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        <BusinessCd>621990</BusinessCd>
        <TotalRevenueColumnAmt>905279</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>905279</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>MANAGEMENT SERVICES</Desc>
        <BusinessCd>621990</BusinessCd>
        <TotalRevenueColumnAmt>191765</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>191765</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>IC CENTER FOR PRE-HOSPITAL AND DI</Desc>
        <BusinessCd>621990</BusinessCd>
        <TotalRevenueColumnAmt>43964</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>43964</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>26468399</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>15322</TotalRevenueColumnAmt>
        <ExclusionAmt>15322</ExclusionAmt>
      </InvestmentIncomeGrp>
      <GrossAmountSalesAssetsGrp>
        <OtherAmt>25000</OtherAmt>
      </GrossAmountSalesAssetsGrp>
      <LessCostOthBasisSalesExpnssGrp>
        <OtherAmt>12667</OtherAmt>
      </LessCostOthBasisSalesExpnssGrp>
      <GainOrLossGrp>
        <OtherAmt>12333</OtherAmt>
      </GainOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>12333</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>12333</RelatedOrExemptFuncIncomeAmt>
      </NetGainOrLossInvestmentsGrp>
      <OtherRevenueMiscGrp>
        <Desc>MISCELLANEOUS INCOME</Desc>
        <BusinessCd>621990</BusinessCd>
        <TotalRevenueColumnAmt>445687</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>445687</RelatedOrExemptFuncIncomeAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueMiscGrp>
        <Desc>MEDICAL EMERGENCY SERVICES TRAINI</Desc>
        <BusinessCd>621990</BusinessCd>
        <TotalRevenueColumnAmt>20960</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>20960</RelatedOrExemptFuncIncomeAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueTotalAmt>466647</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>26962701</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>26947379</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>15322</ExclusionAmt>
      </TotalRevenueGrp>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>862683</TotalAmt>
        <ProgramServicesAmt>733280</ProgramServicesAmt>
        <ManagementAndGeneralAmt>129403</ManagementAndGeneralAmt>
      </CompCurrentOfcrDirectorsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>14834144</TotalAmt>
        <ProgramServicesAmt>12609022</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2225122</ManagementAndGeneralAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
        <TotalAmt>336776</TotalAmt>
        <ProgramServicesAmt>286260</ProgramServicesAmt>
        <ManagementAndGeneralAmt>50516</ManagementAndGeneralAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>1711693</TotalAmt>
        <ProgramServicesAmt>1454939</ProgramServicesAmt>
        <ManagementAndGeneralAmt>256754</ManagementAndGeneralAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>1191122</TotalAmt>
        <ProgramServicesAmt>1012453</ProgramServicesAmt>
        <ManagementAndGeneralAmt>178669</ManagementAndGeneralAmt>
      </PayrollTaxesGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>61274</TotalAmt>
        <ManagementAndGeneralAmt>61274</ManagementAndGeneralAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>40650</TotalAmt>
        <ManagementAndGeneralAmt>40650</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>728563</TotalAmt>
        <ProgramServicesAmt>456488</ProgramServicesAmt>
        <ManagementAndGeneralAmt>272075</ManagementAndGeneralAmt>
      </FeesForServicesOtherGrp>
      <InformationTechnologyGrp>
        <TotalAmt>226890</TotalAmt>
        <ProgramServicesAmt>75071</ProgramServicesAmt>
        <ManagementAndGeneralAmt>151819</ManagementAndGeneralAmt>
      </InformationTechnologyGrp>
      <OccupancyGrp>
        <TotalAmt>939413</TotalAmt>
        <ProgramServicesAmt>778709</ProgramServicesAmt>
        <ManagementAndGeneralAmt>160704</ManagementAndGeneralAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>110084</TotalAmt>
        <ProgramServicesAmt>61880</ProgramServicesAmt>
        <ManagementAndGeneralAmt>48204</ManagementAndGeneralAmt>
      </TravelGrp>
      <InterestGrp>
        <TotalAmt>134103</TotalAmt>
        <ManagementAndGeneralAmt>134103</ManagementAndGeneralAmt>
      </InterestGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>645753</TotalAmt>
        <ProgramServicesAmt>546890</ProgramServicesAmt>
        <ManagementAndGeneralAmt>98863</ManagementAndGeneralAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>1351085</TotalAmt>
        <ProgramServicesAmt>1148421</ProgramServicesAmt>
        <ManagementAndGeneralAmt>202664</ManagementAndGeneralAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>OUTSIDE STAFFING</Desc>
        <TotalAmt>1065771</TotalAmt>
        <ProgramServicesAmt>1065771</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>TAXES/LICENSES/FEES</Desc>
        <TotalAmt>980982</TotalAmt>
        <ProgramServicesAmt>949457</ProgramServicesAmt>
