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        <Desc>THE ASSOCIATION USES WEB AND NON-WEB-BASED RECRUITMENT TOOLS TO ASSIST WITH FILLING HEALTH CENTER STAFFING VACANCIES. VISITING UNIVERSITIES TO TALK ABOUT FQHCS AND PARTICIPATE IN JOB FAIRS. ASSISTING HEALTH CENTERS IN DEVELOPING SYSTEM-WIDE RECRUITMENT PLANS. WORKING WITH CLINICAL AND NON-CLINICAL STAFF TO DEVELOP A CHC ORIENTATION PACKAGE. PARTNERING WITH AHEC AND OTHERS TO PROVIDE PERTINENT TRAINING SESSIONS. COMPILE AND DISTRIBUTE RETENTION BEST PRACTICES. ASSIST WITH DEVELOPING SUCCESSION PLANS AND AN EXIT INTERVIEW PROCESS. DIRECT AND/OR CO-COORDINATE THE DEVELOPMENT OF TRAINING PROGRAMS AND CONFERENCES FOR MEMBER HEALTH CENTERS BY WORKING WITH THE OFFICE MANAGER AND OACHC PROGRAM STAFF. COORDINATE AND SUPPORT DEVELOPMENT OF TOPICS AND CURRICULUM FOR TRAINING SESSIONS, SEMINARS AND CONFERENCES. COLLABORATE WITH PRIMARY CARE ASSOCIATIONS IN OTHER STATES TO DEVELOP AND IMPLEMENT REGIONAL AND/OR NATIONAL TRAINING SESSIONS/SEMINARS AS NECESSARY. DEVELOP AND IMPLEMENT A CURRICULUM FOR HEALTH CENTER BOARDS TO PURSUE LEARNING AND CONTINUING EDUCATION INCLUDING IMPLEMENTATION OF HEALTH CENTER BOARD CERTIFICATE PROGRAM (GOVERNANCE LEARNING INSTITUTE. DEVELOP GOVERNANCE-RELATED TRAINING SESSIONS AND TRACKS AT THE OACHC ANNUAL CONFERENCE. CREATE AND OFFER WORKSHOPS AS NEEDED FOR INDIVIDUAL HEALTH CENTER BOARDS REGARDING GENERAL ROLES AND RESPONSIBILITIES, ELEMENTS OF AN FQHC, HEALTH CARE AND NON-PROFIT TRENDS, ETC. PROVIDE INFORMATION AND RESOURCES TO BOARD MEMBERS AND CEOS/EDS REGARDING HOW TO IMPROVE GOVERNANCE, CONTEMPORARY IDEAS FOR HEALTH CENTER/NON-PROFIT BOARDS, ETC</Desc>
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        <Desc>THE ASSOCIATION COORDINATES THE EARLY CHILDHOOD ORAL HEALTH (ECOH) PROGRAM, WHICH IS A QUALITY IMPROVEMENT INITIATIVE FOCUSED ON FQHC AND FQHCLA NETWORKS WITH SITES LOCATED WITHIN THE ANTHEM FOUNDATION OF OHIO'S (AFO) 36 COUNTY SERVICE AREA. THE GOALS OF THE PROGRAM INCLUDE: THE ESTABLISHMENT OF DENTAL HOMES AND REGULAR DENTAL CARE FOR CHILDREN BY 1 YEAR OF AGE, THE ESTABLISHMENT OF ORAL HEALTH SCREENINGS, CARIES RISK ASSESSMENTS, FLUORIDE VARNISH APPLICATIONS AND CAREGIVER/GUARDIAN EDUCATION/ANTICIPATORY GUIDANCE AS COMPONENTS OF THE EXPECTED STANDARD OF CARE PROVIDED DURING ROUTINE WELL-CHILD AND MINOR ILLNESS PRIMARY CARE VISITS WITHIN PARTICIPATING COMMUNITY HEALTH CENTERS. THE INTENT IS TO SPREAD THE INITIATIVE TO ALL OHIO HEALTH CENTERS, TO INCREASE IN THE NUMBER OF GENERAL DENTISTS PROVIDING CARE TO PEDIATRIC PATIENTS, AND A SIGNIFICANT REDUCTION IN THE INCIDENCE OF ORAL HEALTH PROBLEMS AMONG CHILDREN UNDER 36 MONTHS OF AGE OVER THE COURSE OF THE INITIATIVE.</Desc>
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        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JARED POLLICK</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JAMIE BERRENS</PersonNm>
        <TitleTxt>TREASURER</TitleTxt>
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        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>STEPHANIE WIERSMA</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>STEPHEN ROLLER</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JENNIFER BOWERS</PersonNm>
        <TitleTxt>DIRECTOR OF FINANCE</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>135035</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>RANDALL RUNYON</PersonNm>
        <TitleTxt>PRESIDENT/CEO</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>189455</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>324490</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>0</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>0</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>2</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>0</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>1</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>0</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>AZARA HEALTHCARE</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>70 BLANCHARD RD STE 401</AddressLine1Txt>
