<?xml version="1.0" encoding="utf-8"?>
<Return xmlns="http://www.irs.gov/efile" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" returnVersion="2022v5.0" xsi:schemaLocation="http://www.irs.gov/efile">
  <ReturnHeader binaryAttachmentCnt="0">
    <ReturnTs>2023-08-22T08:48:21-07:00</ReturnTs>
    <TaxPeriodEndDt>2023-06-30</TaxPeriodEndDt>
    <PreparerFirmGrp>
      <PreparerFirmEIN>232175024</PreparerFirmEIN>
      <PreparerFirmName>
        <BusinessNameLine1Txt>Boles Metzger Brosius &amp; Walborn PC</BusinessNameLine1Txt>
      </PreparerFirmName>
      <PreparerUSAddress>
        <AddressLine1Txt>3601 N Front Street</AddressLine1Txt>
        <CityNm>Harrisburg</CityNm>
        <StateAbbreviationCd>PA</StateAbbreviationCd>
        <ZIPCd>17110</ZIPCd>
      </PreparerUSAddress>
    </PreparerFirmGrp>
    <ReturnTypeCd>990</ReturnTypeCd>
    <TaxPeriodBeginDt>2022-07-01</TaxPeriodBeginDt>
    <Filer>
      <EIN>237265132</EIN>
      <BusinessName>
        <BusinessNameLine1Txt>EMERGENCY HEALTH SERVICES FEDERATION INC</BusinessNameLine1Txt>
      </BusinessName>
      <BusinessNameControlTxt>EMER</BusinessNameControlTxt>
      <PhoneNum>7177747911</PhoneNum>
      <USAddress>
        <AddressLine1Txt>722 LIMEKILN ROAD</AddressLine1Txt>
        <CityNm>NEW CUMBERLAND</CityNm>
        <StateAbbreviationCd>PA</StateAbbreviationCd>
        <ZIPCd>17070</ZIPCd>
      </USAddress>
    </Filer>
    <BusinessOfficerGrp>
      <PersonNm>STEVEN LYLE</PersonNm>
      <PersonTitleTxt>Executive Director</PersonTitleTxt>
      <SignatureDt>2023-08-22</SignatureDt>
      <DiscussWithPaidPreparerInd>true</DiscussWithPaidPreparerInd>
    </BusinessOfficerGrp>
    <SigningOfficerGrp>
      <PersonFullName>
        <PersonFirstNm>STEVEN</PersonFirstNm>
        <PersonLastNm>LYLE</PersonLastNm>
      </PersonFullName>
      <SSN>999009999</SSN>
    </SigningOfficerGrp>
    <IRSResponsiblePrtyInfoCurrInd>true</IRSResponsiblePrtyInfoCurrInd>
    <PreparerPersonGrp>
      <PreparerPersonNm>Theodore D Brosius CPA</PreparerPersonNm>
      <PTIN>P00168808</PTIN>
      <PhoneNum>7172380446</PhoneNum>
    </PreparerPersonGrp>
    <AdditionalFilerInformation>
      <TrustedCustomerGrp>
        <TrustedCustomerCd>2</TrustedCustomerCd>
        <AuthenticationAssuranceLevelCd>AAL1</AuthenticationAssuranceLevelCd>
        <IdentityAssuranceLevelCd>IAL1</IdentityAssuranceLevelCd>
        <FederatedAssuranceLevelCd>FAL1</FederatedAssuranceLevelCd>
      </TrustedCustomerGrp>
    </AdditionalFilerInformation>
    <TaxYr>2022</TaxYr>
    <BuildTS>2023-04-26 12:10:37Z</BuildTS>
  </ReturnHeader>
  <ReturnData documentCnt="6">
    <IRS990 documentId="IRS990" referenceDocumentId="IRS990ScheduleO" softwareId="22015553" softwareVersionNum="2022v5.0">
      <PrincipalOfficerNm>C STEVEN LYLE</PrincipalOfficerNm>
      <USAddress>
        <AddressLine1Txt>722 LIMEKILN ROAD</AddressLine1Txt>
        <CityNm>NEW CUMBERLAND</CityNm>
        <StateAbbreviationCd>PA</StateAbbreviationCd>
        <ZIPCd>17070</ZIPCd>
      </USAddress>
      <GrossReceiptsAmt>2952459</GrossReceiptsAmt>
      <GroupReturnForAffiliatesInd>false</GroupReturnForAffiliatesInd>
      <Organization501c3Ind>X</Organization501c3Ind>
      <WebsiteAddressTxt>WWW.EHSF.ORG</WebsiteAddressTxt>
      <TypeOfOrganizationCorpInd>X</TypeOfOrganizationCorpInd>
      <FormationYr>1973</FormationYr>
      <LegalDomicileStateCd>PA</LegalDomicileStateCd>
      <ActivityOrMissionDesc>TO ENGAGE IN AND CONDUCT CHARITABLE, EDUCATIONAL AND SCIENTIFIC ACTIVITIES, AND TO FURTHER SUCH ACTIVITIES AS MAY BE DEEMED ADVISABLE FOR THE ADVANCEMENT OF EMERGENCY HEALTH CARE.</ActivityOrMissionDesc>
      <VotingMembersGoverningBodyCnt>9</VotingMembersGoverningBodyCnt>
      <VotingMembersIndependentCnt>9</VotingMembersIndependentCnt>
      <TotalEmployeeCnt>17</TotalEmployeeCnt>
      <TotalVolunteersCnt>9</TotalVolunteersCnt>
      <TotalGrossUBIAmt>0</TotalGrossUBIAmt>
