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      <Desc>THE KODIAK AREA NATIVE ASSOCIATION (KANA) PROVIDES A VARIETY OF HEALTHCARE SERVICES TO THE PEOPLE OF THE KODIAK ISLAND REGION. THESE SERVICES INCLUDE PRIMARY MEDICAL CARE, DENTAL, COMMUNITY HEALTH AIDE/PRACTITIONER SERVICES, EMERGENCY MEDICAL SERVICE (EMS), ALCOHOL AND SUBSTANCE ABUSE PREVENTION SERVICES, MENTAL HEALTH CARE, IMMUNIZATIONS, PHARMACY, AND OTHER SPECIALIZED PROGRAMS THAT PROVIDE A BROAD, COMPREHENSIVE CONTINUUM OF CARE FOR KANAS BENEFICIARIES AND THE PEOPLE OF KODIAK ISLAND. KANA FACILITATES A WIDE RANGE OF SERVICES DIRECTLY AND IN COOPERATION WITH OTHER AGENCIES THROUGH FIELD CLINICS, REFERRALS, AND OTHER ARRANGEMENTS WITH TRIBAL HEALTH ORGANIZATIONS. KANA PARTICIPATES IN THE GOVERNMENT PERFORMANCE AND RESULTS ACT (GPRA), A BENCHMARKING PROGRAM THAT ENSURES PROGRAMS AND SERVICES PROVIDED BY KANA MEET OR EXCEED CLINICAL STANDARDS FOR BEST PRACTICES. DURING THE GPRA YEAR 2009, WHICH ENDED JUNE 30, 2009, KANA WAS THE FIRST AND ONLY HEALTHCARE ORGANIZATION IN THE STATE TO HAVE MET ALL TWENTY-ONE OF THE IHS GPRA INDICATORS AND ONE OF ONLY FOUR IN THE NATION TO DO SO. DURING GPRA YEAR 2011, KANA WAS ONE OF ONLY THREE ORGANIZATIONS IN THE STATE TO MEET ALL INDICATORS. THIS WAS KANA'S THIRD CONSECUTIVE YEAR MEETING ALL INDICATORS. THIS ACCOMPLISHMENT IS EVIDENCE OF THE DEDICATION AND COMMITMENT OF KANA AND ITS STAFF TO PROVIDE MAXIMUM ACCESS TO THE HIGHEST QUALITY OF HEALTH AND SOCIAL SERVICES TO ITS BENEFICIARIES AND THE PUBLIC IN A FISCALLY RESPONSIBLE MANNER.</Desc>
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        <Desc>THE COMMUNITY SERVICES PROGRAMS AT KANA IMPROVE THE LIVES OF THE PEOPLE OF KODIAK THROUGH MANY COMMUNITY-BASED SERVICE INITIATIVES. TEMPORARY ASSISTANCE FOR NEEDY FAMILIES TEMPORARY ASSISTANCE FOR NEEDY FAMILIES COMPREHENSIVE CASE MANAGEMENT IS PROVIDED FOR RECIPIENTS OF TEMPORARY ASSISTANCE FOR NEEDY FAMILIES (TANF). THIS PROGRAM OFFERS JOB SEARCH ASSISTANCE, LIFE SKILLS DEVELOPMENT, JOB COACHING, AND OTHER SUPPORTIVE SERVICES, WHICH ENABLE PEOPLE TO OBTAIN SELF SUFFICIENCY. THE "WORK FIRST" PHILOSOPHY OF THIS PROGRAM IS BASED ON THE FUNDAMENTAL VALUE OF WORK AS A MEANS OF ENHANCING SELF-ESTEEM AND PROVIDING A GOOD ROLE MODEL TO CHILDREN. OUR OBJECTIVE IS ENSURING TANF CLIENTS REACH THE HIGHEST LEVEL OF ECONOMIC SELF-SUFFICIENCY. DHHS SAFE/STABLE FAMILIES THE SERVICES OFFERED THROUGH THE CHILD AND FAMILY SERVICES PLAN INCLUDE TRAINING FOR THE CHILD WELFARE WORKFORCE, PARENTS, CHILDREN, AND THE COMMUNITY AT LARGE. TRAINING AND TECHNICAL ASSISTANCE FOR COMMUNITY-BASED INITIATIVES TO IMPROVE THE WELFARE OF CHILDREN AND IMPROVE ACCESS TO FAMILY SUPPORT RESOURCES ARE ALSO OFFERED. KANAS GOAL IS TO DEVELOP OPPORTUNITIES TO HELP ENSURE A WELL-QUALIFIED CHILD WELFARE WORKFORCE WITHIN THE KONIAG REGION AND INCREASE COMMUNITY AWARENESS, DIALOGUE, SKILLS, AND COORDINATED EFFORTS TO PREVENT CHILD ABUSE/NEGLECT. THE SAFE AND STABLE FAMILIES PROGRAMS ASSISTS THE VILLAGE AND CITY OF KODIAK COMMUNITIES BY PROVIDING PREVENTION AND INTERVENTION SERVICES FOR HIGH-RISK FAMILIES TO PROMOTE THE SAFETY, PERMANENCE, AND WELL-BEING OF ALL CHILDREN. DHHS FAMILY VIOLENCE KANA PROVIDES TRANSPORTATION TO AND FROM KODIAK ISLAND VILLAGES FOR SERVICES PROVIDED AT THE KODIAK WOMEN'S RESOURCE AND CRISIS CENTER/SHELTER IN KODIAK. EVERY VICTIM IS ALSO PROVIDED WITH ADVOCACY COUNSELING AND ADDITIONAL SUPPORTS TO ENSURE SAFETY FOR THE VICTIM AND DEPENDENTS. DOMESTIC VIOLENCE, SEXUAL ASSAULT, CHILD AND VULNERABLE ADULT ABUSE PREVENTION TRAINING IS PROVIDED TO VILLAGE AND KODIAK AREA SERVICE PROVIDERS. NEWSPAPER/MEDIA ADVERTISEMENTS ANNOUNCED UPCOMING PREVENTION AND AWARENESS WORKSHOPS AND WELLNESS ACTIVITIES. ECONOMIC DEVELOPMENT THE GOAL OF KANA'S ECONOMIC DEVELOPMENT GRANT IS THE ESTABLISHMENT OF A COMPREHENSIVE ECONOMIC DEVELOPMENT STRATEGY (CEDS) THAT WILL