            <CityNm>BURLINGTON</CityNm>
            <StateAbbreviationCd>MA</StateAbbreviationCd>
            <ZIPCd>01803</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>MANAGEMENT SOFTWARE</ServicesDesc>
        <CompensationAmt>1128988</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>1</CntrctRcvdGreaterThan100KCnt>
      <GovernmentGrantsAmt>5449059</GovernmentGrantsAmt>
      <TotalContributionsAmt>5449059</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>CONTRACT INCOME</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>4280024</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>4280024</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>MEMBERSHIP DUES</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>608003</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>608003</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>CONFERENCE &amp; WORKSHOP</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>510948</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>510948</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>5398975</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>2917</TotalRevenueColumnAmt>
        <ExclusionAmt>2917</ExclusionAmt>
      </InvestmentIncomeGrp>
      <GrossRentsGrp>
        <RealAmt>24000</RealAmt>
      </GrossRentsGrp>
      <LessRentalExpensesGrp>
        <RealAmt>0</RealAmt>
      </LessRentalExpensesGrp>
      <RentalIncomeOrLossGrp>
        <RealAmt>24000</RealAmt>
      </RentalIncomeOrLossGrp>
      <NetRentalIncomeOrLossGrp>
        <TotalRevenueColumnAmt>24000</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>24000</RelatedOrExemptFuncIncomeAmt>
      </NetRentalIncomeOrLossGrp>
      <OtherRevenueMiscGrp>
        <Desc>MISCELLANEOUS</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>2447</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>2447</RelatedOrExemptFuncIncomeAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueTotalAmt>2447</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>10877398</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>5425422</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>2917</ExclusionAmt>
      </TotalRevenueGrp>
      <InfoInScheduleOPartIXInd>X</InfoInScheduleOPartIXInd>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>635671</TotalAmt>
        <ProgramServicesAmt>429509</ProgramServicesAmt>
        <ManagementAndGeneralAmt>201134</ManagementAndGeneralAmt>
        <FundraisingAmt>5028</FundraisingAmt>
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      <OtherSalariesAndWagesGrp>
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        <ProgramServicesAmt>1311868</ProgramServicesAmt>
        <ManagementAndGeneralAmt>614334</ManagementAndGeneralAmt>
        <FundraisingAmt>15358</FundraisingAmt>
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      <PensionPlanContributionsGrp>
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        <ProgramServicesAmt>92975</ProgramServicesAmt>
        <ManagementAndGeneralAmt>42985</ManagementAndGeneralAmt>
        <FundraisingAmt>1075</FundraisingAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>398273</TotalAmt>
        <ProgramServicesAmt>270220</ProgramServicesAmt>
        <ManagementAndGeneralAmt>124930</ManagementAndGeneralAmt>
        <FundraisingAmt>3123</FundraisingAmt>
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      <PayrollTaxesGrp>
        <TotalAmt>195119</TotalAmt>
        <ProgramServicesAmt>132385</ProgramServicesAmt>
        <ManagementAndGeneralAmt>61204</ManagementAndGeneralAmt>
        <FundraisingAmt>1530</FundraisingAmt>
      </PayrollTaxesGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>19193</TotalAmt>