      <PYContributionsGrantsAmt>1932302</PYContributionsGrantsAmt>
      <CYContributionsGrantsAmt>2765579</CYContributionsGrantsAmt>
      <PYProgramServiceRevenueAmt>198222</PYProgramServiceRevenueAmt>
      <CYProgramServiceRevenueAmt>164379</CYProgramServiceRevenueAmt>
      <CYInvestmentIncomeAmt>22501</CYInvestmentIncomeAmt>
      <CYOtherRevenueAmt>0</CYOtherRevenueAmt>
      <PYTotalRevenueAmt>2130524</PYTotalRevenueAmt>
      <CYTotalRevenueAmt>2952459</CYTotalRevenueAmt>
      <CYGrantsAndSimilarPaidAmt>0</CYGrantsAndSimilarPaidAmt>
      <CYBenefitsPaidToMembersAmt>0</CYBenefitsPaidToMembersAmt>
      <PYSalariesCompEmpBnftPaidAmt>894011</PYSalariesCompEmpBnftPaidAmt>
      <CYSalariesCompEmpBnftPaidAmt>1045059</CYSalariesCompEmpBnftPaidAmt>
      <CYTotalProfFndrsngExpnsAmt>0</CYTotalProfFndrsngExpnsAmt>
      <CYTotalFundraisingExpenseAmt>0</CYTotalFundraisingExpenseAmt>
      <PYOtherExpensesAmt>1029722</PYOtherExpensesAmt>
      <CYOtherExpensesAmt>1498515</CYOtherExpensesAmt>
      <PYTotalExpensesAmt>1923733</PYTotalExpensesAmt>
      <CYTotalExpensesAmt>2543574</CYTotalExpensesAmt>
      <PYRevenuesLessExpensesAmt>206791</PYRevenuesLessExpensesAmt>
      <CYRevenuesLessExpensesAmt>408885</CYRevenuesLessExpensesAmt>
      <TotalAssetsBOYAmt>684179</TotalAssetsBOYAmt>
      <TotalAssetsEOYAmt>1200945</TotalAssetsEOYAmt>
      <TotalLiabilitiesBOYAmt>171002</TotalLiabilitiesBOYAmt>
      <TotalLiabilitiesEOYAmt>278883</TotalLiabilitiesEOYAmt>
      <NetAssetsOrFundBalancesBOYAmt>513177</NetAssetsOrFundBalancesBOYAmt>
      <NetAssetsOrFundBalancesEOYAmt>922062</NetAssetsOrFundBalancesEOYAmt>
      <MissionDesc>TO ENGAGE IN AND CONDUCT CHARITABLE, EDUCATIONAL AND SCIENTIFIC ACTIVITIES, AND TO FURTHER SUCH ACTIVITIES AS MAY BE DEEMED ADVISABLE FOR THE ADVANCEMENT OF EMERGENCY HEALTH CARE.</MissionDesc>
      <SignificantNewProgramSrvcInd>false</SignificantNewProgramSrvcInd>
      <SignificantChangeInd>false</SignificantChangeInd>
      <ExpenseAmt>1665451</ExpenseAmt>
      <Desc>ADMINISTRATION OF PENNSYLVANIA DEPARTMENT OF HEALTH CONTRACT CONCERNING EMERGENCY HEALTH CARE DELIVERY OF SERVICES.</Desc>
      <ProgSrvcAccomActy2Grp>
        <ExpenseAmt>681654</ExpenseAmt>
        <Desc>We are commitment driven to enhance quality EMS in southcentral PA. ADMINISTRATION OF EMS CONTRACTS AND PROGRAMS IN SOUTH-CENTRAL PA, INCLUDING NAACHO, SOUTH CENTRAL PA TASK FORCE AND EASTERN PA EMS COUNCIL GRANTS.</Desc>
      </ProgSrvcAccomActy2Grp>
      <TotalProgramServiceExpensesAmt>2347105</TotalProgramServiceExpensesAmt>
      <DescribedInSection501c3Ind referenceDocumentId="IRS990ScheduleA">true</DescribedInSection501c3Ind>
      <ScheduleBRequiredInd referenceDocumentId="IRS990ScheduleB">true</ScheduleBRequiredInd>
      <PoliticalCampaignActyInd>false</PoliticalCampaignActyInd>
      <LobbyingActivitiesInd>false</LobbyingActivitiesInd>
      <SubjectToProxyTaxInd>false</SubjectToProxyTaxInd>
      <DonorAdvisedFundInd referenceDocumentId="IRS990ScheduleD">false</DonorAdvisedFundInd>
      <ConservationEasementsInd referenceDocumentId="IRS990ScheduleD">false</ConservationEasementsInd>
      <CollectionsOfArtInd referenceDocumentId="IRS990ScheduleD">false</CollectionsOfArtInd>
      <CreditCounselingInd referenceDocumentId="IRS990ScheduleD">false</CreditCounselingInd>
      <DonorRstrOrQuasiEndowmentsInd referenceDocumentId="IRSScheduleD">false</DonorRstrOrQuasiEndowmentsInd>
      <ReportLandBuildingEquipmentInd referenceDocumentId="IRS990ScheduleD">true</ReportLandBuildingEquipmentInd>
      <ReportInvestmentsOtherSecInd referenceDocumentId="IRS990ScheduleD">false</ReportInvestmentsOtherSecInd>
      <ReportProgramRelatedInvstInd referenceDocumentId="IRS990ScheduleD">false</ReportProgramRelatedInvstInd>
      <ReportOtherAssetsInd referenceDocumentId="IRS990ScheduleD">false</ReportOtherAssetsInd>
      <ReportOtherLiabilitiesInd referenceDocumentId="IRS990ScheduleD">true</ReportOtherLiabilitiesInd>