ADDRESS THE ECONOMIC DEVELOPMENT NEEDS OF KODIAK ISLAND, WHILE TAKING INTO CONSIDERATION THE UNIQUE NEEDS OF EACH NATIVE VILLAGE. KANAS STRATEGIC APPROACH TO ACHIEVING THE GOAL OF A VIABLE CEDS DOCUMENT INCLUDES ASSEMBLING ALL THE VALUABLE WORK THAT HAS ALREADY BEEN COMPLETED IN THE FORM OF COMMUNITY AND ECONOMIC DEVELOPMENT PLANS. THE NEXT STEP INVOLVES A DIALOGUE IN EACH VILLAGE WITH ALL INTERESTED PARTIES. KANA WILL THEN PROCEED TO OBTAIN A CONSENSUS ON THE PRIORITIES OF EACH VILLAGE. ONCE NEEDS OF THE SMALLER VILLAGE COMPONENTS HAVE BEEN FINALIZED, THEY WILL BE MERGED TO FORM ONE CEDS DOCUMENT FOR THE REGION OF KODIAK. THIS CEDS DOCUMENT CAN BE USED BY THE ENTIRE REGION AS A VALUABLE TOOL TO ADVOCATE FOR SPECIFIC ECONOMIC DEVELOPMENT NEEDS. BIA SOCIAL SERVICES BIA SOCIAL SERVICES ARE PROVIDED. THROUGH INDIAN AFFAIRS PROGRAMS, TRIBES IMPROVE THEIR TRIBAL GOVERNMENT INFRASTRUCTURE, COMMUNITY INFRASTRUCTURE, EDUCATION, JOB TRAINING, AND EMPLOYMENT OPPORTUNITIES ALONG WITH OTHER COMPONENTS OF LONG TERM SUSTAINABLE DEVELOPMENT THAT IMPROVE THE QUALITY OF LIFE FOR MEMBERS. DIRECT SERVICES ARE PROVIDED BY ITINERANT STAFF AND INCLUDE OUTREACH, INTERVENTION, CASE MANAGEMENT AND REFERRAL SERVICES TO CHILDREN AND FAMILIES. PREVENTION OUTREACH IS ACCOMPLISHED THROUGH INVOLVEMENT WITH VILLAGE-BASED HEALTH FAIRS AND SUMMER CAMPS. SERVICES INCREASE AWARENESS OF CHILD ABUSE AND NEGLECT OF CHILDREN THROUGH REGULAR ITINERANT VILLAGE VISITS AND AN ANNUAL REGIONAL CHILD ABUSE PREVENTION SUMMIT. PROGRAMS ASSIST WITH IDENTIFYING STRATEGIES THAT HELP THE COMMUNITY COPE WITH THE HIGH RATE OF SUBSTANCE ABUSE AND LACK OF JOBS. BY PROVIDING ON-SITE SUPPORT FOR AT-RISK FAMILIES AND CHILDREN INCLUDING PARENTING CLASSES, DISSEMINATION OF RESOURCES, COUNSELING, AND REFERRALS, LOCAL LEADERSHIP AND REGIONAL AGENCIES COLLABORATE TO ADDRESS AND RESPOND TO THE NEEDS OF THE CHILDREN AND FAMILIES IN THE VILLAGES WHO ARE IN CRISIS. STATE OF ALASKA ICWA COMPLIANCE SERVICES ENCOMPASS ALL OF KODIAK ISLAND AND PROVIDE NECESSARY SERVICES TO RETAIN AND SUPPORT OCS IN PROVIDING STAFF MEET WITH VILLAGE TRIBAL COUNCILS TO ENCOURAGE COLLABORATION AND OFFER RELATIVE FOSTER HOME PARENTS CULTURALLY APPROPRIATE MATERIALS THAT WILL SUPPORT AND ENHANCE UNDERSTANDING OF CHILD DEVELOPMENT, TRAUMA, AND GUIDANCE. PUBLIC AWARENESS IS SUPPORTED THROUGH ADVERTISING CAMPAIGNS DURING FOSTER CARE AWARENESS MONTH, PUBLIC SAFETY ANNOUNCEMENTS, NEWSPAPER ARTICLES ON FOSTER PARENTING, AND INFORMATION FLYERS. JOINT HOME VISITATION SERVICES WITH OCS FOR LICENSED AND UNLICENSED RELATIVE FOSTER CARE PARENTS ARE AVAILABLE AS NEEDED. KANA ADMINISTERS A VARIETY OF GRANTS THAT SUPPORT NUTRITION AND CAREGIVER SERVICES TO ELDERS RESIDING ON KODIAK ISLAND AND THE SIX OUTLYING VILLAGES. SERVICES ENCOMPASS CONGREGATE AND HOME DELIVERED MEALS, AS WELL AS CAREGIVER SERVICES. INFORMATION ABOUT THESE SERVICES IS DISSEMINATED TO THE PUBLIC, AND TRAINING FOR CAREGIVERS AND MEAL PREPARERS IS PROVIDED. DIRECT SUPPORTIVE CARE AND TRAINING ARE ALSO GIVEN TO THOSE PROVIDING ASSISTANCE FOR ELDER PERSONS WITH ALZHEIMER'S DISEASE OR RELATED DISORDERS, AS WELL AS TO THE FRAIL AND ELDERLY. NON-MEDICAL CUSTODIAL CARE AND COORDINATION OF CHORE AND RESPITE SERVICES ARE ALSO OFFERED. CHILD ADVOCACY CENTER KANAS CHILD ADVOCACY CENTER PROVIDES A TEAM APPROACH TO CHILDRENS ADVOCACY THROUGH TRAINING, PREVENTION, AND TREATMENT SERVICES. THE COMMUNITY-BASED, CHILD-FRIENDLY FACILITY IS DESIGNED TO COORDINATE SERVICES TO VICTIMS OF ABUSE AND NEGLECT, ESPECIALLY IN CASES OF CHILD SEXUAL ABUSE AND SEVERE PHYSICAL ABUSE.</Desc>
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        <Desc>PUBLIC SAFETY - THE VILLAGE PUBLIC SAFETY OFFICER PROGRAM IS DESIGNED TO TRAIN AND EMPLOY INDIVIDUALS RESIDING IN THE VILLAGE AS FIRST RESPONDERS TO PUBLIC SAFETY EMERGENCIES SUCH AS SEARCH AND RESCUE, FIRE PROTECTION, EMERGENCY MEDICAL ASSISTANCE, CRIME PREVENTION AND BASIC LAW ENFORCEMENT.</Desc>
