2023-11-03T13:52:07-05:00 2022-12-31 310800053 CLARK SCHAEFER HACKETT & CO 4449 EASTON WAY SUITE 400 COLUMBUS OH 43219 990 2022-01-01 341160526 PSA 3 AGENCY ON AGING PSA3 4192227723 2423 ALLENTOWN ROAD LIMA OH 45805 JACQUELYN LUCKE EXECUTIVE DIRECTOR 4192227723 2023-11-02 1 JACQUELYN LUCKE 999009999 0 NATOSHA CARR P01225377 6148852208 2023-11-02 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z JACQUELYN LUCKE 2423 ALLENTOWN ROAD LIMA OH 45805 22892368 0 X WWW.AAA3.ORG X 1974 OH TO PROMOTE THE HIGHEST QUALITY OF LIFE, AREA AGENCY ON AGING 3 WILL PROVIDE ACCESS TO A NETWORK OF SERVICES, EDUCATION, AND ADVOCACY AS THE REGION'S AGING AND DISABILITY RESOURCE EXPERT. 8 8 148 164 0 0 21805711 22648929 161158 231184 -82715 3198 33334 9057 21917488 22892368 108585 94601 0 0 7569419 7841902 0 0 0 14398625 15218466 22076629 23154969 -159141 -262601 4941365 7431237 2709341 5461814 2232024 1969423 TO PROMOTE THE HIGHEST QUALITY OF LIFE, AREA AGENCY ON AGING 3 WILL PROVIDE ACCESS TO A NETWORK OF SERVICES, EDUCATION, AND ADVOCACY AS THE REGION'S AGING AND DISABILITY RESOURCE EXPERT. 0 0 14525769 94601 62026 PASSPORT HOME CARE & ASSISTED LIVING MEDICAID WAIVER PROGRAM - UTILIZE STATE AND FEDERAL MEDICAID FUNDS TO OPERATE AND PROVIDE HOME AND COMMUNITY BASED SERVICES TO THE ELDERLY TO DELAY/DETER NURSING FACILITY PLACEMENT. PROVIDE SERVICES TO THE DISABLED AND ELDERLY FOR ASSISTED LIVING EXPENSES. 2194131 50050 TITLE III SERVICES OF THE OLDER AMERICANS ACT: FEDERALLY FUNDED SUPPORTIVE SERVICES TO ELDERLY INCLUDING SOCIALIZATION, TRANSPORTATION, NUTRITION, CAREGIVER SUPPORT INFORMATION & REFERRAL, CHORES, ETC. 2893468 119108 OTHER PROGRAM SERVICES: THE OTHER PROGRAM SERVICES THAT ARE PROVIDED TO OLDER ADULTS THROUGH PSA 3 AGENCY ON AGING'S CONTRACTED SERVICE PROVIDERS INCLUDE: DAILY MEAL PROGRAMS, DAY CARE, HOME MAKING/PERSONAL CARE, HEALTH SCREENING, TRANSPORTATION, ESCORT, CHORE, HOME REPAIR, CASE MANAGEMENT, AND CARE COORDINATION PROGRAM. THE CARE COORDINATION PROGRAM IS DESIGNED TO LINK HOME CARE SERVICES TO THOSE VULNERABLE OLDER ADULTS WHO ARE AT RISK OF LOSING THEIR INDEPENDENCE DUE TO HAVING MULTIPLE PROBLEMS WITH DAILY LIVING TASKS AND SKILLS. 19613368 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 1 23 0 1 148 1 0 0 0 0 0 0 0 0 0 0 0 0 X 8 8 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X X JACQUELYN LUCKE 4192227723 2423 ALLENTOWN ROAD LIMA OH 45805 JEFF ALLISON CHAIRMAN 1.00 X X 0 0 0 LANETTE BRILEY VICE-CHAIRMAN, MEMBER AT L 1.00 X X 0 0 0 SHARON PURDY SECT/TREAS BEGIN 2/23 1.00 X X 0 0 0 DONNA GRIMM SECT/TREAS THRU 2/22 1.00 X X 0 0 0 CATHY DODSON TRUSTEE BEGIN 8/23 1.00 X 0 0 0 GARTH BEATTY TRUSTEE 1.00 X 0 0 0 KRIS SCHROEDER TRUSTEE 1.00 X 0 0 0 DAN LEE MEMBER AT LARGE 1.00 X 0 0 0 JUDY HRUSCHKA MEMBER AT LARGE BEGIN 6/28 1.00 X 0 0 0 ANNETTA WATSON TRUSTEE THRU 4/26 1.00 X 0 0 0 JACQUELYN LUCKE EXECUTIVE DIRECTOR 53.00 X 114707 0 6154 LEANN ROLLAND CHIEF OPERATIONS OFFICER 51.00 X 97658 0 10575 JIM MARTIN CONTRACTED CFO 16.00 X 0 0 0 212365 0 16729 1 0 0 0 LOCK SIXTEEN CATERING PO BOX 348 OTTOVILLE OH 45876 MEALS 931224 VANCREST HEALTH CARE CENTER 120 WEST MAIN STREET SUITE 200 VAN WERT OH 45891 ASSISTED LIVING 850463 OAK HAVEN RESIDENTIAL CARE PO BOX 86 CLOVERDALE OH 45827 ASSISTED LIVING 810561 PUTNAM HERITAGE 1380 N LOCUST STREET OTTAWA OH 45875 ASSISTED LIVING 686977 K&P MEDICAL TRANSPORT 24862 ELLIOTT ROAD DEFIANCE OH 