        <ManagementAndGeneralAmt>31525</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>WORKERS COMP AND EMPLOY</Desc>
        <TotalAmt>896172</TotalAmt>
        <ProgramServicesAmt>820136</ProgramServicesAmt>
        <ManagementAndGeneralAmt>76036</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>REPAIRS &amp; MAINTENANCE</Desc>
        <TotalAmt>859036</TotalAmt>
        <ProgramServicesAmt>843609</ProgramServicesAmt>
        <ManagementAndGeneralAmt>15427</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>1936273</TotalAmt>
        <ProgramServicesAmt>1690703</ProgramServicesAmt>
        <ManagementAndGeneralAmt>245570</ManagementAndGeneralAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>28912467</TotalAmt>
        <ProgramServicesAmt>24533089</ProgramServicesAmt>
        <ManagementAndGeneralAmt>4379378</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>1973656</BOYAmt>
        <EOYAmt>919195</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>797113</BOYAmt>
        <EOYAmt>3133806</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <AccountsReceivableGrp>
        <BOYAmt>2018568</BOYAmt>
        <EOYAmt>2036085</EOYAmt>
      </AccountsReceivableGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>1779403</BOYAmt>
        <EOYAmt>2521239</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>11194147</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>8043921</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>2210609</BOYAmt>
        <EOYAmt>3150226</EOYAmt>
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      <IntangibleAssetsGrp>
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        <EOYAmt>1250578</EOYAmt>
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      <OtherAssetsTotalGrp>
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        <EOYAmt>1970587</EOYAmt>
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      <TotalAssetsGrp>
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        <EOYAmt>14981716</EOYAmt>
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      <AccountsPayableAccrExpnssGrp>
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        <EOYAmt>4708972</EOYAmt>
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      <MortgNotesPyblScrdInvstPropGrp>
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        <EOYAmt>1659635</EOYAmt>
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      <OtherLiabilitiesGrp>
        <BOYAmt>1568733</BOYAmt>
        <EOYAmt>1305686</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>6200274</BOYAmt>
        <EOYAmt>7674293</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
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        <EOYAmt>7307423</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>9257189</BOYAmt>
        <EOYAmt>7307423</EOYAmt>
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      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>15457463</BOYAmt>
        <EOYAmt>14981716</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>-1949766</ReconcilationRevenueExpnssAmt>
      <OtherChangesInNetAssetsAmt>0</OtherChangesInNetAssetsAmt>
      <InfoInScheduleOPartXIIInd>X</InfoInScheduleOPartXIIInd>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>0</AccountantCompileOrReviewInd>
      <FSAuditedInd>1</FSAuditedInd>
      <FSAuditedBasisGrp>
        <SeparateBasisFinclStmtInd>X</SeparateBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>1</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>0</FederalGrantAuditRequiredInd>
    </IRS990>
    <IRS990ScheduleA documentId="RetDoc1039100001">
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      <GiftsGrantsContrisRcvd509Grp>
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        <TotalAmt>3483603</TotalAmt>
      </GiftsGrantsContrisRcvd509Grp>
      <GrossReceiptsAdmissionsGrp>
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        <CurrentTaxYearMinus3YearsAmt>23079187</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>24923918</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>25671934</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>26450882</CurrentTaxYearAmt>
        <TotalAmt>128508255</TotalAmt>
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      <Total509Grp>
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        <CurrentTaxYearMinus3YearsAmt>26562790</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>24923918</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>25671934</CurrentTaxYearMinus1YearAmt>
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      <AmountsRcvdDsqlfyPersonGrp>
        <TotalAmt>0</TotalAmt>
      </AmountsRcvdDsqlfyPersonGrp>
      <SubstantialContributorsAmtGrp>
        <TotalAmt>0</TotalAmt>
      </SubstantialContributorsAmtGrp>
      <SubstAndDsqlfyPrsnsTotGrp>
        <TotalAmt>0</TotalAmt>
      </SubstAndDsqlfyPrsnsTotGrp>
      <PublicSupportTotal509Amt>131991858</PublicSupportTotal509Amt>
      <GrossInvestmentIncome509Grp>