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        <OtherCompensationAmt>0</OtherCompensationAmt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Phyllis Amodo</PersonNm>
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        <ReportableCompFromOrgAmt>13000</ReportableCompFromOrgAmt>
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        <OtherCompensationAmt>0</OtherCompensationAmt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Vickie Novak</PersonNm>
        <TitleTxt>Director (Elected 10/1/16)</TitleTxt>
        <AverageHoursPerWeekRt>5.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>3400</ReportableCompFromOrgAmt>
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        <OtherCompensationAmt>0</OtherCompensationAmt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Alex Panamaroff Jr</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>5.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>12265</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Arnold Kewan</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>5.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>11500</ReportableCompFromOrgAmt>
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        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Speridon Simeonoff Sr</PersonNm>
        <TitleTxt>Director (Thru 9/30/17)</TitleTxt>
        <AverageHoursPerWeekRt>5.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>12265</ReportableCompFromOrgAmt>
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        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Gary Watson</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>5.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>13600</ReportableCompFromOrgAmt>
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        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Jill Boskofsky</PersonNm>
        <TitleTxt>Director (Thru 09/30/16)</TitleTxt>
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        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>10650</ReportableCompFromOrgAmt>
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        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Andrew Teuber Jr</PersonNm>
        <TitleTxt>President/CEO</TitleTxt>
        <AverageHoursPerWeekRt>37.5</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>632703</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>91004</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Margie Bezona</PersonNm>
        <TitleTxt>Senior VP of Administration</TitleTxt>
        <AverageHoursPerWeekRt>37.5</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>163509</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>18011</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Tammy Hansen</PersonNm>
        <TitleTxt>VP of Health Services</TitleTxt>
        <AverageHoursPerWeekRt>37.5</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>178336</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>33167</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Michael Pfeffer</PersonNm>
        <TitleTxt>Chief Financial Officer</TitleTxt>
        <AverageHoursPerWeekRt>37.5</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>178438</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>30977</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Elise Pletnikoff</PersonNm>
        <TitleTxt>Physician</TitleTxt>
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        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
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        <OtherCompensationAmt>18758</OtherCompensationAmt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Evan Jones</PersonNm>
        <TitleTxt>Physician</TitleTxt>