        <ManagementAndGeneralAmt>19193</ManagementAndGeneralAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>24195</TotalAmt>
        <ProgramServicesAmt>22532</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1663</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesLobbyingGrp>
        <TotalAmt>59793</TotalAmt>
        <ManagementAndGeneralAmt>59793</ManagementAndGeneralAmt>
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      <FeesForServicesOtherGrp>
        <TotalAmt>5997326</TotalAmt>
        <ProgramServicesAmt>5507134</ProgramServicesAmt>
        <ManagementAndGeneralAmt>490192</ManagementAndGeneralAmt>
      </FeesForServicesOtherGrp>
      <AdvertisingGrp>
        <TotalAmt>16699</TotalAmt>
        <ProgramServicesAmt>15657</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1042</ManagementAndGeneralAmt>
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      <OfficeExpensesGrp>
        <TotalAmt>186916</TotalAmt>
        <ProgramServicesAmt>144629</ProgramServicesAmt>
        <ManagementAndGeneralAmt>42287</ManagementAndGeneralAmt>
      </OfficeExpensesGrp>
      <OccupancyGrp>
        <TotalAmt>142358</TotalAmt>
        <ProgramServicesAmt>62391</ProgramServicesAmt>
        <ManagementAndGeneralAmt>79967</ManagementAndGeneralAmt>
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      <TravelGrp>
        <TotalAmt>82349</TotalAmt>
        <ProgramServicesAmt>47937</ProgramServicesAmt>
        <ManagementAndGeneralAmt>34412</ManagementAndGeneralAmt>
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      <ConferencesMeetingsGrp>
        <TotalAmt>266612</TotalAmt>
        <ProgramServicesAmt>65195</ProgramServicesAmt>
        <ManagementAndGeneralAmt>201417</ManagementAndGeneralAmt>
      </ConferencesMeetingsGrp>
      <InterestGrp>
        <TotalAmt>23246</TotalAmt>
        <ManagementAndGeneralAmt>23246</ManagementAndGeneralAmt>
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      <DepreciationDepletionGrp>
        <TotalAmt>33814</TotalAmt>
        <ProgramServicesAmt>16907</ProgramServicesAmt>
        <ManagementAndGeneralAmt>16907</ManagementAndGeneralAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>10317</TotalAmt>
        <ManagementAndGeneralAmt>10317</ManagementAndGeneralAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>DUES &amp; CONFERENCES</Desc>
        <TotalAmt>78798</TotalAmt>
        <ProgramServicesAmt>53570</ProgramServicesAmt>
        <ManagementAndGeneralAmt>25228</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>MISC</Desc>
        <TotalAmt>30420</TotalAmt>
        <ProgramServicesAmt>8937</ProgramServicesAmt>
        <ManagementAndGeneralAmt>21483</ManagementAndGeneralAmt>
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      <TotalFunctionalExpensesGrp>
        <TotalAmt>10279694</TotalAmt>
        <ProgramServicesAmt>8181846</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2071734</ManagementAndGeneralAmt>
        <FundraisingAmt>26114</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>2210857</BOYAmt>
        <EOYAmt>1979030</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>1256963</BOYAmt>
        <EOYAmt>1259819</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <PledgesAndGrantsReceivableGrp>
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        <EOYAmt>1508543</EOYAmt>
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      <AccountsReceivableGrp>
        <BOYAmt>1760907</BOYAmt>
        <EOYAmt>2508652</EOYAmt>
      </AccountsReceivableGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>9127</BOYAmt>
        <EOYAmt>9193</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>1109660</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>277704</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
