................
Section C. Computation of Public Support Percentage
14
Public Support Percentage for 2010 (line 6 column (f) divided by line 11 column (f))
.........
14
68.660 %
15
Public Support Percentage for 2009 Schedule A, Part II, line 14
...............
15
68.140 %
16a
33 1/3% support test—2010.
If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization
......................
b
33 1/3% support test—2009.
If the organization did not check the box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization
.....................
17a
10%-facts-and-circumstances test—2010.
If the organization did not check a box on line 13, 16a, or 16b and line 14
is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported
organization
..................................................
b
10%-facts-and-circumstances test—2009.
If the organization did not check a box on line 13, 16a, 16b, or 17a and line
15 is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported organization
..............................................
18
Private Foundation
If the organization did not check a box on line 13, 16a, 16b, 17a or 17b, check this box and see
instructions
...................................................
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 3
Part III
Support Schedule for Organizations Described in IRC 509(a)(2) (Complete only if you checked the box on line 9 of Part I or if the organization
failed to qualify under Part II. If the organization fails to qualify under
the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year(or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2
Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......
3
Gross receipts from activities that are not an unrelated trade or business under section 513..
4
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5
The value of services or facilities furnished by a governmental unit to the organization without charge..
6
Total. Add lines 1 through 5.
7a
Amounts included on lines 1, 2, and 3 received from disqualified persons...
b
Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c
Add lines 7a and 7b..
8
Public Support (Subtract line 7c from line 6.)
Section B. Total Support
Calendar year (or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(f) Total
9
Amounts from line 6...
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c
Add lines 10a and 10b.
11
Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12
Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)
13
Total support (Add lines 9, 10c, 11 and 12.).
14
First Five Years
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here.............................................
Section C. Computation of Public Support Percentage
15
Public Support Percentage for 2010 (line 8 column (f) divided by line 13 column (f))
.........
15
16
Public support percentage from 2009 Schedule A, Part III, line 15
...............
16
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2010 (line 10c column (f) divided by line 13 column (f))
......
17
18
Investment income percentage from 2009 Schedule A, Part III, line 17
.............
18
19a
33 1/3% support tests—2010.
If the organization did not check the box on line 14, and line 15 is more than 33 1/3% and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
..........
b
33 1/3% support tests—2009.
If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
....
20
Private Foundation
If the organization did not check a box on line 14, 19a or 19b, check this box and see instructions
.....
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 4
Part IV
Supplemental Information.
Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
Explanation
Schedule A (Form 990 or 990-EZ) 2010
Additional Data
Software ID:
Software Version:
-
TIN:
SCHEDULE O (Form 990 or 990-EZ)
Department of the Treasury Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ
Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
EPILEPSY FOUNDATION OF CENTRAL OHIO
Employer identification number
31-0731310
Identifier
Return Reference
Explanation
ORGANIZATION MISSION STATEMENT
FORM 990, PART III, LINE 1
THE EPILEPSY FOUNDATION OF CENTRAL OHIO IS A PRIVATE, NON-PROFIT SOCIAL SERVICE ORGANIZATION PROVIDING SERVICES TO PEOPLE WITH EPILEPSY/SEIZURE DISORDER, THEIR FAMILIES AND CAREGIVERS AS WELL AS PROVIDING PUBLIC EDUCATION. OUR MISSION IS TO ENHANCE THE QUALITY OF LIFE FOR THOSE AFFECTED BY EPILEPSY AND TO INCREASE THE UNDERSTANDING OF EPILEPSY IN CENTRAL OHIO.