      <IncludeFIN48FootnoteInd referenceDocumentId="IRS990ScheduleD">false</IncludeFIN48FootnoteInd>
      <IndependentAuditFinclStmtInd referenceDocumentId="IRS990ScheduleD">false</IndependentAuditFinclStmtInd>
      <ConsolidatedAuditFinclStmtInd referenceDocumentId="IRS990ScheduleD">false</ConsolidatedAuditFinclStmtInd>
      <SchoolOperatingInd>false</SchoolOperatingInd>
      <ForeignOfficeInd>false</ForeignOfficeInd>
      <ForeignActivitiesInd>false</ForeignActivitiesInd>
      <MoreThan5000KToOrgInd>false</MoreThan5000KToOrgInd>
      <MoreThan5000KToIndividualsInd>false</MoreThan5000KToIndividualsInd>
      <ProfessionalFundraisingInd>false</ProfessionalFundraisingInd>
      <FundraisingActivitiesInd>false</FundraisingActivitiesInd>
      <GamingActivitiesInd>false</GamingActivitiesInd>
      <OperateHospitalInd>false</OperateHospitalInd>
      <GrantsToOrganizationsInd>false</GrantsToOrganizationsInd>
      <GrantsToIndividualsInd>false</GrantsToIndividualsInd>
      <ScheduleJRequiredInd referenceDocumentId="IRS990ScheduleJ">true</ScheduleJRequiredInd>
      <TaxExemptBondsInd>false</TaxExemptBondsInd>
      <EngagedInExcessBenefitTransInd>false</EngagedInExcessBenefitTransInd>
      <PYExcessBenefitTransInd>false</PYExcessBenefitTransInd>
      <LoanOutstandingInd>false</LoanOutstandingInd>
      <GrantToRelatedPersonInd>false</GrantToRelatedPersonInd>
      <BusinessRlnWithOrgMemInd>false</BusinessRlnWithOrgMemInd>
      <BusinessRlnWithFamMemInd>false</BusinessRlnWithFamMemInd>
      <BusinessRlnWith35CtrlEntInd>false</BusinessRlnWith35CtrlEntInd>
      <DeductibleNonCashContriInd>false</DeductibleNonCashContriInd>
      <DeductibleArtContributionInd>false</DeductibleArtContributionInd>
      <TerminateOperationsInd>false</TerminateOperationsInd>
      <PartialLiquidationInd>false</PartialLiquidationInd>
      <DisregardedEntityInd>false</DisregardedEntityInd>
      <RelatedEntityInd>false</RelatedEntityInd>
      <RelatedOrganizationCtrlEntInd>false</RelatedOrganizationCtrlEntInd>
      <TrnsfrExmptNonChrtblRltdOrgInd>false</TrnsfrExmptNonChrtblRltdOrgInd>
      <ActivitiesConductedPrtshpInd>false</ActivitiesConductedPrtshpInd>
      <ScheduleORequiredInd>true</ScheduleORequiredInd>
      <IRPDocumentCnt>29</IRPDocumentCnt>
      <IRPDocumentW2GCnt>0</IRPDocumentW2GCnt>
      <BackupWthldComplianceInd>true</BackupWthldComplianceInd>
      <EmployeeCnt>17</EmployeeCnt>
      <EmploymentTaxReturnsFiledInd>true</EmploymentTaxReturnsFiledInd>
      <UnrelatedBusIncmOverLimitInd>false</UnrelatedBusIncmOverLimitInd>
      <ForeignFinancialAccountInd>false</ForeignFinancialAccountInd>
      <ProhibitedTaxShelterTransInd>false</ProhibitedTaxShelterTransInd>
      <TaxablePartyNotificationInd>false</TaxablePartyNotificationInd>
      <NondeductibleContributionsInd>false</NondeductibleContributionsInd>
      <QuidProQuoContributionsInd>false</QuidProQuoContributionsInd>
      <Form8282PropertyDisposedOfInd>false</Form8282PropertyDisposedOfInd>
      <Form8282FiledCnt>0</Form8282FiledCnt>
      <RcvFndsToPayPrsnlBnftCntrctInd>false</RcvFndsToPayPrsnlBnftCntrctInd>
      <PayPremiumsPrsnlBnftCntrctInd>false</PayPremiumsPrsnlBnftCntrctInd>
      <Form8899Filedind>false</Form8899Filedind>
      <Form1098CFiledInd>false</Form1098CFiledInd>
      <IndoorTanningServicesInd>false</IndoorTanningServicesInd>
      <SubjToTaxRmnrtnExPrchtPymtInd>false</SubjToTaxRmnrtnExPrchtPymtInd>
      <SubjectToExcsTaxNetInvstIncInd>false</SubjectToExcsTaxNetInvstIncInd>
      <InfoInScheduleOPartVIInd>X</InfoInScheduleOPartVIInd>
      <GoverningBodyVotingMembersCnt>9</GoverningBodyVotingMembersCnt>
      <IndependentVotingMemberCnt>9</IndependentVotingMemberCnt>
      <FamilyOrBusinessRlnInd>false</FamilyOrBusinessRlnInd>
      <DelegationOfMgmtDutiesInd>false</DelegationOfMgmtDutiesInd>
      <ChangeToOrgDocumentsInd>false</ChangeToOrgDocumentsInd>