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        <EOYAmt>831956</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <TotalAssetsGrp>
        <BOYAmt>7246987</BOYAmt>
        <EOYAmt>8097193</EOYAmt>
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      <AccountsPayableAccrExpnssGrp>
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        <EOYAmt>2429053</EOYAmt>
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      <DeferredRevenueGrp>
        <BOYAmt>1462415</BOYAmt>
        <EOYAmt>1698544</EOYAmt>
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      <MortgNotesPyblScrdInvstPropGrp>
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        <EOYAmt>495242</EOYAmt>
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      <TotalLiabilitiesGrp>
        <BOYAmt>4370337</BOYAmt>
        <EOYAmt>4622839</EOYAmt>
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      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>2876650</BOYAmt>
        <EOYAmt>3474354</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>2876650</BOYAmt>
        <EOYAmt>3474354</EOYAmt>
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      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>7246987</BOYAmt>
        <EOYAmt>8097193</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>597704</ReconcilationRevenueExpnssAmt>
      <OtherChangesInNetAssetsAmt>0</OtherChangesInNetAssetsAmt>
      <InfoInScheduleOPartXIIInd>X</InfoInScheduleOPartXIIInd>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>0</AccountantCompileOrReviewInd>
      <FSAuditedInd>1</FSAuditedInd>
      <FSAuditedBasisGrp>
        <ConsolidatedBasisFinclStmtInd>X</ConsolidatedBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>1</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>1</FederalGrantAuditRequiredInd>
      <FederalGrantAuditPerformedInd>1</FederalGrantAuditPerformedInd>
    </IRS990>
    <IRS990ScheduleA documentId="RetDoc1039100001">
      <PubliclySupportedOrg509a2Ind>X</PubliclySupportedOrg509a2Ind>
      <GiftsGrantsContrisRcvd509Grp>
        <CurrentTaxYearMinus4YearsAmt>4867206</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>4840764</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>4220370</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>5120825</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>5449059</CurrentTaxYearAmt>
        <TotalAmt>24498224</TotalAmt>
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      <GrossReceiptsAdmissionsGrp>
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        <CurrentTaxYearMinus3YearsAmt>2207791</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>2400574</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>3063562</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>5398975</CurrentTaxYearAmt>
        <TotalAmt>15158912</TotalAmt>
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      <Total509Grp>
        <CurrentTaxYearMinus4YearsAmt>6955216</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>7048555</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>6620944</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>8184387</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>10848034</CurrentTaxYearAmt>
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      <AmountsRcvdDsqlfyPersonGrp>
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      </AmountsRcvdDsqlfyPersonGrp>
      <SubstantialContributorsAmtGrp>
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      </SubstantialContributorsAmtGrp>
      <SubstAndDsqlfyPrsnsTotGrp>
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      <PublicSupportTotal509Amt>39657136</PublicSupportTotal509Amt>
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        <CurrentTaxYearMinus1YearAmt>611</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>2917</CurrentTaxYearAmt>
        <TotalAmt>4160</TotalAmt>