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        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>252199</ReportableCompFromOrgAmt>
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        <OtherCompensationAmt>34474</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Heidi Baines</PersonNm>
        <TitleTxt>Clinical Director</TitleTxt>
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        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>31829</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Sam Chelmo</PersonNm>
        <TitleTxt>Physician</TitleTxt>
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        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>35869</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Tomas Holbrook</PersonNm>
        <TitleTxt>Dental Director</TitleTxt>
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        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>14510</OtherCompensationAmt>
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      <TotalOtherCompensationAmt>308599</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>14</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>false</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>true</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>false</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>PROVIDENCE KODIAK ISLAND MEDICAL CE</PersonNm>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO BOX 3706</AddressLine1Txt>
            <CityNm>PORTLAND</CityNm>
            <StateAbbreviationCd>OR</StateAbbreviationCd>
            <ZIPCd>97208</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>MEDICAL SERVICES</ServicesDesc>
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      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>HEALTHCARE RESOURCES GROUP INC</PersonNm>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>12610 E MIRABEAU PARKWAY SUITE 800</AddressLine1Txt>
            <CityNm>SPOKANE VALLEY</CityNm>
            <StateAbbreviationCd>WA</StateAbbreviationCd>
            <ZIPCd>99216</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>MEDICAL BILLING SVCS</ServicesDesc>
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      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>BANK OF AMERICA BUSINESS CARD</PersonNm>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO Box 15796</AddressLine1Txt>
            <CityNm>WILMINGTON</CityNm>
            <StateAbbreviationCd>DE</StateAbbreviationCd>
            <ZIPCd>198865796</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>TRAVEL SERVICES</ServicesDesc>
        <CompensationAmt>1609772</CompensationAmt>
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      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>Alaska Native Tribal Health Consort</PersonNm>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>4000 Ambassador Drive</AddressLine1Txt>
            <CityNm>ANCHORAGE</CityNm>
            <StateAbbreviationCd>AK</StateAbbreviationCd>
            <ZIPCd>99508</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Medical Services</ServicesDesc>
        <CompensationAmt>1391278</CompensationAmt>
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      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>Island Air Service</PersonNm>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>1420 Airport Way</AddressLine1Txt>
            <CityNm>KODIAK</CityNm>
            <StateAbbreviationCd>AK</StateAbbreviationCd>
            <ZIPCd>99615</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>TRANSPORT</ServicesDesc>
        <CompensationAmt>586435</CompensationAmt>
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      <CntrctRcvdGreaterThan100KCnt>18</CntrctRcvdGreaterThan100KCnt>
      <GovernmentGrantsAmt>19535919</GovernmentGrantsAmt>
      <AllOtherContributionsAmt>1147923</AllOtherContributionsAmt>
