<?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">
  <ReturnHeader binaryAttachmentCnt="0">
    <ReturnTs>2023-10-24T11:50:16-04:00</ReturnTs>
    <TaxPeriodEndDt>2022-12-31</TaxPeriodEndDt>
    <PreparerFirmGrp>
      <PreparerFirmEIN>030325875</PreparerFirmEIN>
      <PreparerFirmName>
        <BusinessNameLine1Txt>DAVIS &amp; HODGDON ASSOCIATES CPAS PLC</BusinessNameLine1Txt>
      </PreparerFirmName>
      <PreparerUSAddress>
        <AddressLine1Txt>33 BLAIR PARK RD STE 201</AddressLine1Txt>
        <CityNm>WILLISTON</CityNm>
        <StateAbbreviationCd>VT</StateAbbreviationCd>
        <ZIPCd>05495</ZIPCd>
      </PreparerUSAddress>
    </PreparerFirmGrp>
    <ReturnTypeCd>990</ReturnTypeCd>
    <TaxPeriodBeginDt>2022-01-01</TaxPeriodBeginDt>
    <Filer>
      <EIN>030215982</EIN>
      <BusinessName>
        <BusinessNameLine1Txt>RICHFORD HEALTH CENTER INC</BusinessNameLine1Txt>
      </BusinessName>
      <BusinessNameControlTxt>RICH</BusinessNameControlTxt>
      <PhoneNum>8022555562</PhoneNum>
      <USAddress>
        <AddressLine1Txt>44 MAIN STREET SUITE 200</AddressLine1Txt>
        <CityNm>RICHFORD</CityNm>
        <StateAbbreviationCd>VT</StateAbbreviationCd>
        <ZIPCd>05476</ZIPCd>
      </USAddress>
    </Filer>
    <BusinessOfficerGrp>
      <PersonNm>KATHY BENOIT</PersonNm>
      <PersonTitleTxt>CEO</PersonTitleTxt>
      <PhoneNum>8022555560</PhoneNum>
      <SignatureDt>2023-10-23</SignatureDt>
      <DiscussWithPaidPreparerInd>true</DiscussWithPaidPreparerInd>
    </BusinessOfficerGrp>
    <SigningOfficerGrp>
      <PersonFullName>
        <PersonFirstNm>KATHY</PersonFirstNm>
        <PersonLastNm>BENOIT</PersonLastNm>
      </PersonFullName>
      <SSN>XXX-XX-XXXX</SSN>
    </SigningOfficerGrp>
    <IRSResponsiblePrtyInfoCurrInd>true</IRSResponsiblePrtyInfoCurrInd>
    <PreparerPersonGrp>
      <PreparerPersonNm>BRET HODGDON</PreparerPersonNm>
      <PTIN>P00497283</PTIN>
      <PhoneNum>8028781963</PhoneNum>
      <PreparationDt>2023-10-24</PreparationDt>
    </PreparerPersonGrp>
    <TaxYr>2022</TaxYr>
    <BuildTS>2023-04-26 12:10:37Z</BuildTS>
  </ReturnHeader>
  <ReturnData documentCnt="8">
    <IRS990 documentId="RetDoc2" referenceDocumentId="RetDoc6">
      <DoingBusinessAsName>
        <BusinessNameLine1Txt>NOTCH</BusinessNameLine1Txt>
      </DoingBusinessAsName>
      <PrincipalOfficerNm>KATHY BENOIT</PrincipalOfficerNm>
      <USAddress>
        <AddressLine1Txt>44 MAIN STREET SUITE 200</AddressLine1Txt>
        <CityNm>RICHFORD</CityNm>
        <StateAbbreviationCd>VT</StateAbbreviationCd>
        <ZIPCd>05476</ZIPCd>
      </USAddress>
      <GrossReceiptsAmt>37250479</GrossReceiptsAmt>
      <GroupReturnForAffiliatesInd>false</GroupReturnForAffiliatesInd>
      <Organization501c3Ind>X</Organization501c3Ind>
      <WebsiteAddressTxt>WWW.NOTCHVT.ORG</WebsiteAddressTxt>
      <TypeOfOrganizationCorpInd>X</TypeOfOrganizationCorpInd>
      <FormationYr>1962</FormationYr>
      <LegalDomicileStateCd>VT</LegalDomicileStateCd>
      <ActivityOrMissionDesc>TO PROMOTE, PRESERVE AND RESTORE THE HEALTH OF PERSONS RESIDING IN NORTHWESTERN VERMONT.</ActivityOrMissionDesc>
      <VotingMembersGoverningBodyCnt>13</VotingMembersGoverningBodyCnt>
      <VotingMembersIndependentCnt>13</VotingMembersIndependentCnt>
      <TotalEmployeeCnt>312</TotalEmployeeCnt>
      <TotalVolunteersCnt>15</TotalVolunteersCnt>
      <TotalGrossUBIAmt>32681</TotalGrossUBIAmt>
      <PYContributionsGrantsAmt>3925625</PYContributionsGrantsAmt>
      <CYContributionsGrantsAmt>4748503</CYContributionsGrantsAmt>
      <PYProgramServiceRevenueAmt>12411574</PYProgramServiceRevenueAmt>
      <CYProgramServiceRevenueAmt>15283202</CYProgramServiceRevenueAmt>
      <PYInvestmentIncomeAmt>232207</PYInvestmentIncomeAmt>
      <CYInvestmentIncomeAmt>56458</CYInvestmentIncomeAmt>
      <PYOtherRevenueAmt>4635611</PYOtherRevenueAmt>
      <CYOtherRevenueAmt>5222072</CYOtherRevenueAmt>
      <PYTotalRevenueAmt>21205017</PYTotalRevenueAmt>
      <CYTotalRevenueAmt>25310235</CYTotalRevenueAmt>
      <CYGrantsAndSimilarPaidAmt>0</CYGrantsAndSimilarPaidAmt>
      <CYBenefitsPaidToMembersAmt>0</CYBenefitsPaidToMembersAmt>
      <PYSalariesCompEmpBnftPaidAmt>13077567</PYSalariesCompEmpBnftPaidAmt>
      <CYSalariesCompEmpBnftPaidAmt>16347046</CYSalariesCompEmpBnftPaidAmt>
      <CYTotalProfFndrsngExpnsAmt>0</CYTotalProfFndrsngExpnsAmt>
      <CYTotalFundraisingExpenseAmt>0</CYTotalFundraisingExpenseAmt>
      <PYOtherExpensesAmt>4430479</PYOtherExpensesAmt>
      <CYOtherExpensesAmt>5202743</CYOtherExpensesAmt>
      <PYTotalExpensesAmt>17508046</PYTotalExpensesAmt>
      <CYTotalExpensesAmt>21549789</CYTotalExpensesAmt>
      <PYRevenuesLessExpensesAmt>3696971</PYRevenuesLessExpensesAmt>
      <CYRevenuesLessExpensesAmt>3760446</CYRevenuesLessExpensesAmt>
      <TotalAssetsBOYAmt>25264953</TotalAssetsBOYAmt>
      <TotalAssetsEOYAmt>30004123</TotalAssetsEOYAmt>
      <TotalLiabilitiesBOYAmt>1425790</TotalLiabilitiesBOYAmt>
      <TotalLiabilitiesEOYAmt>3548802</TotalLiabilitiesEOYAmt>
      <NetAssetsOrFundBalancesBOYAmt>23839163</NetAssetsOrFundBalancesBOYAmt>
      <NetAssetsOrFundBalancesEOYAmt>26455321</NetAssetsOrFundBalancesEOYAmt>
      <InfoInScheduleOPartIIIInd>X</InfoInScheduleOPartIIIInd>
      <MissionDesc>TO PROMOTE, PRESERVE AND RESTORE THE HEALTH OF PERSONS RESIDING IN NORTHWESTERN VERMONT.</MissionDesc>
      <SignificantNewProgramSrvcInd>false</SignificantNewProgramSrvcInd>
      <SignificantChangeInd>false</SignificantChangeInd>
      <ExpenseAmt>9703439</ExpenseAmt>
      <RevenueAmt>10478780</RevenueAmt>