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      <InvestmentIncomeAndUBTIGrp>
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        <CurrentTaxYearMinus2YearsAmt>390</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>611</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>2917</CurrentTaxYearAmt>
        <TotalAmt>4160</TotalAmt>
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        <CurrentTaxYearMinus3YearsAmt>30115</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>146950</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>50947</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>26447</CurrentTaxYearAmt>
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      <TotalSupportCalendarYearGrp>
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        <CurrentTaxYearMinus2YearsAmt>6768284</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>8235945</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>10877398</CurrentTaxYearAmt>
        <TotalAmt>39983161</TotalAmt>
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      <PublicSupportCY509Pct>0.99180</PublicSupportCY509Pct>
      <PublicSupportPY509Pct>0.99120</PublicSupportPY509Pct>
      <InvestmentIncomeCYPct>0.00010</InvestmentIncomeCYPct>
      <ThirtyThrPctSuprtTestsCY509Ind>X</ThirtyThrPctSuprtTestsCY509Ind>
    </IRS990ScheduleA>
    <IRS990ScheduleB documentId="RetDoc1234500001">
      <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>
    <IRS990ScheduleC documentId="RetDoc1039600001">
      <TotalGrassrootsLobbyingGrp>
        <FilingOrganizationsTotalAmt>34593</FilingOrganizationsTotalAmt>
      </TotalGrassrootsLobbyingGrp>
      <TotalDirectLobbyingGrp>
        <FilingOrganizationsTotalAmt>171970</FilingOrganizationsTotalAmt>
      </TotalDirectLobbyingGrp>
      <TotalLobbyingExpendGrp>
        <FilingOrganizationsTotalAmt>206563</FilingOrganizationsTotalAmt>
      </TotalLobbyingExpendGrp>
      <OtherExemptPurposeExpendGrp>
        <FilingOrganizationsTotalAmt>10073131</FilingOrganizationsTotalAmt>
      </OtherExemptPurposeExpendGrp>
      <TotalExemptPurposeExpendGrp>
        <FilingOrganizationsTotalAmt>10279694</FilingOrganizationsTotalAmt>
      </TotalExemptPurposeExpendGrp>
      <LobbyingNontaxableAmountGrp>
        <FilingOrganizationsTotalAmt>663985</FilingOrganizationsTotalAmt>
      </LobbyingNontaxableAmountGrp>
      <GrassrootsNontaxableGrp>
        <FilingOrganizationsTotalAmt>165996</FilingOrganizationsTotalAmt>
      </GrassrootsNontaxableGrp>
      <TotLbbyngGrassrootMnsNonTxGrp>
        <FilingOrganizationsTotalAmt>0</FilingOrganizationsTotalAmt>
      </TotLbbyngGrassrootMnsNonTxGrp>
      <TotLbbyExpendMnsLbbyngNonTxGrp>
        <FilingOrganizationsTotalAmt>0</FilingOrganizationsTotalAmt>
      </TotLbbyExpendMnsLbbyngNonTxGrp>
      <AvgLobbyingNontaxableAmountGrp>
        <CurrentYearMinus3Amt>497625</CurrentYearMinus3Amt>
        <CurrentYearMinus2Amt>467837</CurrentYearMinus2Amt>
        <CurrentYearMinus1Amt>541074</CurrentYearMinus1Amt>
        <CurrentYearAmt>663985</CurrentYearAmt>
        <TotalAmt>2170521</TotalAmt>
      </AvgLobbyingNontaxableAmountGrp>
      <LobbyingCeilingAmt>3255782</LobbyingCeilingAmt>
      <AvgTotalLobbyingExpendGrp>
        <CurrentYearMinus3Amt>108563</CurrentYearMinus3Amt>
        <CurrentYearMinus2Amt>204735</CurrentYearMinus2Amt>
        <CurrentYearMinus1Amt>227818</CurrentYearMinus1Amt>
        <CurrentYearAmt>206563</CurrentYearAmt>
        <TotalAmt>747679</TotalAmt>
      </AvgTotalLobbyingExpendGrp>
      <AvgGrassrootsNontaxableGrp>
        <CurrentYearMinus3Amt>124406</CurrentYearMinus3Amt>
        <CurrentYearMinus2Amt>116959</CurrentYearMinus2Amt>
        <CurrentYearMinus1Amt>135269</CurrentYearMinus1Amt>
        <CurrentYearAmt>165996</CurrentYearAmt>
        <TotalAmt>542630</TotalAmt>
      </AvgGrassrootsNontaxableGrp>