PROGRAM SERVICE STATEMENT
FORM 990, PART III, LINE 4A-SOCIAL HABILITATION PROGRAMS:
EPILEPSY FOUNDATION OF CENTRAL OHIO PROVIDES DIRECT SERVICE PROGRAMS THAT HELP INDIVIDUALS WITH EPILEPSY COPE WITH DAY-TODAY CHALLENGES INCLUDING: INFORMATION AND REFERRAL SERVICES-MANY QUESTIONS ARISE WHEN YOU OR SOMEONE YOU LOVE IS LIVING WITH A CHRONIC HEALTH DISORDER. GETTING CREDITABLE ANSWERS TO MEET YOUR EDUCATIONAL NEEDS BECOMES VERY IMPORTANT IN MANAGING THE PROBLEMS THAT MAY PRESENT WITH EPILEPSY. TRAINED SOCIAL WORKERS ARE AVAILABLE BY PHONE OR AT THE OFFICE TO PROVIDE INFORMATION RANGING FROM MEDICATION ASSISTANCE PROGRAMS TO DIVORCE CUSTODY ISSUES. EPILEPSY PREVENTION, SEIZURE TYPES, CURRENT TREATMENT MODALITIES AND MANAGEMENT ISSUES ARE ADDRESSED AND MAY INCLUDE DIRECT ASSISTANCE OR REFERRAL TO APPROPRIATE SERVICES PROVIDERS. PLEASE NOTE THAT MEDICAL ADVICE IS NOT AVAILABLE AND CALLERS ARE REFERRED TO THEIR HEALTHCARE PRACTITIONERS FOR PERSONAL MEDICAL ISSUES. EDUCATIONAL, LEGAL AND EMPLOYMENT INQUIRIES ARE COMMON AND INFORMATION AND MATERIALS RELATED TO THESE CONCERNS IS AVAILABLE. MEDICATION ASSISTANCE PROGRAMS-TAKING MEDICATIONS IN THE MANNER PRESCRIBED BY YOUR PHYSICIAN IS ESSENTIAL TO GOOD SEIZURE MANAGEMENT. SOMETIMES THIS IS DIFFICULT TO DO WHEN THERE IS NO PRESCRIPTION DRUG COVERAGE AND THERE ARE MULTIPLE MEDICATIONS AND/OR VERY COSTLY ONES. FOR PERSONS NOT ELIGIBLE FOR ANY FORM OF PUBLIC PRESCRIPTION INSURANCE AND WHO DO NOT HAVE PRIVATE COVERAGE, THE MAJORITY OF PHARMACEUTICAL COMPANIES OFFER FREE MEDICATIONS TO THOSE WHO QUALIFY BY MEETING INCOME GUIDELINES. IN GENERAL, THOSE WHO ARE SINGLE WITH ANNUAL INCOMES UNDER $16,000.00, OR FAMILIES OF TWO OR MORE WITH AN INCOME OF $25,000.00 OR LESS, ARE ELIGIBLE FOR THESE PROGRAMS. SOME MANUFACTURERS HAVE MORE GENEROUS INCOME CEILINGS AND IT IS ALWAYS WISE TO CALL THE FOUNDATION TO DETERMINE ELIGIBILITY UNLESS YOUR INCOME GREATLY EXCEEDS THAT LISTED. APPLICATIONS FOR THESE PROGRAMS CAN BE OBTAINED FROM THE FOUNDATION AND MUST BE COMPLETED BY THE INDIVIDUAL AND THE PRESCRIBING PHYSICIAN BEFORE SUBMITTAL TO THE PHARMACEUTICAL FIRM. MEDICATIONS ARE USUALLY MAILED