      <TotalContributionsAmt>20683842</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>PATIENT SERVICE</Desc>
        <BusinessCd>624100</BusinessCd>
        <TotalRevenueColumnAmt>7883686</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>7883686</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>7883686</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>48779</TotalRevenueColumnAmt>
        <ExclusionAmt>48779</ExclusionAmt>
      </InvestmentIncomeGrp>
      <IncmFromInvestBondProceedsGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </IncmFromInvestBondProceedsGrp>
      <RoyaltiesRevenueGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </RoyaltiesRevenueGrp>
      <GrossRentsGrp>
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      </GrossRentsGrp>
      <LessRentalExpensesGrp>
        <RealAmt>350874</RealAmt>
      </LessRentalExpensesGrp>
      <RentalIncomeOrLossGrp>
        <RealAmt>36064</RealAmt>
        <PersonalAmt>0</PersonalAmt>
      </RentalIncomeOrLossGrp>
      <NetRentalIncomeOrLossGrp>
        <TotalRevenueColumnAmt>36064</TotalRevenueColumnAmt>
        <ExclusionAmt>36064</ExclusionAmt>
      </NetRentalIncomeOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
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      <FundraisingGrossIncomeAmt>0</FundraisingGrossIncomeAmt>
      <FundraisingDirectExpensesAmt>0</FundraisingDirectExpensesAmt>
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        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
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      <NetIncomeFromGamingGrp>
        <TotalRevenueColumnAmt>292878</TotalRevenueColumnAmt>
        <UnrelatedBusinessRevenueAmt>169240</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>123638</ExclusionAmt>
      </NetIncomeFromGamingGrp>
      <GrossSalesOfInventoryAmt>0</GrossSalesOfInventoryAmt>
      <CostOfGoodsSoldAmt>0</CostOfGoodsSoldAmt>
      <NetIncomeOrLossGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </NetIncomeOrLossGrp>
      <OtherRevenueMiscGrp>
        <Desc>INCOME ON JOINT VENTURE</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>138721</TotalRevenueColumnAmt>
        <ExclusionAmt>138721</ExclusionAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueMiscGrp>
        <Desc>OTHER REVENUE</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>45196</TotalRevenueColumnAmt>
        <ExclusionAmt>45196</ExclusionAmt>
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      <OtherRevenueTotalAmt>183917</OtherRevenueTotalAmt>
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        <RelatedOrExemptFuncIncomeAmt>7883686</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>169240</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>392398</ExclusionAmt>
      </TotalRevenueGrp>
      <InfoInScheduleOPartIXInd>X</InfoInScheduleOPartIXInd>
      <GrantsToDomesticOrgsGrp>
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        <ProgramServicesAmt>91146</ProgramServicesAmt>
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      <GrantsToDomesticIndividualsGrp>
        <TotalAmt>554868</TotalAmt>
        <ProgramServicesAmt>554868</ProgramServicesAmt>
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      </ForeignGrantsGrp>
      <BenefitsToMembersGrp>
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        <ProgramServicesAmt>1099748</ProgramServicesAmt>
        <ManagementAndGeneralAmt>328072</ManagementAndGeneralAmt>
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        <ProgramServicesAmt>7500024</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2197135</ManagementAndGeneralAmt>
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        <ProgramServicesAmt>360585</ProgramServicesAmt>
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        <ProgramServicesAmt>852850</ProgramServicesAmt>