      <GrassrootsCeilingAmt>813945</GrassrootsCeilingAmt>
      <AvgGrassrootsLobbyingExpendGrp>
        <CurrentYearMinus3Amt>43425</CurrentYearMinus3Amt>
        <CurrentYearMinus2Amt>84610</CurrentYearMinus2Amt>
        <CurrentYearMinus1Amt>41904</CurrentYearMinus1Amt>
        <CurrentYearAmt>34593</CurrentYearAmt>
        <TotalAmt>204532</TotalAmt>
      </AvgGrassrootsLobbyingExpendGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I-A, LINE 1:</FormAndLineReferenceDesc>
        <ExplanationTxt>FUNDS SPENT ON GRASSROOTS LOBBYING TO INFLUENCE PUBLIC OPINION REGARDING HEALTH CARE RELATED ISSUES. FUNDS SPENT ON INFLUENCING LEGISLATIVE BODIES THROUGH DIRECT LOBBYING ON HEALTH CARE RELATED ISSUES.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleC>
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        <FormAndLineReferenceDesc>PART X, LINE 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>GENERALLY ACCEPTED ACCOUNTING PRINCIPLES REQUIRE THE ASSOCIATION TO EVALUATE THE LEVEL OF UNCERTAINTY RELATED TO WHETHER TAX POSITIONS TAKEN WILL BE SUSTAINED UPON EXAMINATION. ANY POSITIONS TAKEN THAT DO NOT MEET THE MORE-LIKELY-THAN-NOT THRESHOLD MUST BE QUANTIFIED AND RECORDED AS A LIABILITY FOR UNRECOGNIZED TAX BENEFITS IN THE ACCOMPANYING BALANCE SHEET ALONG WITH ANY ASSOCIATED INTEREST AND PENALTIES THAT WOULD BE PAYABLE TO THE TAXING AUTHORITY UPON EXAMINATION. MANAGEMENT BELIEVES THAT NONE OF THE TAX POSITIONS TAKEN WOULD MATERIALLY IMPACT THE FINANCIAL STATEMENTS AND NO SUCH LIABILITIES HAVE BEEN RECORDED.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART I, LINE 1,BRIEF DESCRIPTION OF THE ORGANIZATION'S MISSION:</FormAndLineReferenceDesc>
        <ExplanationTxt>TO ENSURE ACCESS TO HIGH-QUALITY AFFORDABLE HEALTH CARE FOR ALL OHIOANS THROUGH THE GROWTH AND DEVELOPMENT OF OHIO'S COMMUNITY HEALTH CENTERS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART III, LINE 4, ORGANIZATION'S MISSION:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE OHIO ASSOCIATION OF COMMUNITY HEALTH CENTERS (OACHC) IS A NOT-FOR-PROFIT PROFESSIONAL TRADE ASSOCIATION REPRESENTING OHIO'S FEDERALLY QUALIFIED HEALTH CENTERS (FQHCS, OR COMMUNITY HEALTH CENTERS). OACHC'S MISSION IS TO ENSURE ACCESS TO HIGH-QUALITY AFFORDABLE HEALTH CARE FOR ALL OHIOANS THROUGH THE GROWTH AND DEVELOPMENT OF OHIO'S COMMUNITY HEALTH CENTERS. OACHC REPRESENTS OHIO'S 39 COMMUNITY HEALTH CENTERS AT OVER 170 LOCATIONS, INCLUDING 3 MOBILE UNITS IN 46 OF OHIO'S 88 COUNTIES. IN 2022, COMMUNITY HEALTH CENTERS PROVIDED CARE TO OVER 900,000 OHIOANS AND RECORDED WELL OVER 1,800,000 PATIENT VISITS. COLLECTIVELY, COMMUNITY HEALTH CENTERS ARE THE LARGEST HEALTH CARE SYSTEM IN THE NATION, AND ARE CONSIDERED THE BEST PROGRAM WITH THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES (WWW.EXPECTMORE.GOV)</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART III, LINE 4A, PROGRAM SERVICE ACCOMPLISHMENTS:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ASSOCIATION PROVIDES SERVICES TO EXISTING AND POTENTIAL HEALTH CENTERS INCLUDING; TECHNICAL ASSISTANCE TO SUPPORT THE ESTABLISHMENT OF NEW FEDERALLY QUALIFIED HEALTH CENTERS AND LOOK-ALIKES AND TECHNICAL ASSISTANCE AND SUPPORT FOR THE EXPANSION OF EXISTING FEDERALLY QUALIFIED HEALTH CENTERS. THE ASSOCIATION UPDATES THE STATEWIDE STRATEGIC PLAN, THE MANAGED GROWTH AND IMPLEMENTATION PLAN, AND OTHER STATE AND FEDERAL REPORTS, AS REQUIRED. THE ASSOCIATION EDUCATES AND ADVOCATES FOR LEGISLATION AND POLICY THAT AFFECTS COMMUNITY HEALTH CENTERS AND THEIR MISSION INCLUDING; COORDINATING A STATE-LEVEL LEGISLATIVE FORUM ON AN ANNUAL BASIS, DEVELOP AND STRENGTHEN THE ASSOCIATION'S GRASSROOTS ADVOCACY NETWORK, DEVELOP AND DISSEMINATE MATERIALS IN AN EFFORT TO ADVANCE THE ASSOCIATION'S LEGISLATIVE AGENDA, REVIEW AND RESEARCH PUBLIC POLICY ISSUES AT THE STATE LEVEL TO PREDICT THE POTENTIAL IMPACT ON OHIO'S FQHCS AND