      <Desc>NOTCH'S LARGEST PROGRAM SERVICES, AS MEASURED BY TOTAL EXPENSES INCURRED, ARE COMPREHENSIVE HEALTH SERVICES DELIVERED TO MORE THAN 17,700 PATIENTS OF ALL AGES. OUR FEDERALLY QUALIFIED HEALTH CENTER (FQHC) SERVES THE GENERAL POPULATION OF 15 TOWNS IN VERMONT'S FRANKLIN AND GRAND ISLE COUNTIES AT FACILITIES SITUATED IN ALBURGH, ENOSBURG, FAIRFAX, GEORGIA, RICHFORD, SWANTON, AND ST. ALBANS. NOTCH OFFERS PRIMARY MEDICAL, BEHAVIORAL, AND SUPPORT SERVICES AT ALL LOCATIONS AND DENTAL SERVICES IN RICHFORD AND SWANTON. MEDICATION ASSISTED TREATMENT (MAT) SERVICES ARE DELIVERED AT ALL NOTCH MEDICAL OFFICES EXCEPT ALBURG HEALTH CENTER. EITHER THROUGH DIRECT PROVISION OR ARRANGEMENT, NOTCH ENSURES ITS USERS ACCESS TO ALL SERVICES REQUIRED UNDER THE FEDERAL 330(E) PROGRAM, REGARDLESS OF ABILITY TO PAY. OUR HEALTH CARE TEAM WORKS FROM AN INTEGRATED HEALTH MODEL. NOTCH MEDICAL PROVIDERS WORK COLLABORATIVELY WITH BEHAVIORAL PROVIDERS TO DELIVER OPTIMUM CARE. INTEGRATED HEALTH SERVICES ARE DESIGNED TO MEET THE NEEDS OF THE ENTIRE FAMILY AND ADDRESS THE WHOLE PERSON. THESE SERVICES INCLUDE: PHYSICAL EXAMINATIONS, IMMUNIZATIONS, CHRONIC DISEASE MANAGEMENT, ACUTE CARE, LABORATORY SERVICES, CARE COORDINATION, REFERRALS, BIRTH CONTROL, DOT PHYSICALS, COUNSELING, GOAL SETTING TO IMPROVE PERSONAL HEALTH, SYMPTOMS MANAGEMENT OF ANXIETY AND DEPRESSION, IDENTIFICATION OF MENTAL HEALTH BARRIERS TO MEET HEALTH CARE GOALS, AND MAT SERVICES.</Desc>
      <ProgSrvcAccomActy2Grp>
        <ExpenseAmt>3281831</ExpenseAmt>
        <RevenueAmt>3051067</RevenueAmt>
        <Desc>DENTAL - NOTCH PROVIDES GENERAL DENTAL SERVICES TO PEOPLE OF ALL AGES. PREVENTIVE TREATMENT AND PRIMARY DENTAL CARE SERVICES INCLUDE: CLEANINGS, EXAMS, X-RAYS, FLUORIDE APPLICATIONS, SEALANTS, FILLINGS (AMALGAM AND COMPOSITE), ROOT CANALS, EXTRACTIONS, DENTURES, AND CROWNS.</Desc>
      </ProgSrvcAccomActy2Grp>
      <ProgSrvcAccomActy3Grp>
        <ExpenseAmt>3943249</ExpenseAmt>
        <RevenueAmt>5951522</RevenueAmt>
        <Desc>PHARMACY - THE ORGANIZATION OWNS AND OPERATES FOUR PHARMACIES THAT ARE OPEN TO THE GENERAL PUBLIC IN RICHFORD, SWANTON, FAIRFAX, AND ST. ALBANS AND IS PART-OWNER OF A MAIL ORDER PHARMACY BASED IN CHITTENDEN COUNTY THAT SERVES FQHC PATIENTS EXCLUSIVELY. NOTCH ALSO CONTRACTS WITH MULTIPLE INDEPENDENT PHARMACIES ACROSS FRANKLIN COUNTY TO DISPENSE MEDICATIONS TO OUR FQHC PATIENTS PURCHASED THROUGH THE US FEDERAL GOVERNMENT 340B DRUG PRICING PROGRAM. MEDICATION PACKAGING IS OFFERED AT OUR PHARMACY IN RICHFORD AND AT THE MAIL ORDER PHARMACY. A SLIDING FEE DISCOUNT PROGRAM IS AVAILABLE TO ELIGIBLE NOTCH PATIENTS AT ALL OWNED PHARMACIES.</Desc>
      </ProgSrvcAccomActy3Grp>
      <ProgSrvcAccomActyOtherGrp>
        <ExpenseAmt>904386</ExpenseAmt>
        <RevenueAmt>939079</RevenueAmt>
        <Desc>OTHER INCOME INCLUDING MANAGEMENT SERVICE FEES AND COMMUNITY BENEFIT PROGRAMS INCLUDING OPERATION OF GROCERY STORE FOR THE BENEFIT OF THE COMMUNITY AS NOTCH IS LOCATED IN A FOOD DESERT.</Desc>
      </ProgSrvcAccomActyOtherGrp>
      <TotalOtherProgSrvcExpenseAmt>904386</TotalOtherProgSrvcExpenseAmt>
      <TotalOtherProgSrvcRevenueAmt>939079</TotalOtherProgSrvcRevenueAmt>
      <TotalProgramServiceExpensesAmt>17832905</TotalProgramServiceExpensesAmt>
      <DescribedInSection501c3Ind referenceDocumentId="RetDoc8">true</DescribedInSection501c3Ind>
      <ScheduleBRequiredInd referenceDocumentId="RetDoc1">true</ScheduleBRequiredInd>
      <PoliticalCampaignActyInd>false</PoliticalCampaignActyInd>
      <LobbyingActivitiesInd>false</LobbyingActivitiesInd>
      <SubjectToProxyTaxInd>false</SubjectToProxyTaxInd>
      <DonorAdvisedFundInd referenceDocumentId="RetDoc3">false</DonorAdvisedFundInd>
      <ConservationEasementsInd referenceDocumentId="RetDoc3">false</ConservationEasementsInd>
      <CollectionsOfArtInd referenceDocumentId="RetDoc3">false</CollectionsOfArtInd>
      <CreditCounselingInd referenceDocumentId="RetDoc3">false</CreditCounselingInd>
      <DonorRstrOrQuasiEndowmentsInd referenceDocumentId="RetDoc3">false</DonorRstrOrQuasiEndowmentsInd>
      <ReportLandBuildingEquipmentInd referenceDocumentId="RetDoc3">true</ReportLandBuildingEquipmentInd>
      <ReportInvestmentsOtherSecInd referenceDocumentId="RetDoc3">false</ReportInvestmentsOtherSecInd>
      <ReportProgramRelatedInvstInd referenceDocumentId="RetDoc3">false</ReportProgramRelatedInvstInd>
      <ReportOtherAssetsInd referenceDocumentId="RetDoc3">true</ReportOtherAssetsInd>
      <ReportOtherLiabilitiesInd referenceDocumentId="RetDoc3">true</ReportOtherLiabilitiesInd>
      <IncludeFIN48FootnoteInd referenceDocumentId="RetDoc3">true</IncludeFIN48FootnoteInd>
      <IndependentAuditFinclStmtInd referenceDocumentId="RetDoc3">false</IndependentAuditFinclStmtInd>
      <ConsolidatedAuditFinclStmtInd referenceDocumentId="RetDoc3">true</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="RetDoc4">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 referenceDocumentId="RetDoc5">true</DeductibleNonCashContriInd>
      <DeductibleArtContributionInd referenceDocumentId="RetDoc5">false</DeductibleArtContributionInd>
      <TerminateOperationsInd>false</TerminateOperationsInd>
      <PartialLiquidationInd>false</PartialLiquidationInd>
      <DisregardedEntityInd referenceDocumentId="RetDoc7">true</DisregardedEntityInd>
      <RelatedEntityInd referenceDocumentId="RetDoc7">true</RelatedEntityInd>
      <RelatedOrganizationCtrlEntInd>false</RelatedOrganizationCtrlEntInd>
      <TrnsfrExmptNonChrtblRltdOrgInd referenceDocumentId="RetDoc7">false</TrnsfrExmptNonChrtblRltdOrgInd>
      <ActivitiesConductedPrtshpInd referenceDocumentId="RetDoc7">false</ActivitiesConductedPrtshpInd>
      <ScheduleORequiredInd>true</ScheduleORequiredInd>
      <IRPDocumentCnt>18</IRPDocumentCnt>
      <IRPDocumentW2GCnt>0</IRPDocumentW2GCnt>
      <EmployeeCnt>312</EmployeeCnt>