      <MaterialDiversionOrMisuseInd>false</MaterialDiversionOrMisuseInd>
      <MembersOrStockholdersInd>false</MembersOrStockholdersInd>
      <ElectionOfBoardMembersInd>false</ElectionOfBoardMembersInd>
      <DecisionsSubjectToApprovaInd>false</DecisionsSubjectToApprovaInd>
      <MinutesOfGoverningBodyInd>true</MinutesOfGoverningBodyInd>
      <MinutesOfCommitteesInd>true</MinutesOfCommitteesInd>
      <OfficerMailingAddressInd>false</OfficerMailingAddressInd>
      <LocalChaptersInd>false</LocalChaptersInd>
      <Form990ProvidedToGvrnBodyInd>true</Form990ProvidedToGvrnBodyInd>
      <ConflictOfInterestPolicyInd>true</ConflictOfInterestPolicyInd>
      <AnnualDisclosureCoveredPrsnInd>true</AnnualDisclosureCoveredPrsnInd>
      <RegularMonitoringEnfrcInd>true</RegularMonitoringEnfrcInd>
      <WhistleblowerPolicyInd>true</WhistleblowerPolicyInd>
      <DocumentRetentionPolicyInd>true</DocumentRetentionPolicyInd>
      <CompensationProcessCEOInd>true</CompensationProcessCEOInd>
      <CompensationProcessOtherInd>false</CompensationProcessOtherInd>
      <InvestmentInJointVentureInd>false</InvestmentInJointVentureInd>
      <StatesWhereCopyOfReturnIsFldCd>PA</StatesWhereCopyOfReturnIsFldCd>
      <UponRequestInd>X</UponRequestInd>
      <BooksInCareOfDetail>
        <PersonNm>THE FEDERATION</PersonNm>
        <PhoneNum>7177747911</PhoneNum>
        <USAddress>
          <AddressLine1Txt>722 LIMEKILN ROAD</AddressLine1Txt>
          <CityNm>NEW CUMBERLAND</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>17070</ZIPCd>
        </USAddress>
      </BooksInCareOfDetail>
      <Form990PartVIISectionAGrp>
        <PersonNm>C STEVEN LYLE</PersonNm>
        <TitleTxt>Executive Direc</TitleTxt>
        <AverageHoursPerWeekRt>37.50</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>117355</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>44685</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>STEVEN SCHIRK</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MAUREEN GALLO</PersonNm>
        <TitleTxt>President</TitleTxt>
        <AverageHoursPerWeekRt>5.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MICHAEL J REINHART MD FACEP</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>TIMOTHY W BALDWIN</PersonNm>
        <TitleTxt>Treasurer</TitleTxt>
        <AverageHoursPerWeekRt>5.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>WILLIAM LITTLE</PersonNm>
        <TitleTxt>SECRETARY</TitleTxt>
        <AverageHoursPerWeekRt>5.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>WARREN P BLADEN JR</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JOHN R LOGAN</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>STEVEN L POFFENBERGER</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ROBERT G SHIPP III</PersonNm>
        <TitleTxt>Vice President</TitleTxt>
        <AverageHoursPerWeekRt>5.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>117355</TotalReportableCompFromOrgAmt>
      <TotalOtherCompensationAmt>44685</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>1</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>false</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>true</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>false</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>ESO SOLUTIONS INC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>N CAPITAL OF TEXAS HWY BLDG 2 300</AddressLine1Txt>
            <CityNm>AUSTIN</CityNm>
            <StateAbbreviationCd>TX</StateAbbreviationCd>
            <ZIPCd>78759</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>SOFTWARE AS A SERVIC</ServicesDesc>
        <CompensationAmt>189876</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>1</CntrctRcvdGreaterThan100KCnt>
      <GovernmentGrantsAmt>2062365</GovernmentGrantsAmt>
      <AllOtherContributionsAmt>703214</AllOtherContributionsAmt>