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        <ProgramServicesAmt>625255</ProgramServicesAmt>
        <ManagementAndGeneralAmt>153794</ManagementAndGeneralAmt>
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      <FeesForServicesManagementGrp>
        <TotalAmt>0</TotalAmt>
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      <FeesForServicesLegalGrp>
        <TotalAmt>55687</TotalAmt>
        <ProgramServicesAmt>24109</ProgramServicesAmt>
        <ManagementAndGeneralAmt>31578</ManagementAndGeneralAmt>
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      <FeesForServicesAccountingGrp>
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        <ManagementAndGeneralAmt>102424</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesLobbyingGrp>
        <TotalAmt>0</TotalAmt>
      </FeesForServicesLobbyingGrp>
      <FeesForServicesProfFundraising>
        <TotalAmt>0</TotalAmt>
      </FeesForServicesProfFundraising>
      <FeesForSrvcInvstMgmntFeesGrp>
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      </FeesForSrvcInvstMgmntFeesGrp>
      <FeesForServicesOtherGrp>
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        <ProgramServicesAmt>3586457</ProgramServicesAmt>
        <ManagementAndGeneralAmt>253354</ManagementAndGeneralAmt>
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      <AdvertisingGrp>
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        <ProgramServicesAmt>64415</ProgramServicesAmt>
        <ManagementAndGeneralAmt>31210</ManagementAndGeneralAmt>
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      <OfficeExpensesGrp>
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        <ProgramServicesAmt>1037221</ProgramServicesAmt>
        <ManagementAndGeneralAmt>418753</ManagementAndGeneralAmt>
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      <InformationTechnologyGrp>
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        <ProgramServicesAmt>56571</ProgramServicesAmt>
        <ManagementAndGeneralAmt>142128</ManagementAndGeneralAmt>
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      <OccupancyGrp>
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        <ProgramServicesAmt>50654</ProgramServicesAmt>
        <ManagementAndGeneralAmt>512196</ManagementAndGeneralAmt>
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      <TravelGrp>
        <TotalAmt>1436773</TotalAmt>
        <ProgramServicesAmt>1184431</ProgramServicesAmt>
        <ManagementAndGeneralAmt>252342</ManagementAndGeneralAmt>
      </TravelGrp>
      <PymtTravelEntrtnmntPubOfclGrp>
        <TotalAmt>0</TotalAmt>
      </PymtTravelEntrtnmntPubOfclGrp>
      <ConferencesMeetingsGrp>
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        <ProgramServicesAmt>16200</ProgramServicesAmt>
        <ManagementAndGeneralAmt>129632</ManagementAndGeneralAmt>
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      <InterestGrp>
        <TotalAmt>56332</TotalAmt>
        <ManagementAndGeneralAmt>56332</ManagementAndGeneralAmt>
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      <PaymentsToAffiliatesGrp>
        <TotalAmt>0</TotalAmt>
      </PaymentsToAffiliatesGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>1089570</TotalAmt>
        <ProgramServicesAmt>221543</ProgramServicesAmt>
        <ManagementAndGeneralAmt>868027</ManagementAndGeneralAmt>
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      <InsuranceGrp>
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        <ProgramServicesAmt>166537</ProgramServicesAmt>
        <ManagementAndGeneralAmt>248038</ManagementAndGeneralAmt>
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      <OtherExpensesGrp>
        <Desc>TRAINING</Desc>
        <TotalAmt>327778</TotalAmt>
        <ProgramServicesAmt>311637</ProgramServicesAmt>
        <ManagementAndGeneralAmt>16141</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>MISCELLANEOUS EXPENSE</Desc>