      <EmploymentTaxReturnsFiledInd>true</EmploymentTaxReturnsFiledInd>
      <UnrelatedBusIncmOverLimitInd>true</UnrelatedBusIncmOverLimitInd>
      <Form990TFiledInd>true</Form990TFiledInd>
      <ForeignFinancialAccountInd>false</ForeignFinancialAccountInd>
      <ProhibitedTaxShelterTransInd>false</ProhibitedTaxShelterTransInd>
      <TaxablePartyNotificationInd>false</TaxablePartyNotificationInd>
      <NondeductibleContributionsInd>false</NondeductibleContributionsInd>
      <QuidProQuoContributionsInd>false</QuidProQuoContributionsInd>
      <Form8282PropertyDisposedOfInd>false</Form8282PropertyDisposedOfInd>
      <RcvFndsToPayPrsnlBnftCntrctInd>false</RcvFndsToPayPrsnlBnftCntrctInd>
      <PayPremiumsPrsnlBnftCntrctInd>false</PayPremiumsPrsnlBnftCntrctInd>
      <Form8899Filedind>false</Form8899Filedind>
      <Form1098CFiledInd>false</Form1098CFiledInd>
      <DAFExcessBusinessHoldingsInd>false</DAFExcessBusinessHoldingsInd>
      <TaxableDistributionsInd>false</TaxableDistributionsInd>
      <DistributionToDonorInd>false</DistributionToDonorInd>
      <IndoorTanningServicesInd>false</IndoorTanningServicesInd>
      <SubjToTaxRmnrtnExPrchtPymtInd>false</SubjToTaxRmnrtnExPrchtPymtInd>
      <SubjectToExcsTaxNetInvstIncInd>false</SubjectToExcsTaxNetInvstIncInd>
      <InfoInScheduleOPartVIInd>X</InfoInScheduleOPartVIInd>
      <GoverningBodyVotingMembersCnt>13</GoverningBodyVotingMembersCnt>
      <IndependentVotingMemberCnt>13</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>true</CompensationProcessOtherInd>
      <InvestmentInJointVentureInd>true</InvestmentInJointVentureInd>
      <WrittenPolicyOrProcedureInd>true</WrittenPolicyOrProcedureInd>
      <UponRequestInd>X</UponRequestInd>
      <BooksInCareOfDetail>
        <PersonNm>KATHY BENOIT</PersonNm>
        <PhoneNum>8022555562</PhoneNum>
        <USAddress>
          <AddressLine1Txt>44 MAIN STREET SUITE 200</AddressLine1Txt>
          <CityNm>RICHFORD</CityNm>
          <StateAbbreviationCd>VT</StateAbbreviationCd>
          <ZIPCd>05476</ZIPCd>
        </USAddress>
      </BooksInCareOfDetail>
      <Form990PartVIISectionAGrp>
        <PersonNm>DAN CARSWELL</PersonNm>
        <TitleTxt>PRESIDENT</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MICHEL CONSEJO</PersonNm>
        <TitleTxt>VICE PRESIDE</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>SANDRA KILBURN</PersonNm>
        <TitleTxt>SECRETARY</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>WENDY HOWARD</PersonNm>
        <TitleTxt>TREASURER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>LINDA COLLINS</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>LISE GATES</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MARIE LANGEVIN</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>VIRGINIA MESSIER</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>BRYANT REYNOLDS</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>WALLACE STEINHOUR</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>NAOMI WOLCOTT-MACCAUSLAND</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>PENNY WRIGHT</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ROBERT ZELAZO MD</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>PAMELA PARSONS</PersonNm>
        <TitleTxt>FORMER CEO</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>175123</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>23032</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>KATHY BENOIT</PersonNm>
        <TitleTxt>CEO</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>166584</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>7398</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DR AUDREY VON LEPEL</PersonNm>
        <TitleTxt>MEDICAL DIRE</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>236723</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>17209</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DR ERICK LAVALLEE</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>213158</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>11299</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DR ERNESTO CANTU</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>197232</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>30780</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DR THERESE RAY</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>200906</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>15232</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DR MEGHRAISINH ATODARIA</PersonNm>
        <TitleTxt>DENTIST</TitleTxt>
        <AverageHoursPerWeekRt>32.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>181923</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>30736</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DR MEHAK NARANG</PersonNm>
        <TitleTxt>DENTIST</TitleTxt>
        <AverageHoursPerWeekRt>32.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>184893</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>10401</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>1556542</TotalReportableCompFromOrgAmt>
      <TotalOtherCompensationAmt>146087</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>29</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>false</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>true</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>false</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>OPEN APPROACH</PersonNm>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO BOX 272</AddressLine1Txt>
            <CityNm>BRISTOL</CityNm>
            <StateAbbreviationCd>VT</StateAbbreviationCd>
            <ZIPCd>05443</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>IT SUPPORT</ServicesDesc>