      <TotalContributionsAmt>2765579</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>AGENCY PCR FEES</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>163457</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>163457</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>PRODUCT SALES</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>922</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>922</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>164379</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </InvestmentIncomeGrp>
      <IncmFromInvestBondProceedsGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </IncmFromInvestBondProceedsGrp>
      <RoyaltiesRevenueGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </RoyaltiesRevenueGrp>
      <NetRentalIncomeOrLossGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </NetRentalIncomeOrLossGrp>
      <GrossAmountSalesAssetsGrp>
        <OtherAmt>22501</OtherAmt>
      </GrossAmountSalesAssetsGrp>
      <GainOrLossGrp>
        <OtherAmt>22501</OtherAmt>
      </GainOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>22501</TotalRevenueColumnAmt>
        <ExclusionAmt>22501</ExclusionAmt>
      </NetGainOrLossInvestmentsGrp>
      <NetIncmFromFundraisingEvtGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </NetIncmFromFundraisingEvtGrp>
      <NetIncomeFromGamingGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </NetIncomeFromGamingGrp>
      <NetIncomeOrLossGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </NetIncomeOrLossGrp>
      <OtherRevenueTotalAmt>0</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>2952459</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>164379</RelatedOrExemptFuncIncomeAmt>
        <ExclusionAmt>22501</ExclusionAmt>
      </TotalRevenueGrp>
      <GrantsToDomesticOrgsGrp>
        <TotalAmt>0</TotalAmt>
      </GrantsToDomesticOrgsGrp>
      <GrantsToDomesticIndividualsGrp>
        <TotalAmt>0</TotalAmt>
      </GrantsToDomesticIndividualsGrp>
      <ForeignGrantsGrp>
        <TotalAmt>0</TotalAmt>
      </ForeignGrantsGrp>
      <BenefitsToMembersGrp>
        <TotalAmt>0</TotalAmt>
      </BenefitsToMembersGrp>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>160521</TotalAmt>
        <ProgramServicesAmt>119428</ProgramServicesAmt>
        <ManagementAndGeneralAmt>41093</ManagementAndGeneralAmt>
      </CompCurrentOfcrDirectorsGrp>
      <CompDisqualPersonsGrp>
        <TotalAmt>0</TotalAmt>
      </CompDisqualPersonsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>558620</TotalAmt>
        <ProgramServicesAmt>482963</ProgramServicesAmt>
        <ManagementAndGeneralAmt>75657</ManagementAndGeneralAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
        <TotalAmt>21147</TotalAmt>
        <ProgramServicesAmt>16608</ProgramServicesAmt>
        <ManagementAndGeneralAmt>4539</ManagementAndGeneralAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>259297</TotalAmt>
        <ProgramServicesAmt>216857</ProgramServicesAmt>
        <ManagementAndGeneralAmt>42440</ManagementAndGeneralAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>45474</TotalAmt>
        <ProgramServicesAmt>37417</ProgramServicesAmt>
        <ManagementAndGeneralAmt>8057</ManagementAndGeneralAmt>
      </PayrollTaxesGrp>
      <FeesForServicesManagementGrp>
        <TotalAmt>0</TotalAmt>
      </FeesForServicesManagementGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>1220</TotalAmt>
        <ManagementAndGeneralAmt>1220</ManagementAndGeneralAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>16619</TotalAmt>
        <ManagementAndGeneralAmt>16619</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesLobbyingGrp>
        <TotalAmt>0</TotalAmt>
      </FeesForServicesLobbyingGrp>
      <FeesForServicesProfFundraising>
        <TotalAmt>0</TotalAmt>
      </FeesForServicesProfFundraising>
      <FeesForSrvcInvstMgmntFeesGrp>
        <TotalAmt>0</TotalAmt>
      </FeesForSrvcInvstMgmntFeesGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>38783</TotalAmt>