TO THE DOCTOR'S OFFICE FOR DISPENSING BUT SOME MANUFACTURERS MAIL THE DRUGS DIRECTLY TO THE PATIENT. ELIGIBILITY MUST BE ESTABLISHED EVERY NINE TO TWELVE MONTHS FOR CONTINUATION IN THE PROGRAM. COUNSELING SERVICES-WHERE DO YOU TURN FOR HELP WHEN YOU OR SOMEONE YOU CARE ABOUT HAS RECURRENT SEIZURES? WHAT DO YOU DO WHEN LIFE IS NOT THE SAME AND NEW CHALLENGES APPEAR? THE EPILEPSY FOUNDATION OF CENTRAL OHIO HELPS PEOPLE OF ALL AGES FACE THEIR FEARS AND ACHIEVE THEIR GOALS THROUGH ASSISTANCE THAT PROMOTES LIVING SUCCESSFULLY WITH EPILEPSY. THE FOUNDATION OFFERS AN ARRAY OF SERVICES DESIGNED TO HELP EACH INDIVIDUAL THROUGH EACH STAGE OF LIFE. FEEL AS THOUGH YOU DON'T REALLY KNOW ENOUGH ABOUT EPILEPSY? ARE YOU HAVING PROBLEMS DEALING WITH ISSUES PRESENTED BY A CHRONIC HEALTH DISORDER. LICENSED COUNSELORS ARE AVAILABLE FOR EDUCATION BASED, INDIVIDUAL COUNSELING SERVICES TO PROVIDE SUPPORT AND MAXIMIZE THE PERSONAL AND SOCIAL ADJUSTMENT OF PERSONS LIVING WITH EPILEPSY. SERVICES ARE DIRECTED TOWARD CAPITALIZING ON THE STRENGTHS OF THE INDIVIDUAL AND ARE SOLUTION FOCUSED. THOSE REQUIRING MORE INTENSIVE INDIVIDUAL COUNSELING ARE LINKED WITH APPROPRIATE COMMUNITY RESOURCES. SUPPORT GROUPS-YOU MAY ASK WHY DO I NEED A SUPPORT GROUP. PERHAPS YOU DON'T. BUT FOR THOSE WHO CHOOSE TO PARTICIPATE, SUPPORT GROUPS CAN OFFER MANY BENEFITS. LIVING WITH EPILEPSY OFTEN REQUIRES SOME CHANGES THAT SEEM LESS DAUNTING WHEN TALKING AND SHARING WITH OTHERS ABOUT COMMON EXPERIENCES. THROUGH THIS MUTUAL SUPPORT, AND THE SHARING OF PROBLEM SOLVING STRATEGIES, A FEELING OF GREATER CONTROL OVER ONE'S LIFE IS OFTEN ACHIEVED. PARTICIPATION CAN BE AS FREQUENT OR INFREQUENT AS YOUR SCHEDULE AND NEEDS DICTATE, BUT YOUR PRESENCE, AND THAT OF A RELATIVE OR FRIEND, IS ALWAYS IMPORTANT TO THE MEMBERSHIP. REMINDERS OF MEETING DATES ARE PROVIDED BY TELEPHONE, PERIODIC MAILINGS AND/OR E-MAILS DEPENDING UPON OF WHICH GROUP YOU DECIDE TO BE A PART. GUEST SPEAKERS ARE ALSO SCHEDULED TO PROVIDE INFORMATION ON PARTICULAR TOPICS OF INTEREST TO THE MEMBERSHIP. MORE IMPORTANTLY, ENCOURAGEMENT IS GIVEN TO THE FREE EXCHANGE OF IDEAS, CONCERNS AND TRIUMPHS ACHIEVED.