        <CompensationAmt>558985</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>NORTHWESTERN COUNSELING SUPPORT</PersonNm>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>107 FISHER POND ROAD</AddressLine1Txt>
            <CityNm>SAINT ALBANS</CityNm>
            <StateAbbreviationCd>VT</StateAbbreviationCd>
            <ZIPCd>05478</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>MENTAL HEALTH</ServicesDesc>
        <CompensationAmt>165610</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>2</CntrctRcvdGreaterThan100KCnt>
      <GovernmentGrantsAmt>3859277</GovernmentGrantsAmt>
      <AllOtherContributionsAmt>889226</AllOtherContributionsAmt>
      <NoncashContributionsAmt>35548</NoncashContributionsAmt>
      <TotalContributionsAmt>4748503</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>PATIENT SERVICE REVENUE</Desc>
        <BusinessCd>621400</BusinessCd>
        <TotalRevenueColumnAmt>13529847</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>13529847</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>CONTRACT REVENUE</Desc>
        <BusinessCd>621400</BusinessCd>
        <TotalRevenueColumnAmt>1547805</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>1547805</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>BILLING AND MGMT. SERVICE</Desc>
        <BusinessCd>621400</BusinessCd>
        <TotalRevenueColumnAmt>199150</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>199150</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>COMMUNITY OUTREACH</Desc>
        <BusinessCd>621400</BusinessCd>
        <TotalRevenueColumnAmt>6400</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>6400</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>15283202</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>147777</TotalRevenueColumnAmt>
        <ExclusionAmt>147777</ExclusionAmt>
      </InvestmentIncomeGrp>
      <GrossRentsGrp>
        <RealAmt>52033</RealAmt>
      </GrossRentsGrp>
      <RentalIncomeOrLossGrp>
        <RealAmt>52033</RealAmt>
      </RentalIncomeOrLossGrp>
      <NetRentalIncomeOrLossGrp>
        <TotalRevenueColumnAmt>52033</TotalRevenueColumnAmt>
        <ExclusionAmt>52033</ExclusionAmt>
      </NetRentalIncomeOrLossGrp>
      <GrossAmountSalesAssetsGrp>
        <SecuritiesAmt>1326115</SecuritiesAmt>
      </GrossAmountSalesAssetsGrp>
      <LessCostOthBasisSalesExpnssGrp>
        <SecuritiesAmt>1417434</SecuritiesAmt>
      </LessCostOthBasisSalesExpnssGrp>
      <GainOrLossGrp>
        <SecuritiesAmt>-91319</SecuritiesAmt>
      </GainOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>-91319</TotalRevenueColumnAmt>
        <ExclusionAmt>-91319</ExclusionAmt>
      </NetGainOrLossInvestmentsGrp>
      <GrossSalesOfInventoryAmt>15511534</GrossSalesOfInventoryAmt>
      <CostOfGoodsSoldAmt>10522810</CostOfGoodsSoldAmt>
      <NetIncomeOrLossGrp>
        <TotalRevenueColumnAmt>4988724</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>4955931</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>32681</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>112</ExclusionAmt>
      </NetIncomeOrLossGrp>
      <OtherRevenueMiscGrp>
        <Desc>INVESTMENT IN LLC</Desc>
        <BusinessCd>621400</BusinessCd>
        <TotalRevenueColumnAmt>181315</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>181315</RelatedOrExemptFuncIncomeAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueTotalAmt>181315</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>25310235</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>20420448</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>32681</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>108603</ExclusionAmt>
      </TotalRevenueGrp>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>372137</TotalAmt>
        <ManagementAndGeneralAmt>372137</ManagementAndGeneralAmt>
      </CompCurrentOfcrDirectorsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>13062904</TotalAmt>
        <ProgramServicesAmt>11442135</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1620769</ManagementAndGeneralAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
        <TotalAmt>390418</TotalAmt>
        <ProgramServicesAmt>329842</ProgramServicesAmt>
        <ManagementAndGeneralAmt>60576</ManagementAndGeneralAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>1542791</TotalAmt>
        <ProgramServicesAmt>1189497</ProgramServicesAmt>
        <ManagementAndGeneralAmt>353294</ManagementAndGeneralAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>978796</TotalAmt>
        <ProgramServicesAmt>825531</ProgramServicesAmt>
        <ManagementAndGeneralAmt>153265</ManagementAndGeneralAmt>
      </PayrollTaxesGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>33033</TotalAmt>
        <ManagementAndGeneralAmt>33033</ManagementAndGeneralAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>34400</TotalAmt>
        <ManagementAndGeneralAmt>34400</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>123437</TotalAmt>
        <ProgramServicesAmt>82617</ProgramServicesAmt>
        <ManagementAndGeneralAmt>40820</ManagementAndGeneralAmt>
      </OfficeExpensesGrp>
      <InformationTechnologyGrp>
        <TotalAmt>196304</TotalAmt>
        <ProgramServicesAmt>161926</ProgramServicesAmt>
        <ManagementAndGeneralAmt>34378</ManagementAndGeneralAmt>
      </InformationTechnologyGrp>
      <OccupancyGrp>
        <TotalAmt>614468</TotalAmt>
        <ProgramServicesAmt>575573</ProgramServicesAmt>
        <ManagementAndGeneralAmt>38895</ManagementAndGeneralAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>19617</TotalAmt>
        <ProgramServicesAmt>9450</ProgramServicesAmt>
        <ManagementAndGeneralAmt>10167</ManagementAndGeneralAmt>
      </TravelGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>459714</TotalAmt>