        <ProgramServicesAmt>38783</ProgramServicesAmt>
      </FeesForServicesOtherGrp>
      <AdvertisingGrp>
        <TotalAmt>0</TotalAmt>
      </AdvertisingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>8974</TotalAmt>
        <ProgramServicesAmt>8650</ProgramServicesAmt>
        <ManagementAndGeneralAmt>324</ManagementAndGeneralAmt>
      </OfficeExpensesGrp>
      <InformationTechnologyGrp>
        <TotalAmt>0</TotalAmt>
      </InformationTechnologyGrp>
      <RoyaltiesGrp>
        <TotalAmt>0</TotalAmt>
      </RoyaltiesGrp>
      <OccupancyGrp>
        <TotalAmt>78967</TotalAmt>
        <ProgramServicesAmt>75991</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2976</ManagementAndGeneralAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>1337</TotalAmt>
        <ProgramServicesAmt>1337</ProgramServicesAmt>
      </TravelGrp>
      <PymtTravelEntrtnmntPubOfclGrp>
        <TotalAmt>0</TotalAmt>
      </PymtTravelEntrtnmntPubOfclGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>10951</TotalAmt>
        <ProgramServicesAmt>10951</ProgramServicesAmt>
      </ConferencesMeetingsGrp>
      <InterestGrp>
        <TotalAmt>0</TotalAmt>
      </InterestGrp>
      <PaymentsToAffiliatesGrp>
        <TotalAmt>0</TotalAmt>
      </PaymentsToAffiliatesGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>116866</TotalAmt>
        <ProgramServicesAmt>116866</ProgramServicesAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>21439</TotalAmt>
        <ProgramServicesAmt>20581</ProgramServicesAmt>
        <ManagementAndGeneralAmt>858</ManagementAndGeneralAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>TRAINING AND EDUCATION</Desc>
        <TotalAmt>442410</TotalAmt>
        <ProgramServicesAmt>442410</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>TRAINING</Desc>
        <TotalAmt>210228</TotalAmt>
        <ProgramServicesAmt>210228</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>PREHOSPITAL PROVIDER SERVICES</Desc>
        <TotalAmt>163457</TotalAmt>
        <ProgramServicesAmt>163457</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>REGIONAL INITIATIVES</Desc>
        <TotalAmt>133337</TotalAmt>
        <ProgramServicesAmt>133337</ProgramServicesAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>253927</TotalAmt>
        <ProgramServicesAmt>251241</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2686</ManagementAndGeneralAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>2543574</TotalAmt>
        <ProgramServicesAmt>2347105</ProgramServicesAmt>
        <ManagementAndGeneralAmt>196469</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>117107</BOYAmt>
        <EOYAmt>319269</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <EOYAmt>0</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <PledgesAndGrantsReceivableGrp>
        <BOYAmt>112919</BOYAmt>
        <EOYAmt>116289</EOYAmt>
      </PledgesAndGrantsReceivableGrp>
      <AccountsReceivableGrp>
        <BOYAmt>74033</BOYAmt>
        <EOYAmt>125705</EOYAmt>
      </AccountsReceivableGrp>
      <ReceivablesFromOfficersEtcGrp>
        <EOYAmt>0</EOYAmt>
      </ReceivablesFromOfficersEtcGrp>
      <RcvblFromDisqualifiedPrsnGrp>
        <EOYAmt>0</EOYAmt>
      </RcvblFromDisqualifiedPrsnGrp>
      <OthNotesLoansReceivableNetGrp>
        <EOYAmt>0</EOYAmt>
      </OthNotesLoansReceivableNetGrp>
      <InventoriesForSaleOrUseGrp>
        <EOYAmt>0</EOYAmt>
      </InventoriesForSaleOrUseGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>140793</BOYAmt>
        <EOYAmt>153406</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>1218538</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>751487</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>229327</BOYAmt>
        <EOYAmt>467051</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <InvestmentsPubTradedSecGrp>
        <EOYAmt>0</EOYAmt>