        <TotalAmt>243038</TotalAmt>
        <ProgramServicesAmt>114580</ProgramServicesAmt>
        <ManagementAndGeneralAmt>128458</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>CLINICAL SUPPLIES</Desc>
        <TotalAmt>132917</TotalAmt>
        <ProgramServicesAmt>132917</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>INDIRECT EXPENSE ALLOCATION</Desc>
        <ProgramServicesAmt>4822312</ProgramServicesAmt>
        <ManagementAndGeneralAmt>-4822312</ManagementAndGeneralAmt>
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      <TotalFunctionalExpensesGrp>
        <TotalAmt>24356315</TotalAmt>
        <ProgramServicesAmt>22874060</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1482255</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
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      <CashNonInterestBearingGrp>
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        <EOYAmt>12033800</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>7335264</BOYAmt>
        <EOYAmt>7493698</EOYAmt>
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      <PledgesAndGrantsReceivableGrp>
        <BOYAmt>3260605</BOYAmt>
        <EOYAmt>3771581</EOYAmt>
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        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>12842</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>18135</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>209415</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Elise Pletnikoff</PersonNm>
        <TitleTxt>Physician</TitleTxt>
        <BaseCompensationFilingOrgAmt>250657</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>17533</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>1225</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>269415</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Evan Jones</PersonNm>
        <TitleTxt>Physician</TitleTxt>
        <BaseCompensationFilingOrgAmt>252199</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>17894</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>16580</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>286673</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Heidi Baines</PersonNm>
        <TitleTxt>Clinical Director</TitleTxt>
        <BaseCompensationFilingOrgAmt>310804</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>13714</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>18115</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>342633</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Sam Chelmo</PersonNm>
        <TitleTxt>Physician</TitleTxt>
        <BaseCompensationFilingOrgAmt>249373</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>17734</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>18135</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>285242</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Tomas Holbrook</PersonNm>
        <TitleTxt>Dental Director</TitleTxt>
        <BaseCompensationFilingOrgAmt>182215</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>14510</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>196725</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
    </IRS990ScheduleJ>
    <IRS990ScheduleL documentId="IRS990ScheduleL">
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <PersonNm>ASHLEE HINER</PersonNm>
        </NameOfInterested>
        <RelationshipDescriptionTxt>SEE PART V</RelationshipDescriptionTxt>
        <TransactionAmt>57095</TransactionAmt>
        <TransactionDesc>WAGES AND BENEFITS</TransactionDesc>
        <SharingOfRevenuesInd>false</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <PersonNm>JAELENE CHRISTOFFERSON</PersonNm>
        </NameOfInterested>
        <RelationshipDescriptionTxt>SEE PART V</RelationshipDescriptionTxt>
        <TransactionAmt>46918</TransactionAmt>