        <ProgramServicesAmt>344266</ProgramServicesAmt>
        <ManagementAndGeneralAmt>115448</ManagementAndGeneralAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>97048</TotalAmt>
        <ProgramServicesAmt>54676</ProgramServicesAmt>
        <ManagementAndGeneralAmt>42372</ManagementAndGeneralAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>CONTRACT SERVICES 340B</Desc>
        <TotalAmt>908394</TotalAmt>
        <ProgramServicesAmt>908394</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>SUPPLIES</Desc>
        <TotalAmt>830740</TotalAmt>
        <ProgramServicesAmt>802470</ProgramServicesAmt>
        <ManagementAndGeneralAmt>28270</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>REPAIRS AND MAINTENANCE</Desc>
        <TotalAmt>635011</TotalAmt>
        <ProgramServicesAmt>427041</ProgramServicesAmt>
        <ManagementAndGeneralAmt>207970</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>OUTSIDE SERVICES</Desc>
        <TotalAmt>269152</TotalAmt>
        <ManagementAndGeneralAmt>269152</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>981425</TotalAmt>
        <ProgramServicesAmt>679487</ProgramServicesAmt>
        <ManagementAndGeneralAmt>301938</ManagementAndGeneralAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>21549789</TotalAmt>
        <ProgramServicesAmt>17832905</ProgramServicesAmt>
        <ManagementAndGeneralAmt>3716884</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>2025110</BOYAmt>
        <EOYAmt>3261909</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>990500</BOYAmt>
        <EOYAmt>1981349</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <PledgesAndGrantsReceivableGrp>
        <BOYAmt>43677</BOYAmt>
        <EOYAmt>584038</EOYAmt>
      </PledgesAndGrantsReceivableGrp>
      <AccountsReceivableGrp>
        <BOYAmt>2623723</BOYAmt>
        <EOYAmt>3459743</EOYAmt>
      </AccountsReceivableGrp>
      <OthNotesLoansReceivableNetGrp>
        <BOYAmt>55900</BOYAmt>
        <EOYAmt>52600</EOYAmt>
      </OthNotesLoansReceivableNetGrp>
      <InventoriesForSaleOrUseGrp>
        <BOYAmt>1355578</BOYAmt>
        <EOYAmt>1689037</EOYAmt>
      </InventoriesForSaleOrUseGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>181883</BOYAmt>
        <EOYAmt>147114</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>10670923</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>3991255</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>6725930</BOYAmt>
        <EOYAmt>6679668</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <InvestmentsPubTradedSecGrp>
        <BOYAmt>10057381</BOYAmt>
        <EOYAmt>9465458</EOYAmt>
      </InvestmentsPubTradedSecGrp>
      <InvestmentsOtherSecuritiesGrp>
        <BOYAmt>466393</BOYAmt>
      </InvestmentsOtherSecuritiesGrp>
      <IntangibleAssetsGrp>
        <BOYAmt>708252</BOYAmt>
        <EOYAmt>781596</EOYAmt>
      </IntangibleAssetsGrp>
      <OtherAssetsTotalGrp>
        <BOYAmt>30626</BOYAmt>
        <EOYAmt>1901611</EOYAmt>
      </OtherAssetsTotalGrp>
      <TotalAssetsGrp>
        <BOYAmt>25264953</BOYAmt>
        <EOYAmt>30004123</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>1259017</BOYAmt>
        <EOYAmt>1571706</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <DeferredRevenueGrp>
        <BOYAmt>6773</BOYAmt>
        <EOYAmt>12046</EOYAmt>
      </DeferredRevenueGrp>
      <MortgNotesPyblScrdInvstPropGrp>
        <BOYAmt>160000</BOYAmt>
        <EOYAmt>106666</EOYAmt>
      </MortgNotesPyblScrdInvstPropGrp>
      <OtherLiabilitiesGrp>
        <EOYAmt>1858384</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>1425790</BOYAmt>
        <EOYAmt>3548802</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>23757744</BOYAmt>
        <EOYAmt>26385321</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <DonorRestrictionNetAssetsGrp>
        <BOYAmt>81419</BOYAmt>
        <EOYAmt>70000</EOYAmt>
      </DonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>23839163</BOYAmt>
        <EOYAmt>26455321</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>25264953</BOYAmt>
        <EOYAmt>30004123</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>3760446</ReconcilationRevenueExpnssAmt>
      <NetUnrlzdGainsLossesInvstAmt>-1144288</NetUnrlzdGainsLossesInvstAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>false</AccountantCompileOrReviewInd>
      <FSAuditedInd>true</FSAuditedInd>
      <FSAuditedBasisGrp>
        <ConsolidatedBasisFinclStmtInd>X</ConsolidatedBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>true</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>true</FederalGrantAuditRequiredInd>
      <FederalGrantAuditPerformedInd>true</FederalGrantAuditPerformedInd>
    </IRS990>
    <IRS990ScheduleA documentId="RetDoc8">
      <PubliclySupportedOrg509a2Ind>X</PubliclySupportedOrg509a2Ind>
      <GiftsGrantsContrisRcvd509Grp>
        <CurrentTaxYearMinus4YearsAmt>2874190</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>3086077</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>5259438</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>3925625</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>4748503</CurrentTaxYearAmt>
        <TotalAmt>19893833</TotalAmt>
      </GiftsGrantsContrisRcvd509Grp>
      <GrossReceiptsAdmissionsGrp>
        <CurrentTaxYearMinus4YearsAmt>15052934</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>18188320</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>20241519</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>24330031</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>30795582</CurrentTaxYearAmt>
        <TotalAmt>108608386</TotalAmt>
      </GrossReceiptsAdmissionsGrp>
      <GrossReceiptsNonUnrltBusGrp>