RECOMMEND A COURSE OF ACTION TO THE OACHC BOARD AS APPROPRIATE, SERVE AS A GENERAL POLICY COMMUNICATIONS LIAISON TO ASSOCIATION ADVOCACY CONTRACTORS, THE STATE LEGISLATURE AND OTHER STATE AND LOCAL AGENCIES, COORDINATE VISITS WITH HEALTH CENTER STAFF AND STATE LEGISLATORS, AND PARTICIPATING IN STATE LEVEL COALITIONS AS NECESSARY TO ACCOMPLISH ASSOCIATION OBJECTIVES. THE ASSOCIATION IS RESPONSIBLE FOR FACILITATING INCREASED OPPORTUNITIES FOR CLINICIAN NETWORKING, TRAINING AND INVOLVEMENT IN POLICY DEVELOPMENT; ADVOCATING FOR QUALITY HEALTH CARE FOR ALL OHIOANS; AND, ALL DESIGNATED ACTIVITIES IN SUPPORT OF THE PHS GRANT OBJECTIVES INCLUDING; COORDINATING DEVELOPMENT OF TRAINING AND T/A RESOURCES TO SUPPORT CHC CLINICAL DEVELOPMENT OBJECTIVES, RESEARCH AND INFORM CLINICIANS OF TRAINING OPPORTUNITIES, CONDUCTING ONGOING ASSESSMENTS OF T/A NEEDS AND RESPOND TO MEMBER NEEDS, AND ASSISTING HEALTH CENTERS WITH MEETING PCER AND JCAHO REQUIREMENTS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART III, LINE 4B, PROGRAM SERVICE ACCOMPLISHMENTS:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ASSOCIATION USES WEB AND NON-WEB-BASED RECRUITMENT TOOLS TO ASSIST WITH FILLING HEALTH CENTER STAFFING VACANCIES. VISITING UNIVERSITIES TO TALK ABOUT FQHCS AND PARTICIPATE IN JOB FAIRS. ASSISTING HEALTH CENTERS IN DEVELOPING SYSTEM-WIDE RECRUITMENT PLANS. WORKING WITH CLINICAL AND NON-CLINICAL STAFF TO DEVELOP A CHC ORIENTATION PACKAGE. PARTNERING WITH AHEC AND OTHERS TO PROVIDE PERTINENT TRAINING SESSIONS. COMPILE AND DISTRIBUTE RETENTION BEST PRACTICES. ASSIST WITH DEVELOPING SUCCESSION PLANS AND AN EXIT INTERVIEW PROCESS. DIRECT AND/OR CO-COORDINATE THE DEVELOPMENT OF TRAINING PROGRAMS AND CONFERENCES FOR MEMBER HEALTH CENTERS BY WORKING WITH THE OFFICE MANAGER AND OACHC PROGRAM STAFF. COORDINATE AND SUPPORT DEVELOPMENT OF TOPICS AND CURRICULUM FOR TRAINING SESSIONS, SEMINARS AND CONFERENCES. COLLABORATE WITH PRIMARY CARE ASSOCIATIONS IN OTHER STATES TO DEVELOP AND IMPLEMENT REGIONAL AND/OR NATIONAL TRAINING SESSIONS/SEMINARS AS NECESSARY. DEVELOP AND IMPLEMENT A CURRICULUM FOR HEALTH CENTER BOARDS TO PURSUE LEARNING AND CONTINUING EDUCATION INCLUDING IMPLEMENTATION OF HEALTH CENTER BOARD CERTIFICATE PROGRAM (GOVERNANCE LEARNING INSTITUTE. DEVELOP GOVERNANCE-RELATED TRAINING SESSIONS AND TRACKS AT THE OACHC ANNUAL CONFERENCE. CREATE AND OFFER WORKSHOPS AS NEEDED FOR INDIVIDUAL HEALTH CENTER BOARDS REGARDING GENERAL ROLES AND RESPONSIBILITIES, ELEMENTS OF AN FQHC, HEALTH CARE AND NON-PROFIT TRENDS, ETC. PROVIDE INFORMATION AND RESOURCES TO BOARD MEMBERS AND CEOS/EDS REGARDING HOW TO IMPROVE GOVERNANCE, CONTEMPORARY IDEAS FOR HEALTH CENTER/NON-PROFIT BOARDS, ETC</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART III, LINE 4C, PROGRAM SERVICE ACCOMPLISHMENTS:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ASSOCIATION COORDINATES THE EARLY CHILDHOOD ORAL HEALTH (ECOH) PROGRAM, WHICH IS A QUALITY IMPROVEMENT INITIATIVE FOCUSED ON FQHC AND FQHCLA NETWORKS WITH SITES LOCATED WITHIN THE ANTHEM FOUNDATION OF OHIO'S (AFO) 36 COUNTY SERVICE AREA. THE GOALS OF THE PROGRAM INCLUDE: THE ESTABLISHMENT OF DENTAL HOMES AND REGULAR DENTAL CARE FOR CHILDREN BY 1 YEAR OF AGE, THE ESTABLISHMENT OF ORAL HEALTH SCREENINGS, CARIES RISK ASSESSMENTS, FLUORIDE VARNISH APPLICATIONS AND CAREGIVER/GUARDIAN EDUCATION/ANTICIPATORY GUIDANCE AS COMPONENTS OF THE EXPECTED STANDARD OF CARE PROVIDED DURING ROUTINE WELL-CHILD AND MINOR ILLNESS PRIMARY CARE VISITS WITHIN PARTICIPATING COMMUNITY HEALTH CENTERS. THE INTENT IS TO SPREAD THE INITIATIVE TO ALL OHIO HEALTH CENTERS, TO INCREASE IN THE NUMBER OF GENERAL DENTISTS PROVIDING CARE TO PEDIATRIC PATIENTS, AND A SIGNIFICANT REDUCTION IN THE INCIDENCE OF ORAL HEALTH PROBLEMS AMONG CHILDREN UNDER 36 MONTHS OF AGE OVER THE COURSE OF THE INITIATIVE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 