PROGRAM SERVICE STATEMENT
FORM 990, PART III, LINE 4B-COMMUNITY EDUCATION PROGRAMS:
EPILEPSY IS A HIGHLY MISUNDERSTOOD DISORDER WITHIN OUR COMMUNITY. THE GENERAL PUBLIC, INCLUDING EDUCATORS, SCHOOL NURSES, POLICE OFFICERS, AND BUSINESS PROFESSIONALS, DO NOT HAVE AN UNDERSTANDING OF WHAT EPILEPSY IS AND HOW IT IS BEST TREATED. IN THE PAST, PEOPLE WITH EPILEPSY HAVE BEEN LABELED AS BEING MENTALLY RETARDED, POSSESSED BY AN EVIL SPIRIT, OR BOTH. AND, ALTHOUGH WE HAVE COME FAR IN THE AREAS OF MEDICINE AND SOCIAL AWARENESS, THIS NEUROLOGICAL DISORDER STILL CAUSES FEAR, STIGMA AND DISCRIMINATION-BARRIERS THAT ARE HARD TO PENETRATE. THE EPILEPSY FOUNDATION OF CENTRAL OHIO IS COMMITTED TO DISPELLING THE MYTHS THAT SURROUND EPILEPSY AND REMOVING THE WALLS THAT KEEP THOSE WITH THE DISORDER FEELING ISOLATED. EDUCATION IS KEY, AND WE OFFER A VARIETY OF PROGRAMS, DESIGNED TO HELP THE GENERAL PUBLIC UNDERSTAND WHAT EPILEPSY IS AND IS NOT; HOW TO RECOGNIZE THE CHARACTERISTICS OF SEIZURE ACTIVITY; HOW TO RESPOND TO AND ASSIST A PERSON WHO IS EXPERIENCING A SEIZURE BY GIVING APPROPRIATE FIRST AID; AND THE IMPACT SEIZURES HAVE ON A PERSON ACADEMICALLY, SOCIALLY AND EMOTIONALLY. THROUGH THIS COMMITMENT, OUR AGENCY IS CONTINUING TO BUILD PARTNERSHIPS WITH PUBLIC HEALTH CARE PROVIDERS, SCHOOL DISTRICTS, CHURCHES, BUSINESSES, AND OTHERS IN OUR COMMUNITY. WE ARE MAKING PROGRESS IN OUR COMMITMENT TO EDUCATE OTHERS ABOUT EPILEPSY.
FORM 990, PART VI, SECTION A, LINE 3
THE ORGANIZATION HAS HIRED A MANAGEMENT COMPANY TO PROVIDE SERVICES TO THE ORGANIZATION INCLUDING THE SERVICES OF THE EXECUTIVE DIRECTOR.
FORM 990, PART VI, SECTION B, LINE 11
THE FORM 990 IS PREPARED BY AN OUTSIDE ACCOUNTING FIRM AND IS REVIEWED BY THE ORGANIZATION'S EXECUTIVE DIRECTOR. A COPY OF THE RETURN IS PROVIDED TO ALL MEMBERS OF THE GOVERNING BODY FOR REVIEW BEFORE FILING.
FORM 990, PART VI, SECTION B, LINE 12C
THE ORGANIZATION REQUIRES THAT OFFICERS, DIRECTORS, TRUSTEES, AND KEY EMPLOYEES DISCLOSE OR UPDATE ANNUALLY INFORMATION REGARDING THEIR INTERESTS AND THOSE OF THEIR FAMILY MEMBERS THAT COULD GIVE RISE TO CONFLICTS OF INTEREST. OFFICERS, DIRECTORS, TRUSTEES AND KEY EMPLOYEES ARE REQUIRED TO DISCLOSE POTENTIAL CONFLICTS OF INTEREST AS THEY OCCUR AND ABSTAIN FROM DELIBERATIONS AND DECISIONS IN ANY TRANSACTION WHERE A CONFLICT OF INTEREST EXISTS.
FORM 990, PART VI, LINE 15, COMPENSATION OF TOP MANAGEMENT OFFICIAL: THE INDEPENDENT BOARD OF DIRECTORS DETERMINES THE COMPENSATION PAID TO THE MANAGEMENT COMPANY THAT IN TURN COMPENSATES THE ORGANIZATION'S EXECUTIVE DIRECTOR WHICH PROVIDES SERVICES IN CONNECTION WITH THE MANAGEMENT CONTRACT.
FORM 990, PART VI, SECTION C, LINE 19
THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
CHANGES IN NET ASSETS OR FUND BALANCES:
FORM 990, PART XI, LINE 5:
NET UNREALIZED GAINS ON INVESTMENTS: 15,833.
FORM 990, PART XII, LINE 2C-AUDIT OVERSIGHT AND SELECTION OF ACCOUNTANT:
THE ORGANIZATION HAS A COMMITTEE THAT OVERSEES THE AUDIT AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THE PROCESS FOR OVERSEEING THE AUDIT AND SELECTION OF AND INDEPENDENT ACCOUNTANT HAS NOT CHANGED SINCE THE PREVIOUS YEAR.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.