        <CurrentTaxYearMinus4YearsAmt>36599</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>38304</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>30149</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>38724</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>35649</CurrentTaxYearAmt>
        <TotalAmt>179425</TotalAmt>
      </GrossReceiptsNonUnrltBusGrp>
      <Total509Grp>
        <CurrentTaxYearMinus4YearsAmt>17963723</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>21312701</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>25531106</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>28294380</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>35579734</CurrentTaxYearAmt>
        <TotalAmt>128681644</TotalAmt>
      </Total509Grp>
      <PublicSupportTotal509Amt>128681644</PublicSupportTotal509Amt>
      <GrossInvestmentIncome509Grp>
        <CurrentTaxYearMinus4YearsAmt>153682</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>210397</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>169821</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>172059</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>199810</CurrentTaxYearAmt>
        <TotalAmt>905769</TotalAmt>
      </GrossInvestmentIncome509Grp>
      <InvestmentIncomeAndUBTIGrp>
        <CurrentTaxYearMinus4YearsAmt>153682</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>210397</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>169821</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>172059</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>199810</CurrentTaxYearAmt>
        <TotalAmt>905769</TotalAmt>
      </InvestmentIncomeAndUBTIGrp>
      <TotalSupportCalendarYearGrp>
        <CurrentTaxYearMinus4YearsAmt>18117405</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>21523098</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>25700927</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>28466439</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>35779544</CurrentTaxYearAmt>
        <TotalAmt>129587413</TotalAmt>
      </TotalSupportCalendarYearGrp>
      <PublicSupportCY509Pct>0.99300</PublicSupportCY509Pct>
      <PublicSupportPY509Pct>0.99270</PublicSupportPY509Pct>
      <InvestmentIncomeCYPct>0.01000</InvestmentIncomeCYPct>
      <InvestmentIncomePYPct>0.01000</InvestmentIncomePYPct>
      <ThirtyThrPctSuprtTestsCY509Ind>X</ThirtyThrPctSuprtTestsCY509Ind>
    </IRS990ScheduleA>
    <IRS990ScheduleB documentId="RetDoc1">
      <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="RetDoc3">
      <LandGrp>
        <OtherCostOrOtherBasisAmt>329330</OtherCostOrOtherBasisAmt>
        <BookValueAmt>329330</BookValueAmt>
      </LandGrp>
      <BuildingsGrp>
        <OtherCostOrOtherBasisAmt>7288930</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>1676585</DepreciationAmt>
        <BookValueAmt>5612345</BookValueAmt>
      </BuildingsGrp>
      <LeaseholdImprovementsGrp>
        <OtherCostOrOtherBasisAmt>101151</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>101151</DepreciationAmt>
      </LeaseholdImprovementsGrp>
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>2907385</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>2213323</DepreciationAmt>
        <BookValueAmt>694062</BookValueAmt>
      </EquipmentGrp>
      <OtherLandBuildingsGrp>
        <OtherCostOrOtherBasisAmt>44127</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>196</DepreciationAmt>
        <BookValueAmt>43931</BookValueAmt>
      </OtherLandBuildingsGrp>
      <TotalBookValueLandBuildingsAmt>6679668</TotalBookValueLandBuildingsAmt>
      <OtherAssetsOrgGrp>
        <Desc>LEASE ROU ASSET</Desc>
        <BookValueAmt>1841909</BookValueAmt>
      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>MSMARKET AG STOCK</Desc>
        <BookValueAmt>55842</BookValueAmt>
      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>SECURITY DEPOSITS</Desc>
        <BookValueAmt>3860</BookValueAmt>
      </OtherAssetsOrgGrp>
      <TotalBookValueOtherAssetsAmt>1901611</TotalBookValueOtherAssetsAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>LEASE LIABILITIES</Desc>
        <Amt>1858384</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>1858384</TotalLiabilityAmt>
      <FootnoteTextInd>X</FootnoteTextInd>
      <TotalRevEtcAuditedFinclStmtAmt>24165947</TotalRevEtcAuditedFinclStmtAmt>
      <NetUnrealizedGainsInvstAmt>-1144288</NetUnrealizedGainsInvstAmt>
      <RevenueNotReportedAmt>-1144288</RevenueNotReportedAmt>
      <RevenueSubtotalAmt>25310235</RevenueSubtotalAmt>
      <TotalRevenuePerForm990Amt>25310235</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>21549789</TotExpnsEtcAuditedFinclStmtAmt>
      <ExpensesSubtotalAmt>21549789</ExpensesSubtotalAmt>
      <TotalExpensesPerForm990Amt>21549789</TotalExpensesPerForm990Amt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE D, PAGE 3, PART X</FormAndLineReferenceDesc>
        <ExplanationTxt>THE CENTER ANNUALLY FILES AN IRS FORM 990, RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX, TAX RETURN IN THE U.S. FEDERAL JURISDICTION. THE CENTER IS NO LONGER SUBJECT TO U.S. FEDERAL INCOME TAX EXAMINATION BY TAX AUTHORITIES FOR THE YEARS PRIOR TO 2019. IN THE NORMAL COURSE OF BUSINESS, THE CENTER IS SUBJECT TO EXAMINATION BY VARIOUS TAXING AUTHORITIES. ALTHOUGH THE OUTCOME OF TAX AUDITS IS ALWAYS UNCERTAIN, THE CENTER BELIEVES THAT THERE ARE NO SIGNIFICANT UNRECOGNIZED TAX LIABILITIES AT DECEMBER 31, 2022.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
    <IRS990ScheduleJ documentId="RetDoc4">
      <CompensationCommitteeInd>X</CompensationCommitteeInd>
      <Form990OfOtherOrganizationsInd>X</Form990OfOtherOrganizationsInd>