      </InvestmentsPubTradedSecGrp>
      <InvestmentsOtherSecuritiesGrp>
        <EOYAmt>0</EOYAmt>
      </InvestmentsOtherSecuritiesGrp>
      <InvestmentsProgramRelatedGrp>
        <EOYAmt>0</EOYAmt>
      </InvestmentsProgramRelatedGrp>
      <IntangibleAssetsGrp>
        <EOYAmt>0</EOYAmt>
      </IntangibleAssetsGrp>
      <OtherAssetsTotalGrp>
        <BOYAmt>10000</BOYAmt>
        <EOYAmt>19225</EOYAmt>
      </OtherAssetsTotalGrp>
      <TotalAssetsGrp>
        <BOYAmt>684179</BOYAmt>
        <EOYAmt>1200945</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>147328</BOYAmt>
        <EOYAmt>269657</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <DeferredRevenueGrp>
        <BOYAmt>23674</BOYAmt>
      </DeferredRevenueGrp>
      <OtherLiabilitiesGrp>
        <EOYAmt>9226</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>171002</BOYAmt>
        <EOYAmt>278883</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>513177</BOYAmt>
        <EOYAmt>922062</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>513177</BOYAmt>
        <EOYAmt>922062</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>684179</BOYAmt>
        <EOYAmt>1200945</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>408885</ReconcilationRevenueExpnssAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>false</AccountantCompileOrReviewInd>
      <FSAuditedInd>true</FSAuditedInd>
      <FSAuditedBasisGrp>
        <SeparateBasisFinclStmtInd>X</SeparateBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>true</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>false</FederalGrantAuditRequiredInd>
    </IRS990>
    <IRS990ScheduleA documentId="IRS990ScheduleA" softwareId="22015553" softwareVersionNum="2022v5.0">
      <PublicOrganization170Ind>X</PublicOrganization170Ind>
      <GiftsGrantsContriRcvd170Grp>
        <CurrentTaxYearMinus4YearsAmt>1667107</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>1743706</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>1773753</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>1932302</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>2788080</CurrentTaxYearAmt>
        <TotalAmt>9904948</TotalAmt>
      </GiftsGrantsContriRcvd170Grp>
      <TaxRevLeviedOrgnztnlBnft170Grp>
        <TotalAmt>0</TotalAmt>
      </TaxRevLeviedOrgnztnlBnft170Grp>
      <GovtFurnSrvcFcltsVl170Grp>
        <TotalAmt>0</TotalAmt>
      </GovtFurnSrvcFcltsVl170Grp>
      <TotalCalendarYear170Grp>
        <CurrentTaxYearMinus4YearsAmt>1667107</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>1743706</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>1773753</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>1932302</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>2788080</CurrentTaxYearAmt>
        <TotalAmt>9904948</TotalAmt>
      </TotalCalendarYear170Grp>
      <SubstantialContributorsTotAmt>0</SubstantialContributorsTotAmt>
      <PublicSupportTotal170Amt>9904948</PublicSupportTotal170Amt>
      <GrossInvestmentIncome170Grp>
        <TotalAmt>0</TotalAmt>
      </GrossInvestmentIncome170Grp>
      <UnrelatedBusinessNetIncm170Grp>
        <TotalAmt>0</TotalAmt>
      </UnrelatedBusinessNetIncm170Grp>
      <OtherIncome170Grp>
        <CurrentTaxYearMinus4YearsAmt>91</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>398</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>299</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>918</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>922</CurrentTaxYearAmt>
        <TotalAmt>2628</TotalAmt>
      </OtherIncome170Grp>
      <TotalSupportAmt>9907576</TotalSupportAmt>
      <GrossReceiptsRltdActivitiesAmt>480844</GrossReceiptsRltdActivitiesAmt>
      <PublicSupportCY170Pct>0.99970</PublicSupportCY170Pct>
      <PublicSupportPY170Pct>0.99980</PublicSupportPY170Pct>
      <ThirtyThrPctSuprtTestsCY170Ind>X</ThirtyThrPctSuprtTestsCY170Ind>
    </IRS990ScheduleA>