6</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION HAS THREE CLASSES OF MEMBERS: ORGANIZATIONAL, ASSOCIATE, AND BUSINESS MEMBERS. ORGANIZATIONAL MEMBERSHIP IN THE ASSOCIATION IS AVAILABLE TO ANY FEDERALLY QUALIFIED HEALTH CENTER FUNDED BY THE UNITED STATES DEPARTMENT OF HUMAN SERVICES HEALTH RESOURCE SERVICES (HRSA) ADMINISTRATION UNDER SECTION 330 OF THE PUBLIC HEALTH ACT OR AN ORGANIZATION DESIGNATED AS A FEDERALLY QUALIFIED HEALTH CENTER LOOK-ALIKE BY HRSA. MEMBERSHIP DUES FOR ORGANIZATION MEMBERSHIP IS BASED ON THE BUDGET OF THE COMMUNITY HEALTH CENTER. ASSOCIATE MEMBERSHIP IS AVAILABLE TO ANY NOT-FOR-PROFIT ORGANIZATION, AGENCY, FOUNDATION OR INDIVIDUAL ASSOCIATION THAT IS COMMITTED TO THE PURPOSE/MISSION AND GOALS OF THE OHIO ASSOCIATION OF COMMUNITY HEALTH CENTERS AND IS NOT OTHERWISE ELIGIBLE FOR ORGANIZATIONAL MEMBERSHIP. MEMBERSHIP DUES FOR ASSOCIATE MEMBERS ARE $500/YEAR. BUSINESS MEMBERSHIP IN THE ASSOCIATION IS AVAILABLE TO ANY FOR-PROFIT BUSINESS THAT IS COMMITTED TO THE PURPOSE/MISSION AND GOALS OF THE OHIO ASSOCIATION OF COMMUNITY HEALTH CENTERS. THE OHIO ASSOCIATION OF COMMUNITY HEALTH CENTERS OFFERS 5 LEVELS OF BUSINESS MEMBERSHIP WITH EACH LEVEL OFFERING DIFFERENT BENEFITS. MEMBERSHIP DUES FOR BUSINESS MEMBERS RANGE FROM $7,500/YEAR FOR THE PLATINUM LEVEL PARTNER TO $1,000/YEAR FOR THE ALLIANCE LEVEL PARTNER.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 7A</FormAndLineReferenceDesc>
        <ExplanationTxt>ORGANIZATIONAL MEMBERS ARE ENTITLED TO VOTE FOR THE BOARD OF DIRECTORS. ASSOCIATE AND BUSINESS MEMBERS ARE ELIGIBLE TO SERVE ON COMMITTEES OF THE BOARD OF DIRECTORS, BUT ARE NOT ENTITLED TO VOTE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE FORM 990 IS PREPARED BY AN OUTSIDE ACCOUNTING FIRM AND THEN REVIEWED BY THE DIRECTOR OF FINANCE AND THE ASSOCIATION PRESIDENT. THE FORM 990 IS THEN REVIEWED AND APPROVED BY THE FINANCE COMMITTEE AND PRESENTED TO THE ENTIRE GOVERNING BODY FOR APPROVAL PRIOR TO FILING.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>THE BYLAWS OF THE ORGANIZATION REQUIRE THAT MEMBERS OF THE BOARD THAT HAVE CONFLICT OF INTEREST ABSTAIN FROM VOTING IN THE BOARD DELIBERATIONS ON THAT ISSUE. BOARD MEMBERS ARE REQUIRED TO REPORT ANY ACTUAL OR POTENTIAL CONFLICT OF INTEREST AS THEY ARISE AND MAY ASK THE BOARD TO RESOLVE ANY QUESTION OF CONFLICT OF INTEREST.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 15A</FormAndLineReferenceDesc>
        <ExplanationTxt>THE EXECUTIVE DIRECTOR IS REVIEWED EACH YEAR BY THE EXECUTIVE COMMITTEE AND BOARD CHAIR TO DETERMINE COMPENSATION ANNUALLY. COMPENSATION IS DETERMINED BASED UPON JOB PERFORMANCE AND REGIONAL AND NATIONAL SALARY SURVEYS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>ALL GOVERNING DOCUMENTS, POLICIES, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC FOR INSPECTION EITHER UPON REQUEST OR BY THIRD PARTY WEBSITE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART IX, LINE 11G</FormAndLineReferenceDesc>
        <ExplanationTxt>OTHER PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 9,466. MANAGEMENT AND GENERAL EXPENSES 11,657. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 21,123. CONSULTING : PROGRAM SERVICE EXPENSES 5,497,668. MANAGEMENT AND GENERAL EXPENSES 478,535. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,976,203.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART XI, LINE 2C, AUDIT OVERSIGHT:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION HAS A COMMITTEE THAT ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT AND SELECTION OF THE INDEPENDENT ACCOUNTANT. THE PROCESS BY WHICH THE COMMITTEE OVERSEES THE AUDIT AND SELECTS THE INDEPENDENT ACCOUNTANT HAS NOT CHANGED FROM PRIOR YEARS.</ExplanationTxt>
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          <AddressLine1Txt>2109 STELLA CT</AddressLine1Txt>
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