      <CompensationSurveyInd>X</CompensationSurveyInd>
      <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>PAMELA PARSONS</PersonNm>
        <TitleTxt>FORMER CEO</TitleTxt>
        <BaseCompensationFilingOrgAmt>175123</BaseCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>7071</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>15961</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>198155</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>KATHY BENOIT</PersonNm>
        <TitleTxt>CEO</TitleTxt>
        <BaseCompensationFilingOrgAmt>166584</BaseCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>6699</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>699</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>173982</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>DR AUDREY VON LEPEL</PersonNm>
        <TitleTxt>MEDICAL DIRECTOR</TitleTxt>
        <BaseCompensationFilingOrgAmt>236723</BaseCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>9501</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>7708</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>253932</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>DR ERICK LAVALLEE</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <BaseCompensationFilingOrgAmt>213158</BaseCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>8398</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>2901</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>224457</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>DR ERNESTO CANTU</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <BaseCompensationFilingOrgAmt>197232</BaseCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>8453</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>22327</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>228012</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>DR THERESE RAY</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <BaseCompensationFilingOrgAmt>200906</BaseCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>8222</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>7010</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>216138</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>DR MEGHRAISINH ATODARIA</PersonNm>
        <TitleTxt>DENTIST</TitleTxt>
        <BaseCompensationFilingOrgAmt>181923</BaseCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>7974</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>22762</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>212659</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>DR MEHAK NARANG</PersonNm>
        <TitleTxt>DENTIST</TitleTxt>
        <BaseCompensationFilingOrgAmt>184893</BaseCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>3975</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>6426</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>195294</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
    </IRS990ScheduleJ>
    <IRS990ScheduleM documentId="RetDoc5">
      <ClothingAndHouseholdGoodsGrp>
        <NonCashCheckboxInd>X</NonCashCheckboxInd>
        <NoncashContributionsRptF990Amt>35548</NoncashContributionsRptF990Amt>
        <MethodOfDeterminingRevenuesTxt>FMV</MethodOfDeterminingRevenuesTxt>
      </ClothingAndHouseholdGoodsGrp>
      <AnyPropertyThatMustBeHeldInd>false</AnyPropertyThatMustBeHeldInd>
      <ReviewProcessUnusualNCGiftsInd>false</ReviewProcessUnusualNCGiftsInd>
      <ThirdPartiesUsedInd>false</ThirdPartiesUsedInd>
    </IRS990ScheduleM>
    <IRS990ScheduleO documentId="RetDoc6">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 2, PART III, LINE 4A</FormAndLineReferenceDesc>
        <ExplanationTxt>NOTCH'S LARGEST PROGRAM SERVICES, AS MEASURED BY TOTAL EXPENSES INCURRED, ARE COMPREHENSIVE HEALTH SERVICES DELIVERED TO MORE THAN 17,700 PATIENTS OF ALL AGES. OUR FEDERALLY QUALIFIED HEALTH CENTER (FQHC) SERVES THE GENERAL POPULATION OF 15 TOWNS IN VERMONT'S FRANKLIN AND GRAND ISLE COUNTIES AT FACILITIES SITUATED IN ALBURGH, ENOSBURG, FAIRFAX, GEORGIA, RICHFORD, SWANTON, AND ST. ALBANS. NOTCH OFFERS PRIMARY MEDICAL, BEHAVIORAL, AND SUPPORT SERVICES AT ALL LOCATIONS AND DENTAL SERVICES IN RICHFORD AND SWANTON. MEDICATION ASSISTED TREATMENT (MAT) SERVICES ARE DELIVERED AT ALL NOTCH MEDICAL OFFICES EXCEPT ALBURG HEALTH CENTER. EITHER THROUGH DIRECT PROVISION OR ARRANGEMENT, NOTCH ENSURES ITS USERS ACCESS TO ALL SERVICES REQUIRED UNDER THE FEDERAL 330(E) PROGRAM, REGARDLESS OF ABILITY TO PAY. OUR HEALTH CARE TEAM WORKS FROM AN INTEGRATED HEALTH MODEL. NOTCH MEDICAL PROVIDERS WORK COLLABORATIVELY WITH BEHAVIORAL PROVIDERS TO DELIVER OPTIMUM CARE. INTEGRATED HEALTH SERVICES ARE DESIGNED TO MEET THE NEEDS OF THE ENTIRE FAMILY AND ADDRESS THE WHOLE PERSON. THESE SERVICES INCLUDE: PHYSICAL EXAMINATIONS, IMMUNIZATIONS, CHRONIC DISEASE MANAGEMENT, ACUTE CARE, LABORATORY SERVICES, CARE COORDINATION, REFERRALS, BIRTH CONTROL, DOT PHYSICALS, COUNSELING, GOAL SETTING TO IMPROVE PERSONAL HEALTH, SYMPTOMS MANAGEMENT OF ANXIETY AND DEPRESSION, IDENTIFICATION OF MENTAL HEALTH BARRIERS TO MEET HEALTH CARE GOALS, AND MAT SERVICES.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 2, PART III, LINE 4D</FormAndLineReferenceDesc>
        <ExplanationTxt>OTHER INCOME INCLUDING MANAGEMENT SERVICE FEES AND COMMUNITY BENEFIT PROGRAMS INCLUDING OPERATION OF GROCERY STORE FOR THE BENEFIT OF THE COMMUNITY AS NOTCH IS LOCATED IN A FOOD DESERT.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>NOTCH MAKES THE IRS FORM 990 AVAILABLE FOR ALL BOARD MEMBERS TO REVIEW PRIOR TO FILING VIA THE MONTHLY BOARD MEETING. AT THE REQUEST OF THE MEMBERS IT CAN ALSO BE SENT ELECTRONICALLY. BOARD MEMBERS HAVE AN OPPORTUNITY TO RESPOND WITH QUESTIONS PRIOR TO THE FINAL REPORT BEING FILED.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>ALL EMPLOYEES AND BOARD MEMEMBERS RECEIVE THE CONFLICT OF INTEREST POLICY ANNUALLY. EVERY RECIPIENT MUST SIGN OFF ON THIS POLICY, INDICATING THAT THEY RECEIVED AND ARE IN COMPLIANCE WITH THE POLICY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 15A</FormAndLineReferenceDesc>