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        <CurrentTaxYearMinus3YearsAmt>6128</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>14310</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>440319</CurrentTaxYearMinus1YearAmt>
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        <CurrentTaxYearMinus2YearsAmt>14310</CurrentTaxYearMinus2YearsAmt>
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      <TotalSupportCalendarYearGrp>
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      <InvestmentIncomePYPct>0.00340</InvestmentIncomePYPct>
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    <IRS990ScheduleD documentId="RetDoc1040000001">
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      <OtherLandBuildingsGrp>
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      <OtherAssetsOrgGrp>
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      <OtherAssetsOrgGrp>
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      <OtherAssetsOrgGrp>
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      <OtherAssetsOrgGrp>
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      <OtherLiabilitiesOrgGrp>
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      <TotalRevEtcAuditedFinclStmtAmt>27012752</TotalRevEtcAuditedFinclStmtAmt>
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      <RevenueNotReportedAmt>50051</RevenueNotReportedAmt>
      <RevenueSubtotalAmt>26962701</RevenueSubtotalAmt>
      <RevenueNotReportedFinclStmtAmt>0</RevenueNotReportedFinclStmtAmt>
      <TotalRevenuePerForm990Amt>26962701</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>28962518</TotExpnsEtcAuditedFinclStmtAmt>
      <OtherExpensesIncludedAmt>50051</OtherExpensesIncludedAmt>
      <ExpensesNotReportedAmt>50051</ExpensesNotReportedAmt>
      <ExpensesSubtotalAmt>28912467</ExpensesSubtotalAmt>
      <ExpensesNotRptFinclStmtAmt>0</ExpensesNotRptFinclStmtAmt>
      <TotalExpensesPerForm990Amt>28912467</TotalExpensesPerForm990Amt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART XI, LINE 2D - OTHER ADJUSTMENTS:</FormAndLineReferenceDesc>
        <ExplanationTxt>REVENUE NETTED WITH EXPENSES ON FORM 990 50,051.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART XII, LINE 2D - OTHER ADJUSTMENTS:</FormAndLineReferenceDesc>
        <ExplanationTxt>REVENUE NETTED WITH EXPENSES ON FORM 990 50,051.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
    <IRS990ScheduleJ documentId="RetDoc1042400001">
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        <TotalCompensationFilingOrgAmt>415537</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>KRISTA HOWARD</PersonNm>
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        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
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      <RltdOrgOfficerTrstKeyEmplGrp>
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        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
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        <TotalCompensationFilingOrgAmt>233917</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>TRENTON MURRIETA</PersonNm>
        <TitleTxt>PARAMEDIC</TitleTxt>
        <BaseCompensationFilingOrgAmt>223767</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>7196</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>230963</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>TAMARA UITHOVEN</PersonNm>
        <TitleTxt>FLIGHT NURSE</TitleTxt>
        <BaseCompensationFilingOrgAmt>193967</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>28152</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>222119</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>REX NEILSON</PersonNm>
        <TitleTxt>PARAMEDIC</TitleTxt>
        <BaseCompensationFilingOrgAmt>196709</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>24703</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>221412</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>ERIC RUDNICK</PersonNm>
        <TitleTxt>MEDICAL DIRECTOR</TitleTxt>
        <BaseCompensationFilingOrgAmt>181113</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>32116</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>213229</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE FORM 990 IS REVIEWED AND APPROVED BY THE CEO OR COO PRIOR TO BEING FILED AND IS REVIEWED BY THE BOARD AFTER IT'S FILED.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>MANAGEMENT REGULARLY REVIEWS ANY ISSUES THAT ARISE UNDER THE CONFLICT OF INTEREST POLICY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 15</FormAndLineReferenceDesc>
        <ExplanationTxt>THE PROCESS FOR DETERMINING COMPENSATION OF THE ORGANIZATION'S CEO, EXECUTIVE DIRECTOR OR TOP MANAGEMENT OFFICIAL REQUIRES BOARD APPROVAL.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 18</FormAndLineReferenceDesc>
        <ExplanationTxt>SEMSA'S 990 IS MADE AVAILABLE UPON REQUEST.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>SEMSA'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART XII, LINE 2C:</FormAndLineReferenceDesc>
        <ExplanationTxt>THIS PROCESS HAS NOT CHANGED FROM PREVIOUS YEARS.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>