43512 TRANSPORTATION 579869 35 11550 22629131 8248 22648929 PROJECT INCOME 624100 169158 169158 CLIENT LIABILITY 624100 62026 62026 231184 3198 3198 MISCELLANEOUS INCOME 624100 9057 9057 9057 22892368 231184 0 12255 94601 94601 229094 151805 77289 6318707 4182751 2135956 204688 137364 67324 577296 387417 189879 512117 343677 168440 674580 364476 310104 371345 171432 199913 140417 75606 64811 26738 22455 4283 CONTRACT AND PROVIDER P 13402570 13402570 MISCELLANEOUS 381066 157167 223899 EQUIPMENT AND SUPPLIES 221750 122047 99703 23154969 19613368 3541601 0 3656450 2423179 1036848 1673941 113512 75934 282103 84884 124555 197219 10000 10000 0 3050964 4941365 7431237 2108606 1988673 600735 332554 92100 0 3048487 2709341 5461814 X 2232024 1969423 2232024 1969423 4941365 7431237 -262601 0 X X 0 1 X 0 1 1 X 17430337 18007119 21768677 21805711 22648929 101660773 17430337 18007119 21768677 21805711 22648929 101660773 101660773 1896 2555 2149 1428 3198 11226 53907 17486 136676 33334 9057 250460 101922459 823685 0.99740 0.99740 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 282103 84884 197219 197219 OPERATING LEASES RIGHT-OF-USE ASSETS 3050964 3050964 OPERATING LEASE LIABILITIES 3048487 3048487 1 LEGAL AID OF WESTERN OHIO 525 JEFFERSON AVE SUITE 400 TOLEDO OH 43604 341485732 501(C)(3) 29955 0 LEGAL ASSISTANCE FOR 60+ INDIVIDUALS ADVOCATES FOR BASIC LEGAL EQUALITY 525 JEFFERSON AVE SUITE 300 TOLEDO OH 43604 237376131 501(C)(3) 26000 0 OMBUDSMAN SERVICES NORTHWEST OH CHAPTER ALZHEIMER'S ASSOCIATION 225 N MICHIGAN AVE FLOOR 17 CHICAGO IL 60601 133039601 501(C)(3) 38646 0 ALZHEIMER'S SERVICES 3 0 PART I, LINE 2: FISCAL MONITORING OF TITLE AND STATE BLOCK GRANT PROVIDERS WHO SHARE IN THE UNIT RATE REIMBURSEMENT METHOD OF PAYMENT BY UTILIZING LOCAL CASH MATCH, PROGRAM INCOME, AND IN-KIND IS DONE ON SITE AT LEAST ONCE PER YEAR. THE VISIT COINCIDES WITH THE PROGRAM MONITORING VISIT WHENEVER POSSIBLE. TESTING IS DONE TO VERIFY THAT THE REPORTED CASH MATCH, PROGRAM INCOME, AND IN-KIND AS WELL AS UNITS ARE SUPPORTED BY THE PROVIDER AGENCY WITH THE APPROPRIATE DOCUMENTS. JIM MARTIN BOARD MEMBER 120900 CONTRACT WORK FOR ORGANIZATION 0 FORM 990, PART VI, SECTION B, LINE 11B THE 990 IS REVIEWED BY THE BOARD OF TRUSTEES DURING AN OFFICIAL BOARD MEETING. THE AUDITOR WILL ATTEND THE MEETING AND REVIEW THE DOCUMENT WITH THE BOARD. FORM 990, PART VI, SECTION B, LINE 12C EACH BOARD OF TRUSTEES MEMBER COMPLETES AN ANNUAL CONFLICT OF INTEREST STATEMENT THAT IS SUBMITTED TO THE STATE LONG TERM CARE OMBUDSMAN OFFICE AND REVIEWED BY THE EXECUTIVE DIRECTOR. ANY CONFLICTS ARE ALSO BROUGHT TO THE ATTENTION OF THE BOARD OF TRUSTEES. FORM 990, PART VI, SECTION B, LINE 15 OHIO ASSOCIATION OF AREA AGENCIES ON AGING HIRED AN INDEPENDENT CONSULTANT TO PERFORM A MARKET BASED STUDY OF SALARY AND BENEFITS. THE BOARD OF TRUSTEES USES THAT INFORMATION TO SET THE AGENCY'S SALARY SCHEDULE AND ANNUAL SALARY INCREASES IF FUNDING IS AVAILABLE. FORM 990, PART VI, SECTION C, LINE 19 AVAILABLE UPON REQUEST REVIEW AND COPIES ARE AVAILABLE. REQUEST MUST BE MADE IN WRITING TO THE EXECUTIVE DIRECTOR. PART XII, LINE 2C THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. AREA AGENCY ON AGING 3 FOUNDATION DBA SILVER BIRCH FOUNDATION 2423 ALLENTOWN RD LIMA OH 45805 822530274 HELP COMMUNITY MEMBERS IN NEED OH 501(C)(3) LINE 7 PSA 3 AGENCY ON AGING 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 0 0