        <ExplanationTxt>THERE IS A PERSONNEL COMMITTEE WHICH MEETS AT LEAST ANNUALLY TO APPROVE PROPOSED PAY SCALES. SEVERAL DIFFERENT SYSTEMS ARE USED TO MAKE SURE WAGES ARE REASONABLE AND COMPETITIVE. THEY INCLUDE: 1) VERMONT DEPARTMENT OF LABOR - THIS SOURCE LISTS JOBS BY DESCRIPTION WITH PAY RANGES BY REGION FOR THE ENTIRE STATE. 2) INDEED 3) LOCAL PREVAILING WAGES - UPON INTERVIEW ASKING WAGE OF CANDIDATES FOR THE POSITION. 4) 990 TAX RETURNS OF OTHER VERMONT FQHCS - THESE RETURNS REPORT WAGES OF HIGHLY COMPENSATED AND KEY EMPLOYEES. THESE ARE PUBLIC RECORD DOCUMENTS AND USUALLY ARE AVAILABLE TIMELY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 15B</FormAndLineReferenceDesc>
        <ExplanationTxt>SAME AS FOR CEO OR TOP MANAGEMENT OFFICIALS (EXCEPT EXECUTIVE DIRECTOR).</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>NOTCH MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST AND THROUGH THE GUIDESTAR WEBSITE.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="RetDoc7">
      <IdDisregardedEntitiesGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>MAIN STREET MILL LLC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>44 MAIN STREET SUITE 200</AddressLine1Txt>
          <CityNm>RICHFORD</CityNm>
          <StateAbbreviationCd>VT</StateAbbreviationCd>
          <ZIPCd>05476</ZIPCd>
        </USAddress>
        <EIN>205388758</EIN>
        <PrimaryActivitiesTxt>RENTAL</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>VT</LegalDomicileStateCd>
        <TotalIncomeAmt>45833</TotalIncomeAmt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>NOTCH</BusinessNameLine1Txt>
        </DirectControllingEntityName>
      </IdDisregardedEntitiesGrp>
      <IdRelatedOrgTxblPartnershipGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>PHARMACY NETWORK LLC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>44 MAIN STREET SUITE 200</AddressLine1Txt>
          <CityNm>RICHFORD</CityNm>
          <StateAbbreviationCd>VT</StateAbbreviationCd>
          <ZIPCd>05476</ZIPCd>
        </USAddress>
        <EIN>263002077</EIN>
        <PrimaryActivitiesTxt>MERCHANT</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>VT</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <PredominantIncomeTypeTxt>RELATED</PredominantIncomeTypeTxt>
        <ShareOfTotalIncomeAmt>5376</ShareOfTotalIncomeAmt>
        <ShareOfEOYAssetsAmt>625605</ShareOfEOYAssetsAmt>
        <DisproportionateAllocationsInd>false</DisproportionateAllocationsInd>
        <GeneralOrManagingPartnerInd>false</GeneralOrManagingPartnerInd>
      </IdRelatedOrgTxblPartnershipGrp>
      <IdRelatedOrgTxblPartnershipGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>GEIGER'S GROCERY LLC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>123 ST PAUL STREET</AddressLine1Txt>
          <CityNm>BURLINGTON</CityNm>
          <StateAbbreviationCd>VT</StateAbbreviationCd>
          <ZIPCd>05401</ZIPCd>
        </USAddress>
        <EIN>320391900</EIN>
        <PrimaryActivitiesTxt>RENTAL</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>VT</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <PredominantIncomeTypeTxt>EXCLUDED</PredominantIncomeTypeTxt>
        <ShareOfEOYAssetsAmt>61887</ShareOfEOYAssetsAmt>
        <DisproportionateAllocationsInd>false</DisproportionateAllocationsInd>
        <GeneralOrManagingPartnerInd>false</GeneralOrManagingPartnerInd>
      </IdRelatedOrgTxblPartnershipGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>false</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>true</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>false</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>false</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>false</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>true</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>false</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>false</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>false</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>false</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>false</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>false</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>false</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>false</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>false</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>false</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>false</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>false</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>true</TransferFromOtherOrgInd>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>GEIGER'S GROCERY LLC</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>S</TransactionTypeTxt>
        <InvolvedAmt>3300</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>FAIR VALUE</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>PHARMACY NETWORK LLC</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>B</TransactionTypeTxt>
        <InvolvedAmt>6000</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>FAIR VALUE</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>PHARMACY NETWORK LLC</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>F</TransactionTypeTxt>
        <InvolvedAmt>204209</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>FAIR VALUE</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
    </IRS990ScheduleR>
  </ReturnData>
</Return>