    <IRS990ScheduleB documentId="IRS990ScheduleB" softwareId="22015553" softwareVersionNum="2022v5.0">
      <ContributorInformationGrp>
        <ContributorNum>RESTRICTED</ContributorNum>
        <ContributorBusinessName>
          <BusinessNameLine1>RESTRICTED</BusinessNameLine1>
        </ContributorBusinessName>
        <ContributorUSAddress>
          <AddressLine1>RESTRICTED</AddressLine1>
          <AddressLine2>RESTRICTED</AddressLine2>
          <City>RESTRICTED</City>
          <State>RESTRICTED</State>
          <ZIPCode>RESTRICTED</ZIPCode>
        </ContributorUSAddress>
        <TotalContributionsAmt>RESTRICTED</TotalContributionsAmt>
      </ContributorInformationGrp>
    </IRS990ScheduleB>
    <IRS990ScheduleD documentId="IRS990ScheduleD" softwareId="22015553" softwareVersionNum="2022v5.0">
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>1051690</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>615234</DepreciationAmt>
        <BookValueAmt>436456</BookValueAmt>
      </EquipmentGrp>
      <OtherLandBuildingsGrp>
        <OtherCostOrOtherBasisAmt>166848</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>136253</DepreciationAmt>
        <BookValueAmt>30595</BookValueAmt>
      </OtherLandBuildingsGrp>
      <TotalBookValueLandBuildingsAmt>467051</TotalBookValueLandBuildingsAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>RIGHT OF USE LIABILITY</Desc>
        <Amt>9226</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>9226</TotalLiabilityAmt>
    </IRS990ScheduleD>
    <IRS990ScheduleJ documentId="IRS990ScheduleJ" softwareId="22015553" softwareVersionNum="2022v5.0">
      <CompensationCommitteeInd>X</CompensationCommitteeInd>
      <WrittenEmploymentContractInd>X</WrittenEmploymentContractInd>
      <BoardOrCommitteeApprovalInd>X</BoardOrCommitteeApprovalInd>
      <SeverancePaymentInd>false</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>false</SupplementalNonqualRtrPlanInd>
      <EquityBasedCompArrngmInd>false</EquityBasedCompArrngmInd>
      <CompBasedOnRevenueOfFlngOrgInd>false</CompBasedOnRevenueOfFlngOrgInd>
      <CompBsdOnRevRelatedOrgsInd>false</CompBsdOnRevRelatedOrgsInd>
      <CompBsdNetEarnsFlngOrgInd>false</CompBsdNetEarnsFlngOrgInd>
      <CompBsdNetEarnsRltdOrgsInd>false</CompBsdNetEarnsRltdOrgsInd>
      <AnyNonFixedPaymentsInd>false</AnyNonFixedPaymentsInd>
      <InitialContractExceptionInd>false</InitialContractExceptionInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>C STEVEN LYLE</PersonNm>
        <TitleTxt>Executive Direc</TitleTxt>
        <BaseCompensationFilingOrgAmt>115836</BaseCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>6950</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>37735</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>160521</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="IRS990ScheduleO" softwareId="22015553" softwareVersionNum="2022v5.0">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>A COPY OF THE FORM 990 WILL BE DISTRIBUTED TO EACH OF THE GOVERNING BOARD MEMBERS BEFORE THE 990 IS SUBMITTED.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>NEW BOARD MEMBERS HAVE TO DISCLOSE AND SIGN ANY CONFLICTS OF INTEREST WHEN APPOINTED. CURRENT EMPLOYEES HAVE TO SIGN THE SAME LETTER FOR CONFLICTS OF INTEREST ANNUALLY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 15a</FormAndLineReferenceDesc>
        <ExplanationTxt>THE BOARD OF DIRECTORS APPROVED THE SALARY OF THE EXECUTIVE DIRECTOR.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 15b</FormAndLineReferenceDesc>
        <ExplanationTxt>Comparability data provided by the Pennsylvania Department of Health is used by the Board of Directors to determine the compensation of the Executive Director.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section C, Line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>AVAILABLE UPON REQUEST.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>