        <TransactionDesc>WAGES AND BENEFITS</TransactionDesc>
        <SharingOfRevenuesInd>false</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <PersonNm>SPERIDON SIMEONOFF JR</PersonNm>
        </NameOfInterested>
        <RelationshipDescriptionTxt>SEE PART V</RelationshipDescriptionTxt>
        <TransactionAmt>89464</TransactionAmt>
        <TransactionDesc>WAGES AND BENEFITS</TransactionDesc>
        <SharingOfRevenuesInd>false</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <PersonNm>SAMANTHA SHULTS</PersonNm>
        </NameOfInterested>
        <RelationshipDescriptionTxt>SEE PART V</RelationshipDescriptionTxt>
        <TransactionAmt>20634</TransactionAmt>
        <TransactionDesc>WAGES AND BENEFITS</TransactionDesc>
        <SharingOfRevenuesInd>false</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <PersonNm>ALYSSA BRENTESON</PersonNm>
        </NameOfInterested>
        <RelationshipDescriptionTxt>SEE PART V</RelationshipDescriptionTxt>
        <TransactionAmt>35063</TransactionAmt>
        <TransactionDesc>WAGES AND BENEFITS</TransactionDesc>
        <SharingOfRevenuesInd>false</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, SCHEDULE L, PART IV:</FormAndLineReferenceDesc>
        <ExplanationTxt>RELATIONSHIP BETWEEN INTERESTED PERSON AND THE ORGANIZATION: (1) ASHLEE HINER - DAUGHTER OF AL CRATTY, JR., BOARD MEMBER (2) JAELENE CHRISTOFFERSON - DAUGHTER OF CHERYL CHRISTOFFERSON, BOARD MEMBER (3) SPERIDON SIMEONOFF, JR. - SON OF SPERIDON SIMEONOFF, SR, BOARD MEMBER (4) SAMANTHA SHULTS - GRANDDAUGHTER OF MARGARET ROBERTS, BOARD MEMBER (5) ALYSSA BRENTESON - DAUGHTER OF PHYLISS AMODO, BOARD MEMBER</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleL>
    <IRS990ScheduleO documentId="IRS990ScheduleO">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 6:</FormAndLineReferenceDesc>
        <ExplanationTxt>KANA'S BENEFICIARIES (MEMBERS) ELECT THE MEMBERS OF THE BOARD OF DIRECTORS AND CAN PARTICIPATE IN THE ORGANIZATIONS PROGRAMS IF ELIGIBILITY REQUIREMENTS ARE MET.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 7A:</FormAndLineReferenceDesc>
        <ExplanationTxt>KANA'S BENEFICIARIES (MEMBERS) ELECT THE MEMBERS OF THE BOARD OF DIRECTORS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11:</FormAndLineReferenceDesc>
        <ExplanationTxt>PRIOR TO FILING THE FORM 990, THE DOCUMENT IS REVIEWED BY THE FINANCE DIRECTOR AND PRESIDENT. AFTER ANY CHANGES HAVE BEEN MADE BASED ON THIS REVIEW, COPIES OF THE COMPLETED DOCUMENT ARE DISTRIBUTED TO THE FINANCE COMMITTEE OF THE BOARD OF DIRECTORS AND THEN THE FORM 990 IS SUBMITTED TO THE INTERNAL REVENUE SERVICE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 12C:</FormAndLineReferenceDesc>
        <ExplanationTxt>EACH YEAR DIRECTORS ARE REQUIRED TO RESUBMIT THEIR DECLARATION OF CONFLICT OF INTERESTS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 15A:</FormAndLineReferenceDesc>
        <ExplanationTxt>The KANA Board of Directors determines compensation of the CEO by evaluating market conditions and salary surveys.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19:</FormAndLineReferenceDesc>
        <ExplanationTxt>AT THE ORGANIZATION'S ANNUAL MEETING, COPIES OF THE FINANCIAL STATEMENTS, CONFLICT OF INTEREST POLICY AND GOVERNING DOCUMENTS ARE MADE AVAILABLE FOR PUBLIC REVIEW.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990 PART IX LINE 11G</FormAndLineReferenceDesc>
        <ExplanationTxt>DESCRIPTION:MEDICAL SERVICES TOTAL FEES:1457467</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990 PART IX LINE 11G</FormAndLineReferenceDesc>
        <ExplanationTxt>DESCRIPTION:CONTRACTOR SERVICES TOTAL FEES:1768272</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990 PART IX LINE 11G</FormAndLineReferenceDesc>
        <ExplanationTxt>DESCRIPTION:IPA/MOA TOTAL FEES:614072</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>